US20040117020A1 — Devices and techniques for a posterior lateral di…

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.

Devices and techniques for a posterior lateral disc space approach

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