US20060036261A1 - Insertion guide for a spinal implant - Google Patents
Insertion guide for a spinal implant Download PDFInfo
- Publication number
- US20060036261A1 US20060036261A1 US11/204,062 US20406205A US2006036261A1 US 20060036261 A1 US20060036261 A1 US 20060036261A1 US 20406205 A US20406205 A US 20406205A US 2006036261 A1 US2006036261 A1 US 2006036261A1
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- United States
- Prior art keywords
- spinal implant
- insertion guide
- pieces
- piece
- guide
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
- 239000007943 implant Substances 0.000 title claims abstract description 149
- 238000003780 insertion Methods 0.000 title claims abstract description 94
- 230000037431 insertion Effects 0.000 title claims abstract description 94
- 238000000034 method Methods 0.000 claims description 29
- 239000000463 material Substances 0.000 claims description 8
- 230000000087 stabilizing effect Effects 0.000 claims description 2
- 230000006641 stabilisation Effects 0.000 claims 2
- 238000011105 stabilization Methods 0.000 claims 2
- 230000013011 mating Effects 0.000 claims 1
- 238000013461 design Methods 0.000 description 10
- 238000002513 implantation Methods 0.000 description 5
- 238000010276 construction Methods 0.000 description 4
- 238000011882 arthroplasty Methods 0.000 description 3
- 210000000988 bone and bone Anatomy 0.000 description 3
- 229910001220 stainless steel Inorganic materials 0.000 description 3
- 239000010935 stainless steel Substances 0.000 description 3
- 238000001356 surgical procedure Methods 0.000 description 3
- 229910052751 metal Inorganic materials 0.000 description 2
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- 241000333074 Eucalyptus occidentalis Species 0.000 description 1
- 206010061246 Intervertebral disc degeneration Diseases 0.000 description 1
- 208000027418 Wounds and injury Diseases 0.000 description 1
- 239000000560 biocompatible material Substances 0.000 description 1
- 230000006378 damage Effects 0.000 description 1
- 208000018180 degenerative disc disease Diseases 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 230000009395 genetic defect Effects 0.000 description 1
- 210000004247 hand Anatomy 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 208000021600 intervertebral disc degenerative disease Diseases 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
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- 230000000717 retained effect Effects 0.000 description 1
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Images
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2/4611—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/025—Joint distractors
- A61B2017/0256—Joint distractors for the spine
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/442—Intervertebral or spinal discs, e.g. resilient
- A61F2/4425—Intervertebral or spinal discs, e.g. resilient made of articulated components
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30383—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
- A61F2002/30387—Dovetail connection
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30601—Special structural features of bone or joint prostheses not otherwise provided for telescopic
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
- A61F2002/30616—Sets comprising a plurality of prosthetic parts of different sizes or orientations
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2002/4625—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof with relative movement between parts of the instrument during use
- A61F2002/4627—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof with relative movement between parts of the instrument during use with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00Â -Â A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
Definitions
- the present invention relates generally to apparatus and methods for use in spinal disc arthroplasty, and more particularly, to apparatus and methods for use in the insertion of disc replacement implants into the intervertebral space between two adjacent vertebrae.
- intervertebral disc degeneration is a problem suffered by many people.
- this spinal problem has been addressed by removing the disc material and replacing it with a spinal implant which fuses two adjacent vertebrae.
- spinal implant which fuses two adjacent vertebrae.
- spinal implants that permit relatively natural movement of the two adjacent vertebrae with respect to each other.
- disc replacement implants which act like normal functioning spinal discs.
- a spinal implant insertion guide includes at least one channel adapted for receiving and facilitating movement of at least two cooperating pieces of a spinal implant and a portion suitable for insertion into the intervertebral space between two vertebrae.
- the portion suitable for insertion into the intervertebral space is a projecting portion having a sloped height and a rounded end. This shape allows the portion to be easily inserted between the two vertebrae. After the projecting portion has been inserted between two vertebrae, the channel desirably extends into the intervertebral space, thereby allowing the implant to be implanted therein.
- the two pieces of the spinal implant may remain in cooperation with each other throughout movement in the at least one channel, however, slight movement of the pieces may be possible.
- the channel may further include slots for positioning the pieces of the spinal implant in cooperation with one another.
- the insertion guide according to this embodiment of the present invention may also include a plunger for facilitating the movement of the spinal implant pieces.
- the portion suitable for insertion into the intervertebral space between two vertebrae may cause distraction of the two vertebrae upon insertion.
- the insertion guide may be packaged with the spinal implant preloaded therein.
- the spinal implant may be loaded into the insertion guide immediately before a surgical procedure.
- the insertion guide may be constructed of a broad range of biocompatible materials such as stainless steel.
- the insertion guide is made of a polymeric material, thereby making it relatively inexpensive to construct and disposable.
- Another preferred embodiment of the present invention includes a spinal implant insertion guide having at least one channel suitable for receiving and facilitating movement of a spinal implant, the at least one channel extending into an intervertebral space between two vertebrae.
- the insertion guide desirably includes a portion suitable for insertion into the intervertebral space, and a plunger for facilitating the movement of the spinal implant into the intervertebral space.
- This embodiment of the present invention may be configured to allow for the insertion of a spinal implant of unitary construction.
- Yet another preferred embodiment of the present invention is a disposable spinal implant insertion guide including at least one channel suitable for receiving and facilitating movement of a spinal implant, the at least one channel extending into an intervertebral space between two vertebra, and a portion suitable for insertion into the intervertebral space.
- the disposable insertion guide according to this embodiment may be constructed from a broad range of materials including stainless steel or other metals.
- the insertion guide is made of a polymeric material.
- the kit desirably includes at least two insertion guides, the at least two insertion guides being of different dimensions.
- Each guide includes at least one channel suitable for receiving and facilitating movement of at least two cooperating pieces of a spinal implant, the at least one channel extending into an intervertebral space between two vertebrae.
- Each guide also includes a portion suitable for insertion into the intervertebral space. The pieces of the spinal implant remain in cooperation throughout movement in the at least one channel.
- the at least two insertion guides have different sized projecting portions suitable for insertion into the intervertebral space.
- the at least two insertion guides have different sized channels.
- a method of inserting an at least two piece spinal implant includes providing an insertion guide having at least one channel, inserting at least a portion of the insertion guide into an intervertebral space between two vertebrae, placing the at least two piece spinal implant into the at least one channel such that the spinal implant pieces cooperate with one another, and moving the spinal implant pieces together into the intervertebral space.
- the implant pieces preferably remain in cooperation throughout their insertion.
- the method according to this aspect of the present invention may also include distracting the vertebrae and/or preparing the vertebrae for receiving the spinal implant.
- the method may also include stabilizing the guide with respect to the vertebrae, with or without an external support.
- this method may also include providing and utilizing a plunger for facilitating the movement of the implant.
- Yet another preferred embodiment of the present invention includes a method of implanting a spinal implant of unitary construction.
- the method according to this embodiment includes providing an insertion guide having at least one channel, inserting at least a portion of the insertion guide into an intervertebral space between two vertebrae, placing the spinal implant into the at least one channel, and moving the spinal implant into the intervertebral space by manipulating a plunger in the at least one channel.
- Yet another embodiment of the present invention includes a method of implanting a multi-piece spinal implant.
- the method according to this embodiment includes providing an insertion guide having at least one channel, inserting at least a portion of the guide into an intervertebral space between two vertebrae, and moving the pieces through the at least one channel into the intervertebral space. During this movement of the pieces into the intervertebral space, the pieces are capable of slight movement with respect to each other.
- a preferred method in accordance with the present invention may be a method of inserting a multi-piece spinal implant.
- This method may include the steps of providing an insertion guide defined by a channel having at least two slots therein, inserting at least a portion of the insertion guide into an intervertebral space between two vertebrae, placing each piece of the multi-piece spinal implant into the channel such that each implant piece engages at least one slot and the spinal implant pieces cooperate with on another, and moving the spinal implant pieces into the intervertebral space while maintaining the spinal implant pieces in cooperation with one another and allowing slight movement of the spinal implant pieces with respect to each other.
- a preferred multi-piece spinal implant insertion guide in accordance with the present invention may include a channel including at least two slots, each of the at least two slots capable of engaging a different portion of a multi-piece spinal implant, and at least one extension suitable for insertion into an intervertebral space.
- the guide should be configured so that the pieces of the multi-piece spinal implant remain in cooperation throughout movement in the channel and are capable of slight movement with respect to each other.
- Yet another preferred multi-piece spinal implant insertion guide in accordance with the present invention may include a channel including at least two slots, each of the at least two slots capable of engaging a different portion of a multi-piece spinal implant, at least one extension suitable for insertion into an intervertebral space, and a plunger for facilitating movement of the spinal implant pieces.
- the guide should be configured so that the pieces of the multi-piece spinal implant remain in cooperation throughout movement in the channel and are capable of slight movement with respect to each other.
- FIG. 1 is a top perspective view of a spinal implant insertion guide according to an embodiment of the present invention.
- FIG. 2 is a side cross sectional view of the spinal implant insertion guide shown in FIG. 1 .
- FIG. 3 is a top plan view of the spinal implant insertion guide shown in FIG. 1 .
- FIG. 4 is a top perspective view of a spinal implant insertion guide according to another embodiment of the present invention.
- FIG. 5 is a side cross sectional view of the spinal implant insertion guide shown in FIG. 4 .
- FIG. 6 is a front plan view of a spinal implant insertion guide according to another embodiment of the present invention.
- FIGS. 1-3 there is shown in FIGS. 1-3 , in accordance with an embodiment of the present invention, an insertion guide for a spinal implant designated generally by reference numeral 10 .
- insertion guide 10 is designed to be used in aiding in the insertion of a spinal implant 7 .
- insertion guide 10 is of unitary construction having a top side 12 , a bottom side 14 , a proximal end 16 , and a distal end 18 .
- Guide 10 also includes a channel 20 adapted to receive a spinal implant 7 , and intervertebral extensions 22 and 24 that project from the distal end 18 of insertion guide 10 .
- Guide 10 is adapted for being inserted between two adjacent vertebrae 3 and 5 during a spinal surgical procedure.
- the intervertebral extensions 22 and 24 are preferably inserted into the intervertebral space 2 for distracting the adjacent vertebrae 3 and 5 , as shown in FIG. 2 .
- extensions 22 and 24 can be sized so that their insertion does not distract vertebrae 3 and 5 .
- Channel 20 is an opening within guide 10 configured and dimensioned to receive and allow sliding movement of spinal implant 7 from the proximal end 16 toward the distal end 18 . As best shown in FIG. 2 , the sliding movement allows insertion of implant 7 into intervertebral space 2 between vertebrae 3 and 5 .
- Channel 20 is defined by first lateral wall 26 , second lateral wall 28 , and distal end wall 30 . Distal end wall 30 preferably connects first wall 26 to second wall 28 .
- the guide 10 includes a channel 20 capable of receiving a multi-piece spinal implant 7 having two pieces 8 a and 8 b.
- channel 20 further includes four slots, 32 a and 32 b which are cut into first wall 26 and 32 c and 32 d which are cut into second wall 28 .
- the slots are preferably cut into the inner faces of the first and second lateral walls 26 and 28 .
- These slots engage and allow for two portions of each piece 8 a and 8 b to ride through channel 20 , while remaining in cooperation with one another.
- a second distal end wall may be located directly below posterior wall 30 to provide even more stability between the first and second lateral walls.
- implant 7 is sized so that its height is less than the distance between posterior wall 30 and any second posterior end wall located directly below wall 30 (not shown). Thus, a clearance between the implant and these walls exists, and implant 7 can be moved through channel 20 .
- Intervertebral extensions 22 and 24 are preferably narrower in height than the height of the first lateral wall 26 and second lateral wall 28 , respectively. Extensions 22 and 24 extend beyond the portion of the first and second walls at which distal end wall 30 intersects them. As best shown in FIGS. 1 and 2 , extensions 22 and 24 preferably increase in height in a direction from the distal end 18 toward the proximal end 16 . In the embodiment shown, the distal ends of extensions 22 , 24 are rounded in order to facilitate easy insertion into the space between the two vertebrae, and are spread to cause distraction of vertebrae 3 and 5 upon insertion. However, the distal ends of extensions 22 and 24 may be of any shape.
- extensions 22 , 24 may sized to distract or properly fit between the two vertebrae 3 and 5 .
- a result of the latter construction is that the two vertebrae are not distracted upon insertion of the extensions 22 , 24 therebetween. This may be useful in a surgery in which a separate distraction tool is utilized.
- extensions 22 , 24 each have a width which creates a space between the two extensions large enough to allow passage of implant 7 therethrough.
- implant pieces 8 a and 8 b are preferably allowed to ride along slots 32 a, 32 b, 32 c and 32 d and past extensions 22 , 24 during insertion between vertebrae 3 and 5 .
- the forced cooperation of the pieces is retained by way of vertebrae 3 and 5 .
- extensions 22 , 24 are not required to contact any portion of implant 7 .
- slots like slots 32 a, 32 b, 32 c and 32 d, which continue along the length of extensions 22 , 24 . Therefore, these slots would guide and retain implant pieces 8 a and 8 b in cooperation with one another throughout the entire passage through guide 10 .
- guide 10 may be fitted with a plunger or driver 40 .
- Plunger 40 includes a channel sized end 42 , an elongate shaft 44 , and a handle 46 .
- Channel sized end 42 is sized to fit snuggly within channel 20 , while also being capable of contacting implant 7 .
- Handle 46 is an easily operable handle, which allows a surgeon to facilitate movement of plunger 40 .
- Handle 46 preferably has a wide variety of designs, including ergonomic designs and thumb operable designs.
- Elongate shaft 44 creates a connection between end 42 and handle 46 . In certain preferred embodiments the elongate shaft 44 is dimensioned in length to allow for the full implantation of implant 7 within intervertebral space 2 , without the introduction of handle 46 into channel 20 .
- Another aspect of the present invention is a method for inserting a spinal implant into an intervertebral space.
- the method according to this aspect of the invention includes the step of providing an insertion guide as discussed above.
- the guide can be in accordance with any of the various embodiments disclosed herein, as the particular design may not cause the standard method step to significantly deviate.
- insertion guide 10 will be utilized below.
- intervertebral extensions 22 and 24 of guide 10 are inserted between vertebrae 3 and 5 .
- the insertion of such may cause distraction of vertebrae 3 and 5 from one another.
- a surgeon may simply utilize his own bare hands to push extensions 22 and 24 into intervertebral space 2 , or other tools such as hammers and mallets may be utilized, as for example in situations where vertebrae 3 and 5 are distracted during insertion of the guide.
- This distraction is accomplished by utilizing the rounded ends and/or sloped nature of the extensions to slowly insert guide 10 between vertebrae 3 and 5 to simultaneously distract the same.
- extensions 22 and 24 need not be sized for such distraction and can be dimensioned to allow for a snug fit between vertebrae 3 and 5 without causing significant distraction.
- vertebrae 3 and 5 may be prepared to receive an implant prior to the insertion of extensions 22 and 24 . Depending upon the type of implant, this may include the removal of the deteriorated or damaged disc material, and/or the shaping of the bone to better receive the implant. For example, when utilizing implants that include keels, spikes or other protrusions, it may be necessary to cut channels or otherwise remove bone from vertebrae 3 and 5 to allow for proper implantation of the implant. It is also contemplated that once guide 10 is inserted between vertebrae 3 and 5 , it may be supported by means other than the snug connection between the vertebrae. For example, an external support may be utilized to support guide 10 outside of the vertebrae. However, it is noted that often times, the fit of extensions 22 , 24 between vertebrae 3 and 5 and the pressure exerted thereby is enough hold guide 10 in place.
- spinal implant 7 is preferably then placed into channel 20 . It is also possible to pre-seat spinal implant 7 within channel 20 , prior to guide 10 being inserted between the vertebrae. The latter design may be important in providing prepackaged, easily autoclaved or otherwise sterilized individual units. Regardless of when implant 7 is placed into channel 20 , the inserted position of guide 10 allows for the implant to be moved into intervertebral space 2 .
- the multiple pieces are placed into the insertion guide so that they cooperate with one another (e.g.—their articulating surfaces mate), and remain in this cooperation throughout their movement into the intervertebral space.
- pieces 8 a and 8 b of implant 7 are in cooperation with each other, these pieces may be capable of slightly moving with respect to each other. This slight motion may aid in the insertion of implant 7 . For example, the slight motion may allow a surgeon to better manipulate pieces 8 a and 8 b to overcome hindrances caused by the adjacent vertebrae.
- guide 10 is configured and dimensioned so as to allow for the above noted slight movement of pieces 8 a and 8 b of implant 7 with respect to each other. More particularly, channel 20 and slots 32 a, 32 b, 32 c and 32 d may be configured and dimensioned to allow for enough clearance so that slight canting of implant pieces 8 a and 8 b, or slight translation of the two implant pieces may be accomplished. In certain embodiments, the slots may simply be larger than the portions of pieces 8 a and 8 b being inserted therein. This would create a clearance that may allow for the two implant pieces to be moved with respect to one another.
- any movement of pieces 8 a and 8 b with respect to each other should be such that the articulation surfaces of the two pieces remain in cooperation with each other.
- the movement may be slight movement that is merely a portion of that which is allowed by the aforementioned articulation surfaces of pieces 8 a and 8 b.
- allowing such slight movement may aid a surgeon during the implantation of implant 7 .
- such movement may not be necessary.
- the movement of spinal implant 7 into intervertebral space 2 is accomplished by applying a force to push the implant through channel 20 of the guide 10 and into the space.
- This force may be provided by utilizing a plunger 40 , as described above.
- plunger 40 is inserted into channel 20 subsequent to the placing of implant 7 therein.
- plunger 40 may be packaged in an inserted position. Operation of handle 46 allows a surgeon to more easily push implant 7 into intervertebral space 2 .
- the sizing of plunger 40 should be such that the channel sized end 42 can fully situate implant 7 into intervertebral space 2 , without handle 46 entering channel 20 .
- implant 7 may be seated in intervertebral space 2 in accordance with standard practices relating to the particular implant.
- implant 7 may be seated in intervertebral space 2 in accordance with standard practices relating to the particular implant.
- the individual pieces 8 a and 8 b of spinal implant 7 may both be cemented to adjacent vertebrae.
- various implants may have many different manners of being seated within an intervertebral space.
- certain spinal implants may include flanges for facilitating connection with a bone screw or keels/spikes for implantation into the vertebral endplates.
- end 42 of plunger 40 may be operatively connected to implant 7 , or in other embodiments, may merely be capable of abutting the implant.
- extensions 22 and 24 are sized so that insertion between vertebrae 3 and 5 causes distraction. However, this is not necessary. In embodiments in which the extensions are sized to facilitate distraction, the sloped configuration of extensions 22 and 24 allows for the increase of distraction of the vertebrae with respect to the further insertion of the extensions between the vertebrae.
- guide 10 may be removed. Similarly, guide 10 may be removed prior to the fixation of implant 7 to vertebrae 3 and 5 , respectively.
- extensions 22 and 24 are sized and configured to cause distraction of vertebrae 3 and 5
- removal of guide 10 may cause the vertebrae to return to their non-distracted position, thereby clamping and/or seating implant 7 in place. For implants that utilize keels or spikes, this vertebrae movement may cause the projections to become seated in their respective vertebrae.
- FIGS. 4 and 5 depict an insertion guide 110 used for inserting single piece implant 107 in accordance with other preferred embodiments of the present invention.
- guide 110 is similar in design to guide 10 , the only deviation in design residing in the inclusion of only two slots 132 a and 132 b, as opposed to the four slots of guide 10 .
- slots 132 a and 132 b are cut into first lateral wall 126 and second lateral wall 128 .
- guide 110 may be utilized in conjunction with a properly sized and dimensioned plunger 40 , in a manner like that disclosed above.
- a guide 210 includes an enclosed channel 220 for receiving a spinal implant. Walls 226 , 228 , 230 , and 232 define channel 220 , and rid guide 210 of the need for any slots.
- other guides may include cross sections that better suit the cross section of particular spinal implants. For example, guides having a rectangular cross section may be employed.
- the exterior surface of certain embodiments of the present invention may be shaped to allow for the easier insertion of the guide through an incision.
- any of the above guides and/or each of their respective elements and components may be constructed of any type of material suitable for insertion into the human body.
- these devices may be constructed of polymers.
Abstract
A spinal implant insertion guide is disclosed. The insertion guide includes at least one channel suitable for receiving and facilitating movement of a spinal implant into an intervertebral space between two vertebrae and a portion suitable for insertion into the intervertebral space. In embodiments for use with spinal implant having multiple pieces, the pieces of the spinal implant remain in cooperation throughout movement. The guide may further include a plunger for facilitating the movement of the spinal implant.
Description
- his application claims the benefit of the filing date of U.S. Provisional Patent Application No. 60/601,461 filed Aug. 13, 2004, the disclosure of which is hereby incorporated herein by reference
- The present invention relates generally to apparatus and methods for use in spinal disc arthroplasty, and more particularly, to apparatus and methods for use in the insertion of disc replacement implants into the intervertebral space between two adjacent vertebrae.
- Whether due to injury, wear, or genetic defect, intervertebral disc degeneration is a problem suffered by many people. Typically, this spinal problem has been addressed by removing the disc material and replacing it with a spinal implant which fuses two adjacent vertebrae. Recently, however, there has been a significant amount of activity directed toward filling the intervertebral space with spinal implants that permit relatively natural movement of the two adjacent vertebrae with respect to each other. In other words, it is now becoming relatively common to utilize disc replacement implants which act like normal functioning spinal discs.
- During a standard spinal disc arthroplasty, the damaged spinal disc material is removed and the two adjacent vertebrae are distracted to a distance sufficient to receive the spinal implant. Regardless of the type or size of implant utilized during spinal disc arthroplasty, one of the most difficult steps involves implanting the spinal implant in the intervertebral space. Often, a surgeon will struggle with properly inserting the spinal implant between two vertebrae. This is because inserting the implant requires moving the implant into the intervertebral space, while simultaneously distracting or spreading the two vertebrae. Heretofore, instruments utilized in this process have been rather cumbersome and difficult to manipulate, especially when implanting the aforementioned disc replacement implants.
- For the foregoing reasons, there exists a need for an insertion guide for and a method of inserting a disc replacement implant into an intervertebral space.
- In one preferred embodiment of the present invention, a spinal implant insertion guide includes at least one channel adapted for receiving and facilitating movement of at least two cooperating pieces of a spinal implant and a portion suitable for insertion into the intervertebral space between two vertebrae. The portion suitable for insertion into the intervertebral space is a projecting portion having a sloped height and a rounded end. This shape allows the portion to be easily inserted between the two vertebrae. After the projecting portion has been inserted between two vertebrae, the channel desirably extends into the intervertebral space, thereby allowing the implant to be implanted therein. The two pieces of the spinal implant may remain in cooperation with each other throughout movement in the at least one channel, however, slight movement of the pieces may be possible. There may be several embodiments relating to this aspect of the invention. For example, the channel may further include slots for positioning the pieces of the spinal implant in cooperation with one another. The insertion guide according to this embodiment of the present invention may also include a plunger for facilitating the movement of the spinal implant pieces. The portion suitable for insertion into the intervertebral space between two vertebrae may cause distraction of the two vertebrae upon insertion. In certain embodiments, the insertion guide may be packaged with the spinal implant preloaded therein. In other preferred embodiments, the spinal implant may be loaded into the insertion guide immediately before a surgical procedure. The insertion guide may be constructed of a broad range of biocompatible materials such as stainless steel. In certain preferred embodiments, the insertion guide is made of a polymeric material, thereby making it relatively inexpensive to construct and disposable.
- Another preferred embodiment of the present invention includes a spinal implant insertion guide having at least one channel suitable for receiving and facilitating movement of a spinal implant, the at least one channel extending into an intervertebral space between two vertebrae. The insertion guide desirably includes a portion suitable for insertion into the intervertebral space, and a plunger for facilitating the movement of the spinal implant into the intervertebral space. This embodiment of the present invention may be configured to allow for the insertion of a spinal implant of unitary construction.
- Yet another preferred embodiment of the present invention is a disposable spinal implant insertion guide including at least one channel suitable for receiving and facilitating movement of a spinal implant, the at least one channel extending into an intervertebral space between two vertebra, and a portion suitable for insertion into the intervertebral space. The disposable insertion guide according to this embodiment may be constructed from a broad range of materials including stainless steel or other metals. In one preferred embodiment, the insertion guide is made of a polymeric material.
- Another preferred embodiment of the present invention provides a spinal insertion guide kit. The kit desirably includes at least two insertion guides, the at least two insertion guides being of different dimensions. Each guide includes at least one channel suitable for receiving and facilitating movement of at least two cooperating pieces of a spinal implant, the at least one channel extending into an intervertebral space between two vertebrae. Each guide also includes a portion suitable for insertion into the intervertebral space. The pieces of the spinal implant remain in cooperation throughout movement in the at least one channel. In certain embodiments according to this aspect of the present invention, the at least two insertion guides have different sized projecting portions suitable for insertion into the intervertebral space. In other embodiments according to this aspect of the present invention, the at least two insertion guides have different sized channels.
- In another preferred embodiment of the present invention, a method of inserting an at least two piece spinal implant includes providing an insertion guide having at least one channel, inserting at least a portion of the insertion guide into an intervertebral space between two vertebrae, placing the at least two piece spinal implant into the at least one channel such that the spinal implant pieces cooperate with one another, and moving the spinal implant pieces together into the intervertebral space. The implant pieces preferably remain in cooperation throughout their insertion. The method according to this aspect of the present invention may also include distracting the vertebrae and/or preparing the vertebrae for receiving the spinal implant. The method may also include stabilizing the guide with respect to the vertebrae, with or without an external support. Finally, this method may also include providing and utilizing a plunger for facilitating the movement of the implant.
- Yet another preferred embodiment of the present invention includes a method of implanting a spinal implant of unitary construction. The method according to this embodiment includes providing an insertion guide having at least one channel, inserting at least a portion of the insertion guide into an intervertebral space between two vertebrae, placing the spinal implant into the at least one channel, and moving the spinal implant into the intervertebral space by manipulating a plunger in the at least one channel.
- Yet another embodiment of the present invention includes a method of implanting a multi-piece spinal implant. The method according to this embodiment includes providing an insertion guide having at least one channel, inserting at least a portion of the guide into an intervertebral space between two vertebrae, and moving the pieces through the at least one channel into the intervertebral space. During this movement of the pieces into the intervertebral space, the pieces are capable of slight movement with respect to each other.
- A preferred method in accordance with the present invention may be a method of inserting a multi-piece spinal implant. This method may include the steps of providing an insertion guide defined by a channel having at least two slots therein, inserting at least a portion of the insertion guide into an intervertebral space between two vertebrae, placing each piece of the multi-piece spinal implant into the channel such that each implant piece engages at least one slot and the spinal implant pieces cooperate with on another, and moving the spinal implant pieces into the intervertebral space while maintaining the spinal implant pieces in cooperation with one another and allowing slight movement of the spinal implant pieces with respect to each other.
- A preferred multi-piece spinal implant insertion guide in accordance with the present invention may include a channel including at least two slots, each of the at least two slots capable of engaging a different portion of a multi-piece spinal implant, and at least one extension suitable for insertion into an intervertebral space. Preferably, the guide should be configured so that the pieces of the multi-piece spinal implant remain in cooperation throughout movement in the channel and are capable of slight movement with respect to each other.
- Yet another preferred multi-piece spinal implant insertion guide in accordance with the present invention may include a channel including at least two slots, each of the at least two slots capable of engaging a different portion of a multi-piece spinal implant, at least one extension suitable for insertion into an intervertebral space, and a plunger for facilitating movement of the spinal implant pieces. Preferably, the guide should be configured so that the pieces of the multi-piece spinal implant remain in cooperation throughout movement in the channel and are capable of slight movement with respect to each other.
- The present invention will be better understood on reading the following detailed description of non-limiting embodiments thereof, and on examining the accompanying drawings, in which:
-
FIG. 1 is a top perspective view of a spinal implant insertion guide according to an embodiment of the present invention. -
FIG. 2 is a side cross sectional view of the spinal implant insertion guide shown inFIG. 1 . -
FIG. 3 is a top plan view of the spinal implant insertion guide shown inFIG. 1 . -
FIG. 4 is a top perspective view of a spinal implant insertion guide according to another embodiment of the present invention. -
FIG. 5 is a side cross sectional view of the spinal implant insertion guide shown inFIG. 4 . -
FIG. 6 is a front plan view of a spinal implant insertion guide according to another embodiment of the present invention. - In describing the preferred embodiments of the subject matter illustrated and to be described with respect to the drawings, specific terminology will be used for the sake of clarity. However, the invention is not intended to be limited to the specific terminology and includes all technical equivalence which operates in a similar manner to accomplish a similar purpose.
- Referring to the drawings, wherein like reference numerals represent like elements, there is shown in
FIGS. 1-3 , in accordance with an embodiment of the present invention, an insertion guide for a spinal implant designated generally byreference numeral 10. In the preferred embodiment shown in the figures,insertion guide 10 is designed to be used in aiding in the insertion of aspinal implant 7. As best shown inFIG. 1 ,insertion guide 10 is of unitary construction having atop side 12, abottom side 14, aproximal end 16, and adistal end 18.Guide 10 also includes achannel 20 adapted to receive aspinal implant 7, andintervertebral extensions distal end 18 ofinsertion guide 10.Guide 10 is adapted for being inserted between twoadjacent vertebrae intervertebral extensions intervertebral space 2 for distracting theadjacent vertebrae FIG. 2 . However, it is noted thatextensions vertebrae -
Channel 20 is an opening withinguide 10 configured and dimensioned to receive and allow sliding movement ofspinal implant 7 from theproximal end 16 toward thedistal end 18. As best shown inFIG. 2 , the sliding movement allows insertion ofimplant 7 intointervertebral space 2 betweenvertebrae Channel 20 is defined by firstlateral wall 26, secondlateral wall 28, anddistal end wall 30.Distal end wall 30 preferably connectsfirst wall 26 tosecond wall 28. In the particular preferred embodiment shown inFIG. 1 , theguide 10 includes achannel 20 capable of receiving a multi-piecespinal implant 7 having two pieces 8 a and 8 b. In order to facilitate this reception,channel 20 further includes four slots, 32 a and 32 b which are cut intofirst wall second wall 28. The slots are preferably cut into the inner faces of the first and secondlateral walls channel 20, while remaining in cooperation with one another. In certain embodiments, a second distal end wall may be located directly belowposterior wall 30 to provide even more stability between the first and second lateral walls. Preferably,implant 7 is sized so that its height is less than the distance betweenposterior wall 30 and any second posterior end wall located directly below wall 30 (not shown). Thus, a clearance between the implant and these walls exists, andimplant 7 can be moved throughchannel 20. -
Intervertebral extensions lateral wall 26 and secondlateral wall 28, respectively.Extensions distal end wall 30 intersects them. As best shown inFIGS. 1 and 2 ,extensions distal end 18 toward theproximal end 16. In the embodiment shown, the distal ends ofextensions vertebrae extensions extensions vertebrae extensions - Preferably, as shown in
FIG. 3 ,extensions implant 7 therethrough. In other words, in the preferred embodiment, implant pieces 8 a and 8 b are preferably allowed to ride alongslots 32 a, 32 b, 32 c and 32 d andpast extensions vertebrae vertebrae extensions implant 7. However, it is contemplated to provide slots, likeslots 32 a, 32 b, 32 c and 32 d, which continue along the length ofextensions guide 10. - As best shown in
FIGS. 2 and 3 , guide 10 may be fitted with a plunger ordriver 40.Plunger 40 includes a channelsized end 42, anelongate shaft 44, and ahandle 46. Channelsized end 42, as shown inFIGS. 2 and 3 , is sized to fit snuggly withinchannel 20, while also being capable of contactingimplant 7.Handle 46 is an easily operable handle, which allows a surgeon to facilitate movement ofplunger 40.Handle 46 preferably has a wide variety of designs, including ergonomic designs and thumb operable designs.Elongate shaft 44 creates a connection betweenend 42 and handle 46. In certain preferred embodiments theelongate shaft 44 is dimensioned in length to allow for the full implantation ofimplant 7 withinintervertebral space 2, without the introduction ofhandle 46 intochannel 20. - Another aspect of the present invention is a method for inserting a spinal implant into an intervertebral space. The method according to this aspect of the invention includes the step of providing an insertion guide as discussed above. It is noted that the guide can be in accordance with any of the various embodiments disclosed herein, as the particular design may not cause the standard method step to significantly deviate. For the sake of ease in explaining the method,
insertion guide 10 will be utilized below. - Initially,
intervertebral extensions guide 10 are inserted betweenvertebrae extensions vertebrae extensions intervertebral space 2, or other tools such as hammers and mallets may be utilized, as for example in situations wherevertebrae guide 10 betweenvertebrae extensions vertebrae - In certain embodiments,
vertebrae extensions vertebrae guide 10 is inserted betweenvertebrae guide 10 outside of the vertebrae. However, it is noted that often times, the fit ofextensions vertebrae enough hold guide 10 in place. - Subsequent to guide 10 being inserted into
intervertebral space 2,spinal implant 7 is preferably then placed intochannel 20. It is also possible to pre-seatspinal implant 7 withinchannel 20, prior to guide 10 being inserted between the vertebrae. The latter design may be important in providing prepackaged, easily autoclaved or otherwise sterilized individual units. Regardless of whenimplant 7 is placed intochannel 20, the inserted position ofguide 10 allows for the implant to be moved intointervertebral space 2. For embodiments in which a spinal implant having two or more pieces is being implanted, it should be noted that the multiple pieces are placed into the insertion guide so that they cooperate with one another (e.g.—their articulating surfaces mate), and remain in this cooperation throughout their movement into the intervertebral space. It should also be noted that while pieces 8 a and 8 b ofimplant 7 are in cooperation with each other, these pieces may be capable of slightly moving with respect to each other. This slight motion may aid in the insertion ofimplant 7. For example, the slight motion may allow a surgeon to better manipulate pieces 8 a and 8 b to overcome hindrances caused by the adjacent vertebrae. - In a preferred embodiment, guide 10 is configured and dimensioned so as to allow for the above noted slight movement of pieces 8 a and 8 b of
implant 7 with respect to each other. More particularly,channel 20 andslots 32 a, 32 b, 32 c and 32 d may be configured and dimensioned to allow for enough clearance so that slight canting of implant pieces 8 a and 8 b, or slight translation of the two implant pieces may be accomplished. In certain embodiments, the slots may simply be larger than the portions of pieces 8 a and 8 b being inserted therein. This would create a clearance that may allow for the two implant pieces to be moved with respect to one another. It is noted that any movement of pieces 8 a and 8 b with respect to each other should be such that the articulation surfaces of the two pieces remain in cooperation with each other. For example, the movement may be slight movement that is merely a portion of that which is allowed by the aforementioned articulation surfaces of pieces 8 a and 8 b. As mentioned above, allowing such slight movement may aid a surgeon during the implantation ofimplant 7. However, in certain cases, such movement may not be necessary. - The movement of
spinal implant 7 intointervertebral space 2 is accomplished by applying a force to push the implant throughchannel 20 of theguide 10 and into the space. This force may be provided by utilizing aplunger 40, as described above. In these embodiments,plunger 40 is inserted intochannel 20 subsequent to the placing ofimplant 7 therein. Once again, in the prepackaged units mentioned above,plunger 40 may be packaged in an inserted position. Operation ofhandle 46 allows a surgeon to more easily pushimplant 7 intointervertebral space 2. In certain preferred embodiments, the sizing ofplunger 40 should be such that the channelsized end 42 can fully situateimplant 7 intointervertebral space 2, withouthandle 46 enteringchannel 20. Onceimplant 7 is moved intointervertebral space 2, guide 10 may be removed from its position betweenvertebrae implant 7 may be seated inintervertebral space 2 in accordance with standard practices relating to the particular implant. For example, the individual pieces 8 a and 8 b ofspinal implant 7 may both be cemented to adjacent vertebrae. However, it is also contemplated that various implants may have many different manners of being seated within an intervertebral space. For example, certain spinal implants may include flanges for facilitating connection with a bone screw or keels/spikes for implantation into the vertebral endplates. It is noted that in certain embodiments, end 42 ofplunger 40 may be operatively connected toimplant 7, or in other embodiments, may merely be capable of abutting the implant. - In certain embodiments,
extensions vertebrae extensions implant 7, guide 10 may be removed. Similarly, guide 10 may be removed prior to the fixation ofimplant 7 tovertebrae extensions vertebrae guide 10 may cause the vertebrae to return to their non-distracted position, thereby clamping and/orseating implant 7 in place. For implants that utilize keels or spikes, this vertebrae movement may cause the projections to become seated in their respective vertebrae. -
FIGS. 4 and 5 depict aninsertion guide 110 used for insertingsingle piece implant 107 in accordance with other preferred embodiments of the present invention. As shown in these figures, guide 110 is similar in design to guide 10, the only deviation in design residing in the inclusion of only two slots 132 a and 132 b, as opposed to the four slots ofguide 10. As in the design ofguide 10, slots 132 a and 132 b are cut into firstlateral wall 126 and secondlateral wall 128. Also as inguide 10, guide 110 may be utilized in conjunction with a properly sized and dimensionedplunger 40, in a manner like that disclosed above. - It is also contemplated that while the designs of both guide 10 and guide 110 include at least two slots for receiving and holding the spinal implant, designs are envisioned that do not require slots. For example, as shown in
FIG. 6 , a guide 210 includes anenclosed channel 220 for receiving a spinal implant.Walls channel 220, and rid guide 210 of the need for any slots. Rather than the substantially square cross section ofguide 220, other guides may include cross sections that better suit the cross section of particular spinal implants. For example, guides having a rectangular cross section may be employed. Similarly, the exterior surface of certain embodiments of the present invention may be shaped to allow for the easier insertion of the guide through an incision. For example, the exterior surface of a guide may be rounded. Once again, guide 210, likeguides 10 and 100, can be used in conjunction with a properly sized and dimensionedplunger 40, in a manner like that disclosed above. Finally, it is noted that any of the above guides and/or each of their respective elements and components may be constructed of any type of material suitable for insertion into the human body. For example, it is contemplated to construct any of the guides and/or plungers of metals such as stainless steel. In addition, these devices may be constructed of polymers. - Although the invention herein has been described with reference to particular embodiments, it is to be understood that these embodiments are merely illustrative of the principles and applications of the present invention. It is therefore to be understood that numerous modifications may be made to the illustrative embodiments and that other arrangements may be devised without departing from the spirit and scope of the present invention as defined by the appended claims.
Claims (20)
1. A method of inserting a multi-piece spinal implant comprising:
providing an insertion guide defined by a channel having at least two slots therein;
inserting at least a portion of the insertion guide into an intervertebral space between two vertebrae;
placing each piece of the multi-piece spinal implant into the channel such that each implant piece engages at least one slot and the spinal implant pieces cooperate with one another; and
moving the spinal implant pieces into the intervertebral space while maintaining the spinal implant pieces in cooperation with one another and allowing slight canting of the spinal implant pieces with respect to each other.
2. The method according to claim 1 , wherein said insertion guide further includes at least one extension for insertion into the intervertebral space.
3. The method according to claim 2 , wherein said inserting step includes distracting the vertebrae.
4. The method according to claim 1 , further including the step of preparing each vertebrae for receiving the spinal implant.
5. The method according to claim 1 , further including the step of stabilizing the insertion guide with respect to the vertebrae.
6. The method according to claim 5 , wherein the stabilization is achieved by supporting the insertion guide outside of the vertebrae.
7. The method according to claim 1 , wherein the stabilization is achieved by supporting the insertion guide within the vertebrae.
8. The method according to claim 1 , wherein the insertion guide further includes a plunger.
9. The method according to claim 8 , wherein said moving step includes manipulating the plunger to move the spinal implant pieces.
10. The method according to claim 9 , wherein the plunger is inserted into the channel subsequent to the spinal implant pieces.
11. The method according to claim 1 , wherein said placing step is performed prior to said inserting step.
12. A multi-piece spinal implant insertion guide comprising:
a channel including at least two slots lying in a transverse plane, each of the at least two slots capable of engaging a different portion of a multi-piece spinal implant; and
at least one extension suitable for insertion into an intervertebral space,
wherein said guide is configured so that the pieces of the multi-piece spinal implant remain in cooperation throughout movement in said channel and are capable of slight movement with respect to each other.
13. The multi-piece spinal implant insertion guide of claim 12 , further comprising a plunger for facilitating movement of the spinal implant pieces.
14. The multi-piece spinal implant insertion guide of claim 12 , wherein said at least one extension is capable of causing distraction of adjacent vertebrae.
15. The multi-piece spinal implant insertion guide of claim 12 , wherein the cooperation of the pieces of the multi-piece spinal implant includes the mating of at least two articulating surfaces.
16. The multi-piece spinal implant insertion guide of claim 12 , further comprising a multi-piece implant disposed within said channel.
17. The spinal implant insertion guide of claim 12 , wherein said insertion guide is packaged with a spinal implant.
18. The spinal implant insertion guide of claim 17 , wherein said insertion guide and the spinal implant are sterilized.
19. The spinal implant insertion guide of claim 12 , wherein said insertion guide is constructed of a polymeric material.
20. A multi-piece spinal implant insertion guide comprising:
a channel including at least two slots lying in a transverse plane, each of the at least two slots capable of engaging a different portion of a multi-piece spinal implant;
at least one extension suitable for insertion into an intervertebral space; and,
a plunger for facilitating movement of the spinal implant pieces,
wherein said guide is configured so that the pieces of the multi-piece spinal implant remain in cooperation throughout movement in said channel and are capable of slight movement with respect to each other.
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