Polyaxial articulating instrument

Patent metadata

Field	Value
Publication number	US-10022245-B2
Application number	US-201313744789-A
Country	US
Kind code	B2
Filing date	Jan 18, 2013
Priority date	Dec 17, 2012
Publication date	Jul 17, 2018
Grant date	Jul 17, 2018

Abstract

A polyaxial instrument suitable for preparing the intervertebral disc space of a patient through an anterior, posterior, transforaminal or anterolateral approach. The trial can be partially inserted into a disc space and then its angle adjusted to ease its further insertion into the disc space. The trial work tip can be interchangeable with the working tip of another type of instrument such as a curette, a rasp, a spreader, a shaver, a cobb elevator, a penfield, a woodson, a chisel and an osteotome.

First claim

We claim:

1. A method of preparing an intervertebral disc space or vertebral body in a spinal column in a patient, comprising the steps of:
a) inserting a polyaxial instrument into the intervertebral disc space or the vertebral body via an approach selected from the group consisting of an anterior approach, a posterior approach, a transforaminal approach and an anterolateral approach to the spinal column, wherein the instrument comprises a distal head and a proximal shaft connected by a polyaxial joint, whereby the polyaxial joint allows the distal head to polyaxially pivot about the proximal shaft, and wherein the distal head is a trial adapted to assess implant fit in the disc space,
b) determining an angle set by the head and shaft in the disc space via a graphic display of trial orientation on the instrument, wherein the graphical display reports the angle as a polyaxial insertion angle of the head relative to the shaft,
c) removing the distal head of the instrument from the disc space
d) fixing the angle to an apparatus comprising an implant attached to an inserter, and
e) inserting the implant into the disc space via the approach, wherein the implant-inserter apparatus is fixed at the angle.

2. The method of claim 1 wherein the distal head comprises a distal working tip and a proximal generally hemispherical portion, the proximal shaft comprises a distal socket, and wherein the polyaxial joint comprises the generally hemispherical portion received in the socket.

3. The method of claim 2 wherein the socket has a collet that is compressed upon retraction into a sheath and thereby grips the generally hemispherical portion to lock an orientation of the instrument.

4. The method of claim 2 further comprising, after step b), the step of:
f) loosening the joint and adjusting the shaft to a second angle.

5. The method of claim 4 wherein the step of loosening the joint includes turning a knob on the shaft.

6. The method of claim 5 further comprising the step of:
g) leaving the joint loose while impacting on the shaft, thereby allowing the distal head to freely turn as it enters the disc space.

7. The method of claim 4 further comprising the step of:
g) locking the loosened joint at the second angle, and then impacting on the shaft without allowing any additional rotation.

8. The method of claim 4 wherein the adjustment is accomplished manually.

9. The method of claim 4 wherein the adjustment is accomplished remotely.

10. A method of preparing an intervertebral disc space or a vertebral body in a spinal column in a patient, comprising the steps of:
selecting an articulating instrument comprising a distal head and a proximal shaft connected by an articulating joint, whereby the articulating joint is adapted to allow the distal head to polyaxially pivot about the proximal shaft, and wherein the distal head is a trial adapted to assess implant fit in the disc space,
partially inserting the articulating instrument into the intervertebral disc space or vertebral body, wherein the articulating joint is held locked at an angle of the head relative to the shaft,
loosening the joint,
determining an angle set by the head and shaft in the disc space via a graphic display of trial orientation on the instrument, wherein the graphical display reports the angle as a polyaxial insertion angle of the head relative to the shaft,
adjusting the shaft of the instrument to a different angle,
locking the shaft at the different angle, and then
impacting on the shaft without allowing any additional rotation, and
removing the distal head of the instrument from the disc space.

11. The method of claim 10 further comprising the step of:
once the instrument is fully inserted, loosening the joint.

12. The method of claim 11 , wherein a handle is connected to a proximal end of the shaft, further comprising the steps of:
removing the handle, and
rotating the shaft.

13. The method of claim 11 further comprising the step of:
reconnecting the handle.

14. The method of claim 13 further comprising the step of:
removing the distal head from the disc space with the joint loosened.

15. The method of claim 10 wherein the articulating instrument has a polyaxial joint.

16. The method of claim 15 wherein the polyaxial joint is locked into place through the use of either i) an outer sleeve surrounding the hemispherical portion, wherein the outer sleeve tightens down on the joint or ii) an inner push shaft located within the sleeve that tightens down on the joint.

17. The method of claim 15 wherein the shaft is adjusted to a different angle manually or remotely.

18. The method of claim 10 wherein the instrument is partially inserted via an approach selected from the group consisting of an anterior approach, a posterior approach, a transforaminal approach and an anterolateral approach.

19. The method of claim 10 further comprising the steps of:
fixing the different angle to an apparatus comprising an implant attached to an inserter having a shaft, and
inserting the implant into the disc space via the approach, wherein the implant-inserter apparatus is fixed at the angle.

20. A method of preparing an intervertebral disc space in a patient, comprising the steps of:
selecting an articulating instrument comprising a distal head and a proximal shaft connected by an articulating joint, whereby the articulating joint is adapted to allow the distal head to polyaxially pivot about the proximal shaft, and wherein the distal head is a trial adapted to assess implant fit in the disc space,
partially inserting the polyaxial instrument into the intervertebral disc space,
wherein the articulating joint is held locked at a first angle, the proximal shaft having a proximal end connected to a handle,
loosening the joint,
adjusting the shaft of the instrument to a second angle,
leaving the joint loose while impacting the shaft, thereby allowing the distal head to freely turn as it enters the disc space,
determining an angle set by the head and shaft in the disc space via a graphic display of trial orientation on the instrument, wherein the graphical display reports the angle as a polyaxial insertion angle of the head relative to the shaft,
and
removing the distal head of the instrument from the disc space.

21. The method of claim 20 further comprising the step of:
removing the handle after loosening the joint.

22. The method of claim 21 further comprising the step of:
adjusting the shaft to a third angle.

23. The method of claim 21 further comprising the step of:
reconnecting the handle.

24. The method of claim 20 wherein the joint is a polyaxial joint.

25. The method of claim 24 wherein the polyaxial joint is locked into place through the use of either i) an outer sleeve surrounding the hemisphere that tightens down on the joint or ii) an inner pushshaft located in the sleeve that tightens down on the joint.

26. The method of claim 24 wherein the shaft is adjusted to a second angle manually or remotely.

27. The method of claim 20 wherein the instrument is partially inserted via an approach selected from the group consisting of an anterior approach, a posterior approach, a transforaminal approach and an anterolateral approach.

28. The method of claim 20 further comprising the steps of:
fixing the angle to an apparatus comprising an implant att

Assignees

• Depuy Synthes Products Inc

Inventors

• Frasier William
• O'Neil Michael J
• Serhan Hassan
• Defossez Henri
• Chandanson Thibault

Classifications

• A61F2002/30593

  hollow · CPC title

• A61F2002/3054

  about a connection axis or implantation axis for selecting any one of a plurality of radial orientations between two modular parts, e.g. Morse taper connections, at discrete positions, angular positions or continuous positions · CPC title

• A61F2/4465

  having a circular or kidney shaped cross-section substantially perpendicular to the axis of the spine · CPC title

• A61F2/4611 Primary

  of spinal prostheses · CPC title

• A61F2002/30777

  Oblong apertures · CPC title