Method and inserter for interbody fusion

Patent metadata

Field	Value
Publication number	US-9039767-B2
Application number	US-201414466214-A
Country	US
Kind code	B2
Filing date	Aug 22, 2014
Priority date	Mar 13, 2013
Publication date	May 26, 2015
Grant date	May 26, 2015

Abstract

An elongate inserter has a distal end releasably connected to an expandable interbody fusion device and a proximal end including a trigger actuator. The interbody fusion device comprises a superior endplate and an inferior endplate that are movable in an expansion direction relative to each other in the intradiscal space. The inserter includes a lifting platform and an elevator that define cooperatively engaging ramps and ramps surfaces that upon operation of the trigger actuator cause the superior and inferior endplates to move relatively away from each other. A driver is supported by the inserter for pushing an insert into the expanded device between the superior and inferior endplates.

First claim

What is claimed is:

1. A method of providing interbody fusion between two opposing vertebral bodies of the spine with an expandable spinal interbody fusion device, said device including an inferior endplate having an outer surface configured to contact a vertebral body of the spine, a superior endplate having an outer surface configured to contact an opposing vertebral body of said spine, said inferior endplate and said superior endplate being movable relative to each other in a direction of expansion, comprising the steps of:
inserting said device by an inserter into the intradiscal space between said two opposing vertebral bodies during surgery, said inserter including a distal end releasably attached to said device and a proximal end including an actuator;
initially operating said actuator to cause said inferior endplate and said superior endplate to move apart relative to, and to separate from, each other in a direction of expansion to expand said device;
inserting a first insert movably supported by said inserter into said device after expansion of said device between said inferior endplate and said superior endplate without assisting in the separation of the inferior and superior endplates during insertion of said first insert; and then
further operating said actuator to cause said superior endplate and said first insert to move together and apart jointly relative to, and to separate from, said inferior endplate to further expand said device independently of the insertion of an insert, and after said further expansion sequentially inserting a second insert movably supported by said inserter directly below and in contact with said first insert without assisting in the further separation of the inferior and superior endplates during insertion of said second insert.

2. The method of claim 1 , wherein said first insert and said second insert are supported linearly by said inserter immediately adjacent each other, and wherein after said device is expanded in the initial operating step said first insert is inserted directly below and in contact with said superior endplate.

3. The method of claim 1 , further including the step of determining whether said expanded device is capable of receiving a further insert prior to insertion of said further insert between said inferior endplate and said superior endplate.

4. The method of claim 3 , wherein said determining step is effected by tactile feedback through said actuator.

5. The method of claim 1 , wherein said actuator comprises a trigger actuator including a handle and a linkage mechanism, and wherein the expansion of said device is effected in an operational stroke of said trigger actuator.

6. The method of claim 5 , wherein said insertion of said at least one insert into said expanded device is effected in an operational stroke of said trigger actuator.

7. The method of claim 6 , wherein the expansion of said device and the insertion of said at least one insert into said expanded device is effected in a single operational stroke of said trigger actuator.

8. A method of providing interbody fusion between two opposing vertebral bodies of the spine with an expandable spinal interbody fusion device, said device including an inferior endplate having an outer surface configured to contact a vertebral body of the spine, a superior endplate having an outer surface configured to contact an opposing vertebral body of said spine, said inferior endplate and said superior endplate being movable relative to each other in a direction of expansion, comprising the steps of:
inserting said device by an inserter into the intradiscal space between said two opposing vertebral bodies during surgery, said inserter including a distal end releasably attached to said device, a proximal end including an actuator and an elongate track between said distal end and said proximal end supporting a plurality of inserts for individual insertion into said device, each insert having substantially the same thickness in the direction of expansion;
operating said actuator to cause the inferior endplate and the superior endplate to move apart relative to each other, and to separate from, in the direction of expansion independently of the insertion of an insert to expand said device and create a first incremental space in the expanded device below and in communication with said superior endplate of dimension greater than the thickness of an insert, and then
further operating said actuator to insert a first insert from said elongate track into said first incremental space without assisting in the separation of the inferior and superior endplates during insertion of said first insert.

9. The method of claim 8 , further including the step of operating said actuator to cause said superior endplate and said first insert to jointly move apart relative to, and to separate from, said inferior endplate in the direction of expansion independently of the insertion of an insert to further expand said device and create a second incremental space in the expanded device below and in communication with said first insert of dimension greater than the thickness of an insert, and then further operating said actuator to insert a second insert from said elongate track into second incremental space without assisting in the further separation of the inferior and superior endplates during insertion of said second insert.

10. The method of claim 9 , further including the step of determining whether said expanded device is capable of receiving a third insert prior to insertion of said third insert into said device.

11. The method of claim 10 , wherein said determining step is effected by tactile feedback through said actuator.

12. A method of providing interbody fusion between two opposing vertebral bodies of the spine with an expandable spinal interbody fusion device, said device including an inferior endplate having an outer surface configured to contact a vertebral body of the spine, and a superior endplate having an outer surface configured to contact an opposing vertebral body of said spine, said inferior endplate and said superior endplate being movable relative to each other in a direction of expansion, comprising the steps of:
inserting said device by an inserter into the intradiscal space between said two opposing vertebral bodies during surgery, said inserter including a distal end releasably attached to said device and a proximal end including a trigger actuator, said trigger actuator including an operable handle;
expanding said device by operation of said handle to move said inferior endplate apart from said superior endplate, so as to separate, in the direction of expansion allowing a space to be created between said inferior endplate and said superior endplate after expansion; and
inserting an insert into said space by said inserter without assisting in the separation of the inferior and superior endplates during insertion of said insert, wherein the expansion of said device and the insertion of said insert into said expanded device is effected in a single operational stroke of said handle.

13. An inserter for expanding an expandable spinal interbody fusion device and inserting an insert therewithin, comprising:
a barrel including an elongate track linearly supporting a plurality of inserts for sequential insertion into said device one below the other;
an elongate lifting platform supported by said track and movable relative to said barrel for expanding said device;
an elongate driver movably coupled to said lifting platform for inserting an insert from said plurality of inserts into said device one at a time; and
an actuator supported by said barrel and operably

Assignees

• Spine Wave Inc

Inventors

• Raymond Spanky Allen
• Mclean Scott
• Cullinan Nicola

Classifications

• A61F2/4611 Primary

  of spinal prostheses · CPC title

• A61F2/442 Primary

  Intervertebral or spinal discs, e.g. resilient (non-disc-shaped intervertebral inflatable pockets A61F2/441; non-disc-shaped intervertebral fusion implants A61F2/4455) · CPC title

• A61F2/447

  substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section · CPC title

• A61F2002/30556

  for adjusting thickness · CPC title

• A61F2/4455

  for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages (intervertebral discs A61F2/442) · CPC title