U.S. patent application number 12/917089 was filed with the patent office on 2011-02-24 for minimally invasive interbody device.
Invention is credited to John A. Miller, John R. Pepper, Miquelangelo J. Perez-Cruet.
Application Number | 20110046743 12/917089 |
Document ID | / |
Family ID | 39618382 |
Filed Date | 2011-02-24 |
United States Patent
Application |
20110046743 |
Kind Code |
A1 |
Perez-Cruet; Miquelangelo J. ;
et al. |
February 24, 2011 |
Minimally Invasive Interbody Device
Abstract
An interbody device that restores the disc space height between
two vertebrae during spinal fusion surgery. The device includes a
center plate surrounded by a perimeter portion that combine to have
a relatively flat configuration in one dimension and relatively
wide configuration in a perpendicular dimension. After the disc
space has been cleared, the device is inserted into the disc space
in a direction so that the wide dimension of the device is
substantially parallel to the body of the vertebrae. The device is
then rotated so that the wide dimension of the device becomes
perpendicular to the vertebral body so as to cause the disc space
height to be restored. Bone graft material is then introduced
through a fill tube coupled to the device so that the bone graft
material is distributed on both sides of the center plate and into
the disc space.
Inventors: |
Perez-Cruet; Miquelangelo J.;
(Bloomfield, MI) ; Pepper; John R.; (Cheshire,
CT) ; Miller; John A.; (Bloomfield Village,
MI) |
Correspondence
Address: |
MCANDREWS HELD & MALLOY, LTD
500 WEST MADISON STREET, SUITE 3400
CHICAGO
IL
60661
US
|
Family ID: |
39618382 |
Appl. No.: |
12/917089 |
Filed: |
November 1, 2010 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
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11623356 |
Jan 16, 2007 |
7824427 |
|
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12917089 |
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Current U.S.
Class: |
623/17.16 |
Current CPC
Class: |
A61F 2/4601 20130101;
A61F 2002/4629 20130101; A61F 2230/0028 20130101; A61F 2002/30367
20130101; A61F 2002/3082 20130101; A61F 2/4611 20130101; A61F
2002/4627 20130101; A61F 2250/0098 20130101; A61B 2017/0256
20130101; A61F 2220/0025 20130101; A61F 2002/3008 20130101; A61F
2/447 20130101; A61F 2002/30235 20130101; A61F 2002/30166 20130101;
A61F 2220/0033 20130101; A61F 2230/0069 20130101; A61F 2310/00023
20130101; A61F 2002/30426 20130101; A61F 2/4455 20130101 |
Class at
Publication: |
623/17.16 |
International
Class: |
A61F 2/44 20060101
A61F002/44 |
Claims
1-20. (canceled)
21. An interbody device for restoring the disc space height of the
disc space between opposing vertebral bodies of adjacent vertebrae
during a spinal fusion procedure, said device comprising: a
perimeter portion including spaced apart elongated members
extending along a length of the perimeter portion and opposing end
pieces coupled to the elongated members, wherein one of the end
pieces includes a channel extending therethrough; and a center
plate member positioned within the perimeter portion and extending
along the length of the perimeter portion, said center plate member
extending along a central plane of the device between the end
pieces of the device, said plate member including an opening
proximate the channel so that a bonegraft material introduced
through the channel and into the opening is distributed by the
plate member to both sides of the plate member and the perimeter
portion, wherein the device has a length defined by the distance
between the end pieces, a width defined by the width of the
elongated members and a height defined by the distance between the
elongated members where the height of the device is substantially
greater than the width of the device so that the device is operable
to be inserted into the disc space in a substantially flat
orientation and be rotated to an orientation where the elongated
members contact the opposing vertebral bodies.
22. The device according to claim 21 wherein the channel is
rectangular.
23. The device according to claim 21 wherein the elongated members
have a plurality of spaced apart ribs defining spaces
therebetween.
24. The device according to claim 21 wherein the channel extending
through the end piece is configured to accept a fill tube that is
operable to rotate the device and distribute a bone graft material
through the channel and into the device.
25. The device according to claim 24 wherein the fill tube includes
a pair of opposing clasps that connect to an outside surface of the
one end piece.
26. The device according to claim 24 wherein the channel is
threaded and the fill tube includes a threaded end portion that is
operable to be threaded to the threaded channel.
27. The device according to claim 24 wherein the channel includes
one or more of a slot and an elongated tab and the fill tube
includes one or more of a slot and an elongated tab that are
configured to engage each other to allow the interbody device to be
rotated.
28. An interbody device assembly for restoring the disc space
height of the disc space between two vertebral bodies of adjacent
vertebra during a spinal fusion procedure, said assembly
comprising: an interbody device including a perimeter portion
having spaced apart spines extending along a length of the
perimeter portion and opposing end pieces coupled to the spines,
wherein one of the end pieces includes a channel extending
therethrough, and wherein the perimeter portion has a length
defined by the distance between the end pieces, a width defined by
the width of the spines and a height defined by the distance
between the spines where the height of the device is substantially
greater than the width of the device, said interbody device further
including a center plate positioned within the perimeter portion
and including an opening proximate the channel, said center plate
extending along the length of the perimeter portion, said center
plate extending along a central plane of the device between the end
pieces of the device, wherein the device is operable to be inserted
between two vertebrae in a disc space and then rotated to restore
disc space height; and a fill tube coupled to the one end piece and
in fluid communication with the channel, wherein the fill tube is
operable to provide bone graft material to the space within the
perimeter portion and the center plate is effective to distribute
the bone graft material within the disc space on both sides of the
device, said fill tube also being operable to rotate the interbody
device.
29. The assembly according to claim 28 wherein the spines include a
series of ribs defining spaces therebetween extending along a
length of the perimeter portion.
30. The assembly according to claim 28 wherein the fill tube has a
rectangular shape and includes a plurality of fingers that are
positioned within slots in an outside surface of the one end
piece.
31. An interbody assembly comprising an interbody device to be
positioned within a disc space between two vertebrae, said device
including an opening and a center plate extending along the length
of the device, said center plate extending along a central plane of
the device between ends of the device, said assembly further
comprising a fill tube including a fill chamber, said fill tube
being coupled to the device so that bone graft material can be
passed through the fill chamber in the fill tube and into the
opening in the device and being distributed within the disc space
on both sides of device by the center plate, said fill tube also
being operable to rotate the device.
32. An interbody device assembly for restoring the disc space
height of the disc space between opposing vertebral bodies of
adjacent vertebrae during a spinal fusion procedure, the assembly
comprising: a body having a first end, a second end, a top, and a
bottom, the body defining a height and a width, wherein the height
is greater than the width, wherein the body is configured to be
inserted into the disc space in a substantially flat orientation
and to be rotated to an orientation where the top and the bottom
contact the opposing vertebral bodies; wherein the body comprises a
distribution feature positioned along a central plane defined by
the body, the central plane extending generally from the top to the
bottom and from the first end to the second end, the distribution
feature configured to distribute bone graft material to either side
of the central plane when the top and bottom of the body contact
the opposing vertebral bodies.
33. The interbody device assembly of claim 32 wherein the
distribution feature comprises a nub.
34. The interbody device assembly of claim 33 wherein the body
comprises a central plate lying along the central plane, and the
nub is formed as part of the central plate.
35. The interbody device assembly of claim 32 wherein the
distribution feature comprises a ridge.
36. The interbody device assembly of claim 33 further comprising a
fill tube, the fill tube configured to be coupled to the body
proximate to one of the first and second ends so that bone graft
material can be passed through the fill tube to the distribution
feature and be distributed to either side of the central plane by
the distribution feature.
37. The interbody device assembly of claim 36 wherein the fill tube
includes a bore that is substantially open along the length of the
bore, wherein the assembly is configured to provide a substantially
unimpeded flow path through the bore to the distribution feature
when the fill tube is coupled to the interbody device.
38. The interbody device assembly of claim 36 wherein the fill tube
comprises an end having a shape that conforms with a shape of the
distribution feature.
39. An interbody device for restoring the disc space height of the
disc space between opposing vertebral bodies of adjacent vertebrae
during a spinal fusion procedure, said device comprising: a
perimeter portion including spaced apart elongated members
extending along a length of the perimeter portion and opposing end
pieces coupled to the elongated members, wherein one of the end
pieces includes a channel extending therethrough; and a center
plate member positioned within the perimeter portion and extending
along the length of the perimeter portion, said center plate member
extending along a central plane of the device between the end
pieces of the device, said plate member including an opening
proximate the channel so that a bonegraft material introduced
through the channel and into the opening is distributed by the
plate member to both sides of the plate member and the perimeter
portion, wherein the device has a length defined by the distance
between the end pieces, a width defined by the width of the
elongated members and a height defined by the distance between the
elongated members.
40. An interbody device assembly for restoring the disc space
height of the disc space between two vertebral bodies of adjacent
vertebra during a spinal fusion procedure, said assembly
comprising: an interbody device including a perimeter portion
having spaced apart spines extending along a length of the
perimeter portion and opposing end pieces coupled to the spines,
wherein one of the end pieces includes a channel extending
therethrough, and wherein the perimeter portion has a length
defined by the distance between the end pieces, a width defined by
the width of the spines and a height defined by the distance
between the spines, said interbody device further including a
center plate positioned within the perimeter portion and including
an opening proximate the channel, said center plate extending along
the length of the perimeter portion, said center plate extending
along a central plane of the device between the end pieces of the
device; and a fill tube coupled to the one end piece and in fluid
communication with the channel, wherein the fill tube is operable
to provide bone graft material to the space within the perimeter
portion and the center plate is effective to distribute the bone
graft material within the disc space on both sides of the
device.
41. An interbody assembly comprising an interbody device to be
positioned within a disc space between two vertebrae, said device
including an opening and a center plate extending along the length
of the device, said center plate extending along a central plane of
the device between ends of the device, said assembly further
comprising a fill tube including a fill chamber, said fill tube
being coupled to the device so that bone graft material can be
passed through the fill chamber in the fill tube and into the
opening in the device and being distributed within the disc space
on both sides of device by the center plate.
Description
BACKGROUND OF THE INVENTION
[0001] 1. Field of the Invention
[0002] This invention relates generally to an interbody device for
restoring the disc space height between two vertebrae during spinal
fusion surgery and, more particularly, to an interbody device for
restoring the disc space height between two vertebrae during
minimally invasive spinal fusion surgery, where the device also
allows for an effective distribution of bone graft material in the
disc space.
[0003] 2. Discussion of the Related Art
[0004] The human spine includes a series of vertebrae
interconnected by connective tissue referred to as discs that act
as a cushion between the vertebrae. The discs allow for movement of
the vertebrae so that the back can bend and rotate.
[0005] Spinal fusion is a surgical procedure that fuses two or more
vertebrae together using bone grafts and/or other devices. Spinal
fusion is a commonly performed procedure for the treatment of
chronic neck and back pain refractory to non-operative treatments.
Spinal fusion is used to stabilize or eliminate motion of vertebrae
segments that may be unstable, i.e., move in an abnormal way, that
may lead to pain and discomfort. Spinal fusion is typically
performed to treat injuries to the vertebrae, degeneration of the
spinal discs, abnormal spinal curvature and a weak or unstable
spine.
[0006] Spinal fusion generally requires a graft material, usually
bone material, to fuse the vertebrae together. The bone graft
material can be placed over the spine to fuse adjacent vertebrae
together. Alternatively, a cage is positioned between the vertebrae
being fused, and is filed with the bone graft material. The cage
includes holes that allow the vertebrae and the graft material to
grow together to provide the fusion. The cage supports the weight
of adjacent vertebrae while the fusion is occurring through the
holes in the cage.
[0007] Typically the bone graft material is autogenous bone
material taken from the patient, or allograft bone material
harvested from a cadaver. Synthetic bone material can also be used
as the graft material. Generally, the patient's own bone material
offers the best fusion material and is the current "gold standard."
Known bone fusion materials include an iliac crest harvest from the
patient, bone graft extenders, such as hydroxyapetite and
demineralized bone matrix, and bone morphogenic protein.
[0008] In an attempt to preserve normal anatomical structures
during spinal surgery, minimally invasive surgical procedures have
been devised. One such procedure involves the use of a series of
muscle dilators that separate the muscle fibers of the spine to
create a pathway to the spine. A Kirschner (K-wire) is initially
introduced through a small incision and directed towards the spinal
pathology. The position of the K-wire is visualized by a
fluoroscopic imaging system to identify its location. An initial
narrow diameter muscle dilator is passed over the K-wire, and the
K-wire is removed and subsequent larger muscle dilators are
continually passed. When the opening is large enough, an access
tube or retractor is positioned around the last muscle dilator
through which the surgery is performed. The inner sequential muscle
dilators are then removed allowing the surgeon to operate through
the tubular retractor. The retractors come in a variety of lengths
and diameters for different patients and procedures.
[0009] As mentioned above, a cage is typically positioned in the
interbody region between the vertebrae after the disc has been
removed. These cages typically have a box like design. The cage is
forced into the interbody region through the surgical area where
the bone and disc have been removed. The cage is filled with the
bone graft material that subsequently fuses the vertebrae together.
However, known cage designs are limited in that they only allow for
partial filling of the interbody space where the graft material is
maintained within the cage, thus only allowing partial fusion
between the vertebrae. Further, the known bone graft cages are
difficult to place because of their square or cylindrical shape,
and put the nerve roots at risk during the procedure, sometimes
resulting in injury. Also, the known cages do not allow the
collapsed disc space height to be fully restored in that they
cannot distract the open disc space once they are in place.
Further, the known cage designs require that the bone graft
material be placed in the cage prior to it being inserted into the
interbody region, which limits the amount of bone material placed
in the disc space and subsequent fusion surface. Also, once the
cages are placed, they are difficult to remove and reposition.
SUMMARY OF THE INVENTION
[0010] In accordance with the teachings of the present invention, a
minimally invasive interbody device is disclosed that restores the
disc space height between two vertebrae and allows for the
placement of bone graft material during spinal fusion surgery. The
device includes a center plate surrounded by a perimeter portion
that combine to have a relatively flat configuration in one
dimension and relatively wide configuration in a perpendicular
dimension. After the disc space has been cleared, the device is
inserted into the disc space in a direction so that the wide
dimension of the device is substantially parallel to the body of
the vertebrae. The device is then rotated so that the wide
dimension of the device becomes perpendicular to the vertebral body
so as to cause the disc space height to be restored. Bone graft
material is then introduced through a fill tube coupled to the
device so that the bone graft material is distributed on both sides
of the center plate around the perimeter portion and into the disc
space, where the center plate helps to direct bone graft material
around the device.
[0011] Additional features of the present invention will become
apparent from the following description and appended claims, taken
in conjunction with the accompanying drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
[0012] FIG. 1 is a perspective view of a minimally invasive
interbody device for restoring the disc space height during spinal
fusion surgery, according to an embodiment of the present
invention;
[0013] FIG. 2 is a top view of the interbody device shown in FIG.
1;
[0014] FIG. 3 is a cross-sectional, perspective view of the
interbody device shown in FIG. 1;
[0015] FIG. 4 is a side view of the interbody device shown in FIG.
1 positioned between two vertebrae in an insertion direction;
[0016] FIG. 5 is a side view of the interbody device shown in FIG.
1 positioned between the vertebrae in a disc height restoring
direction;
[0017] FIG. 6 is a perspective view of a fill tube and a minimally
invasive interbody device, according to another embodiment of the
present invention;
[0018] FIG. 7 is broken-away perspective view of a fill tube and a
minimally invasive interbody device employing a threaded
attachment, according to another embodiment of the present
invention;
[0019] FIG. 8 is a broken-away perspective view of a fill tube and
a minimally invasive interbody device employing a tab and slot
connection, according to another embodiment of the present
invention;
[0020] FIG. 9 is a broken-away perspective view of a fill tube and
a minimally invasive interbody device, according to another
embodiment of the present invention;
[0021] FIG. 9A is an end view of the fill tube shown in FIG. 9;
[0022] FIG. 9B is a broken-away end view of the interbody device
shown in FIG. 9;
[0023] FIG. 10 is a perspective view of a minimally invasive
interbody device for restoring the disc space height during spinal
fusion surgery, according to another embodiment of the present
invention;
[0024] FIG. 11 is a perspective view of the minimally invasive
interbody device shown in FIG. 10 and including a rotating tool and
a fill tube;
[0025] FIG. 12 is a perspective view of a minimally invasive
interbody device for restoring the disc space height during spinal
fusion surgery, according to an embodiment of the present
invention.
DETAILED DESCRIPTION OF THE EMBODIMENTS
[0026] The following discussion of the embodiments of the invention
directed to a minimally invasive interbody device for restoring the
disc space height during spinal fusion surgery and allowing
dispersion of bone graft material within the disc space is merely
exemplary in nature, and is in no way intended to limit the
invention or its applications or uses.
[0027] FIG. 1 is a perspective view, FIG. 2 is a top view and FIG.
3 is a cross-sectional view of a minimally invasive interbody
device 10 that is to be positioned within the interbody disc space
between two vertebral bodies once the disc has been removed as part
of a spinal fusion surgical procedure. As will be discussed in
detail below, the device 10 operates to restore the disc space
height that has been lost by age or damage and may be causing pain
as a result of nerve pinching, as discussed above. Additionally,
the device 10 facilitates the distribution of bone graft material
within the disc space.
[0028] The interbody device 10 includes a perimeter portion 12 and
a center plate 14 that are an integral body in this embodiment. The
perimeter portion 12 includes opposing spines 26 and 28 having ribs
30 extending therefrom. The ribs 30 define spaces 32 between the
ribs 30 along the length of the spines 26 and 28. The perimeter
portion 12 also includes a first end piece 36 and a second end
piece 38. A coupling tube 18 is formed to the end piece 38 where a
bore 20 is defined through the coupling tube 18 and the end piece
38. The center plate 14 includes an opening 22 in communication
with the bore 20 to facilitate the distribution of bone graft
material. The center plate 14 includes a nub 24 extending into the
opening 22, where the nub 24 helps to distribute the bone graft
material on either side of the center plate 14 within the disc
space. In an alternate embodiment, the center plate 14 can be
eliminated. However, some load bearing structure may be needed
between the spines 26 and 28.
[0029] Although this embodiment includes the spines 26 and 28 and
the ribs 30, other embodiments can provide other configurations
within the scope of the present invention. For example, the body of
the device can be a solid piece having a consistent thickness,
where an opening is provided in the body to distribute the bone
graft material.
[0030] The device 10 can be made of any material suitable for the
purposes described herein, such as titanium or a durable plastic.
In one embodiment, the device 10 is radiolucent and is invisible on
an X-ray. A reflective strip 44 can be attached to the end piece 36
and a reflective strip 46 can be attached to the end piece 38. The
reflective strips 44 and 46 allow the ends of the device 10 to be
visible on an X-ray so that the surgeon will know the position of
the device 10 in the disc space.
[0031] As discussed above, the bone graft material is introduced
through the coupling tube 18. In order to get the bone graft
material to the coupling tube 18, a fill tube 50 is attached to the
coupling tube 18, as shown. The fill tube 50 includes integral
clasps 54 and 56 that extend from an end of the fill tube 50, as
shown. The clasps 54 and 56 include angled end portions 58 and 60,
respectively, that allow the clasps 54 and 56 to be mounted to the
interbody device 10. The interbody device 10 is attached to the
fill tube 50 outside of the patient. The fill tube 50 is an
elongated member that extends out of the patient's body and allows
the surgeon to position the interbody device 10 in the disc space,
as will be discussed in more detail below. When the interbody
device 10 is attached to the fill tube 50, the clasps 54 and 56 are
spread apart and positioned within recesses 42 in the end piece 38,
as shown. The clamping force of the clasps 54 and 56 allows the
fill tube 50 to be securely attached to the device 10. Also, the
angled end portions 58 and 60 are positioned against an opposite
side of the end piece 38 to help lock the fill tube 50 the coupling
tube 18. The clasps 54 and 56 are robust enough to allow the
surgeon to rotate the fill tube 50, and cause the interbody device
10 to rotate within the disc space.
[0032] As discussed above, the bone graft material is inserted into
the disc space through the coupling tube 18 and the end piece 38.
In an alternate embodiment, the bone graft material can be inserted
into the disc space through a port outside of the device 10, such
as around the end piece 38.
[0033] FIG. 4 shows the interbody device 10 positioned in a disc
space 68 between two vertebrae 70 and 72 in an insertion direction
where the wider dimension of the device 10 is parallel to the plane
of vertebral bodies 74 and 76 of the vertebrae 70 and 72,
respectively. Once the interbody device 10 is positioned within the
disc space 68, as shown, the fill tube 50 is rotated so that the
plane of the center plate 14 becomes perpendicular to the opposing
faces of the vertebral bodies 74 and 76, as shown in FIG. 5.
[0034] Bone graft material is then introduced through the fill tube
50 into the interbody device 10 through the coupling tube 18 so
that it flows into the opening 22 and is spread out on both sides
of the center plate 14. The bone graft material will enter the
spaces 32 between the ribs 30, and provide a complete and even
distribution of bone graft material within the disc space 68 for
proper vertebral fusion.
[0035] Once the bone graft material has been forced into the disc
space, the fill tube 50 is pulled off of the interbody device 10.
The clasping strength of the clasps 54 and 56 allow the interbody
device 10 to be held to the fill tube 50, but also be removed
therefrom under a reasonably low enough force. The interbody device
10 remains in the disc space 68 to maintain the disc space height
and facilitate bone fusion.
[0036] The spines 26 and 28 and the ribs 30 define the width of the
device 10 and the distance between the ribs 26 and 28 defines the
height of the device 10. The height of the interbody device 10 is
selected to be the desired disc height for a particular disc space
so that the disc height is restored by the device 10 as part of the
fusion process. The interbody device 10 can be provided in
different lengths and heights to accommodate the anatomy of
different patients. The width of the device 10 is such that it can
be relatively easily slipped into the disc space 68 through a
dilator tube (not shown) used in minimally invasive surgical
procedures without risk of injury to the nerve roots through the
same channel that the disc has been removed from. In one
non-limiting embodiment, the device 10 has a width in the range of
3-4 mm and a height in the range of 8-15 mm. The length of the
device 10 would be suitable for the size of the disc space, such as
15-25 mm.
[0037] FIG. 6 is a broken-away perspective view of a minimally
invasive interbody device 80 and associated fill tube handle 82,
according to another embodiment of the present invention, where
like elements to the device 10 are identified by the same reference
numeral. In this embodiment, the coupling tube 18 is replaced with
a coupling tube 84. The coupling tube 84 has a tapered portion 86
and a cylindrical portion 88, both having a bore 90 running
therethrough. Two elongated opposing tabs 92 and 94 are formed to
an outside surface of the cylindrical portion 88. The center plate
14 has been replaced with a series of support columns 96 to provide
support when the interbody device 80 is rotated within the disc
space. The support columns 96 are intended to represent any
suitable load bearing structure within the space defined by the
perimeter portion 12
[0038] The fill tube handle 82 includes a fill tube 96 having a
central bore 98. A pair of slots 100 and 102 is formed in the bore
98 in alignment with the elongated tabs 92 and 94. The fill tube
handle 82 is slipped on to the coupling portion 84 so that the tabs
92 and 94 slide down the slots 100 and 102. The internal bore 98
then forced onto the tapered portion 86 to lock the handle 82 to
the interbody device 80. The coupling between the tabs 92 and 94
and the slots 100 and 102 is robust enough so that the interbody
device 80 can be rotated within the disc space. Although two of the
tabs 92 and 94 are used in this embodiment, it will be appreciated
by those skilled in the art that a single tab and slot
configuration may be adequate, or more than two tab and slot
couplings may be needed. The cylindrical portion 88 is positioned
within the bore 98 so that minimal resistance is provided for
depositing bone graft material down the bore 98, through the
coupling portion 84 and into the space between the ribs 26 and
28.
[0039] FIG. 7 is a perspective view of a minimally invasive
interbody device 110 and associated fill tube 112, according to
another embodiment of the present invention, where like elements to
the interbody device 10 are identified by the same reference
numeral. In this embodiment, the coupling tube 18 is replaced with
a threaded bore 114 that extends through the end piece 38. The fill
tube 112 includes a fill tube body 116 having a bore 118 and a
threaded end portion 120 at the end of the body 116. The threaded
end portion 120 is threaded into the threaded portion 114 in the
proper direction to attach and detach the fill tube 112 to the
device 110 so that the fill tube 112 can rotate the interbody
device 110.
[0040] FIG. 8 is a perspective view of a minimally invasive
interbody device 130 and associated fill tube 132, according to
another embodiment of the present invention, where like elements to
the interbody device 10 are identified by the same reference
numeral. In this embodiment, the coupling tube 18 is replaced with
an internal bore 134 that includes elongated tabs 136 and 138 and
slots 140 and 142. The fill tube 132 includes a fill tube body 146
and a narrow diameter end portion 148 defining a shoulder 144
therebetween, where a central bore 150 extends through the fill
tube body 146 and the end portion 148. The end portion 148 includes
tabs 152 and 154 and slots 156 and 158 that align with the tabs 136
and 138 and the slots 140 and 142 in the bore 134 so as to allow
the device 130 to be rotated by the fill tube 132 when the end
portion 148 is inserted into the bore 134. Although a specific
configuration of tabs and slots are shown between the end portion
148 and the bore 134, any suitable configuration of tab and slots
in this manner can be used within the scope of the present
invention. The device 130 is held to the fill tube 132 by a
friction engagement between the end portion 148 and the bore 134.
Alternately, the end portion 148 and the bore 134 can be tapered as
a Wider diameter to a narrower diameter to provide a better locking
arrangement. The shoulder 144 prevents the fill tube 132 from being
pushed into the device 130.
[0041] FIG. 9 is a perspective view of a minimally invasive
interbody device 160 and associated fill tube 162, according to
another embodiment of the present invention, where like elements to
the device 10 are identified by the same reference numeral. FIG. 9A
is an end view of the fill tube 162 and FIG. 9B is a broken-away
end view of the device 160. In this embodiment, the coupling tube
18 is replaced with an internal bore 164 that includes a slot 166
and an arced portion 168 defining the ledge 170. The fill tube 162
includes a fill tube body 172 and a narrow diameter end portion 174
defining a shoulder 176 therebetween, where a central bore 178
extends through the fill tube body 162 and the end portion 174. A
nub 180 is attached to the end of the end portion 174 and a stop
182 is attached to the end portion 174, as shown. The end portion
174 is inserted into the bore 164 so that the nub 180 aligns with
the slot 166. The end portion 174 is slid into the bore 164 so that
the nub 180 extends behind the end piece 38. The fill tube 162 is
rotated so the nub 180 locks behind the end piece 38. At the same
time, the nub 180 rides up a ramp 184 so that the stop 182 is
rotated and contacts the ledge 170. The contact between the stop
182 and the ledge 170 allows the device 160 to be rotated within
the disc space, as discussed above. The shoulder 176 and the nub
180 lock the fill tube 162 to the device 160. The fill tube 162 can
then be rotated in the opposite direction so that the nub 180 again
aligns with the slot 166 to remove the fill tube 162, as discussed
above.
[0042] FIG. 10 is a perspective view of a minimally invasive
interbody device 190 for restoring the disc space height during
spinal fusion surgery, according to an embodiment of the present
invention, where like elements to the device 10 are identified by
the same reference numeral. In this embodiment, the nub 24 is
replaced with a triangular ridge 192 that distributes the bone
graft material on both sides of the center plate 14. Further, the
end piece 38 is replaced with an end piece 194. The end piece 194
includes a cylindrical bore 196 extending therethrough. The end
piece 194 also includes a first set of two opposing slots 198 and
200 on opposite sides of the end piece 194 and a second set of two
opposing slots 202 and 204 on opposite sides of the end piece 194,
as shown.
[0043] FIG. 11 is a perspective view of the interbody device 190 in
combination with a rotating tool 210 and a fill tube 212. The
rotating tool 210 includes a rectangular body 214 having a
cylindrical bore 216 extending therethrough. The body 214 includes
four rigid fingers 218 that are configured to be positioned within
the slots 198-204, as shown, to allow the tool 210 to rotate the
interbody device 190 for the purposes discussed above. The fill
tube 212 extends through the bore 216 and is coupled to or
positioned relative to the ridge 190 so that bone graft material
forced through the tube 212 is dispersed on both sides of the
center plate 14 as discussed above. The end 208 of the fill tube
212 may have a shape that conforms with the shape of the ridge
192.
[0044] FIG. 12 is a perspective view of a minimally invasive
interbody device 220 for restoring the disc space height during
spinal fusion surgery, according to an embodiment of the present
invention. The device 220 includes opposing elongated members 222
and 224 and opposing end pieces 226 and 228 that combine to define
a perimeter structure. A center member 230 is coupled to the
elongated members 222 and 224 and provides structural support. A
rectangular opening 232 is provided through the end piece 228, and
accepts a fill tube and rotating tool to rotate the interbody
device 220 and provide the bone graft material within the perimeter
structure, as discussed above.
[0045] The foregoing discussion discloses and describes merely
exemplary embodiments of the present invention. One skilled in the
art will readily recognize from such discussion and from the
accompanying drawings and claims that various changes,
modifications and variations can be made therein without departing
from the spirit and scope of the invention as defined in the
following claims.
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