U.S. patent application number 10/774078 was filed with the patent office on 2004-11-04 for instruments and methods for aligning implants for insertion.
This patent application is currently assigned to SDGI Holdings, Inc.. Invention is credited to Eisermann, Lukas, Friesem, Tai, Josse, Loic, LeHuec, Jean-Charles, Liu, Mingyan, Matthews, Hallet, Zdeblick, Thomas, Zhang, Jeffrey.
Application Number | 20040220567 10/774078 |
Document ID | / |
Family ID | 32869579 |
Filed Date | 2004-11-04 |
United States Patent
Application |
20040220567 |
Kind Code |
A1 |
Eisermann, Lukas ; et
al. |
November 4, 2004 |
Instruments and methods for aligning implants for insertion
Abstract
An assembly for aligning a prosthetic device for insertion into
an intervertebral space is provided. The assembly includes an
alignment instrument, a first clamp assembly slidably engaged with
the alignment instrument, a second clamp assembly slidably engaged
with the first clamp assembly, and an implantation device slidably
engaged with the second clamp assembly, the implantation device
being adapted to retain a prosthetic device thereon.
Inventors: |
Eisermann, Lukas; (Memphis,
TN) ; Friesem, Tai; (Ingleby Barwick, GB) ;
LeHuec, Jean-Charles; (Pessac, FR) ; Matthews,
Hallet; (Williamsburg, VA) ; Zhang, Jeffrey;
(Collierville, TN) ; Zdeblick, Thomas; (Middleton,
WI) ; Josse, Loic; (Paris, FR) ; Liu,
Mingyan; (Bourg la Reine, FR) |
Correspondence
Address: |
HAYNES AND BOONE, LLP
901 MAIN STREET, SUITE 3100
DALLAS
TX
75202
US
|
Assignee: |
SDGI Holdings, Inc.
Wilmington
DE
|
Family ID: |
32869579 |
Appl. No.: |
10/774078 |
Filed: |
February 6, 2004 |
Related U.S. Patent Documents
|
|
|
|
|
|
Application
Number |
Filing Date |
Patent Number |
|
|
60446963 |
Feb 12, 2003 |
|
|
|
Current U.S.
Class: |
606/86A ;
606/104; 606/247; 606/279; 606/305 |
Current CPC
Class: |
A61F 2230/0028 20130101;
A61F 2220/0025 20130101; A61F 2220/0033 20130101; A61B 17/1637
20130101; A61B 17/1642 20130101; A61F 2002/30785 20130101; A61F
2002/30172 20130101; A61F 2002/30373 20130101; A61F 2002/30401
20130101; A61F 2002/2835 20130101; A61F 2002/30387 20130101; A61F
2230/0052 20130101; A61F 2002/30845 20130101; A61B 17/1671
20130101; A61B 17/1757 20130101; A61F 2/30767 20130101; A61F 2/4684
20130101; A61F 2230/0023 20130101; A61B 17/1624 20130101; A61F
2002/30133 20130101; A61F 2230/0013 20130101; A61F 2/08 20130101;
A61F 2310/00796 20130101; A61F 2002/30686 20130101; A61F 2002/30884
20130101; A61F 2002/30166 20130101; A61F 2/4611 20130101; A61F
2002/4627 20130101; A61F 2/447 20130101; A61F 2002/30769 20130101;
A61F 2250/0098 20130101; A61F 2002/3008 20130101; A61F 2002/30649
20130101; A61F 2002/30836 20130101; A61F 2310/00017 20130101; A61B
17/1615 20130101; A61F 2/4425 20130101; A61F 2002/30925 20130101;
A61F 2002/30156 20130101; A61F 2002/30593 20130101; A61F 2002/30131
20130101; A61B 2017/1602 20130101; A61F 2230/0015 20130101; A61F
2310/00023 20130101; A61F 2002/30507 20130101 |
Class at
Publication: |
606/061 ;
606/073; 606/104 |
International
Class: |
A61B 017/70 |
Claims
What is claimed is:
1. An instrument for aiding in aligning a prosthetic device for
insertion into an intervertebral space, comprising an annular
housing, a plunger member disposed within the annular housing and
adapted to be moved therethrough, and an anchoring device partially
disposed within the annular housing, the anchoring device adapted
to be driven by the plunger member.
2. The instrument of claim 1 wherein the annular housing includes a
threaded surface and the plunger member includes a threaded surface
for engaging the threaded surface of the annular housing.
3. The instrument of claim 1 wherein the anchoring device is a bone
screw.
4. The instrument of claim 1 wherein the annular housing is stepped
in diameter to divide the annular housing into a first portion and
a second portion, the first portion having a diameter greater than
the second portion.
5. The instrument of claim 4 wherein the first portion includes a
first radiographic marker housed therein, and the second portion
includes a second radiographic marker housed therein, the second
radiographic marker having a diameter smaller than that of the
first radiographic marker.
6. The instrument of claim 5 wherein the first and second
radiographic markers cooperate with a fluoroscopic machine to align
the instrument.
7. The instrument of claim 3 wherein the bone screw comprises a
spherical-shaped screw head disposed within the annular housing and
a threaded connector extending from the screw head to an area
outside of the annular housing.
8. The instrument of claim 7 wherein a distal end of the plunger
member comprises a recess defined therein, the recess being shaped
to correspond to the shape of the screw head.
9. The instrument of claim 1 further comprising a knob operatively
connected to the plunger member such that rotation of the knob
imparts rotation to the plunger member.
10. The instrument of claim 1 further comprising a bubble level
operatively connected to the annular housing.
11. An assembly for aligning a prosthetic device for insertion into
an intervertebral space, comprising means for anchoring an
alignment instrument in a vertebral body disposed adjacent to the
intervertebral space, means for operatively connecting an
implantation device to the alignment instrument, the prosthetic
device being disposed on the implantation device, and means for
adjusting the implantation device to position the prosthetic device
adjacent to the intervertebral space.
12. An assembly for aligning a prosthetic device for insertion into
an intervertebral space, comprising an alignment instrument, a
first clamp assembly slidably engaged with the alignment
instrument, a second clamp assembly slidably engaged with the first
clamp assembly, and an implantation device slidably engaged with
the second clamp assembly, the implantation device being adapted to
retain a prosthetic device thereon.
13. The assembly of claim 12 wherein the alignment instrument
comprises a means for engaging an anchoring device partially
disposed within the alignment instrument and driving the anchoring
device into bone.
14. The assembly of claim 13 wherein the alignment instrument
further comprises means for aligning the alignment instrument.
15. The assembly of claim 14 wherein the means for aligning the
alignment instrument is a radiographic marker adapted to cooperate
with a fluoroscopic machine.
16. The assembly of claim 14 wherein the means for aligning the
alignment instrument is a bubble level device operatively connected
to the alignment instrument.
17. The assembly of claim 12 wherein the first clamp assembly
comprises a connector, the connector being adapted to lock the
first clamp assembly, thereby restricting movement of the first
clamp assembly along the alignment instrument.
18. The assembly of claim 12 wherein the second clamp assembly
comprises a connector, the connector being adapted to lock the
second clamp assembly, thereby restricting movement of the second
clamp assembly along the first clamp assembly.
19. The assembly of claim 18 wherein the second clamp assembly
comprises an additional connector, the additional connector being
adapted to lock the implantation device, thereby restricting
movement of the implantation device along the second clamp
assembly.
20. A method for aligning a prosthetic device for insertion into an
intervertebral space, comprising providing an alignment instrument
having an anchoring device extending therefrom, engaging the
anchoring device with a vertebral body located adjacent to the
intervertebral space, aligning the alignment instrument relative to
the intervertebral space, driving the anchoring device into the
vertebral body, and providing an implantation device adjacent to
the alignment instrument via a clamp assembly operatively connected
to the alignment instrument, the implantation device holding the
prosthetic device at a distal end thereof.
21. The method of claim 20 wherein aligning the alignment
instrument comprises aligning a radiographic marker disposed within
the alignment instrument via a fluoroscopic machine.
22. The method of claim 20 wherein aligning the alignment
instrument comprises viewing a bubble level device operatively
connected to the alignment instrument.
23. The method of claim 20 wherein the clamp assembly is
operatively connected to the alignment instrument via a second
clamp assembly.
24. The method of claim 23 further comprising slidably adjusting
the second clamp assembly along the alignment instrument to
position the prosthetic device adjacent to the intervertebral
space
25. The method of claim 24 further comprising locking the second
clamp-assembly to the alignment instrument.
26. The method of claim 25 further comprising slidably adjusting
the first clamp assembly along the second clamp assembly to further
position the prosthetic device adjacent to the intervertebral
space.
27. The method of claim-26 further comprising locking the first
clamp assembly to the second clamp assembly.
28. The method of claim 27 further comprising slidably adjusting
the implantation device along the first clamp assembly to further
position the prosthetic device adjacent to the intervertebral
space.
29. The method of claim 28 further comprising locking the
implantation device to the first clamp assembly.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application claims the benefit of U.S. Provisional
Application No. 60/446,963 filed on Feb. 12, 2003. U.S. Provisional
Application No. 60/446,963 is herein incorporated by reference for
all legitimate purposes. This application is also related to U.S.
patent application Ser. No. 10/430,473, which is herein
incorporated by reference for all legitimate purposes.
BACKGROUND
[0002] The present disclosure relates generally to the field of
orthopedics and spinal surgery, and in some embodiments, the
present disclosure relates to instrumentation and methods for the
insertion of prosthetic devices.
[0003] In the treatment of diseases, injuries or malformations
affecting spinal motion segments, and especially those affecting
disc tissue, it has long been known to remove some or all of a
degenerated, ruptured or otherwise failing disc. In cases involving
intervertebral disc tissue that has been removed or is otherwise
absent from a spinal motion segment, corrective measures are taken
to ensure the proper spacing of the vertebrae formerly separated by
the removed disc tissue. In some instances, prosthetic devices are
inserted into the disc space to maintain the structural integrity
of the spinal column.
[0004] Implantation of prosthetic devices and associated tools and
instrumentation has heretofore been accomplished with the aid of
complex electronic equipment such as intraoperative X-ray
(Fluoroscopy) equipment. However, the use of such equipment can
bear burdensome costs while the complexity of the equipment
complicates the procedures associated with the use of the
equipment. Alternatives to the use of complex electronic equipment
during the insertion of prosthetic devices into the human body are
therefore desirable.
[0005] Therefore, what is needed is are instrumentation and methods
for aligning implants for insertion, which reduce, or eliminate,
the use of fluoroscopic equipment.
SUMMARY
[0006] An instrument for aiding in aligning a prosthetic device for
insertion into an intervertebral space is described. The instrument
includes an annular housing, a plunger member disposed within the
annular housing and adapted to be moved therethrough, and an
anchoring device partially disposed within the annular housing, the
anchoring device adapted to be driven by the plunger member.
[0007] An assembly for aligning a prosthetic device for insertion
into an intervertebral space is provided. The assembly includes
means for anchoring an alignment instrument in a vertebral body
disposed adjacent to the intervertebral space, means for
operatively connecting an implantation device to the alignment
instrument, the prosthetic device being disposed on the
implantation device, and means for adjusting the implantation
device to position the prosthetic device adjacent to the
intervertebral space.
[0008] An assembly for aligning a prosthetic device for insertion
into an intervertebral space is provided. The assembly includes an
alignment instrument, a first clamp assembly slidably engaged with
the alignment instrument, a second clamp assembly slidably engaged
with the first clamp assembly, and an implantation device slidably
engaged with the second clamp assembly, the implantation device
being adapted to retain a prosthetic device thereon.
[0009] A method for aligning a prosthetic device for insertion into
an intervertebral space is described. The method includes providing
an alignment instrument having an anchoring device extending
therefrom, engaging the anchoring device with a vertebral body
located adjacent to the intervertebral space, aligning the
alignment instrument relative to the intervertebral space, driving
the anchoring device into the vertebral body, and providing an
implantation device adjacent to the alignment instrument via a
clamp assembly operatively connected to the alignment instrument,
the implantation device holding the prosthetic device at a distal
end thereof.
BRIEF DESCRIPTION OF THE DRAWINGS
[0010] FIG. 1 is an anterior view of an intervertebral space
defined between a pair of vertebral bodies.
[0011] FIG. 2 is a perspective view of an assembly incorporating an
alignment instrument and an implantation device according to one
embodiment of the present disclosure.
[0012] FIG. 3A is a sectional view of the alignment instrument of
FIG. 2.
[0013] FIG. 3B is a detailed view of a portion of the alignment
instrument of FIG. 3A.
[0014] FIG. 4 is a perspective View of the assembly of FIG. 2 shown
schematically in use during implantation of a prosthetic
device.
[0015] FIG. 5 is an exploded view of an alternative alignment
instrument according to another embodiment of the present
disclosure.
DESCRIPTION
[0016] This disclosure relates generally to instrumentation and
methods for delivering prosthetic devices under mechanical guidance
and, in some instances, providing limited fluoroscopic guidance to
aid in such mechanical guidance. For the purposes of promoting an
understanding of the principles of the disclosure, reference will
now be made to the embodiments, or examples, illustrated in the
drawings and specific language will be used to describe the same.
It will nevertheless be understood that no limitation of the scope
of the disclosure is thereby intended. Any alterations and further
modifications in the described embodiments, and any further
applications of the principles of the disclosure as described
herein are contemplated as would normally occur to one skilled in
the art to which this disclosure relates. As such, individual
features of separately described embodiments can be combined to
form additional embodiments.
[0017] Referring now to FIG. 1, shown therein is an anterior view
of a portion of a spinal column 10, illustrating a pair of adjacent
upper and lower vertebrae V1 and V2 separated by an intervertebral
space S created by the removal of a natural intervertebral disc.
The illustration of two vertebrae is only intended as an example.
Another example would be a sacrum and one vertebrae.
[0018] Referring now to FIGS. 2, 3A and 3B, an assembly for aiding
in the implantation of a prosthetic device into the intervertebral
space S (FIG. 1) is generally referred to by reference numeral 20,
and is shown, in one embodiment, as including an alignment
instrument 22 and an associated implantation device 24. It is
understood that the alignment instrument 22 may be used to aid in
the implantation of a variety of prosthetic devices such as screws,
cages, total joint implants, etc. In one embodiment, the alignment
instrument 22 is generally linear in shape and extends along an
X-axis defined by the longitudinal axis of the alignment
instrument. The alignment instrument 22 includes a plunger member
26 positioned within a generally annular housing 28 of the
instrument, and a knob 30 integrally formed with the proximal end
of the plunger member 26. In this manner, rotation of the knob 30
is adapted to impart rotation to the plunger member 26. An
anchoring device, such as a threaded bone screw 32, is disposed
within the distal end of the alignment instrument 22 to receive a
rotational and a translational force from the plunger member 26 as
will be further described. In one embodiment, the bone screw 32 is
formed of a radiopaque material such as steel. In the present
disclosure, the term "proximal" refers to the direction generally
towards a user, such as a surgeon (not shown), of the alignment
instrument 20, and the term "distal" refers to the direction
generally towards a patient (not shown)..
[0019] In one embodiment, an inner annular surface 34 of the
housing 28 includes a threaded portion 36 for receiving and
engaging a corresponding threaded portion 38 of the plunger member
26. Accordingly, rotation of the plunger member 26 via the knob 30,
not only rotates the plunger member in the housing, but translates
the plunger member through the housing 24 as well. As better seen
in FIG. 3B, the distal end of the plunger member 26 includes a
spherical-shaped groove 40 formed therein, which is adapted to
engage a spherical head 42 of the bone screw 32. In the present
example, the distal end of the housing 28 is reduced in diameter
and chamfered to allow a threaded portion 44 of the bone screw 32
to rotate relative to the housing, while retaining the head 42 of
the bone screw within the housing.
[0020] The alignment instrument 22 is also configured to provide
radiographic alignment, and as such, the proximal portion of the
alignment instrument is increased in diameter relative to the
distal portion of the alignment instrument to house a radiographic
marker generally depicted by reference numeral 46. In one
embodiment, the radiographic marker 46 includes a pair of rings 48,
50. The ring 48 is positioned within the proximal portion of the
alignment instrument 22 and, accordingly, has a diameter
corresponding to fit within the diameter of the proximal portion.
The ring 50 is positioned within the distal portion of the
alignment instrument 20 and, accordingly, has a diameter
corresponding to fit within the diameter of the distal portion. As
such, the rings 48, 50 cooperate to aid with alignment as will be
described. It is understood that the rings 48, 50 may be formed of
any radiographic material such as metal. It is further understood
that the rings 48, 50 may be replaced with alternative radiographic
markers such as metal rods configured to form an X-like shape,
thereby also aiding in alignment.
[0021] Referring again to FIG. 2, a pair of clamp assemblies 52, 54
are provided to operatively connect the alignment instrument 22
with the associated implantation device 24. In one embodiment, the
implantation device 24 is substantially similar to the instrument
described in U.S. patent application Ser. No. 10/430,473, which is
herein incorporated by reference for all legitimate purposes. The
inner clamp assembly 52 (relative to the alignment instrument 22)
is adapted to slidably engage the alignment instrument 22, and as
such, includes a groove 56 defined through an adjustable clamping
portion 57 to facilitate the slidable engagement. The inner clamp
assembly 52 includes a connector 58, which is adapted to releasably
secure the inner clamp assembly 52 to the alignment instrument 22.
In the present example, the connector 58 is threaded through the
inner clamp assembly 52 to contact the clamping portion 57, and
thus can be actuated to engage or disengage the clamping portion
with the alignment instrument 22. Accordingly, the inner clamp
assembly 52 is adjustable along the X-axis defined by the alignment
instrument 22, yet can be secured to the alignment instrument upon
adjustment of the inner clamp assembly 52 to a desired
position.
[0022] The outer clamp assembly 54 (relative to the alignment
instrument 22) is adapted to slidably engage the inner clamp
assembly 52. In one embodiment, the outer clamp assembly 54
includes a groove 60 defined therein for allowing the outer clamp
assembly to slidably engage the inner clamp assembly 52 via a
flange portion 62 of the inner clamp assembly. Accordingly, the
outer clamp assembly 54 is adjustable relative to the inner clamp
assembly 52 along a Y-axis. For example, in the embodiment of FIG.
2, the outer clamp assembly 54 is laterally adjustable relative to
the alignment instrument 22. The outer clamp assembly 54 further
includes a connector 64, which is adapted to releasably secure the
outer clamp assembly 54 to the inner clamp assembly 52. In the
present example, the connector 64 is threaded through the outer
clamp assembly 54, and thus can be actuated to engage or disengage
with the inner clamp assembly 52.
[0023] As can be appreciated, the inner clamp assembly 52 is
rotatable about the alignment instrument 22. Therefore, although
described as being a lateral axis as viewed in FIG. 2, descriptions
of the Y-axis can change depending on the position of the inner
clamp assembly 52 relative to the alignment instrument 22. For
example, the inner clamp assembly 52 can be rotated to position the
implantation device 24 in the same horizontal plane as the
alignment-instrument 22. In this example, the outer clamp assembly
54 is still adjustable along the Y-axis, but the Y-axis would be
considered an elevational axis.
[0024] The outer clamp assembly 54 is further adapted to receive
the implantation device 24 (FIG. 4) via a pair of grooves 66, 68
formed in a pair of corresponding clamping portions 70, 72,
respectively, of the outer clamp assembly. The implantation device
24 is adapted for placement within the grooves 66, 68 such that the
implantation device is slidable relative to the outer clamp
assembly 54. Moreover, an additional connector 74 is associated
with the outer clamp assembly 54 to advance the clamping portion 70
towards the clamping portion 72, thereby securing the implantation
device 24 within the outer clamp assembly 52 upon adjustment of the
implantation device to a desired position. In the present example,
the connector 74 is adjustable along a threaded rod (not shown)
associated with the clamping portion 70, and thus, the clamping
portion 70 can be actuated towards the clamping portion 72 via
adjustment of the connector 74. As such, the implantation device 24
is adjustable along an A-axis defined by the longitudinal axis of
the implantation device. Of course, the implantation device 24 can
be rotated within the outer clamp assembly 54 to adjust to
correspond to different positions of the outer clamp assembly
relative to the inner clamp assembly 52, and as such, the
implantation device is rotatable about the A-axis.
[0025] Referring to FIG. 4, in one embodiment, the bone screw 32 is
adapted to be inserted into the vertebrae VI to provide an anchor
point from which to align the associated implantation device 24
prior to insertion of a prosthetic device, generally depicted by
reference numeral 80, into the intervertebral space S. Of course,
the bone screw. 32 may alternatively be inserted into the vertebrae
V2. A fluoroscopic machine, or C-arm 82, is further provided to
fluoroscopically aid in positioning of the alignment instrument 22.
For sake of clarity, the method for aligning the alignment
instrument 22 for insertion of the prosthetic device 80 will be
described with respect to the anterior/oblique approach to the
intervertebral space S; however, it is understood that the
alignment process, in a general sense, is adaptable for other
approaches to the interverterbral space including the lateral
approach.
[0026] In operation, and with continued reference to FIG. 4, the
alignment instrument 22 is aligned with fluoroscopic assistance by
positioning the C-arm 82 in a direct anterior view of the vertebrae
V1, V2 for corresponding to an anterior/oblique insertion approach.
The alignment instrument 22 is then positioned such that the bone
screw 32 engages the upper vertebra V1. In one embodiment, the bone
screw 32 is positioned relatively close to a midline of the upper
vertebra V1, however, it is understood that the exact position of
the bone screw relative to the upper vertebra is not critical. Upon
proper positioning, the plunger member 26 (FIGS. 3A, 3B) is driven
against the bone screw 32 to drive the bone screw into the upper
vertebra V1, thereby providing a fixed anchor location defined by
the position of the bone screw.
[0027] The proximal portion of the alignment instrument 22 is then
adjusted to align the radiographic marker 46 with the spherical
head 42 of the bone screw 32 as viewed on a monitor (not shown)
associated with the C-arm 82. Upon proper alignment determined by
viewing the monitor, the alignment instrument 22 is then locked
into place by further advancement of the plunger member 26 against
the bone screw 32. The implantation device 24 is then placed within
the grooves 66, 68 of the outer clamp assembly 54. The position of
the implantation device 24 is then adjusted to correspond to the
center of the intervertebral space S, and upon reaching the desired
position, the position of the implantation device is locked by
engaging the connector 64 against the inner clamp assembly 52.
[0028] The implantation device 24 is further adjustable along the
A-axis to properly position the prosthetic device 80 for
implantation into the intervertebral space S. In one embodiment,
proper positioning entails positioning the prosthetic device 80
proximate to the vertebral bodies V1, V2 to the point of touching.
Upon proper positioning, the implantation device 24 is locked along
the A-axis by engaging the connector 74 against the outer clamp
assembly 54. The implantation device 24 is then actuated to insert
the prosthetic device 80 into the intervertebral space S.
[0029] Thus, the above-described process and associated
instrumentation allows for alignment and implantation of the
prosthetic device 80 with minimal fluoroscopic guidance.
[0030] Referring now to FIG. 5, in an alternative embodiment,
alignment and insertion of the prosthetic device 80 can be
accomplished without fluoroscopic guidance through the use of an
alternative alignment instrument 90. The alignment instrument 90
includes a bubble level device 92, which in one embodiment,
eliminates the need for radiographic markers and a C-arm
fluoroscopic machine. The alignment instrument 90 is substantially
similar to the alignment instrument 22 except for the features
described below, and, as such, features of the alignment instrument
90 that are substantially similar to features of the alignment
instrument 22 are given the same reference numerals.
[0031] The alignment instrument 90 includes a substantially uniform
housing 94 through which the plunger member 26 is adapted to move
through to engage the bone screw 32. The alignment instrument 90 is
adapted for use with the bubble level 92, which may connect with
the alignment instrument 90 in any conventional manner, such as via
a threaded connection. For example, the bubble level 92 may include
a threaded connector 96 for engaging a threaded receptacle 98
defined in the alignment instrument 90. Of course, in some
embodiments, the bubble level 92 may be integrally formed with the
alignment instrument 90. The bubble level 92 is conventional in
most respects, and therefore, includes a cavity (not shown) defined
therethrough for holding fluid, and a transparent portion 100 for
viewing the fluid.
[0032] In operation, the alignment instrument 90 is used in
conjunction with the inner and outer clamp assemblies 52, 54 to
align the prosthetic device 80 for insertion into the
intervertebral space S. Prior to anchoring of the alignment
instrument 90, the patient (not shown) is first aligned at a
substantially 90.degree. angle relative to the operating table (not
shown). Upon proper alignment of the patient, the bone screw 32 of
the alignment instrument 90 is then inserted into the upper
vertebra V1 to provide an anchoring point. The proximal, or free,
end of the alignment instrument 90 is then aligned to the proper
position by adjusting the alignment instrument 90 until the bubble
level 92 reflects a neutral position.
[0033] The present disclosure has been described relative to
several preferred embodiments. Improvements or modifications that
become apparent to persons of ordinary skill in the art after
reading this disclosure are deemed within the spirit and scope of
the application. For example, during the alignment process, a probe
may be used in conjunction with the alignment-instrument 22, 90
prior to placement of the implantation device 24. In this manner,
proper alignment of the various instrumentation relative to the
intervertebral space S may be further ensured. Moreover, although
described with reference to an anterior-oblique approach, it is
understood that the above-described methods and instrumentation may
be used with a variety of insertion approaches. Still further,
although the anchoring device is described as a bone screw, a
variety of anchoring devices may be used with the alignment
instruments 22, 90.
[0034] Accordingly, it is understood that several modifications,
changes and substitutions are intended in the foregoing disclosure
and, in some instances, some features of the disclosure will be
employed without a corresponding use of other features. It is also
understood that all spatial references, such as "inner," "outer,"
"proximal," and "distal" are for illustrative purposes only and can
be varied within the scope of the disclosure. Accordingly, it is
appropriate that the appended claims be construed broadly and in a
manner consistent with the scope of the disclosure.
* * * * *