US20040117020A1
Expired / Lapsed
US
⏱️ 0.0 years remaining
Devices and techniques for a posterior lateral disc space approach
Assignee: Individual
•
Filing: 2003-11-25
•
Granted: —
•
Expires: 2023-11-25
Abstract
Abstract This invention relates to methods and instruments for performing disc space preparation and implant insertion from a unilateral approach to the spine through a posterior lateral opening to the disc space. The instruments include spreaders, distractors, reamers, scrapers, cutters, chisels, pushers and implant inserters. A surgical procedure is provided that allows bilateral support of the adjacent vertebrae with at least one interbody fusion device inserted into the disc space via a unilateral approach. Implants for insertion into the disc space are also provided.
Inventors
- 👤 George Frey
- 👤 Mingyan Liu
- 👤 Loic Josse
- 👤 Lawrence Boyd
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-23 03:31
CPC Classifications
A; A61; A61F; A61F2/00; A61F2/02; A61F2/30; A61F2/46; A61F2/4603; A61F2/4611; A61B; A61B17/00; A61B17/02; A61B17/025; A61B17/16; A61B17/1604; A61B17/1642; A61B17/1659; A61B17/1662; A61B17/1671; A61F2/44; A61F2/4455; A61F2/4465; A61B17/0206; A61B17/1613; A61B17/1631; A61B2017/0256; A61F2/442; A61F2/28; A61F2002/2835; A61F2002/30001; A61F2002/30003; A61F2002/3006; A61F2002/3008; A61F2002/30108; A61F2002/3011; A61F2002/30112; A61F2002/30113; A61F2002/30115; A61F2002/30133; A61F2002/30199; A61F2002/30224; A61F2002/30235; A61F2002/30316; A61F2002/30329; A61F2002/30535; A61F2002/30593; A61F2/30767; A61F2/30771; A61F2002/30772; A61F2002/30774; A61F2002/30777; A61F2002/30784; A61F2002/30785; A61F2002/30787; A61F2002/30789; A61F2002/3082; A61F2002/30827; A61F2002/30828; A61F2/30907; A61F2002/30909; A61F2002/30912; A61F2002/448; A61F2002/4625; A61F2002/4627; A61F2002/4635; A61F2220/00; A61F2220/0025; A61F2230/00; A61F2230/0002; A61F2230/0004; A61F2230/0006; A61F2230/0015; A61F2230/0063; A61F2230/0069; A61F2250/00; A61F2250/0058; A61F2250/0096; A61F2250/0098; A61F2310/00; A61F2310/00005; A61F2310/00011; A61F2310/00017; A61F2310/00023
Claims Analysis
Total Claims: 57
Claim 1
Independent Claim
75 words
1 . A spinal implant adapted for non-linear insertion in an intradiscal space, comprising: a leading end wall; a trailing end wall having an insertion tool engaging portion; a posterior wall extending between said leading end wall and said trailing end wall; and an anterior wall extending between said leading end wall and said trailing end wall, wherein said posterior wall has a height that is less than the height of said anterior end wall.
Claim 2
Dependent Claim
75 words
1 . A spinal implant adapted for non-linear insertion in an intradiscal space, comprising: a leading end wall; a trailing end wall having an insertion tool engaging portion; a posterior wall extending between said leading end wall and said trailing end wall; and an anterior wall extending between said leading end wall and said trailing end wall, wherein said posterior wall has a height that is less than the height of said anterior end wall.
Claim 3
Dependent Claim
37 words
2 . The implant of claim 1 , wherein said trailing end wall and said leading end wall each have a height that is less than the height of both said anterior wall and said posterior wall.
Claim 4
Dependent Claim
20 words
3 . The implant of claim 1 , wherein said posterior wall is concave and said anterior wall is convex.
Claim 5
Dependent Claim
22 words
4 . The implant of claim 1 , wherein said leading end wall and said trailing end wall have the same height.
Claim 6
Dependent Claim
60 words
5 . The implant of claim 1 , further comprising: an upper bearing member extending between and connected to said leading end wall, said anterior wall, said posterior wall and said trailing end wall; and an opposite lower bearing member extending between and connected to said leading end wall, said anterior wall, said posterior wall and said trailing end wall.
Claim 7
Dependent Claim
19 words
6 . The implant of claim 1 , wherein said leading end wall includes an insertion tool engaging portion.
Claim 8
Dependent Claim
25 words
7 . The implant of claim 1 , wherein said insertion tool engaging portion is an internally threaded holed formed through said trailing end wall.
Claim 9
Dependent Claim
112 words
8 . A spinal implant, comprising: a leading end wall; a trailing end wall; a posterior wall extending between said leading end wall and said trailing end wall; an anterior wall extending between said leading end wall and said trailing end wall; an upper bearing member extending between and connected to said leading end wall, said anterior wall, said posterior wall and said trailing end wall; and an opposite lower bearing member extending between and connected to said leading end wall, said anterior wall, said posterior wall and said trailing end wall, wherein said upper bearing member and said lower bearing member each include a cantilevered portion extending beyond said anterior wall.
Claim 10
Dependent Claim
112 words
8 . A spinal implant, comprising: a leading end wall; a trailing end wall; a posterior wall extending between said leading end wall and said trailing end wall; an anterior wall extending between said leading end wall and said trailing end wall; an upper bearing member extending between and connected to said leading end wall, said anterior wall, said posterior wall and said trailing end wall; and an opposite lower bearing member extending between and connected to said leading end wall, said anterior wall, said posterior wall and said trailing end wall, wherein said upper bearing member and said lower bearing member each include a cantilevered portion extending beyond said anterior wall.
Claim 11
Dependent Claim
33 words
9 . The implant of claim 8 , wherein anterior wall includes a first anterior lateral opening adjacent said leading end wall and a second anterior lateral opening adjacent said trailing end wall.
Claim 12
Dependent Claim
79 words
10 . The implant of claim 9 , wherein: said first anterior lateral opening is defined between a first vertical strut, said leading end wall and said upper and lower bearing members; said second anterior lateral opening is defined between a second vertical strut, said trailing end wall and said upper and lower bearing members; and said anterior wall further including a middle opening defined between said first strut, said second strut, and said upper and lower bearing members.
Claim 13
Dependent Claim
37 words
11 . The implant of claim 10 , further comprising an offset strut adjacent said middle opening and offset towards said posterior wall, said offset strut extending between said upper bearing member and said lower bearing member.
Claim 14
Dependent Claim
38 words
12 . The implant of claim 8 , wherein said anterior wall has a height that is greater than a height of said posterior wall, and said trailing end wall is adapted for coupling to an insertion tool.
Claim 15
Dependent Claim
50 words
13 . The implant of claim 8 , wherein: said upper bearing member includes an upper strut and a pair of openings on either side of said upper strut; and said lower bearing member includes a lower strut and a pair of openings on either side of said lower strut.
Claim 16
Dependent Claim
42 words
14 . The implant of claim 8 , wherein: said upper bearing member includes a number of grooves formed in an upper bearing surface thereof; and said lower bearing member includes a number of grooves formed in a lower bearing surface thereof.
Claim 17
Dependent Claim
162 words
15 . A spinal implant adapted for non-linear insertion in an intradiscal space, comprising: a leading end wall; a trailing end wall including an engaging tool engaging portion; a posterior wall extending between said leading end wall and said trailing end wall; an anterior wall extending between said leading end wall and said trailing end wall; an upper bearing member extending between said leading end wall, said anterior wall, said posterior wall and said trailing end wall; and an opposite lower bearing member extending between said leading end wall, said anterior wall, said posterior wall and said trailing end wall, wherein the implant has a center axis extending generally in the direction between said leading end wall and said trailing end wall, said posterior wall and said anterior wall being positioned on opposite sides of said center axis, whereby said leading end wall and said trailing end wall are each offset from said center axis in the direction of said posterior wall.
Claim 18
Dependent Claim
162 words
15 . A spinal implant adapted for non-linear insertion in an intradiscal space, comprising: a leading end wall; a trailing end wall including an engaging tool engaging portion; a posterior wall extending between said leading end wall and said trailing end wall; an anterior wall extending between said leading end wall and said trailing end wall; an upper bearing member extending between said leading end wall, said anterior wall, said posterior wall and said trailing end wall; and an opposite lower bearing member extending between said leading end wall, said anterior wall, said posterior wall and said trailing end wall, wherein the implant has a center axis extending generally in the direction between said leading end wall and said trailing end wall, said posterior wall and said anterior wall being positioned on opposite sides of said center axis, whereby said leading end wall and said trailing end wall are each offset from said center axis in the direction of said posterior wall.
Claim 19
Dependent Claim
27 words
16 . The implant of claim 15 , wherein said upper bearing member and said lower bearing member each include a cantilevered portion along said anterior wall.
Claim 20
Dependent Claim
37 words
17 . The implant of claim 15 , wherein said trailing end wall and said leading end wall each have a height that is less than the height of both said anterior wall and said posterior wall.
Claim 21
Dependent Claim
20 words
18 . The implant of claim 15 , wherein said posterior wall is concave and said anterior wall is convex.
Claim 22
Dependent Claim
22 words
19 . The implant of claim 15 , wherein said leading end wall and said trailing end wall have the same height.
Claim 23
Dependent Claim
81 words
20 . An assembly for non-linear insertion of a spinal implant in an intradiscal space, comprising: an implant having an insertion tool engaging portion; an inserter connectable to said implant, said inserter including: an elongated shaft having an impaction tool engaging portion; a handle at the proximal end of said shaft; an implant connector at the distal end of said shaft engageable to said insertion tool engaging portion of said implant; and a pusher engageable to said impaction tool engaging portion.
Claim 24
Dependent Claim
81 words
20 . An assembly for non-linear insertion of a spinal implant in an intradiscal space, comprising: an implant having an insertion tool engaging portion; an inserter connectable to said implant, said inserter including: an elongated shaft having an impaction tool engaging portion; a handle at the proximal end of said shaft; an implant connector at the distal end of said shaft engageable to said insertion tool engaging portion of said implant; and a pusher engageable to said impaction tool engaging portion.
Claim 25
Dependent Claim
26 words
21 . The assembly of claim 20 , wherein said shaft of said inserter has a lateral offset portion adjacent the distal end of said shaft.
Claim 26
Dependent Claim
24 words
22 . The assembly of claim 20 , wherein said shaft of said inserter has a bend adjacent the distal end of said shaft.
Claim 27
Dependent Claim
41 words
23 . The assembly of claim 22 , wherein said shaft of said inserter is hollow, said inserter further including a flexible inner shaft extending through said shaft, said implant connector being coupled to a distal end of said inner shaft.
Claim 28
Dependent Claim
31 words
24 . The assembly of claim 20 , wherein impaction tool engaging portion is a notch formed around said shaft and said pusher includes a U-shaped prong positionable in said notch.
Claim 29
Dependent Claim
34 words
25 . The assembly of claim 20 , wherein said impaction tool engaging portion is a bore formed in said shaft and said pusher includes a reduced diameter distal tip positionable in said bore.
Claim 30
Dependent Claim
24 words
26 . The assembly of claim 20 , wherein said implant defines a boomerang shape in a plane generally parallel to the vertebral endplates.
Claim 31
Dependent Claim
107 words
27 . A lamina spreader, comprising: a first arm including a distal portion with a lamina engaging portion for engaging an upper lamina; and a second arm including a distal portion with a lamina engaging portion for engaging a lower lamina, said second arm being pivotally connected to said first arm, said first and second arms extending generally along a first axis when in a first spreading position, wherein said first arm and said second arm are each hinged whereby a proximal portion of each arm can be rotated with respect to said distal portion of said arm to a second position transverse to said first axis.
Claim 32
Dependent Claim
107 words
27 . A lamina spreader, comprising: a first arm including a distal portion with a lamina engaging portion for engaging an upper lamina; and a second arm including a distal portion with a lamina engaging portion for engaging a lower lamina, said second arm being pivotally connected to said first arm, said first and second arms extending generally along a first axis when in a first spreading position, wherein said first arm and said second arm are each hinged whereby a proximal portion of each arm can be rotated with respect to said distal portion of said arm to a second position transverse to said first axis.
Claim 33
Dependent Claim
18 words
28 . The lamina spreader of claim 27 , wherein said lamina engaging portions each have a U-shape.
Claim 34
Dependent Claim
23 words
29 . The lamina spreader of claim 27 , further comprising a spreading mechanism extending between said first arm and said second arm.
Claim 35
Dependent Claim
46 words
30 . The lamina spreader of claim 27 , wherein each of said first and second arms includes a manually releasable locking mechanism, said locking mechanism locking said arm in said first position and releasable to allow said arm to be rotated to said second position.
Claim 36
Dependent Claim
28 words
31 . The lamina spreader of claim 30 , wherein said locking mechanism includes a spring biased finger releasably positioned in a notch formed in said distal portion.
Claim 37
Dependent Claim
68 words
32 . A surgical instrument for performing a surgical procedure through a posterior lateral opening in the disc space, comprising: a proximal portion residing outside the disc space, said proximal portion extending along an axis; and a distal portion having a distal working end insertable in the disc space, said distal portion having a lateral offset portion, whereby said distal working end is laterally offset from said axis.
Claim 38
Dependent Claim
68 words
32 . A surgical instrument for performing a surgical procedure through a posterior lateral opening in the disc space, comprising: a proximal portion residing outside the disc space, said proximal portion extending along an axis; and a distal portion having a distal working end insertable in the disc space, said distal portion having a lateral offset portion, whereby said distal working end is laterally offset from said axis.
Claim 39
Dependent Claim
17 words
33 . The instrument of claim 32 , wherein the surgical instrument is a disc space spreader.
Claim 40
Dependent Claim
46 words
34 . The instrument of claim 33 , wherein said distal working end includes a pair of spreading portions and said proximal portion includes a pair of branches pivotally connected to one another, each of said branches connected with a corresponding one of said spreading portions.
Claim 41
Dependent Claim
20 words
35 . The instrument of claim 34 , further comprising a spreading mechanism extending between and connected to said branches.
Claim 42
Dependent Claim
25 words
36 . The instrument of claim 32 , wherein the surgical instrument is an implant inserter and said distal working end is an implant connector.
Claim 43
Dependent Claim
46 words
37 . The instrument of claim 32 , wherein said distal working end includes a pair of guide members and said proximal portion includes a pair of branches pivotally connected to one another, each of said branches connected with a corresponding one of said guide members.
Claim 44
Dependent Claim
36 words
38 . The instrument of claim 32 , wherein said lateral offset portion includes a bend and a straight portion connected to said distal working end, wherein said straight portion extends generally parallel with said axis.
Claim 45
Dependent Claim
110 words
39 . A method for inserting an implant in a spinal disc space, comprising: providing a posterior lateral opening into the disc space; selecting an implant for insertion into the disc space; securing a trailing end of an implant to an implant inserter; positioning a leading end of the implant at the opening; engaging a pusher to the implant inserter; applying an impaction force to the implant with the pusher to push the implant through the opening and into the disc space; and applying a pivoting force to the implant with the implant inserter to move the leading end of the implant towards a distal portion of the disc space.
Claim 46
Dependent Claim
110 words
39 . A method for inserting an implant in a spinal disc space, comprising: providing a posterior lateral opening into the disc space; selecting an implant for insertion into the disc space; securing a trailing end of an implant to an implant inserter; positioning a leading end of the implant at the opening; engaging a pusher to the implant inserter; applying an impaction force to the implant with the pusher to push the implant through the opening and into the disc space; and applying a pivoting force to the implant with the implant inserter to move the leading end of the implant towards a distal portion of the disc space.
Claim 47
Dependent Claim
21 words
40 . The method of claim 39 , further comprising alternating between applying an impaction force and applying a pivoting force.
Claim 48
Dependent Claim
29 words
41 . The method of claim 39 , further comprising removing disc material from the disc space prior to positioning the leading end of the implant at the opening.
Claim 49
Dependent Claim
30 words
42 . The method of claim 39 , further comprising forming a square entrance port at the opening prior to positioning the leading end of the implant at the opening.
Claim 50
Dependent Claim
45 words
43 . The method of claim 39 , further comprising: positioning the implant at a distal portion of the disc space; and inserting a second implant into the disc space through the opening after positioning the implant at the distal portion of the disc space.
Claim 51
Dependent Claim
23 words
44 . The method of claim 39 , further comprising: inserting an implant template into the disc space prior to selecting the implant.
Claim 52
Dependent Claim
31 words
45 . The method of claim 39 , further comprising inserting an implant insertion guide into the disc space prior to positioning the leading end of the implant at the opening.
Claim 53
Dependent Claim
73 words
46 . A method for preparing a disc space for insertion of an implant between adjacent vertebrae, comprising: accessing the disc space; engaging a lamina spreader to the adjacent vertebrae; spreading the lamina of the adjacent vertebra with the lamina spreader; forming an opening into the disc space; inserting a disc space spreader into the disc space; and spreading the adjacent vertebra until the endplates of the vertebrae are parallel with one another.
Claim 54
Dependent Claim
73 words
46 . A method for preparing a disc space for insertion of an implant between adjacent vertebrae, comprising: accessing the disc space; engaging a lamina spreader to the adjacent vertebrae; spreading the lamina of the adjacent vertebra with the lamina spreader; forming an opening into the disc space; inserting a disc space spreader into the disc space; and spreading the adjacent vertebra until the endplates of the vertebrae are parallel with one another.
Claim 55
Dependent Claim
36 words
47 . The method of claim 46 , further comprising: inserting a straight reamer through the opening into the disc space; and removing material from the proximal portion of the disc space with the straight reamer.
Claim 56
Dependent Claim
37 words
48 . The method of claim 47 , further comprising: inserting a curved reamer through the opening into the disc space; and removing disc material from the distal portion of the disc space with the curved reamer.
Claim 57
Dependent Claim
27 words
49 . The method of claim 48 , further comprising: inserting a chisel into the opening; forming a square entrance port at the opening with the chisel.
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