CA2363562A1 - Nested interbody spinal fusion implants - Google Patents

Nested interbody spinal fusion implants Download PDF

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Publication number
CA2363562A1
CA2363562A1 CA002363562A CA2363562A CA2363562A1 CA 2363562 A1 CA2363562 A1 CA 2363562A1 CA 002363562 A CA002363562 A CA 002363562A CA 2363562 A CA2363562 A CA 2363562A CA 2363562 A1 CA2363562 A1 CA 2363562A1
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CA
Canada
Prior art keywords
implant
implants
adjacent vertebral
arcuate portions
vertebral bodies
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.)
Granted
Application number
CA002363562A
Other languages
French (fr)
Other versions
CA2363562C (en
Inventor
Gary Karlin Michelson
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Warsaw Orthopedic Inc
Original Assignee
Gary Karlin Michelson
Sdgi Holdings, Inc.
Warsaw Orthopedic, Inc.
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Filing date
Publication date
Application filed by Gary Karlin Michelson, Sdgi Holdings, Inc., Warsaw Orthopedic, Inc. filed Critical Gary Karlin Michelson
Publication of CA2363562A1 publication Critical patent/CA2363562A1/en
Application granted granted Critical
Publication of CA2363562C publication Critical patent/CA2363562C/en
Anticipated expiration legal-status Critical
Expired - Fee Related legal-status Critical Current

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Classifications

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    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
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Abstract

Tapered root threaded hollow perforated interbody spinal fusion implants (10 0, 200) are disclosed for placement into a disc space in a human spine between adjacent vertebral bodies. The implants have opposite arcuate portions (134, 134', 234, 234') with lockable screws (500) passing therethrough for engagin g each of the adjacent vertebral bodies. The implants are adapted for use in side-by-side pairs such that a portion of the circumference of a first impla nt nests within the circumference of a second implant, so as to have a reduced combined width.

Claims (100)

1. A pair of interbody spinal fusion implants for insertion across a disc space between two adjacent vertebral bodies of a spine, said pair of implants comprising:
a first spinal fusion implant having a leading end, a trailing end opposite said leading end and a mid-longitudinal axis and length therebetween, said first implant having opposite arcuate portions adapted for placement toward and at least in part within the adjacent vertebral bodies and having a distance therebetween defining a first implant height greater than the normal height of the disc space to be fused, said opposite arcuate portions being angled toward each other along at least a portion of said length, each of said opposite arcuate portions having at least one opening communicating with one another for permitting the growth of bone from vertebral body to adjacent vertebral body through said first implant, at least a portion of a thread formed on the exterior of each of said opposite arcuate portions for penetrably engaging the adjacent vertebral bodies and to facilitate securing said first implant into the spine by at least in part rotating said first implant about the mid-longitudinal axis of said first implant, said first implant having a lateral side and a medial side and having a distance therebetween defining an implant width transverse to said first implant height, said implant width being less than said first implant height along at least a portion of the length of said first implant; and a second spinal fusion implant having a leading end, a trailing end opposite said leading end and a mid-longitudinal axis and length therebetween, said second implant having opposite arcuate portions adapted for placement toward and at least in part within the adjacent vertebral bodies and having a distance therebetween defining a second implant height greater than the normal height of the disc space to be fused, said opposite arcuate portions being angled toward each other along at least a portion of said length, each of said opposite arcuate portions having at least one opening communicating with one another for permitting the growth of bone from vertebral body to adjacent vertebral body through said second implant, at least a portion of a thread formed on the exterior of each of said opposite arcuate portions for penetrably engaging the adjacent vertebral bodies and to facilitate securing said second implant into the spine by at least in part rotating said second implant about the mid-longitudinal axis of said second implant, said second implant having a lateral side and a medial side and having a distance therebetween defining an implant width transverse to said second implant height, said medial side of said first implant being configured to be positioned in close proximity to said second implant;
said first and second implants having a combined width therebetween less than the combined height of said first implant and said second implant when said medial side of said second implant is placed in close proximity to said medial side of said first implant.
2. The implants of claim 1, wherein said medial side of said first implant is at least in part concave along the length of said first implant.
3. The implants of claim 1, wherein said medial side of said first implant is open along at least a portion the length of said first implant.
4. The implants of claim 3, wherein said lateral side of said first implant is open along at least a portion of the length of said first implant.
5. The implants of claim 1, wherein said medial side of said first implant is configured to receive at least a portion of said medial side of said second implant.
6. The implants of claim 5, wherein said lateral side of said first implant is configured to receive at least a portion of said medial side of said second implant.
7. The implants of claim 1, wherein said trailing ends of said first and second implants have a perimeter and said perimeter of said trailing end of said first implant proximate said medial side is configured to receive at least a portion of said perimeter of said trailing end of said second implant when said second implant is placed in close proximity to said first implant.
8. The implants of claim 1, wherein said trailing ends of said first and second implants have a perimeter and said perimeter of said trailing end of said first implant proximate said lateral side is configured to receive at least a portion of said perimeter of said trailing end of said second implant when said second implant is placed in close proximity to said first implant.
9. The implants of claim 1, wherein said second implant has an outer diameter having a circumference and said medial side of said first implant is adapted to receive at least a portion of the circumference of the outer diameter of said second implant.
10. The implants of claim 1, wherein said second implant has an outer diameter having a circumference and said lateral side of said first implant is adapted to receive at least a portion of the circumference of the outer diameter of said second implant.
11. The implants of claim 1, wherein said first implant has a hollow interior and said medial side of said first implant includes an aperture for loading bone growth promoting material into said hollow interior.
12. The implants of claim 11, wherein said bone promoting material is compressively loaded into said implant.
13. The implants of claim 1, wherein said trailing end of at least one of said first and second implants is rotationally asymmetrical along its mid-longitudinal axis.
14. The implants of claim 1, wherein said trailing end of at least one of said first and second implants is rotationally symmetrical along its mid-longitudinal axis.
15. The implants of claim 1, wherein said trailing end of at least one of said first and second implants is anatomically contoured to correspond to the natural contour of at least a portion of the anterior aspect of the vertebral bodies.
16. The implants of claim 1, wherein said trailing end of at least one of said first and second implants is contoured to sit proximate to the anterior rim of the vertebral body and conforms thereto.
17. The implants of claim 1, wherein at least one of said first and second implants has a lesser length along said lateral side than through its mid-longitudinal axis.
18. The implants of claim 1, wherein at least one of said first and second implants has a length along its mid-longitudinal axis greater than the length along said medial side and said lateral side.
19. The implants of claim 1, wherein at least one of said first and second implants includes opposed and divergently angled openings extending from said trailing end and through said arcuate portions adapted to receive opposed vertebral bone engaging screws, and is configured so that said bone screw receiving openings are adapted to be oriented towards the adjacent vertebral bodies in half rotation increments of said implant.
20. The implants of claim 1, wherein said trailing end of at least one of said first and second implants is configured to cooperatively engage an implant driver.
21. The implants of claim 1, wherein said thread of at least one of said first and second implants has peaks and said peaks are relatively constant along its length so that the outer diameter of said implant is generally constant.
22. The implants of claim 1, wherein said thread of at least one of said first and second implants has a substantially constant height as measured from said opposite arcuate portions over a substantial portion of its length.
23. The implants of claim 1, wherein said thread of at least one of said first and second implants is interrupted.
24. The implants of claim 1, wherein said thread of at least one of said first and second implants is configured for linear advancement of said implant and requires an element of rotation to set said thread into the bone of the adjacent vertebral bodies.
25. The implants of claim 24, wherein said element of rotation is approximately 90 degrees.
26. The implants of claim 1, wherein said thread of at least one of said first and second implants has a sharp pointed profile at said leading end and progresses to a thicker and more squared profile at said trailing end.
27. The implants of claim 1, wherein said thread of at least one of said first and second implants is a projection generally oriented perpendicular to the mid-longitudinal axis.
28. The implants of claim 1, wherein said thread of at least one of said first and second implants forms a single helix.
29. The implants of claim 1, wherein said thread of at least one of said first and second implants is a fin.
30. The implants of claim 1, wherein said thread of at least one of said first and second implants comprises a ridge.
31. The implants of claim 1, further comprising a hollow defined between said arcuate portions in communication with said openings in each of said arcuate portions, said hollow being adapted to receive fusion-promoting substances.
32. The implants of claim 31, wherein at least one of said leading and trailing ends are open to allow access to said hollow.
33. The implants of claim 1, wherein said openings are sufficiently sized and located to allow for interbody spinal fusion through said implant.
34. The implants of claim 1, wherein said opposite arcuate portions form at least a portion of a cylinder along the length of said implant.
35. The implants of claim 1, wherein said opposite arcuate portions form a generally frusto-conical shape.
36. The implants of claim 1, wherein at least one of said first and second implants is tapered along a substantial portion of its length.
37. The implants of claim 1, wherein said first and second implants are adapted to be placed side-by-side in close proximity to each other such that said mid-longitudinal axes are convergent proximate said leading ends.
38. The implants of claim 1, wherein at least one of said first and second implants has an interior, and at least one of said opposite arcuate portions has a screw hole adapted to transmit a screw therethrough and into one of the vertebral bodies, said trailing end adapted to receive a screw therefthrough and passing through said interior of said implant and through said screw hole and into one of the adjacent vertebral bodies.
39. The implants of claim 38, wherein each of said opposite arcuate portions has at least one screw hole passing therethrough adapted to transmit a screw passing from said trailing end through said interior of said implant and into the adjacent vertebral body in contact with each of said arcuate portions, respectively.
40. The implants of claim 38, further comprising at least one screw adapted to pass from said interior of said implant through said screw hole and into the adjacent vertebral body to anchor said implant to the adjacent vertebral body.
41. The implants of claim 1, wherein said trailing end of at least one of said first and second implants is adapted to receive opposed bone screws and to transmit at least a portion of the screws through said arcuate portions so as to engage at least one each into each of the vertebral bodies adjacent the disc space.
42. The implants of claim 1, wherein said trailing end of at least one of said first and second implants includes opposed and divergently angled openings extending from said trailing end and through said opposite arcuate portions adapted to receive opposed vertebral bone engaging screws.
43. The implants of claim 38, wherein said trailing end of at least one of said first and second implants includes retaining seats circumferentially around said screw holes adapted to receive and to block the passage of at least a portion of the screws to be inserted therethrough.
44. The implants of claim 38, wherein said trailing end of at least one of said first and second implants is configured to cooperatively engage a lock for locking opposed bone screws to said implant.
45. The implants of claim 38, further including a lock for preventing backing out of the bone screws from said implant.
46. The implants of claim 45, wherein the bone screws are lag screws and said lock allows for angular motion of the lag screws relative to the implant.
47. The implants of claim 45 wherein said lock is insertable into one of said first and second implants.
48. The implants of claim 38 in combination with a bone screw.
49. The implants of claim 48 in combination with a lock for locking said bone screw.
50. The implants of claim 1, further comprising a cap for closing at least one of said ends of said first and second implants, said cap having an exterior surface and an interior surface.
51. The implants of claim 50, wherein said interior surface of said cap has spaced slots about its circumference to facilitate a snap fit of said cap into said implant.
52. The implants of claim 50, wherein said cap includes a threaded portion for threadably engaging said leading end of at least one of said first and second implants.
53. The implants of claim 50, wherein said cap is perforated.
54. The implants of claim 1, wherein at least one of said first and second implants comprises bone.
55. The implants of claim 54, wherein said bone includes cortical bone.
56. The implants of claim 1, wherein at least one of said first and second implants comprises bone growth promoting material.
57. The implants of claim 56, wherein said bone growth promoting material is selected from one of bone morphogenetic protein, hydroxyapatite, and genes coding for the production of bone.
58. The implants of claim 1, wherein at least one of said first and second implants is treated with a bone growth promoting substance.
59. The implants of claim 1, wherein at least one of said first and second implants is a source of osteogenesis.
60. The implants of claim 1, wherein at least one of said first and second implants is at least in part bioabsorbable.
61. The implants of claim 1, wherein at least one of said first and second implants comprises a plastic material.
62. The implants of claim 1, wherein at least one of said first and second implants comprises a ceramic material.
63. The implants of claim 1, wherein at least one of said first and second implants is formed of a porous material.
64. The implants of claim 1, wherein at least one of said first and second implants is formed of a material that intrinsically participates in the growth of bone from adjacent vertebral body to adjacent vertebral body through said implants.
65. The implants of claim 1, wherein at least one of said first and second implants has an interior surface and a hollow defined therein, said hollow being capable of containing bone growth promoting material.
66. The implants of claim 65, wherein said bone growth promoting material is selected from one of bone morphogenetic protein, hydroxyapatite, and genes coding for the production of bone.
67. The implants of claim 1, wherein said at least one opening is adapted to retain fusion-promoting materials.
68. The implants of claim 1, wherein at least a portion of at least one of said first and second implants is treated to promote bone ingrowth between said implant and said adjacent vertebral bodies.
69. The implants of claim 1, in combination with a chemical substance to inhibit scar formation.
70. The implants of claim 1, wherein at least one of said first and second implants comprises cancellously structured tantalum.
71. A pair of interbody spinal fusion implants for insertion across a disc space between two adjacent vertebral bodies of a spine, said pair of implants comprising:
a first spinal fusion implant having a leading end, a trailing end opposite said leading end and a mid-longitudinal axis and length therebetween, said first implant having opposite arcuate portions adapted for placement toward and at least in part within the adjacent vertebral bodies and having a distance therebetween defining a first implant height greater than the normal height of the disc space to be fused, each of said opposite arcuate portions having at least one opening communicating with one another for permitting the growth of bone from vertebral body to adjacent vertebral body through said first implant, each of said opposite arcuate portions having at least one screw hole passing therethrough adapted to transmit a screw passing from said trailing end through the interior of said implant and into the adjacent vertebral body in contact with each of said arcuate portions, respectively, a bone penetrating protrusion formed on the exterior of each of said opposite arcuate portions for penetrably engaging the adjacent vertebral bodies and to facilitate securing said first implant into the spine by at least in part rotating said first implant about the mid-longitudinal axis of said first implant, said first implant having a lateral side and a medial side and having a distance therebetween defining an implant width transverse to said first implant height, said implant width being less than said first implant height along at least a portion of the length of said first implant, said medial side being configured to be positioned in close proximity to another spinal implant;
a second spinal fusion implant having a leading end, a trailing end opposite said leading end and a mid-longitudinal axis and length therebetween, said second implant having opposite arcuate portions adapted for placement toward and at least in part within the adjacent vertebral bodies and having a distance therebetween defining a second implant height greater than the normal height of the disc space to be fused, each of said opposite arcuate portions having at least one opening communicating with one another for permitting the growth of bone from vertebral body to adjacent vertebral body through said second implant, each of said opposite arcuate portions having at least one screw hole passing therethrough adapted to transmit a screw passing from said trailing end through the interior of said implant and into the adjacent vertebral body in contact with each of said arcuate portions, respectively, a bone penetrating protrusion formed on the exterior of each of said opposite arcuate portions for penetrably engaging the adjacent vertebral bodies and to facilitate securing said second implant into the spine by at least in part rotating said second implant about the mid-longitudinal axis of said second implant, said second implant having a lateral side and a medial side and having a distance therebetween defining an implant width transverse to said second implant height; and said first and second implants having a combined width therebetween less than the combined height of said first implant and said second implant when said medial side of said second implant is placed in close proximity to said medial side of said first implant.
72. The implants of claim 38, further comprising at least one screw adapted to pass from said interior of said implant through said screw hole and into the adjacent vertebral body to anchor said implant to the adjacent vertebral body.
73. The implants of claim 1, wherein said trailing end of at least one of said first and second implants is adapted to receive opposed bone screws and to transmit at least a portion of the screws through said arcuate portions so as to engage at least one each into each of the vertebral bodies adjacent the disc space.
74. The implants of claim 38, wherein said trailing end of at least one of said first and second implants includes retaining seats circumferentially around said screw holes adapted to receive and to block the passage of at least a portion of the screws to be inserted therethrough.
75. The implants of claim 38, wherein said trailing end of at least one of said first and second implants is configured to cooperatively engage a lock for locking opposed bone screws to said implant.
76. The implants of claim 38, further including a lock for preventing backing out of the bone screws from said implant.
77. The implants of claim 76, wherein the bone screws are lag screws and said lock allows for angular motion of the lag screws relative to the implant.
78. The implants of claim 71, wherein said bone penetrating protrusion includes at least one of said first and second implants comprises a fin.
79. The implants of claim 71, wherein said bone penetrating protrusion of at least one of said first and second implants comprises a ridge.
80. The implants of claim 71, wherein said bone penetrating protrusion of at least one of said first and second implants is configured for linear advancement of said implant and requires an element of rotation to set said thread into the bone of the adjacent vertebral bodies.
81. The implants of claim 80, wherein said element of rotation is approximately 90 degrees.
82. The implants of claim 71, wherein said bone penetrating protrusion of at least one of said first and second implants comprises a thread.
83. A pair of interbody spinal fusion implants for insertion across a disc space between two adjacent vertebral bodies of a spine, said pair of implants comprising:
a first spinal fusion implant having a leading end, a trailing end opposite said leading end and a mid-longitudinal axis and length therebetween, said trailing end being anatomically contoured to correspond to the natural contour of at least a portion of the anterior aspect of the vertebral bodies, said first implant having opposite arcuate portions adapted for placement toward and at least in part within the adjacent vertebral bodies and having a distance therebetween defining a first implant height greater than the normal height of the disc space to be fused, each of said opposite arcuate portions having at least one opening communicating with one another for permitting the growth of bone from vertebral body to adjacent vertebral body through said first implant, at least a portion of a thread formed on the exterior of each of said opposite arcuate portions for penetrably engaging the adjacent vertebral bodies and to facilitate securing said first implant into the spine by at least in part rotating said first implant about the mid-longitudinal axis of said first implant, said first implant having a lateral side and a medial side and having a distance therebetween defining an implant width transverse to said first implant height, said implant width being less than said first implant height along at least a portion of the length of said first implant; and a second spinal fusion implant having a leading end, a trailing end opposite said leading end and a mid-longitudinal axis and length therebetween, said trailing end being anatomically contoured to correspond to the natural contour of at least a portion of the anterior aspect of the vertebral bodies, said second implant having opposite arcuate portions adapted for placement toward and at least in part within the adjacent vertebral bodies and having a distance therebetween defining a second implant height greater than the normal height of the disc space to be fused, each of said opposite arcuate portions having at least one opening communicating with one another for permitting the growth of bone from vertebral body to adjacent vertebral body through said second implant, at least a portion of a thread formed on the exterior of each of said opposite arcuate portions for penetrably engaging the adjacent vertebral bodies and to facilitate securing said second implant into the spine by at least in part rotating said second implant about the mid-longitudinal axis of said second implant, said second implant having a lateral side and a medial side and having a distance therebetween defining an implant width transverse to said second implant height, said medial side of said first implant being configured to be positioned in close proximity to said second implant;
said first and second implants having a combined width therebetween less than the combined height of said first implant and said second implant when said medial side of said second implant is placed in close proximity to said medial side of said first implant.
84. The implants of claim 83, wherein said trailing end of at least one of said first and second implants is rotationally asymmetrical along its mid-longitudinal axis.
85. The implants of claim 83, wherein said trailing end of at least one of said first and second implants is rotationally symmetrical along its mid-longitudinal axis.
86. An interbody spinal fusion implant for insertion across a disc space between two adjacent vertebral bodies of a spine, said implant comprising:
a leading end, a trailing end opposite said leading end and a mid-longitudinal axis and length therebetween;
a hollow interior;
opposite arcuate portions adapted for placement toward and at least in part within the adjacent vertebral bodies and having a distance therebetween defining an implant height greater than the normal height of the disc space to be fused, each of said opposite arcuate portions having at least one opening communicating with one another for permitting the growth of bone from vertebral body to adjacent vertebral body through said hollow interior of said implant;
at least a portion of a thread formed on the exterior of each of said opposite arcuate portions for penetrably engaging the adjacent vertebral bodies and to facilitate securing said implant into the spine by at least in part rotating said implant about the mid-longitudinal axis;
a leading support wall connecting said opposite arcuate portions at said leading end;
a trailing support wall connecting said opposite arcuate portions at said trailing end; and a lateral side and a medial side opposite said lateral side, said medial side being configured to be positioned in close proximity to another implant, wherein the area between said leading end and trailing end along a substantial portion of said medial side is substantially open.
87. An interbody spinal fusion implant for surgical implantation within a disc space between two adjacent vertebral bodies in a segment of a human spine, said implant comprising:

opposed upper and lower arcuate portions for contacting each of the adjacent vertebral bodies when positioned therein, each of said upper and lower arcuate portions having at least one opening adapted to communicate with one of the adjacent vertebral bodies, said openings of said upper and lower portions being in communication with one another and adapted for permitting for the growth of bone from adjacent vertebral body to adjacent vertebral body through said implant;
at least a portion of a helical thread formed on the exterior of each of said opposed arcuate portions of said upper and lower members for penetrably engaging the adjacent vertebral bodies and to facilitate securing said implant into the spine by at least in part rotating said implant about the longitudinal axis of said implant, said thread having a pitch;
an insertion end for entry into the spine, a trailing end opposite said insertion end, and a length therebetween; and a characteristic on said trailing end of said implant adapted for indicating a rotational orientation of said openings in said upper and lower arcuate portions relative to the adjacent vertebral bodies into which said implant is adapted to be inserted, the length and pitch of said implant having a ratio relative to one another such that the length of said implant when divided by the pitch of said implant equals an integer, whereby said openings in said upper and lower arcuate portions may be oriented toward the adjacent vertebral bodies into which said implant is adapted to be inserted upon a predetermined number of complete rotations of said implant.
88. An interbody spinal fusion implant for surgical implantation within a disc space between two adjacent vertebral bodies in a segment of a human spine, said implant comprising:
opposed upper and lower arcuate portions for contacting each of the adjacent vertebral bodies when positioned therein, each of said upper and lower arcuate portions having at least one opening adapted to communicate with one of the adjacent vertebral bodies, said openings of said upper and lower portions being in communication with one another and adapted for permitting for the growth of bone from adjacent vertebral body to adjacent vertebral body through said implant;

at least a portion of a helical thread formed on the exterior of each of said opposed arcuate portions of said upper and lower members for penetrably engaging the adjacent vertebral bodies and to facilitate securing said implant into the spine by at least in part rotating said implant about the longitudinal axis of said implant, said thread having a pitch;
an insertion end for entry into the spine, a trailing end opposite said insertion end, and a length therebetween; and a characteristic on said trailing end of said implant adapted for indicating a rotational orientation of said openings in said upper and lower arcuate portions relative to the adjacent vertebral bodies into which said implant is adapted to be inserted, the length and pitch of said implant having a ratio relative to one another such that the length of said implant when divided by the pitch of said implant equals a number that when divided by one of 0.25 and 0.5 equals an integer, whereby said openings in said upper and lower arcuate portions may be oriented toward the adjacent vertebral bodies into which said implant is adapted to be inserted upon one of a predetermined number of a quarter and a half rotations of said implant.
89. An apparatus comprising:
an interbody spinal fusion implant for surgical implantation within a disc space between two adjacent vertebral bodies in a segment of a human spine, said implant comprising:
opposed upper and lower arcuate portions for contacting each of the adjacent vertebral bodies when positioned therein, each of said upper and lower arcuate portions having at least one opening adapted to communicate with one of the adjacent vertebral bodies, said openings of said upper and lower portions being in communication with one another and adapted for permitting for the growth of bone from adjacent vertebral body to adjacent vertebral body through said implant;
at least a portion of a helical thread formed on the exterior of each of said opposed arcuate portions of said upper and lower members for penetrably engaging the adjacent vertebral bodies and to facilitate securing said implant into the spine by at least in part rotating said implant about the longitudinal axis of said implant, said thread having a pitch; and an insertion end for entry into the spine, a trailing end opposite said insertion end, and a length therebetween; and a tool cooperatively engaged with said implant adapted to indicate a rotational orientation of said openings in said upper and lower arcuate portions relative to the adjacent vertebral bodies into which said implant is adapted to be inserted, the length and pitch of said implant having a ratio relative to one another such that the length of said implant when divided by the pitch of said implant equals an integer, whereby said openings in said upper and lower arcuate portions may be oriented toward the adjacent vertebral bodies into which said implant is adapted to be inserted upon a predetermined number of complete rotations of said implant.
90. An apparatus comprising:
an interbody spinal fusion implant for surgical implantation within a disc space between two adjacent vertebral bodies in a segment of a human spine, said implant comprising:
opposed upper and lower arcuate portions for contacting each of the adjacent vertebral bodies when positioned therein, each of said upper and lower arcuate portions having at least one opening adapted to communicate with one of the adjacent vertebral bodies, said openings of said upper and lower portions being in communication with one another and adapted for permitting for the growth of bone from adjacent vertebral body to adjacent vertebral body through said implant;
at least a portion of a helical thread formed on the exterior of each of said opposed arcuate portions of said upper and lower members for penetrably engaging the adjacent vertebral bodies and to facilitate securing said implant into the spine by at least in part rotating said implant about the longitudinal axis of said implant, said thread having a pitch; and an insertion end for entry into the spine, a trailing end opposite said insertion end, and a length therebetween; and a tool cooperatively engaged with said implant adapted to indicate a rotational orientation of said openings in said upper and lower arcuate portions relative to the adjacent vertebral bodies into which said implant is adapted to be inserted, the length and pitch of said implant having a ratio relative to one another such that the length of said implant when divided by the pitch of said implant equals a number that when divided by one of 0.25 and 0.5 equals an integer, whereby said openings in said upper and lower arcuate portions may be oriented toward the adjacent vertebral bodies into which said implant is adapted to be inserted upon upon one of a predetermined number of a quarter and a half rotations of said implant.
91. A method for inserting a plurality of spinal fusion implants across a disc space between two adjacent vertebral bodies of a spine, said plurality of implants comprising opposite threaded arcuate portions adapted for placement toward and at least in part within the adjacent vertebral bodies and having a distance therebetween defining an implant height greater than the normal height of the disc space to be fused, at least a first of said plurality of implants implant having a mid-longitudinal axis and at least a medial side along said mid-longitudinal axis configured for placement in close proximity to a second of said plurality of implants, said method comprising the steps of:
forming two partially overlapping bores across the disc space by removing arc shaped portions from each of the vertebral bodies adjacent the disc space;
inserting said first implant into one of said overlapping bores with said medial side being oriented facing the interior of said disc space;
inserting with at least an element of rotation said second implant having a medial side and an opposite lateral side into a second of said overlapping bores, said lateral side of said second implant being adjacent and in close proximity to said medial side of said first implant.
92. The method of claim 91, wherein said forming step includes forming bores having a diameter generally corresponding to the root diameter proximate the leading end of the implants.
93. The method of claim 91, further comprising the step of pre-tapping the bores prior to the steps of inserting the implants.
94. The method of claim 91, wherein the inserting steps include the step of positioning the implants at an angle toward each other within the overlapping bores such that the combined width of the implants at their leading ends will be less than the combined width of the implants at their trailing ends.
95. The method of claim 91, wherein the inserting step includes rotating that implant such that when threaded fully the implant will come to rest so that the trailing end will be correctly rotationally aligned so that the profile of the trailing end will correspond to the contour of the anterior vertebral body.
96. A method for inserting a plurality of spinal fusion implants across a disc space between two adjacent vertebral bodies of a spine, at least one of the plurality of implants having the form of a threaded partial cylinder with a mid-longitudinal axis with a portion of the external surface being concave and another of the implants having the form of a threaded cylinder with a mid-longitudinal axis wherein the largest diameter of the partial cylinder and the diameter of the complete cylinder are each larger than the disc space between the two adjacent vertebral bodies, said method comprising the steps of:
forming two partially overlapping cylindrical holes across the disc space between the two adjacent vertebral bodies;
threading the partially cylindrical spinal fusion implant having a concave portion into one of the overlapping cylindrical holes, the concave portion being oriented such that the concave portion will substantially lie on an arc defined by the radius of the second cylindrical hole adjacent; and threading the second implant into the second of said overlapping holes with the second implant in close proximity to the concave portion of the first implant.
97. The method of claim 96, wherein said forming step includes forming bores having a diameter generally corresponding to the root diameter proximate the leading end of the implants.
98. The method of claim 96, further comprising the step of pre-tapping the bores prior to the steps of inserting the implants.
99. The method of claim 96, wherein the inserting steps include the step of positioning the implants at an angle toward each other within the overlapping bores such that the combined width of the implants at their leading ends will be less than the combined width of the implants at their trailing ends.
100. The method of claim 96, wherein the inserting step includes rotating that implant such that when threaded fully the implant will come to rest so that the trailing end will be correctly rotationally aligned so that the profile of the trailing end will correspond to the contour of the anterior vertebral body.
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