US20200397594A1 - Articulating intervertebral devices, related tools, systems, and methods - Google Patents
Articulating intervertebral devices, related tools, systems, and methods Download PDFInfo
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- US20200397594A1 US20200397594A1 US17/011,463 US202017011463A US2020397594A1 US 20200397594 A1 US20200397594 A1 US 20200397594A1 US 202017011463 A US202017011463 A US 202017011463A US 2020397594 A1 US2020397594 A1 US 2020397594A1
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- shaft
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- interbody device
- end wall
- implant
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
- A61F2/4465—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages having a circular or kidney shaped cross-section substantially perpendicular to the axis of the spine
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2/4611—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/28—Bones
- A61F2002/2835—Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
- A61F2002/30378—Spherically-shaped protrusion and recess
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30428—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by inserting a protrusion into a slot
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
- A61F2002/30538—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30565—Special structural features of bone or joint prostheses not otherwise provided for having spring elements
- A61F2002/30566—Helical springs
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30617—Visible markings for adjusting, locating or measuring
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30841—Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
- A61F2002/30843—Pyramidally-shaped
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2002/3093—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth for promoting ingrowth of bone tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2002/4629—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof connected to the endoprosthesis or implant via a threaded connection
Definitions
- Various aspects of the present disclosure relate generally to intervertebral implants and related systems and methods. More specifically, the present disclosure relates to articulating intervertebral devices, tools, systems, and methods for deployment within a body of a patient.
- a patient's spinal column includes twenty-six bones called vertebrae which protect the spinal cord. While the shape and/or size of each vertebra varies depending on the placement, loading, posture, and/or pathology within the spinal column, each vertebra is composed of cancellous bone, which is a spongy type of osseous tissue. The cancellous bone of each vertebra is then covered by a thin coating of cortical bone, which is a hard and dense type of osseous tissue.
- An intervertebral disc is positioned between each pair of adjacent vertebrae in the spinal column. Each disc forms a fibrocartilaginous joint between adjacent vertebrae so as to allow movement of the vertebrae. Beyond enabling relative motion between adjacent vertebrae, each disc acts as a shock absorber for the spinal column.
- Each disc comprises a fibrous exterior surrounding an inner gel-like center, which together cooperate to distribute pressure evenly across each disc, which prevents the development of stress concentrations that might otherwise damage and/or impair the vertebrae of the spinal column.
- the discs may be subject to various injuries and/or disorders which may interfere with the disc's ability to adequately distribute pressure and protect the vertebrae.
- disc herniation, degeneration, and infection may result in insufficient disc thickness and/or support to absorb and/or distribute forces imparted to the spinal column.
- Disc degeneration for example, may result when the inner gel-like center begins to dehydrate, which may result in a degenerated disc having decreased thickness. This decreased thickness may limit the ability of the degenerated disc to absorb shock which, if left untreated, may result in pain and/or vertebral injury.
- TLIF transforaminal lumbar interbody fusion
- a medical professional may make a small (e.g., between about 1 inch and about 6 inches) incision along a patient's back.
- one or more portions of the vertebral bone such as, e.g., a facet joint of adjacent vertebral bodies
- a medical professional may partially remove the damaged and/or degenerated disc, leaving at least a portion of the disc intact to facilitate guiding an interbody device into the disc space.
- bone graft including, but not limited to, morselized bone
- a medical professional may enlarge the disc space between adjacent vertebrae via a distraction process.
- an interbody device e.g., implant
- the interbody device may relieve pressure from pinched nerves and provide additional therapeutic effects.
- a medical professional also may implant one or more bone screws and/or rods to provide additional support to the spinal column. Additionally, morselized bone may be placed along the sides of the spinal column to promote fusion.
- Distraction is often done with various tools and implements (e.g., rods, screws, etc.) which may interfere, impede, and/or block an interbody device's insertion and/or entrance into the disc space. Accordingly, it may be difficult to guide the interbody device into position between adjacent vertebrae that have been distracted by conventional methods. If distraction is not performed, however, it may be challenging to insert the interbody device so as to create sufficient space between (e.g., distract) adjacent vertebrae itself, while maintaining control. Further, during insertion of the interbody device, the interbody device may impact remaining portions of the disc and/or bone graft which may interfere with the proper placement of the interbody device.
- various tools and implements e.g., rods, screws, etc.
- Examples of the present disclosure relate to, among other things, intervertebral implants.
- Each of the embodiments disclosed herein may include one or more of the features described in connection with any of the other disclosed embodiments.
- an intervertebral implant may include a superior exterior surface, an inferior exterior surface, a first exterior lateral surface, and a second exterior lateral surface.
- the first and second exterior lateral surfaces may be substantially transverse to the superior and inferior exterior surfaces.
- the implant may further include a first curved end wall at a first longitudinal extremity of the body.
- the first curved end wall may include a bore configured to receive a first shaft of a tool.
- the implant may include a second curved end wall at a second longitudinal extremity of the body and an elongated slot extending from a portion of the first curved end wall to a portion of the first exterior lateral surface.
- examples of the implant may include one or more of the following features: the first exterior lateral surface may include at least a central portion having a concavity; the second exterior lateral surface may include at least a central portion having a convexity; the elongated slot may include a T-shaped cross-sectional configuration such that an anterior-posterior dimension of the elongated slot is greater than an anterior-posterior dimension of an opening of the elongated slot; the body may further include a through hole in one or both of the first and second exterior lateral surfaces; the second curved wall may include a leading edge angled relative to a longitudinal axis of the body; each of the superior exterior surface and the inferior exterior surface may include a portion angled relative to the longitudinal axis of the body; the bore may be internally threaded; one or more protrusions may extend from one or both of the superior exterior surface and the inferior exterior surface; the body may include a central through opening; and the elongated slot may be configured to receive and retain a second
- a system for performing interbody fusion may include an intervertebral implant.
- the implant may have a body including a superior exterior surface, an inferior exterior surface, a first exterior lateral surface, and a second exterior lateral surface.
- the first and second exterior lateral surfaces may be substantially transverse to the superior and inferior exterior surfaces.
- the body may further include a first curved end wall at a first longitudinal extremity of the body.
- the first curved end wall may include a bore.
- the body may include a second curved end wall at a second longitudinal extremity of the body.
- the body may include an articulation groove which may extend from a portion of the first curved end wall to a portion of the first exterior lateral surface.
- the system may further include a locking shaft which may be configured for selective coupling and uncoupling from the bore. Further, the system may include a shaft which may be configured for selective insertion and retraction from the articulation groove.
- examples of the system may include one or more of the following features: the bore may be internally threaded; a distal end of the locking shaft may be externally threaded; the shaft may include a distal end having an enlarged extension; the shaft may be rotatable between a first configuration and a second configuration, wherein in the first configuration the extension may be oriented such that the extension is configured for insertion within the articulation groove, and wherein, in the second configuration, the extension may be oriented such that the extension is retained within the articulation groove; and the extension may be configured to move within the articulation groove.
- a method for delivering an interbody device may include inserting a body into a prepared disc space between adjacent vertebrae of a patient.
- the body may include a superior exterior surface, an inferior exterior surface, a first exterior lateral surface, and a second exterior lateral surface.
- the first exterior lateral surface and the second exterior lateral surface may be substantially transverse to the superior and inferior exterior surfaces.
- the body may further include a first curved end wall at a first longitudinal extremity of the body and a second curved end wall at a second longitudinal extremity of the body.
- the first curved end wall may include a bore.
- an articulation groove may extend from a portion of the first curved end wall to a portion of the first exterior lateral surface.
- the method may further include uncoupling a locking shaft from the bore and moving a shaft along the articulation groove so as to articulate the body relative to the shaft.
- examples of the method may include one or more of the following features: rotating the shaft relative to the body and removing the articulation shaft from the articulation groove of the body; uncoupling the locking shaft from the bore may include rotating the locking shaft; the bore and locking shaft may be configured to be threadably coupled; and the shaft may include a distal end having an enlarged extension, wherein the shaft may be rotatable between a first configuration and a second configuration, wherein, in the first configuration the extension may be oriented such that the extension is configured for insertion within the articulation groove, and wherein, in the second configuration, the extension may be oriented such that the extension is retained within the articulation groove.
- the terms “comprises,” “comprising,” or any other variation thereof, are intended to cover a non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements does not include only those elements, but may include other elements not expressly listed or inherent to such process, method, article, or apparatus.
- the term “exemplary” is used in the sense of “example,” rather than “ideal.”
- FIG. 1 illustrates an exemplary interbody device coupled to an exemplary delivery tool
- FIGS. 2A-2C illustrate various views of the exemplary interbody device of FIG. 1 ;
- FIG. 3 is a perspective view of a distal end of the exemplary delivery tool of FIG. 1 ;
- FIG. 4 illustrates a distal end of the exemplary delivery tool of FIG. 1 , in a locked configuration, and coupled to the exemplary interbody device of FIG. 2 ;
- FIG. 5A illustrates a distal end of the exemplary delivery tool of FIG. 1 , in an unlocked configuration, and coupled to the exemplary interbody device of FIG. 2 when articulated relative to the delivery tool;
- FIGS. 5B and 5C illustrate an exemplary shaft of the delivery tool in a first state within the exemplary interbody device of FIG. 2 , and a second state for removal from and insertion into the exemplary interbody device of FIG. 2 , respectively;
- FIG. 6A illustrates a cross-sectional view of an exemplary lock actuator and shaft release of the exemplary delivery tool of FIG. 1 ;
- FIG. 6B illustrates a sectional view of the shaft release of FIG. 6A ;
- FIG. 6C illustrates an exploded view of the shaft release of FIGS. 6A and 6B ;
- FIGS. 6D and 6E illustrate partial side views of the delivery tool in an unlocked configuration and a locked configuration, respectively;
- FIGS. 7A-7C illustrate an exemplary method for delivering the exemplary interbody device of FIG. 2 ;
- FIG. 8 is a top-view of an additional exemplary interbody device
- FIG. 9 is a side-view of the exemplary interbody device of FIG. 8 ;
- FIGS. 10-12 illustrate various cross-sectional arrangements of an inner wall of the exemplary interbody device of FIG. 1 ;
- FIGS. 13 and 14 illustrate various views of an alternative coupling arrangement between a shaft and a bore of the exemplary interbody device of FIG. 1 ;
- FIGS. 15 and 16 illustrate various views of an alternative coupling arrangement between a shaft and an articulation groove of the exemplary interbody device of FIG. 1 .
- proximal and distal are used herein to refer to the relative positions of the components of an exemplary interbody device.
- proximal refers to a position relatively closer to the exterior of the body or closer to a medical professional using the interbody device or insertion device.
- distal refers to a position relatively further away from the medical professional using the interbody device or insertion device, or closer to the interior of the body.
- proximal and distal are used to describe relative portions of an interbody device when coupled to the delivery tool described below.
- an exemplary delivery tool 10 is selectively coupled to an exemplary interbody device 20 .
- delivery tool 10 may include a handle 12 coupled to and extending proximally of a shaft 14 .
- An outer surface of handle 12 may be roughened, textured, notched, slotted, etched, sand-blasted, coated or otherwise modified to provide a better gripping surface.
- Shaft 14 may include a distal portion 16 configured for insertion into a patient's spinal column, as will be described in further detail below.
- a proximal portion 18 of shaft 14 may house, enclose, or otherwise support a lock actuator 28 and a shaft release 22 , as will be described in further detail below.
- Interbody device 20 may be comprised of any one or more of metal, metal alloys, plastics, ceramics, and elastomers capable of supporting one or more vertebrae of a patient's spinal column.
- interbody device 20 may be made of a composite material embedded with radiopaque components to provide interbody device 20 with radiopacity when visualized with x-ray or fluoroscopic imaging techniques.
- interbody device 20 may be appropriately sized for a particular patient's needs and/or to achieve a desired therapeutic effect.
- interbody device 20 may have a width W between about 8 mm and about 15 mm.
- interbody device 20 may have a length L between about 25 mm and about 40 mm.
- a height H of interbody device 20 may be between about 5 mm and about 25 mm.
- interbody device 20 may have an angle of lordosis between about 0° and about 15°. That is, the superior exterior and inferior exterior surfaces of interbody device 20 may be sloped or angled towards one another between the first and second exterior lateral surfaces.
- the terms “about,” “substantially,” and “approximately,” may indicate a range of values within +/ ⁇ 20° of a stated value.
- interbody device 20 may include a superior exterior surface and an inferior exterior surface. Additionally, interbody device 20 may include first and second exterior lateral surfaces along the length of interbody device 20 . As shown, one of the first and second exterior lateral surfaces may define a concavity while the other may define a convexity. Alternatively, in some arrangements, one of the first and second exterior lateral surfaces may define a convexity, while the other of the first and second exterior lateral surfaces may define a substantially flat planar surface, or a plurality of substantially flat planar surfaces. As shown, each of the first and second exterior lateral surfaces may extend in a substantially transverse direction relative to the superior and inferior exterior surfaces of interbody device 20 .
- Interbody device 20 may also include a proximal end 24 configured to be selectively coupled and uncoupled from delivery tool 10 , as will be described in further detail below.
- Proximal end 24 may include a curved wall along a first longitudinal extremity of interbody device 20 .
- a distal end 26 of interbody device 20 may include a curved wall at a second longitudinal extremity of interbody device 20 and may include a tapered leading edge 30 .
- each of the superior and inferior exterior surfaces adjacent leading edge 30 may be tapered at an angle ⁇ ( FIG. 2B ) relative to a longitudinal axis X of interbody device 20 so as to define sloped superior and/or inferior surfaces 23 ( FIGS.
- angle ⁇ may be selected such that as interbody device 20 is inserted into empty disc space between adjacent vertebrae, sloped superior and/or inferior surfaces 23 may guide interbody device 20 towards a desired position.
- angle ⁇ may be between about 30° and about 60°.
- angle ⁇ may be about 45°.
- leading edge 30 may be tapered at an angle relative to an anterior-most surface of interbody device 20 . That is, leading edge 30 may be angled relative to an axis Y extending substantially normal to the longitudinal axis X of interbody device 20 .
- leading edge 30 may impact remaining disc material and/or bone graft positioned between the adjacent vertebrae.
- angle ⁇ may be selected so as to control the degree of articulation of interbody device 20 upon impaction.
- angles ⁇ and/or ⁇ may be relatively small thereby enabling smooth distraction of the disc space and controlled insertion of interbody device 20 between adjacent vertebrae so as to avoid potentially damaging kinetic motion during the impaction and/or distraction.
- angle ⁇ and/or ⁇ may be relatively large or aggressive thereby enabling insertion of interbody device 20 between adjacent vertebrae without the need to distract the disc space.
- angle ⁇ may be relatively larger or aggressive in comparison the arrangement depicted in FIG. 2A .
- interbody device 20 may define a generally central space 32 or through opening.
- Space 32 may be configured so as to receive and retain bone graft material (not shown) therein.
- bone graft material may be packed within space 32 so as to facilitate ossification of bone and subsequent fusion of adjacent vertebrae.
- interbody device 20 may include one or more retention features.
- an internal geometry of interbody device 20 may be configured such that bone graft material packed within interbody device 20 may be prevented from dislodging from and/or falling out of space 32 .
- interior surface(s) of interbody device 20 defining space 32 may define one or more non-uniform or uneven surfaces which, upon receipt of bone graft material, may act to hold bone graft material therein.
- one or more inner walls 34 of interbody device 20 may be rounded, curved, or otherwise define a wall concavity.
- one or more inner walls 34 of interbody device 20 may form a planar wall recess.
- one or more inner walls 34 of interbody device 20 may include one or more serrations, teeth, or protrusions 35 thereon.
- walls 34 may define a lip extending slightly over space 32 so as to retain bone graft material therein. Accordingly, due to the irregularity of wall(s) 34 , and or the other features described herein, bone graft material received within space 32 may be maintained therein during impaction and/or manipulation of interbody device 20 .
- Interbody device 20 may further include one or more blood flow passageways 40 , as shown in FIG. 2A .
- Passageways 40 may include bores (e.g., through holes, slots, and/or openings) extending through the walls (e.g., one or more of the first and second lateral exterior surfaces) of interbody device 20 and configured to enable circulation (e.g., fluidly communicate) of blood in and through interbody device 20 and/or bone graft material packed within space 32 , which may facilitate improved ossification.
- interbody device 20 may include one or more anti-migration features 42 configured to maintain interbody device 20 within a desired position between adjacent vertebrae. The anti-migration features may be disposed on superior and/or inferior surfaces of interbody device 20 .
- Such features 42 may include any one or more of notches, bumps, tangs, grips, and/or protrusions extending from interbody device 20 and configured to increase a coefficient of friction between interbody device 20 and an endplate of an adjacent vertebral body.
- Features 42 may include any appropriate configuration, such as, for example, triangular, pyramidal, conical, and/or irregular shapes. Further, it is understood that any combination of geometric shapes and/or arrangement of features 42 may be disposed along any surface of interbody device 20 .
- anti-migration features 42 may define a plurality of tracking grooves disposed on proximal and/or distal portions of interbody device 20 .
- the tracking grooves may be formed by a plurality of spaced apart elongated features 42 defining valleys between adjacent features. The tracking grooves may assist in inhibiting medial or lateral movement of interbody device 20 during implantation or impaction within narrow disc spaces.
- interbody device 20 may include a lock bore 50 positioned along a proximal end 24 thereof.
- Lock bore 50 may be disposed in a first curved end wall (e.g., an exterior side surface) of interbody device 20 .
- Lock bore 50 may be internally (e.g., female) threaded 52 so as to selectively couple and uncouple from an externally (e.g., male) threaded 58 locking shaft 56 , as will be described in further detail below.
- lock bore 50 can be replaced with an externally (e.g., male) threaded protrusion configured to be received in an internally (e.g., female) threaded opening in a distal end of the locking shaft 56 .
- an alternative arrangement as shown in FIGS.
- locking shaft 56 may be hollow and radially expandable. That is, as shown, locking shaft 56 may define a plurality of slots, slits, and/or cuts 57 extending along a distal end thereof. Cuts 57 may define a plurality of petals 59 extending circumferentially about locking shaft 56 . In use, the medical professional may insert the distal end of locking shaft 56 , including petals 59 , within lock bore 50 . In order to secure locking shaft 56 relative to lock bore 50 , a stylet 61 , rod, tube, or similar member may be passed through a lumen defined by the hollow locking shaft 56 .
- At least a portion (e.g., tip, head, or distal end) of stylet 61 may have an diameter such that, when positioned within the lumen of locking shaft 56 adjacent petals 59 may be urged radially outwardly. With petals 59 expanded radially outwardly so as to abut internal circumferential surfaces of lock bore 56 , locking shaft 56 may be fixed relative to lock bore 50 .
- Lock bore 50 may extend distally from proximal end 24 towards and into space 32 ( FIG. 4 ).
- interbody device 20 may include an articulation groove 60 extending distally from proximal end 24 and around a side (e.g., an exterior lateral surface) of interbody device 20 .
- Articulation groove 60 also may be disposed in a side surface of interbody device 20 .
- articulation groove 60 may extend from a portion of the first curved wall of proximal end 24 towards and along a lateral exterior surface of interbody device 20 .
- articulation groove 60 may be disposed in the same side surface as lock bore 50 and spaced therefrom.
- articulation groove 60 may have a T-shaped cross-section such that an anterior-posterior dimension of the articulation groove 60 is greater than an anterior-posterior dimension of an opening to articulation groove 60 .
- articulation groove 60 may have a depth configured (e.g., sized and/or shaped) so as to receive a distal end 64 of a shaft 62 therein.
- articulation groove 60 may define an elongate opening having a height G H .
- articulation groove 60 may have any appropriate cross-sectional shape in the anterior-posterior direction so as to selectively retain shaft 62 therein and permit retraction of shaft 62 therefrom. That is, in some arrangements, articulation groove 60 may define a rounded, dove-tailed, or other such key or small opening configured to cooperate with a corresponding geometric feature of shaft 62 .
- FIG. 3 illustrates a perspective view of a distal end of a delivery tool 10 uncoupled from interbody device 20 .
- externally threaded 58 locking shaft 56 may extend along shaft 14 .
- Locking shaft 56 may be rotatable relative to shaft 14 so as to selectively couple and decouple from interbody device 20 .
- external threading 58 of locking shaft may cooperate, mate, and/or otherwise engage internal threading 52 of lock bore 50 . That is, locking shaft 56 may be rotated a first direction so as to selectively couple and/or engage external threading 58 of locking shaft 56 with internal threading 52 of lock bore 50 .
- locking shaft 56 may be rotated in a second direction, opposite the first direction, so as to selectively decouple and/or disengage external threading 58 of locking shaft 56 from internal threading 52 of lock bore 50 .
- Locking shaft 56 may be rotated relative to shaft 14 via any appropriate mechanism, as will be described in further detail below.
- locking shaft 56 may be selectively extended out of and withdrawn into shaft 14 . That is to say, locking shaft 56 may be axially translatable relative to shaft 14 .
- Locking shaft may be rotated and/or axially translated relative to shaft 14 via any appropriate mechanism, as will be described in further detail below.
- shaft 62 may extend along shaft 14 .
- Shaft 62 may be axially translatable and rotatable relative to shaft 14 so as to selectively couple and decouple from interbody device 20 . That is, shaft 62 may be rotated a first direction so as to selectively couple and/or engage distal end 64 of shaft 62 with articulation groove 60 . Additionally, shaft 62 may be rotated in a second direction, opposite the first direction, so as to selectively decouple and/or disengage distal end 64 of shaft 62 from within articulation groove 60 .
- distal end 64 of shaft 62 may include a disc, lobe, bulb, wheel, or other such extension 66 .
- Extension 66 may have a thickness E T and height E H configured for insertion within articulation groove 60 .
- extension 66 may be aligned such that the thickness E T direction of extension 66 extends generally parallel to the groove height G H direction of articulation groove 60 .
- Thickness E T of extension 66 may be smaller than groove height G H .
- extension 66 in the first configuration ( FIG. 5C ), extension 66 may be passed into and received within or removed from articulation groove 60 with sufficient clearance. In such a manner, extension 66 may be freely inserted into or removed from articulation groove 60 . Once inserted into articulation groove 60 , extension 66 may be configured to slidingly move within groove 66 as desired.
- extension 66 may be appropriately dimensioned so as to move reciprocally, as desired, within articulation groove 60 .
- shaft 62 and therefore, extension 66 , may be rotated approximately 90°.
- the thickness E T direction of extension 66 may extend generally perpendicular to the groove height G H direction of articulation groove 60
- the height E H direction of extension 66 extends generally parallel to the groove height G H direction of articulation groove 60 .
- Height E H of extension 66 may be larger than groove height G H .
- extension 66 may be prevented from being removed from (e.g., pulled out of) articulation groove 60 via interaction between extension 66 and articulation groove 60 .
- Shaft 62 may be rotated and/or axially translated relative to shaft 14 via any appropriate mechanism, as will be described in further detail below.
- a distal surface of shaft 14 may be configured to complement a portion of interbody device 20 .
- the distal surface of shaft 14 may include a curvature that corresponds to the curvature of a proximal end of interbody device 20 .
- a distal surface of shaft 14 may include an extension 15 configured to cooperate with a proximal end of interbody device 20 so as to limit articulation and/or rotation of interbody device 20 relative to shaft 14 beyond a desired amount, as will be described in further detail below.
- each of locking shaft 56 and shaft 62 may extend through a common lumen.
- the lumen of shaft 14 may be elongated and/or ovular so as to accommodate multiple shafts therethrough.
- shaft 14 may define a plurality of lumens.
- each of locking shaft 56 and shaft 62 may extend through a separate and distinct lumen of shaft 14 .
- Shaft 14 may also include any appropriate visualization, illumination, irrigation, aspiration, and other such lumens configured to deliver one or more tools, fluids, or other materials to a distal end of shaft 14 .
- locking shaft 56 may extend through a lumen of a first delivery tool 10
- shaft 62 may extend through a lumen of a second delivery tool 10 , different than the first tool.
- FIGS. 4 and 5A-5C illustrate the exemplary delivery tool 10 of FIG. 1 coupled to interbody device 20 in a locked and unlocked configuration, respectively.
- external threading 58 of locking shaft 56 may be engaged with internal threading 52 of lock bore 50 such that interbody device 20 is securely coupled to delivery tool 10 . That is, a distal end of locking shaft may be extended out of shaft 14 and threadingly coupled to lock bore 50 .
- shaft 62 may be rotated towards the second configuration such that extension 66 may be prevented from being removed from (e.g., pulled out of) articulation groove 60 via interaction between extension 66 and articulation groove 60 , as shown in FIG. 5B (in which locking shaft 56 and shaft 14 have been omitted for clarity).
- extension 66 of shaft 62 may be retained within articulation slot 60 to enable articulation of interbody device 20 relative to shaft 62 of delivery tool 10 during insertion and/or impaction between adjacent vertebrae.
- shaft 56 may be maintained in the locked configuration so as to enable a medical professional increased control and rigidity during delivery.
- locking shaft 56 may be rotated so as to decouple and/or disengage external threading 58 of locking shaft 56 from internal threading 52 of lock bore 50 .
- extension 66 may glide, slide, or otherwise move along articulation groove 60 ( FIG. 5B ), thereby enabling articulation of interbody device 20 relative to shaft 14 of delivery tool 10 .
- interbody device 20 may be naturally urged toward an articulated (e.g., bent) configuration.
- articulation of interbody device 20 may occur in a controlled manner. That is, delivery tool 10 enables insertion of, and impaction by, interbody device 20 while maintaining dominance over interbody device 20 along all surgical planes.
- interbody device 20 may include a recess 25 configured to receive extension 15 therein. That is, recess 25 may include a shape corresponding (e.g., similar) to the shape of extension 15 such that, when interbody device 20 is articulated relative to shaft 62 , extension 15 may be received within recess 25 .
- recess 25 may define a slot, trajectory, or guide to control the degree of articulation of interbody device 20 relative to shaft 62 . That is, during articulation, extension 15 may ride along recess 25 to prevent overarticulation.
- recess 25 may prevent extension 15 from rotating relative thereto. That is, recess 25 may maintain or otherwise keep interbody device 20 within a desired plane during articulation, and inhibit or prevent interbody device 20 from rotating away from such a plane of articulation.
- shaft 62 may be releasably coupled to extension 66 .
- extension 66 may include an enlarged ball, sphere, bearing, or other such member configured to be non-releasably (e.g., non-removably) received within articulation groove 60 .
- extension 66 may include a nipple 67 extending therefrom and configured to cooperate with shaft 62 . That is, in some arrangements, nipple 67 may be externally threaded (e.g., male) so as to selectively couple and uncouple from internally threaded (e.g., female) shaft 62 .
- nipple 67 may be internally threaded (e.g., female) so as to selectively couple and uncouple from an externally threaded (e.g., male) shaft 62 .
- shaft 62 may be rotated so as to be decoupled from nipple 67 as shown in FIGS. 15 and 16 .
- locking shaft 56 may be rotated relative to shaft 14 via any appropriate mechanism.
- proximal portion 18 of shaft 14 may define an enlarged actuation portion having therein a passageway, aperture, and/or other opening 70 therethrough.
- the enlarged portion may include any suitable configuration.
- the enlarged portion may be substantially cylindrical.
- the enlarged portion may include a substantially rectangular cross-sectional configuration.
- lock actuator 28 may be positioned within opening 70 .
- Lock actuator 28 may include a threaded knob 72 and a continuous push assembly 74 , including a spring 78 and a retainer 80 .
- threaded knob 72 may be rotatable about a longitudinal axis of locking shaft 56 against a biasing force of spring 78 .
- Threaded knob 72 may include a substantially cylindrical configuration having an open distal end. The proximal end of threaded knob 72 may be substantially closed with the exception of an opening for locking shaft 56 to pass through.
- threading knob 72 may include an opening 82 in a side wall of threaded knob 72 . Opening 82 may be configured to receive, cooperate, and fixedly retain a radially outwardly directed projection 84 or coupling feature extending from locking shaft 56 .
- opening 82 may be configured (e.g., sized and/or shaped) so as to cooperate with (e.g., matingly receive therein) projection 84 .
- projection 84 may be received with opening 82 , relative longitudinal motion between locking shaft 56 and threaded knob 72 may be prevented or otherwise limited.
- projection 44 may be a semi-hemispherical nub while opening 82 may include a tubular channel.
- projection 84 on locking shaft 56 may be replaced with an opening (not shown) for receiving a set screw therein.
- opening 82 and the opening on locking shaft 56 may be aligned, and a set screw (or other similar fastener) may fixedly couple together threaded knob 72 and locking shaft 56 .
- a set screw or other similar fastener
- rotation of threaded knob 72 may be configured to cause likewise rotation of locking shaft 56 due to the interaction between opening 82 and projection 84 .
- Retainer 80 may include a substantially cylindrical configuration having an open proximal end.
- a distal end of retainer 80 may be configured to engage (e.g., abut) a distal wall of opening 70 .
- the distal end of retainer 80 may be substantially closed with the exception of an opening for locking shaft 56 to pass through.
- a distal end of spring 78 (or any other suitable biasing element known in the art) may be received within retainer 80 .
- a proximal end of spring 78 may be received within threaded knob 72 .
- spring 78 biases threaded knob 72 (and, consequently, locking shaft 56 as a result of the connection described herein) in the proximal direction.
- Rotation and distal urging (e.g., pushing) of threaded knob 72 in a first direction may be configured to move locking shaft 56 against spring 78 and couple and/or engage external threading 58 of locking shaft 56 with internal threading 52 of lock bore 50 of interbody device 20 .
- rotation of threading knob 72 in a second direction, opposite the first direction may be configured to decouple and/or disengage external threading 58 of locking shaft 56 from internal threading 52 of lock bore 50 of interbody 20 .
- spring 78 and retainer 80 may be configured to maintain threading knob 72 in position along opening 70 .
- spring 78 may be biased so as to spread apart (e.g., separate) retainer 80 and threading knob 72 . In such a manner, interaction between threading knob 72 , spring 78 and retainer 80 may maintain threaded knob 72 along a desired position along opening 70 .
- shaft release 22 may include a knob 90 configured for axial displacement along and rotation about a longitudinal axis of shaft 14 .
- Shaft release 22 may be coupled to shaft 62 via a projection 92 .
- an internal surface of knob 90 may define projection 92 which may in turn, be received and/or mate with a feature (e.g., a hole, opening, or similar irregularity) on shaft 62 . Accordingly, rotation and/or axial displacement of knob 90 relative to shaft 14 may cause and/or result in likewise rotation and/or axial displacement of shaft 62 .
- rotation and/or axial displacement of knob 90 in a first direction may be configured so as to selectively couple and/or engage distal end 64 of shaft 62 with articulation groove 60 .
- rotation and/or axial displacement of knob 90 in a second direction, opposite the first direction may be configured so as to decouple and/or disengage distal end 64 of shaft 62 from with articulation groove 60 .
- shaft 62 may have a proximal end (not shown) fixedly retained or coupled within a proximal hub 94 .
- Proximal hub 94 may define a passage or slot 96 .
- Slot 96 may extend approximately 90° about a circumferential surface of hub 94 .
- hub 94 may be received within a lumen or other such opening of knob 90 and projection 92 ( FIG. 6A ) may be received within slot 96 of hub 94 . Due to the interaction between projection 92 and slot 96 , shaft 62 may be limited to approximately 90° of rotation relative to handle 12 of delivery tool 10 .
- one or more portions, e.g., knob 90 and handle 12 , of delivery tool may include indicia 98 or other such markings indicating a position or orientation of shaft 62 , and consequently, extension 66 .
- indicia 98 may indicate that shaft 62 is in the first configuration ( FIG. 5C ), in which extension 66 may be passed into and received within or freely removed from articulation groove 60 with sufficient clearance.
- indicia 98 may indicate that shaft 62 is in the second configuration ( FIG. 5B ), in which extension 66 may be prevented from being removed from (e.g., pulled out of) articulation groove 60 via interaction between extension 66 and articulation groove 60 .
- FIGS. 6D and 6E illustrate partial side views of the delivery tool in an unlocked configuration and a locked configuration, respectively.
- indicia 98 when indicia 98 are arranged so as to indicate shaft 62 is in the first configuration (e.g., unlocked), extension 66 of shaft 62 may extend from shaft 14 in a first rotational orientation.
- knob 90 is rotated such that indicia 98 are arranged to indicate shaft 62 is in the second configuration (e.g., locked), extension 66 of shaft 62 may extend from shaft 14 in a second rotational orientation.
- FIGS. 7A-7C illustrate an exemplary method of delivering interbody device 20 between adjacent vertebrae of a patient's spinal column.
- one or more portions of the vertebral bone may be removed so as to access a disc between adjacent vertebrae. That is, a passage 100 extending through one or more vertebrae 102 may be formed, so as to enable insertion of a luminal member 104 therethrough.
- Luminal member 104 may be any appropriate member configured to introduce delivery tool 10 therethrough.
- luminal member 104 may include one or more sheaths, tubes, and/or members configured for facilitating low profile delivery of a delivery tool 10 .
- a medical professional may then partially remove the damaged and/or degenerated disc, leaving at least a portion of the disc intact to facilitate guiding an interbody device and retaining subsequently implanted bone graft therein.
- the medical professional may form a passage 106 in a disc 108 so as to provide access to disc space 110 between adjacent vertebrae 102 .
- delivery tool 10 may be extended through passages 100 and 106 , distally of luminal member 104 , and into disc space 110 .
- interbody device 20 may be coupled to shaft 14 of delivery tool 10 in the locked configuration so as to provide the medical professional control over interbody device 20 .
- interbody device 20 may be securely coupled to delivery tool 10 .
- space 32 of interbody device 120 may be filled with bone graft material prior to insertion of interbody device 120 into disc space 110 .
- leading edge 30 may impact remaining disc material and/or bone graft positioned between the adjacent vertebrae 102 .
- further advancement of interbody device 20 by a medical professional may naturally urge interbody device 20 to pivot, rotate, and/or articulate.
- locking shaft 56 may be rotated so as to decouple and/or disengage external threading 58 of locking shaft 56 from internal threading 52 of lock bore 50 . Once disengaged, as shown in FIG.
- extension 66 may glide, slide, or otherwise move along articulation groove 60 , thereby enabling articulation of interbody device 20 along disc 108 , relative to shaft 14 of delivery tool 10 , while allowing the medical professional to maintain control over interbody device 120 . That is, by virtue of coupling between extension 66 and interbody device 20 , advancement and/or articulation of interbody device 20 may occur in a controlled manner along all surgical planes. Following proper positioning of interbody device 20 within disc space 110 , shaft 62 , and therefore, extension 66 , may be rotated approximately 90° such that the thickness E T direction of extension 66 may extend generally parallel to the groove height G H direction of articulation groove 60 .
- extension 66 may be removed from (e.g., pulled out of) articulation groove 60 , thereby decoupling or disengaging interbody device 20 from delivery tool 10 , as shown in FIG. 7C .
- morselized bone (or any other ingrowth promoting material) may be added to remaining disc space 110 .
- a medical professional may also place morselized bone along the sides of the spinal column to promote fusion.
- interbody device 20 may include a leading edge 30 , as discussed above.
- Leading edge 30 may be tapered at an angle ⁇ so as to enable smooth and controlled insertion of interbody device 20 , with or without distraction, between adjacent vertebrae.
- leading edge 30 may be tapered at an angle relative to an anterior-most surface of interbody device 20 . That is, leading edge 30 may be angled relative to an axis Y extending substantially normal to the longitudinal axis X of interbody device 20 .
- angle may be relatively large or aggressive thereby enabling insertion of interbody device 20 between adjacent vertebrae to enable greater control during insertion.
- interbody device 20 may define a space 32 configured so as to retain bone graft material (not shown) therein.
- Interbody device 20 may include one or more anti-migration features 42 configured to maintain interbody device 20 within a desired position within between adjacent vertebrae.
- Such features 42 may include any one or more of notches, bumps, tangs, grips, and/or protrusions extending from interbody device 20 .
- Features 42 may include any appropriate configuration, such as, for example, triangular, pyramidal, conical, and/or irregular shapes.
- features 42 may be disposed along any surface of interbody device 20 .
- features 42 may extend along top and bottom (e.g., vertebrae mating) surfaces of interbody device 20 .
Abstract
An intervertebral implant may include a superior exterior surface, an inferior exterior surface, a first exterior lateral surface, and a second exterior lateral surface. The first and second exterior lateral surfaces may be substantially transverse to the superior and inferior exterior surfaces. The implant may further include a first curved end wall at a first longitudinal extremity of the body. The first curved end wall may include a bore configured to receive a first shaft of a tool. Additionally, the implant may include a second curved end wall at a second longitudinal extremity of the body and an elongated slot extending from a portion of the first curved end wall to a portion of the first exterior lateral surface.
Description
- This application is a continuation of Utility patent application Ser. No. 14/974,174 filed Dec. 18, 2015, titled “ARTICULATING INTERVERTEBRAL DEVICES, RELATED TOOLS, SYSTEMS, AND METHODS,” which is hereby incorporated herein by reference in its entirety.
- Various aspects of the present disclosure relate generally to intervertebral implants and related systems and methods. More specifically, the present disclosure relates to articulating intervertebral devices, tools, systems, and methods for deployment within a body of a patient.
- A patient's spinal column includes twenty-six bones called vertebrae which protect the spinal cord. While the shape and/or size of each vertebra varies depending on the placement, loading, posture, and/or pathology within the spinal column, each vertebra is composed of cancellous bone, which is a spongy type of osseous tissue. The cancellous bone of each vertebra is then covered by a thin coating of cortical bone, which is a hard and dense type of osseous tissue. An intervertebral disc is positioned between each pair of adjacent vertebrae in the spinal column. Each disc forms a fibrocartilaginous joint between adjacent vertebrae so as to allow movement of the vertebrae. Beyond enabling relative motion between adjacent vertebrae, each disc acts as a shock absorber for the spinal column.
- Each disc comprises a fibrous exterior surrounding an inner gel-like center, which together cooperate to distribute pressure evenly across each disc, which prevents the development of stress concentrations that might otherwise damage and/or impair the vertebrae of the spinal column. However, the discs may be subject to various injuries and/or disorders which may interfere with the disc's ability to adequately distribute pressure and protect the vertebrae. For example, disc herniation, degeneration, and infection may result in insufficient disc thickness and/or support to absorb and/or distribute forces imparted to the spinal column. Disc degeneration, for example, may result when the inner gel-like center begins to dehydrate, which may result in a degenerated disc having decreased thickness. This decreased thickness may limit the ability of the degenerated disc to absorb shock which, if left untreated, may result in pain and/or vertebral injury.
- While pain medication, physical therapy, and other non-operative conditions may alleviate some symptoms, such interventions may not be sufficient for every patient. Accordingly, various procedures have been developed to surgically improve patient quality of life via abatement of pain and/or discomfort. One particularly advantageous procedure includes transforaminal lumbar interbody fusion (TLIF). TLIF may be performed via a minimally invasive technique, thus reducing trauma to the spinal column, and decreasing patient recovery times.
- During TLIF, a medical professional may make a small (e.g., between about 1 inch and about 6 inches) incision along a patient's back. Next, one or more portions of the vertebral bone (such as, e.g., a facet joint of adjacent vertebral bodies) may be removed so as to access a disc between adjacent vertebrae. A medical professional then may partially remove the damaged and/or degenerated disc, leaving at least a portion of the disc intact to facilitate guiding an interbody device into the disc space. If necessary, bone graft (including, but not limited to, morselized bone) also may be placed within the disc space to promote fusion. Commonly, a medical professional may enlarge the disc space between adjacent vertebrae via a distraction process. Following removal of a portion of the disc and/or distraction of the disc space, an interbody device (e.g., implant) is positioned in the disc space between adjacent vertebrae. The interbody device may relieve pressure from pinched nerves and provide additional therapeutic effects. In some instances, a medical professional also may implant one or more bone screws and/or rods to provide additional support to the spinal column. Additionally, morselized bone may be placed along the sides of the spinal column to promote fusion.
- When a TLIF procedure is performed according to a minimally invasive technique, however, direct vision of the disc space is not available. In addition, it may be difficult to visualize an interbody device during implantation. Accordingly, proper placement of an interbody device along the spinal column may be a difficult and tedious task, often requiring extensive skill and experience. Additionally, it is often the case that the available space (e.g., distance) between two adjacent vertebrae intended to receive an interbody device is smaller than the height of the interbody device chosen for insertion. In such cases, a medical professional may need to distract the disc space to prepare for insertion of the interbody device. Distraction, however, is often done with various tools and implements (e.g., rods, screws, etc.) which may interfere, impede, and/or block an interbody device's insertion and/or entrance into the disc space. Accordingly, it may be difficult to guide the interbody device into position between adjacent vertebrae that have been distracted by conventional methods. If distraction is not performed, however, it may be challenging to insert the interbody device so as to create sufficient space between (e.g., distract) adjacent vertebrae itself, while maintaining control. Further, during insertion of the interbody device, the interbody device may impact remaining portions of the disc and/or bone graft which may interfere with the proper placement of the interbody device.
- Thus, there remains a need for improved interbody devices, associated systems, tools, and insertion methods.
- Examples of the present disclosure relate to, among other things, intervertebral implants. Each of the embodiments disclosed herein may include one or more of the features described in connection with any of the other disclosed embodiments.
- In one example, an intervertebral implant may include a superior exterior surface, an inferior exterior surface, a first exterior lateral surface, and a second exterior lateral surface. The first and second exterior lateral surfaces may be substantially transverse to the superior and inferior exterior surfaces. The implant may further include a first curved end wall at a first longitudinal extremity of the body. The first curved end wall may include a bore configured to receive a first shaft of a tool. Additionally, the implant may include a second curved end wall at a second longitudinal extremity of the body and an elongated slot extending from a portion of the first curved end wall to a portion of the first exterior lateral surface.
- Additionally or alternatively, examples of the implant may include one or more of the following features: the first exterior lateral surface may include at least a central portion having a concavity; the second exterior lateral surface may include at least a central portion having a convexity; the elongated slot may include a T-shaped cross-sectional configuration such that an anterior-posterior dimension of the elongated slot is greater than an anterior-posterior dimension of an opening of the elongated slot; the body may further include a through hole in one or both of the first and second exterior lateral surfaces; the second curved wall may include a leading edge angled relative to a longitudinal axis of the body; each of the superior exterior surface and the inferior exterior surface may include a portion angled relative to the longitudinal axis of the body; the bore may be internally threaded; one or more protrusions may extend from one or both of the superior exterior surface and the inferior exterior surface; the body may include a central through opening; and the elongated slot may be configured to receive and retain a second shaft of the tool.
- In another example, a system for performing interbody fusion may include an intervertebral implant. The implant may have a body including a superior exterior surface, an inferior exterior surface, a first exterior lateral surface, and a second exterior lateral surface. The first and second exterior lateral surfaces may be substantially transverse to the superior and inferior exterior surfaces. The body may further include a first curved end wall at a first longitudinal extremity of the body. The first curved end wall may include a bore. Further, the body may include a second curved end wall at a second longitudinal extremity of the body. Additionally, the body may include an articulation groove which may extend from a portion of the first curved end wall to a portion of the first exterior lateral surface. The system may further include a locking shaft which may be configured for selective coupling and uncoupling from the bore. Further, the system may include a shaft which may be configured for selective insertion and retraction from the articulation groove.
- Additionally or alternatively, examples of the system may include one or more of the following features: the bore may be internally threaded; a distal end of the locking shaft may be externally threaded; the shaft may include a distal end having an enlarged extension; the shaft may be rotatable between a first configuration and a second configuration, wherein in the first configuration the extension may be oriented such that the extension is configured for insertion within the articulation groove, and wherein, in the second configuration, the extension may be oriented such that the extension is retained within the articulation groove; and the extension may be configured to move within the articulation groove.
- In another example, a method for delivering an interbody device may include inserting a body into a prepared disc space between adjacent vertebrae of a patient. The body may include a superior exterior surface, an inferior exterior surface, a first exterior lateral surface, and a second exterior lateral surface. The first exterior lateral surface and the second exterior lateral surface may be substantially transverse to the superior and inferior exterior surfaces. The body may further include a first curved end wall at a first longitudinal extremity of the body and a second curved end wall at a second longitudinal extremity of the body. The first curved end wall may include a bore. Further, an articulation groove may extend from a portion of the first curved end wall to a portion of the first exterior lateral surface. The method may further include uncoupling a locking shaft from the bore and moving a shaft along the articulation groove so as to articulate the body relative to the shaft.
- Additionally or alternatively, examples of the method may include one or more of the following features: rotating the shaft relative to the body and removing the articulation shaft from the articulation groove of the body; uncoupling the locking shaft from the bore may include rotating the locking shaft; the bore and locking shaft may be configured to be threadably coupled; and the shaft may include a distal end having an enlarged extension, wherein the shaft may be rotatable between a first configuration and a second configuration, wherein, in the first configuration the extension may be oriented such that the extension is configured for insertion within the articulation groove, and wherein, in the second configuration, the extension may be oriented such that the extension is retained within the articulation groove.
- It may be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the disclosure, as claimed.
- As used herein, the terms “comprises,” “comprising,” or any other variation thereof, are intended to cover a non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements does not include only those elements, but may include other elements not expressly listed or inherent to such process, method, article, or apparatus. The term “exemplary” is used in the sense of “example,” rather than “ideal.”
- The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate exemplary arrangements of the present disclosure and together with the description, serve to explain the principles of the disclosure.
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FIG. 1 illustrates an exemplary interbody device coupled to an exemplary delivery tool; -
FIGS. 2A-2C illustrate various views of the exemplary interbody device ofFIG. 1 ; -
FIG. 3 is a perspective view of a distal end of the exemplary delivery tool ofFIG. 1 ; -
FIG. 4 illustrates a distal end of the exemplary delivery tool ofFIG. 1 , in a locked configuration, and coupled to the exemplary interbody device ofFIG. 2 ; -
FIG. 5A illustrates a distal end of the exemplary delivery tool ofFIG. 1 , in an unlocked configuration, and coupled to the exemplary interbody device ofFIG. 2 when articulated relative to the delivery tool; -
FIGS. 5B and 5C illustrate an exemplary shaft of the delivery tool in a first state within the exemplary interbody device ofFIG. 2 , and a second state for removal from and insertion into the exemplary interbody device ofFIG. 2 , respectively; -
FIG. 6A illustrates a cross-sectional view of an exemplary lock actuator and shaft release of the exemplary delivery tool ofFIG. 1 ; -
FIG. 6B illustrates a sectional view of the shaft release ofFIG. 6A ; -
FIG. 6C illustrates an exploded view of the shaft release ofFIGS. 6A and 6B ; -
FIGS. 6D and 6E illustrate partial side views of the delivery tool in an unlocked configuration and a locked configuration, respectively; -
FIGS. 7A-7C illustrate an exemplary method for delivering the exemplary interbody device ofFIG. 2 ; -
FIG. 8 is a top-view of an additional exemplary interbody device; -
FIG. 9 is a side-view of the exemplary interbody device ofFIG. 8 ; -
FIGS. 10-12 illustrate various cross-sectional arrangements of an inner wall of the exemplary interbody device ofFIG. 1 ; -
FIGS. 13 and 14 illustrate various views of an alternative coupling arrangement between a shaft and a bore of the exemplary interbody device ofFIG. 1 ; and -
FIGS. 15 and 16 illustrate various views of an alternative coupling arrangement between a shaft and an articulation groove of the exemplary interbody device ofFIG. 1 . - Reference now will be made in detail to examples of the present disclosure and illustrated in the accompanying drawings. Wherever possible, the same reference numbers will be used throughout the drawings to refer to the same or like parts.
- The terms “proximal” and “distal” are used herein to refer to the relative positions of the components of an exemplary interbody device. When used herein, “proximal” refers to a position relatively closer to the exterior of the body or closer to a medical professional using the interbody device or insertion device. In contrast, “distal” refers to a position relatively further away from the medical professional using the interbody device or insertion device, or closer to the interior of the body. With specific reference to the interbody device(s) disclosed herein, the terms “proximal” and “distal” are used to describe relative portions of an interbody device when coupled to the delivery tool described below.
- With reference now to
FIG. 1 , anexemplary delivery tool 10 is selectively coupled to anexemplary interbody device 20. As shown,delivery tool 10 may include ahandle 12 coupled to and extending proximally of ashaft 14. An outer surface ofhandle 12 may be roughened, textured, notched, slotted, etched, sand-blasted, coated or otherwise modified to provide a better gripping surface.Shaft 14 may include adistal portion 16 configured for insertion into a patient's spinal column, as will be described in further detail below. Aproximal portion 18 ofshaft 14 may house, enclose, or otherwise support alock actuator 28 and ashaft release 22, as will be described in further detail below. -
Interbody device 20 may be comprised of any one or more of metal, metal alloys, plastics, ceramics, and elastomers capable of supporting one or more vertebrae of a patient's spinal column. In some embodiments,interbody device 20 may be made of a composite material embedded with radiopaque components to provideinterbody device 20 with radiopacity when visualized with x-ray or fluoroscopic imaging techniques. - Turning to
FIGS. 2A-2C ,interbody device 20 may be appropriately sized for a particular patient's needs and/or to achieve a desired therapeutic effect. For example, in some arrangements,interbody device 20 may have a width W between about 8 mm and about 15 mm. Further,interbody device 20 may have a length L between about 25 mm and about 40 mm. Moreover, a height H ofinterbody device 20 may be between about 5 mm and about 25 mm. Additionally,interbody device 20 may have an angle of lordosis between about 0° and about 15°. That is, the superior exterior and inferior exterior surfaces ofinterbody device 20 may be sloped or angled towards one another between the first and second exterior lateral surfaces. As used herein, the terms “about,” “substantially,” and “approximately,” may indicate a range of values within +/−20° of a stated value. - As shown in
FIG. 2A ,interbody device 20 may include a superior exterior surface and an inferior exterior surface. Additionally,interbody device 20 may include first and second exterior lateral surfaces along the length ofinterbody device 20. As shown, one of the first and second exterior lateral surfaces may define a concavity while the other may define a convexity. Alternatively, in some arrangements, one of the first and second exterior lateral surfaces may define a convexity, while the other of the first and second exterior lateral surfaces may define a substantially flat planar surface, or a plurality of substantially flat planar surfaces. As shown, each of the first and second exterior lateral surfaces may extend in a substantially transverse direction relative to the superior and inferior exterior surfaces ofinterbody device 20.Interbody device 20 may also include aproximal end 24 configured to be selectively coupled and uncoupled fromdelivery tool 10, as will be described in further detail below.Proximal end 24 may include a curved wall along a first longitudinal extremity ofinterbody device 20. Further, adistal end 26 ofinterbody device 20 may include a curved wall at a second longitudinal extremity ofinterbody device 20 and may include a tapered leadingedge 30. For example, each of the superior and inferior exterior surfaces adjacent leadingedge 30 may be tapered at an angle α (FIG. 2B ) relative to a longitudinal axis X ofinterbody device 20 so as to define sloped superior and/or inferior surfaces 23 (FIGS. 2B and 2C ), which enable smooth and controlled insertion ofinterbody device 20, with or without distraction, between adjacent vertebrae. That is, angle α may be selected such that asinterbody device 20 is inserted into empty disc space between adjacent vertebrae, sloped superior and/orinferior surfaces 23 may guideinterbody device 20 towards a desired position. In some arrangements, as shown in FIG. 2B, angle α may be between about 30° and about 60°. For example, angle α may be about 45°. Additionally, leadingedge 30 may be tapered at an angle relative to an anterior-most surface ofinterbody device 20. That is, leadingedge 30 may be angled relative to an axis Y extending substantially normal to the longitudinal axis X ofinterbody device 20. Accordingly, during insertion into the empty disc space, leadingedge 30 may impact remaining disc material and/or bone graft positioned between the adjacent vertebrae. Upon impaction, further advancement ofinterbody device 20 by a medical professional may causeinterbody device 20 to pivot, rotate, and/or articulate. Accordingly, angle α may be selected so as to control the degree of articulation ofinterbody device 20 upon impaction. In some arrangements, angles α and/or β may be relatively small thereby enabling smooth distraction of the disc space and controlled insertion ofinterbody device 20 between adjacent vertebrae so as to avoid potentially damaging kinetic motion during the impaction and/or distraction. Alternatively, angle α and/or β may be relatively large or aggressive thereby enabling insertion ofinterbody device 20 between adjacent vertebrae without the need to distract the disc space. By way of example only, as shown inFIG. 8 , angle β may be relatively larger or aggressive in comparison the arrangement depicted inFIG. 2A . - With continuing reference to
FIG. 2A ,interbody device 20 may define a generallycentral space 32 or through opening.Space 32 may be configured so as to receive and retain bone graft material (not shown) therein. For example, bone graft material may be packed withinspace 32 so as to facilitate ossification of bone and subsequent fusion of adjacent vertebrae. In order to ensure bone graft material inserted withinspace 32 remains therein,interbody device 20 may include one or more retention features. For example, an internal geometry ofinterbody device 20 may be configured such that bone graft material packed withininterbody device 20 may be prevented from dislodging from and/or falling out ofspace 32. That is, interior surface(s) ofinterbody device 20 definingspace 32 may define one or more non-uniform or uneven surfaces which, upon receipt of bone graft material, may act to hold bone graft material therein. For example, as shown inFIGS. 2A and 10 , one or moreinner walls 34 ofinterbody device 20 may be rounded, curved, or otherwise define a wall concavity. Alternatively, as shown inFIG. 11 , one or moreinner walls 34 ofinterbody device 20 may form a planar wall recess. Still further, in some examples, as shown inFIG. 12 , one or moreinner walls 34 ofinterbody device 20 may include one or more serrations, teeth, orprotrusions 35 thereon. In addition, due to the geometric irregularity (e.g., concavity, planar recess, and/or serrations) ofwalls 34,walls 34 may define a lip extending slightly overspace 32 so as to retain bone graft material therein. Accordingly, due to the irregularity of wall(s) 34, and or the other features described herein, bone graft material received withinspace 32 may be maintained therein during impaction and/or manipulation ofinterbody device 20. -
Interbody device 20 may further include one or moreblood flow passageways 40, as shown inFIG. 2A .Passageways 40 may include bores (e.g., through holes, slots, and/or openings) extending through the walls (e.g., one or more of the first and second lateral exterior surfaces) ofinterbody device 20 and configured to enable circulation (e.g., fluidly communicate) of blood in and throughinterbody device 20 and/or bone graft material packed withinspace 32, which may facilitate improved ossification. Additionally,interbody device 20 may include one or more anti-migration features 42 configured to maintaininterbody device 20 within a desired position between adjacent vertebrae. The anti-migration features may be disposed on superior and/or inferior surfaces ofinterbody device 20.Such features 42 may include any one or more of notches, bumps, tangs, grips, and/or protrusions extending frominterbody device 20 and configured to increase a coefficient of friction betweeninterbody device 20 and an endplate of an adjacent vertebral body.Features 42 may include any appropriate configuration, such as, for example, triangular, pyramidal, conical, and/or irregular shapes. Further, it is understood that any combination of geometric shapes and/or arrangement offeatures 42 may be disposed along any surface ofinterbody device 20. In some embodiments, anti-migration features 42 may define a plurality of tracking grooves disposed on proximal and/or distal portions ofinterbody device 20. The tracking grooves may be formed by a plurality of spaced apart elongated features 42 defining valleys between adjacent features. The tracking grooves may assist in inhibiting medial or lateral movement ofinterbody device 20 during implantation or impaction within narrow disc spaces. - Additionally,
interbody device 20 may include a lock bore 50 positioned along aproximal end 24 thereof. Lock bore 50 may be disposed in a first curved end wall (e.g., an exterior side surface) ofinterbody device 20. Lock bore 50 may be internally (e.g., female) threaded 52 so as to selectively couple and uncouple from an externally (e.g., male) threaded 58 lockingshaft 56, as will be described in further detail below. Alternatively, in some arrangements, lock bore 50 can be replaced with an externally (e.g., male) threaded protrusion configured to be received in an internally (e.g., female) threaded opening in a distal end of the lockingshaft 56. In an alternative arrangement, as shown inFIGS. 13 and 14 , lockingshaft 56 may be hollow and radially expandable. That is, as shown, lockingshaft 56 may define a plurality of slots, slits, and/orcuts 57 extending along a distal end thereof.Cuts 57 may define a plurality ofpetals 59 extending circumferentially about lockingshaft 56. In use, the medical professional may insert the distal end of lockingshaft 56, includingpetals 59, within lock bore 50. In order to secure lockingshaft 56 relative to lockbore 50, astylet 61, rod, tube, or similar member may be passed through a lumen defined by thehollow locking shaft 56. At least a portion (e.g., tip, head, or distal end) ofstylet 61 may have an diameter such that, when positioned within the lumen of lockingshaft 56adjacent petals 59 may be urged radially outwardly. Withpetals 59 expanded radially outwardly so as to abut internal circumferential surfaces of lock bore 56, lockingshaft 56 may be fixed relative to lockbore 50. - Lock bore 50 may extend distally from
proximal end 24 towards and into space 32 (FIG. 4 ). Additionally,interbody device 20 may include anarticulation groove 60 extending distally fromproximal end 24 and around a side (e.g., an exterior lateral surface) ofinterbody device 20.Articulation groove 60 also may be disposed in a side surface ofinterbody device 20. For example,articulation groove 60 may extend from a portion of the first curved wall ofproximal end 24 towards and along a lateral exterior surface ofinterbody device 20. As shown inFIG. 2A ,articulation groove 60 may be disposed in the same side surface as lock bore 50 and spaced therefrom. In some arrangements,articulation groove 60 may have a T-shaped cross-section such that an anterior-posterior dimension of thearticulation groove 60 is greater than an anterior-posterior dimension of an opening toarticulation groove 60. For example,articulation groove 60 may have a depth configured (e.g., sized and/or shaped) so as to receive adistal end 64 of ashaft 62 therein. For example,articulation groove 60 may define an elongate opening having a height GH. Height GH may be sufficient so as to allow insertion and retraction ofdistal end 64 ofshaft 62 into and/or fromarticulation groove 60 in a first configuration, while preventing insertion and retraction ofdistal end 64 ofshaft 62 into and/or fromarticulation groove 60 in a second configuration, as will be described in further detail below. Additionally or alternatively,articulation groove 60 may have any appropriate cross-sectional shape in the anterior-posterior direction so as to selectively retainshaft 62 therein and permit retraction ofshaft 62 therefrom. That is, in some arrangements,articulation groove 60 may define a rounded, dove-tailed, or other such key or small opening configured to cooperate with a corresponding geometric feature ofshaft 62. - For example,
FIG. 3 illustrates a perspective view of a distal end of adelivery tool 10 uncoupled frominterbody device 20. As shown inFIGS. 1 and 3 , externally threaded 58 lockingshaft 56 may extend alongshaft 14. Lockingshaft 56 may be rotatable relative toshaft 14 so as to selectively couple and decouple frominterbody device 20. For example, external threading 58 of locking shaft may cooperate, mate, and/or otherwise engage internal threading 52 of lock bore 50. That is, lockingshaft 56 may be rotated a first direction so as to selectively couple and/or engage external threading 58 of lockingshaft 56 with internal threading 52 of lock bore 50. Additionally, lockingshaft 56 may be rotated in a second direction, opposite the first direction, so as to selectively decouple and/or disengage external threading 58 of lockingshaft 56 from internal threading 52 of lock bore 50. Lockingshaft 56 may be rotated relative toshaft 14 via any appropriate mechanism, as will be described in further detail below. In addition, lockingshaft 56 may be selectively extended out of and withdrawn intoshaft 14. That is to say, lockingshaft 56 may be axially translatable relative toshaft 14. Locking shaft may be rotated and/or axially translated relative toshaft 14 via any appropriate mechanism, as will be described in further detail below. - Further, as shown in
FIGS. 1, 3, and 5A-5C ,shaft 62 may extend alongshaft 14.Shaft 62 may be axially translatable and rotatable relative toshaft 14 so as to selectively couple and decouple frominterbody device 20. That is,shaft 62 may be rotated a first direction so as to selectively couple and/or engagedistal end 64 ofshaft 62 witharticulation groove 60. Additionally,shaft 62 may be rotated in a second direction, opposite the first direction, so as to selectively decouple and/or disengagedistal end 64 ofshaft 62 from withinarticulation groove 60. For example,distal end 64 ofshaft 62 may include a disc, lobe, bulb, wheel, or othersuch extension 66.Extension 66 may have a thickness ET and height EH configured for insertion withinarticulation groove 60. For example, in a first configuration,extension 66 may be aligned such that the thickness ET direction ofextension 66 extends generally parallel to the groove height GH direction ofarticulation groove 60. Thickness ET ofextension 66 may be smaller than groove height GH. Accordingly, in the first configuration (FIG. 5C ),extension 66 may be passed into and received within or removed fromarticulation groove 60 with sufficient clearance. In such a manner,extension 66 may be freely inserted into or removed fromarticulation groove 60. Once inserted intoarticulation groove 60,extension 66 may be configured to slidingly move withingroove 66 as desired. That is,extension 66 may be appropriately dimensioned so as to move reciprocally, as desired, withinarticulation groove 60. In a second configuration,shaft 62, and therefore,extension 66, may be rotated approximately 90°. Accordingly, the thickness ET direction ofextension 66 may extend generally perpendicular to the groove height GH direction ofarticulation groove 60, while the height EH direction ofextension 66 extends generally parallel to the groove height GH direction ofarticulation groove 60. Height EH ofextension 66 may be larger than groove height GH. Accordingly, in the second configuration (FIG. 5B ),extension 66 may be prevented from being removed from (e.g., pulled out of)articulation groove 60 via interaction betweenextension 66 andarticulation groove 60.Shaft 62 may be rotated and/or axially translated relative toshaft 14 via any appropriate mechanism, as will be described in further detail below. - In addition, as shown in
FIG. 3 , a distal surface ofshaft 14 may be configured to complement a portion ofinterbody device 20. For example, the distal surface ofshaft 14 may include a curvature that corresponds to the curvature of a proximal end ofinterbody device 20. Additionally, a distal surface ofshaft 14 may include anextension 15 configured to cooperate with a proximal end ofinterbody device 20 so as to limit articulation and/or rotation ofinterbody device 20 relative toshaft 14 beyond a desired amount, as will be described in further detail below. Further, as shown inFIG. 3 , each of lockingshaft 56 andshaft 62 may extend through a common lumen. Accordingly, the lumen ofshaft 14 may be elongated and/or ovular so as to accommodate multiple shafts therethrough. However, in some arrangements,shaft 14 may define a plurality of lumens. According, each of lockingshaft 56 andshaft 62 may extend through a separate and distinct lumen ofshaft 14.Shaft 14 may also include any appropriate visualization, illumination, irrigation, aspiration, and other such lumens configured to deliver one or more tools, fluids, or other materials to a distal end ofshaft 14. Still further, in some arrangements, lockingshaft 56 may extend through a lumen of afirst delivery tool 10, whileshaft 62 may extend through a lumen of asecond delivery tool 10, different than the first tool. -
FIGS. 4 and 5A-5C illustrate theexemplary delivery tool 10 ofFIG. 1 coupled tointerbody device 20 in a locked and unlocked configuration, respectively. For example, in the locked configuration of lockingshaft 56, as shown inFIG. 4 , external threading 58 of lockingshaft 56 may be engaged with internal threading 52 of lock bore 50 such thatinterbody device 20 is securely coupled todelivery tool 10. That is, a distal end of locking shaft may be extended out ofshaft 14 and threadingly coupled to lockbore 50. Additionally, after insertion ofextension 66 intoarticulation groove 60,shaft 62 may be rotated towards the second configuration such thatextension 66 may be prevented from being removed from (e.g., pulled out of)articulation groove 60 via interaction betweenextension 66 andarticulation groove 60, as shown inFIG. 5B (in which lockingshaft 56 andshaft 14 have been omitted for clarity). In such a manner,extension 66 ofshaft 62 may be retained withinarticulation slot 60 to enable articulation ofinterbody device 20 relative toshaft 62 ofdelivery tool 10 during insertion and/or impaction between adjacent vertebrae. - Indeed, during insertion of
interbody device 20 between adjacent vertebrae,shaft 56 may be maintained in the locked configuration so as to enable a medical professional increased control and rigidity during delivery. Onceinterbody device 20 is at least partially inserted between adjacent vertebrae, lockingshaft 56 may be rotated so as to decouple and/or disengage external threading 58 of lockingshaft 56 from internal threading 52 of lock bore 50. Once disengaged, as shown inFIG. 5A-5C ,extension 66 may glide, slide, or otherwise move along articulation groove 60 (FIG. 5B ), thereby enabling articulation ofinterbody device 20 relative toshaft 14 ofdelivery tool 10. Indeed, upon impaction of leadingedge 30 with remaining disc material and/or bone graft positioned between the adjacent vertebrae,interbody device 20 may be naturally urged toward an articulated (e.g., bent) configuration. By virtue of coupling betweenextension 66 andinterbody device 20, articulation ofinterbody device 20 may occur in a controlled manner. That is,delivery tool 10 enables insertion of, and impaction by,interbody device 20 while maintaining dominance overinterbody device 20 along all surgical planes. Onceinterbody device 20 has been positioned at the appropriate location and/or articulated relative toshaft 62,shaft 62 may be rotated such thatextension 66 ofshaft 62 may be removed fromarticulation groove 60 as shown inFIG. 5C (in which lockingshaft 56 andshaft 14 have been omitted for clarity). To limit articulation ofinterbody device 20 relative toshaft 62,interbody device 20 may include arecess 25 configured to receiveextension 15 therein. That is,recess 25 may include a shape corresponding (e.g., similar) to the shape ofextension 15 such that, wheninterbody device 20 is articulated relative toshaft 62,extension 15 may be received withinrecess 25. For example,recess 25 may define a slot, trajectory, or guide to control the degree of articulation ofinterbody device 20 relative toshaft 62. That is, during articulation,extension 15 may ride alongrecess 25 to prevent overarticulation. Additionally, asrecess 25 andextension 15 are correspondingly shaped,recess 25 may preventextension 15 from rotating relative thereto. That is,recess 25 may maintain or otherwise keepinterbody device 20 within a desired plane during articulation, and inhibit or preventinterbody device 20 from rotating away from such a plane of articulation. - In an alternative arrangement, as shown in
FIGS. 15 and 16 ,shaft 62 may be releasably coupled toextension 66. In such an arrangements, as shown,extension 66 may include an enlarged ball, sphere, bearing, or other such member configured to be non-releasably (e.g., non-removably) received withinarticulation groove 60. Additionally,extension 66 may include anipple 67 extending therefrom and configured to cooperate withshaft 62. That is, in some arrangements,nipple 67 may be externally threaded (e.g., male) so as to selectively couple and uncouple from internally threaded (e.g., female)shaft 62. Alternatively, in some arrangements,nipple 67 may be internally threaded (e.g., female) so as to selectively couple and uncouple from an externally threaded (e.g., male)shaft 62. In either arrangement, onceinterbody device 20 has been positioned at the appropriate location and/or articulated relative toshaft 62,shaft 62 may be rotated so as to be decoupled fromnipple 67 as shown inFIGS. 15 and 16 . - As noted above, locking
shaft 56 may be rotated relative toshaft 14 via any appropriate mechanism. For example, as shown inFIG. 6A ,proximal portion 18 ofshaft 14 may define an enlarged actuation portion having therein a passageway, aperture, and/orother opening 70 therethrough. The enlarged portion may include any suitable configuration. For example, the enlarged portion may be substantially cylindrical. In other embodiments, the enlarged portion may include a substantially rectangular cross-sectional configuration. As shown,lock actuator 28 may be positioned withinopening 70.Lock actuator 28 may include a threadedknob 72 and acontinuous push assembly 74, including aspring 78 and aretainer 80. For example, threadedknob 72 may be rotatable about a longitudinal axis of lockingshaft 56 against a biasing force ofspring 78. Threadedknob 72 may include a substantially cylindrical configuration having an open distal end. The proximal end of threadedknob 72 may be substantially closed with the exception of an opening for lockingshaft 56 to pass through. Additionally, threadingknob 72 may include anopening 82 in a side wall of threadedknob 72.Opening 82 may be configured to receive, cooperate, and fixedly retain a radially outwardly directedprojection 84 or coupling feature extending from lockingshaft 56. For example, opening 82 may be configured (e.g., sized and/or shaped) so as to cooperate with (e.g., matingly receive therein)projection 84. As a result ofprojection 84 being received withopening 82, relative longitudinal motion between lockingshaft 56 and threadedknob 72 may be prevented or otherwise limited. In one arrangement, projection 44 may be a semi-hemispherical nub while opening 82 may include a tubular channel. In some embodiments,projection 84 on lockingshaft 56 may be replaced with an opening (not shown) for receiving a set screw therein. In such instances, theopening 82 and the opening on lockingshaft 56 may be aligned, and a set screw (or other similar fastener) may fixedly couple together threadedknob 72 and lockingshaft 56. As a result of the coupling between threadedknob 72 and lockingshaft 56 contemplated herein, rotation of threadedknob 72 may be configured to cause likewise rotation of lockingshaft 56 due to the interaction betweenopening 82 andprojection 84. -
Retainer 80 may include a substantially cylindrical configuration having an open proximal end. A distal end ofretainer 80 may be configured to engage (e.g., abut) a distal wall ofopening 70. In addition, the distal end ofretainer 80 may be substantially closed with the exception of an opening for lockingshaft 56 to pass through. Moreover, as shown inFIG. 6A , a distal end of spring 78 (or any other suitable biasing element known in the art) may be received withinretainer 80. Similarly, a proximal end ofspring 78 may be received within threadedknob 72. As a result ofretainer 80 engaging a distal wall of opening 70,spring 78 biases threaded knob 72 (and, consequently, lockingshaft 56 as a result of the connection described herein) in the proximal direction. - Rotation and distal urging (e.g., pushing) of threaded
knob 72 in a first direction may be configured to move lockingshaft 56 againstspring 78 and couple and/or engage external threading 58 of lockingshaft 56 with internal threading 52 of lock bore 50 ofinterbody device 20. Additionally, rotation of threadingknob 72 in a second direction, opposite the first direction, may be configured to decouple and/or disengage external threading 58 of lockingshaft 56 from internal threading 52 of lock bore 50 ofinterbody 20. Additionally,spring 78 andretainer 80 may be configured to maintain threadingknob 72 in position along opening 70. For example,spring 78 may be biased so as to spread apart (e.g., separate)retainer 80 and threadingknob 72. In such a manner, interaction between threadingknob 72,spring 78 andretainer 80 may maintain threadedknob 72 along a desired position along opening 70. - With continuing reference to
FIG. 6A ,shaft release 22 may include aknob 90 configured for axial displacement along and rotation about a longitudinal axis ofshaft 14.Shaft release 22 may be coupled toshaft 62 via aprojection 92. For example, an internal surface ofknob 90 may defineprojection 92 which may in turn, be received and/or mate with a feature (e.g., a hole, opening, or similar irregularity) onshaft 62. Accordingly, rotation and/or axial displacement ofknob 90 relative toshaft 14 may cause and/or result in likewise rotation and/or axial displacement ofshaft 62. As such, rotation and/or axial displacement ofknob 90 in a first direction may be configured so as to selectively couple and/or engagedistal end 64 ofshaft 62 witharticulation groove 60. Additionally, rotation and/or axial displacement ofknob 90 in a second direction, opposite the first direction, may be configured so as to decouple and/or disengagedistal end 64 ofshaft 62 from witharticulation groove 60. - For example, as shown in
FIGS. 6B and 6C ,shaft 62 may have a proximal end (not shown) fixedly retained or coupled within aproximal hub 94.Proximal hub 94, may define a passage orslot 96.Slot 96 may extend approximately 90° about a circumferential surface ofhub 94. Once assembled,hub 94 may be received within a lumen or other such opening ofknob 90 and projection 92 (FIG. 6A ) may be received withinslot 96 ofhub 94. Due to the interaction betweenprojection 92 andslot 96,shaft 62 may be limited to approximately 90° of rotation relative to handle 12 ofdelivery tool 10. Additionally, as shown, one or more portions, e.g.,knob 90 and handle 12, of delivery tool may includeindicia 98 or other such markings indicating a position or orientation ofshaft 62, and consequently,extension 66. For example, as shown in a first orientation,such indicia 98 may indicate thatshaft 62 is in the first configuration (FIG. 5C ), in whichextension 66 may be passed into and received within or freely removed fromarticulation groove 60 with sufficient clearance. In a second orientation,such indicia 98 may indicate thatshaft 62 is in the second configuration (FIG. 5B ), in whichextension 66 may be prevented from being removed from (e.g., pulled out of)articulation groove 60 via interaction betweenextension 66 andarticulation groove 60. -
FIGS. 6D and 6E , illustrate partial side views of the delivery tool in an unlocked configuration and a locked configuration, respectively. For example, as shown inFIG. 6D , whenindicia 98 are arranged so as to indicateshaft 62 is in the first configuration (e.g., unlocked),extension 66 ofshaft 62 may extend fromshaft 14 in a first rotational orientation. When, however,knob 90 is rotated such thatindicia 98 are arranged to indicateshaft 62 is in the second configuration (e.g., locked),extension 66 ofshaft 62 may extend fromshaft 14 in a second rotational orientation. -
FIGS. 7A-7C illustrate an exemplary method of deliveringinterbody device 20 between adjacent vertebrae of a patient's spinal column. For example, as discussed above, prior to insertion ofinterbody device 20, one or more portions of the vertebral bone may be removed so as to access a disc between adjacent vertebrae. That is, apassage 100 extending through one ormore vertebrae 102 may be formed, so as to enable insertion of aluminal member 104 therethrough.Luminal member 104 may be any appropriate member configured to introducedelivery tool 10 therethrough. For example,luminal member 104 may include one or more sheaths, tubes, and/or members configured for facilitating low profile delivery of adelivery tool 10. Further, as noted above, a medical professional may then partially remove the damaged and/or degenerated disc, leaving at least a portion of the disc intact to facilitate guiding an interbody device and retaining subsequently implanted bone graft therein. For example, as shown inFIG. 7A , the medical professional may form apassage 106 in adisc 108 so as to provide access todisc space 110 betweenadjacent vertebrae 102. Thereafter,delivery tool 10 may be extended throughpassages luminal member 104, and intodisc space 110. During insertion,interbody device 20 may be coupled toshaft 14 ofdelivery tool 10 in the locked configuration so as to provide the medical professional control overinterbody device 20. That is, external threading 58 of lockingshaft 56 may be engaged with internal threading 52 of lock bore 50 (FIG. 4 ) such thatinterbody device 20 is securely coupled todelivery tool 10. In some embodiments,space 32 of interbody device 120 may be filled with bone graft material prior to insertion of interbody device 120 intodisc space 110. - As shown in
FIG. 7B , during insertion ofinterbody device 20 intodisc space 110, leadingedge 30 may impact remaining disc material and/or bone graft positioned between theadjacent vertebrae 102. Upon impaction, further advancement ofinterbody device 20 by a medical professional may naturally urgeinterbody device 20 to pivot, rotate, and/or articulate. Accordingly, lockingshaft 56 may be rotated so as to decouple and/or disengage external threading 58 of lockingshaft 56 from internal threading 52 of lock bore 50. Once disengaged, as shown inFIG. 7B ,extension 66 may glide, slide, or otherwise move alongarticulation groove 60, thereby enabling articulation ofinterbody device 20 alongdisc 108, relative toshaft 14 ofdelivery tool 10, while allowing the medical professional to maintain control over interbody device 120. That is, by virtue of coupling betweenextension 66 andinterbody device 20, advancement and/or articulation ofinterbody device 20 may occur in a controlled manner along all surgical planes. Following proper positioning ofinterbody device 20 withindisc space 110,shaft 62, and therefore,extension 66, may be rotated approximately 90° such that the thickness ET direction ofextension 66 may extend generally parallel to the groove height GH direction ofarticulation groove 60. Accordingly,extension 66 may be removed from (e.g., pulled out of)articulation groove 60, thereby decoupling or disengaginginterbody device 20 fromdelivery tool 10, as shown inFIG. 7C . Following implantation, morselized bone (or any other ingrowth promoting material) may be added to remainingdisc space 110. In some instances, a medical professional may also place morselized bone along the sides of the spinal column to promote fusion. - As shown in
FIGS. 8 and 9 ,interbody device 20 may include aleading edge 30, as discussed above. Leadingedge 30 may be tapered at an angle α so as to enable smooth and controlled insertion ofinterbody device 20, with or without distraction, between adjacent vertebrae. Additionally, leadingedge 30 may be tapered at an angle relative to an anterior-most surface ofinterbody device 20. That is, leadingedge 30 may be angled relative to an axis Y extending substantially normal to the longitudinal axis X ofinterbody device 20. As noted above, in the arrangement ofFIGS. 8 and 9 , angle may be relatively large or aggressive thereby enabling insertion ofinterbody device 20 between adjacent vertebrae to enable greater control during insertion. Further, as discussed above, angle α may be relatively large or aggressive thereby enabling insertion ofinterbody device 20 between adjacent vertebrae without the need to distract the disc space. Additionally, as discussed above,interbody device 20 may define aspace 32 configured so as to retain bone graft material (not shown) therein.Interbody device 20 may include one or more anti-migration features 42 configured to maintaininterbody device 20 within a desired position within between adjacent vertebrae.Such features 42 may include any one or more of notches, bumps, tangs, grips, and/or protrusions extending frominterbody device 20.Features 42 may include any appropriate configuration, such as, for example, triangular, pyramidal, conical, and/or irregular shapes. Further, it is understood that any combination of geometric shapes and/or arrangement offeatures 42 may be disposed along any surface ofinterbody device 20. For example, as shown inFIG. 9 , features 42 may extend along top and bottom (e.g., vertebrae mating) surfaces ofinterbody device 20. - While principles of the present disclosure are described herein with reference to illustrative embodiments for particular applications, it should be understood that the disclosure is not limited thereto. Those having ordinary skill in the art and access to the teachings provided herein will recognize additional modifications, applications, embodiments, and substitution of equivalents all fall within the scope of the embodiments described herein. Accordingly, the disclosure is not to be considered as limited by the foregoing description.
Claims (20)
1. An intervertebral implant, comprising: a superior exterior surface; an inferior exterior surface; a first exterior lateral surface; a second exterior lateral surface, wherein the first and second exterior lateral surfaces are substantially transverse to the superior and inferior exterior surfaces; a first curved end wall at a first longitudinal extremity of the body, the first curved end wall including a bore configured to receive a first shaft of a tool; and a second curved end wall at a second longitudinal extremity of the body, wherein the implant further includes an elongated slot extending from a portion of the first curved end wall to a portion of the first exterior lateral surface.
2. The implant of claim 1 , wherein the first exterior lateral surface includes at least a central portion having a concavity.
3. The implant of claim 1 , wherein the second exterior lateral surface includes at least a central portion having a convexity.
4. The implant of claim 1 , wherein the elongated slot includes a T-shaped cross-sectional configuration such that an anterior-posterior dimension of the elongated slot is greater than an anterior-posterior dimension of an opening of the elongated slot.
5. The implant of claim 1 , wherein the body further includes a through hole in one or both of the first and second exterior lateral surfaces.
6. The implant of claim 1 , wherein the second curved end wall includes a leading edge angled relative to a longitudinal axis of the body.
7. The implant of claim 1 , wherein each of the superior exterior surface and the inferior exterior surface include a portion angled relative to the longitudinal axis of the body.
8. The implant of claim 1 , wherein the bore is internally threaded.
9. The implant of claim 1 , further comprising one or more protrusions extending from one or both of the superior exterior surface and the inferior exterior surface.
10. The implant of claim 1 , wherein the body includes a central through opening.
11. The implant of claim 1 , wherein the elongated slot is configured to receive and retain a second shaft of the tool.
12. A system for performing interbody fusion, the system comprising: an intervertebral implant including a body, the body comprising: a superior exterior surface; an inferior exterior surface; a first exterior lateral surface; a second exterior lateral surface, wherein the first exterior later surface and the second exterior lateral surface are substantially transverse to the superior and inferior exterior surfaces; a first curved end wall at a first longitudinal extremity of the body, the first curved end wall including a bore; a second curved end wall at a second longitudinal extremity of the body; and an articulation groove extending from a portion of the first curved end wall to a portion of the first exterior lateral surface; a locking shaft configured for selective coupling and uncoupling from the bore; and a shaft configured for selective insertion and retraction from the articulation groove.
13. The system of claim 12 , wherein the bore is internally threaded.
14. The system of claim 13 , wherein a distal end of the locking shaft is externally threaded.
15. The system of claim 12 , wherein the shaft includes a distal end having an enlarged extension.
16. The system of claim 15 , wherein the shaft is rotatable between a first configuration and a second configuration, wherein in the first configuration the extension is oriented such that the extension is configured for insertion within the articulation groove, and wherein, in the second configuration, the extension is oriented such that the extension is retained within the articulation groove.
17. The system of claim 15 , wherein the extension is configured to move within the articulation groove.
18. A method for delivering an interbody device, the method comprising: inserting a body into a prepared disc space between adjacent vertebrae of a patient, the body comprising: a superior exterior surface; an inferior exterior surface; a first exterior lateral surface; a second exterior lateral surface, wherein the first exterior later surface and the second exterior lateral surface are substantially transverse to the superior and inferior exterior surfaces; a first curved end wall at a first longitudinal extremity of the body, the first curved end wall including a bore; a second curved end wall at a second longitudinal extremity of the body; and an articulation groove extending from a portion of the first curved end wall to a portion of the first exterior lateral surface; uncoupling a locking shaft from the bore; and moving a shaft along the articulation groove so as to articulate the body relative to the shaft.
19. The method of claim 18 , further including: rotating the shaft relative to the body; and removing the shaft from the articulation groove of the body.
20. The method of claim 18 , wherein uncoupling the locking shaft from the bore includes rotating the locking shaft.
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US17/011,463 US20200397594A1 (en) | 2015-12-18 | 2020-09-03 | Articulating intervertebral devices, related tools, systems, and methods |
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US17/011,463 US20200397594A1 (en) | 2015-12-18 | 2020-09-03 | Articulating intervertebral devices, related tools, systems, and methods |
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EP1814474B1 (en) | 2004-11-24 | 2011-09-14 | Samy Abdou | Devices for inter-vertebral orthopedic device placement |
US8764806B2 (en) | 2009-12-07 | 2014-07-01 | Samy Abdou | Devices and methods for minimally invasive spinal stabilization and instrumentation |
US8845728B1 (en) | 2011-09-23 | 2014-09-30 | Samy Abdou | Spinal fixation devices and methods of use |
US20130226240A1 (en) | 2012-02-22 | 2013-08-29 | Samy Abdou | Spinous process fixation devices and methods of use |
US9198767B2 (en) | 2012-08-28 | 2015-12-01 | Samy Abdou | Devices and methods for spinal stabilization and instrumentation |
US9320617B2 (en) | 2012-10-22 | 2016-04-26 | Cogent Spine, LLC | Devices and methods for spinal stabilization and instrumentation |
US10857003B1 (en) | 2015-10-14 | 2020-12-08 | Samy Abdou | Devices and methods for vertebral stabilization |
US9895235B2 (en) * | 2015-12-18 | 2018-02-20 | Warsaw Orthopedic, Inc. | Spinal implant system and method |
US10973648B1 (en) | 2016-10-25 | 2021-04-13 | Samy Abdou | Devices and methods for vertebral bone realignment |
US10744000B1 (en) | 2016-10-25 | 2020-08-18 | Samy Abdou | Devices and methods for vertebral bone realignment |
US11179248B2 (en) | 2018-10-02 | 2021-11-23 | Samy Abdou | Devices and methods for spinal implantation |
US11369491B2 (en) | 2018-12-07 | 2022-06-28 | Globus Medical, Inc. | Trial inserter and trial head |
US11039931B2 (en) * | 2019-02-01 | 2021-06-22 | Globus Medical, Inc. | Intervertebral spinal implant |
EP3795120B1 (en) * | 2019-09-18 | 2023-11-01 | Biedermann Technologies GmbH & Co. KG | Intervertebral implant and insertion device therefor |
US11951021B2 (en) * | 2021-11-30 | 2024-04-09 | DePuy Synthes Products, Inc. | Surgical implant position detection |
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FR2897259B1 (en) * | 2006-02-15 | 2008-05-09 | Ldr Medical Soc Par Actions Si | INTERSOMATIC TRANSFORAMINAL CAGE WITH INTERBREBAL FUSION GRAFT AND CAGE IMPLANTATION INSTRUMENT |
FR2799639B1 (en) * | 1999-10-18 | 2002-07-19 | Dimso Sa | TOOTHED FACED INTERVERTEBRAL DISC PROSTHESIS |
US20060229627A1 (en) * | 2004-10-29 | 2006-10-12 | Hunt Margaret M | Variable angle spinal surgery instrument |
US7811292B2 (en) * | 2004-03-02 | 2010-10-12 | Aesculap Implant Systems, Inc. | Surgical instrument for implants |
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US20080027544A1 (en) * | 2006-07-28 | 2008-01-31 | Warsaw Orthopedic Inc. | Instruments and techniques for engaging spinal implants for insertion into a spinal space |
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EP3135254B1 (en) * | 2015-08-26 | 2019-01-02 | Biedermann Technologies GmbH & Co. KG | Intervertebral implant and device for inserting an intervertebral implant |
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