US20010029377A1 - Spinal disc space distractor - Google Patents
Spinal disc space distractor Download PDFInfo
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- US20010029377A1 US20010029377A1 US09/879,911 US87991101A US2001029377A1 US 20010029377 A1 US20010029377 A1 US 20010029377A1 US 87991101 A US87991101 A US 87991101A US 2001029377 A1 US2001029377 A1 US 2001029377A1
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- 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
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- 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
- A61B17/0206—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors with antagonistic arms as supports for retractor elements
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/2804—Surgical forceps with two or more pivotal connections
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
- A61B2017/00473—Distal part, e.g. tip or head
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00681—Aspects not otherwise provided for
- A61B2017/00738—Aspects not otherwise provided for part of the tool being offset with respect to a main axis, e.g. for better view for the surgeon
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- Techniques For Improving Reliability Of Storages (AREA)
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Abstract
A distractor for separating adjacent elements, such as vertebrae. The distractor preferably has a scissors-type distracting mechanism, either in a simple scissors or double-acting scissors configuration. A set of blades is provided on each jaw such that an implant may be inserted between the spaced apart blades. The set of blades includes at least two blades.
Description
- This application is a continuation of copending U.S. patent application Ser. No. 09/411,161, filed Oct. 1, 1999, which claims priority to U.S. Provisional Application No. 60/102,669, filed Oct. 2, 1998.
- The present invention relates to a device and method for spreading apart adjacent vertebrae of a vertebral column so that an implant may be inserted therebetween. More particularly, the present invention relates to a distractor device shaped and configured for minimally invasive insertion and use, such as for distraction of vertebrae using an anterior or anterolateral approach.
- Back pain can be caused by either one or a combination of the following: a loss of disc height, compression of nerve roots, degenerative disc disease, spondylolisthesis, and other causes. The current standard of treatment for people suffering from severe back pain requiring surgical intervention due to different types of pathology is by intervertebral fusion. Intervertebral fusion is achieved by fusing two adjacent vertebral bodies together by removing the affected disc and inserting a suitably sized implant into the disc space that allows for bone to grow between the two vertebral bodies bridging the gap left by the disc removal.
- Known intervertebral fusion procedures typically involve the steps of removing a portion or all of the affected disc material, spreading apart adjacent vertebrae with a distractor, and inserting an implant into the space previously occupied by the removed disc material. This procedure can be done either from the front of the patient (anterior interbody fusion) or from the back (posterior interbody fusion). If done from the front, it is important to reduce the size of the distractor so that the procedure is as minimally invasive as possible and thus minimally interferes with and traumatizes the organs and vasculature between the vertebral region being treated and the insertion point. Posterior fusion can utilize larger implants and tools since the insertion space is more accommodating.
- Current implants used for interbody fusion include allograft rings/dowels and cages such as threaded cages. However, the technique for the insertion of these implants generally does not achieve distraction because of their height limitations, thus making it difficult to restore the natural disc height. The force necessary to insert these implants (such as by drilling and tapping) may cause damage to the vertebrae or vertebral endplates at the insertion site. Moreover, allograft products and cages made out of other brittle materials (e.g., carbon fiber and ceramics) may break during insertion, particularly when distraction is not used and external force is necessary to insert the implant. Threaded cages on the other hand do not restore lordosis, and do not allow for atraumatic distraction to restore disc height. Thus, there remains a need for improvements in this area.
- In accordance with the principles of the present invention, a spinal disc distractor is provided to allow for an implant insertion technique to be performed during distraction of the disc space. The implants are slid into the disc space between the distractor blades, preferably while the blades are in contact with the upper and lower surfaces of the adjacent vertebral bodies. The distractor of the present invention is formed to be as minimally invasive and atraumatic as possible such that it may readily be used in an anterior or anterolaterial approach. Thus, the distractor of the present invention is configured to be used in the confined spaces of the human anatomy through a small surgical incision and permits the use of laparoscopic approaches like Balloon Assisted Endoscopic Retroperitoneal Gasless (“BERG”).
- In a preferred embodiment, the distractor of the present invention has a scissor-like configuration with a pair of handles pivotally connected together. A distractor jaw is coupled to a distal end of each handle such that movement of the handles together draws the jaws apart to separate the vertebrae being treated. In an even more preferred embodiment, the jaws and handles are pivotally coupled together in a double-acting scissor-like configuration to further reduce the space required to move the jaws apart and thus further minimize the invasiveness of the device and procedure.
- Although the handles, jaws, and distractor mechanism of the present invention may all lie in the same plane, in order to facilitate visualization of the treatment site during distraction and insertion of an implant, at least the handles may be angled away from the plane of the distractor jaws. In a preferred embodiment, the distractor mechanism is angled downwardly with respect to the jaws and the handles are angled downwardly with respect to the distractor mechanism to further enhance visualization and also to permit greater space for the implant holder adjacent the proximal end of the distractor during insertion of the implant.
- A locking mechanism preferably is provided adjacent to or in the handle to maintain distraction. The locking mechanism may include a spindle or threaded bolt mounted on a first handle and passing through the second handle. An internally threaded speed nut is rotatably mounted on the threaded bolt such that movement of the speed nut along the bolt selectively inhibits movement of the second handle away from the first handle and thus maintains the vertebrae at the desired distracted position.
- The blades of the distractor of the present invention are configured to increase versatility of the distractor. In a first embodiment of the present invention, the blades are removably coupled to the distractor jaws. Thus, the blades maybe changed, as necessary or desired, for a given procedure or patient.
- In another embodiment, the blades of the distractor are gradually curved to be out of the plane of the distractor mechanism. Because of the gradual curve, the distal end of the jaws may safely be manipulated through the patient's body with as minimal contact as possible with organs and vasculature including major blood vessels such as the vena cava and aorta. Moreover, such curvature permits insertion through a smaller incision because of the increased manipulability of the gradually curved blades through small openings and spaces.
- In yet another embodiment, the blades of the distractor are configured to permit insertion of any type of implant. In particular, although certain implants may be provided with slots for engagement with a surface of the distractor blades during insertion, other implants do not have such slots. The blades of the third embodiment of the present invention are configured and sufficiently spaced apart to permit insertion of either type of implant, regardless of whether slots are provided for engaging distractor blades.
- The spinal disc distractor of the present invention is thus designed to distract disc space atraumatically with respect to both the vertebrae and the implant during endplate preparation, implant sizing, and implant insertion. The distractor may be used in a straight anterior, anterolateral, or lateral approach, and may be used in either an open or a laparoscopic procedure. Moreover, the distractor is designed to ensure the selection of an anatomically correct implant size by permitting the annulus to be fully stretched so that the largest possible implant may be inserted and compressed upon release of the vertebrae, thereby enhancing stability and assuring correct placement of the implant. Thus, the present invention permits disc height and lordosis to be restored. The jaws are shaped and configured to preserve the endplate and the vertebral body during distraction, as well as to permit insertion of an implant during distraction. The risk of breakage of allograft implants and other cages made from brittle materials during insertion is thereby reduced.
- The detailed description will be better understood in conjunction with the accompanying drawings, wherein like reference characters represent like elements, as follows:
- FIG. 1 is a top elevational view of a distractor with removable blades formed in accordance with the principles of the present invention;
- FIG. 2 is a side elevational view of the distractor of FIG. 1;
- FIG. 3 is a top elevational view of the distractor of FIG. 1 in a working configuration with the jaws separated for distraction;
- FIG. 4 is a perspective view of a femoral ring implant which may be used with a distractor formed in accordance with the principles of the present invention;
- FIG. 5 is a perspective view of a cage implant which may be used with a distractor formed in accordance with the principles of the present invention;
- FIG. 6 is an isolated top elevational view of the blade of the distractor of FIG. 1;
- FIG. 7 is a perspective exploded view of the distractor of FIG. 1;
- FIG. 8 is a side elevational view of the blade of the distractor of FIG. 1;
- FIG. 9 is a side elevational view partially in cross-section of the distractor of FIG. 1 with the blade removed;
- FIG. 10 is a schematic illustration of the distractor of FIG. 1 with blades of different lengths in use;
- FIG. 11 is a schematic illustration of the distractor of FIG. 1 with blades in use which are positioned at an angle which is not parallel with the distractor mechanism;
- FIG. 12 is a side elevational view of a distractor with curved blades formed in accordance with the principles of the present invention;
- FIG. 13 is a top elevational view of the distractor of FIG. 12;
- FIG. 14 is a side elevational view of a distractor with a pair of blades coupled to each handle in accordance with the principles of the present invention;
- FIG. 15 is a top elevational view of the distractor of FIG. 14; and
- FIG. 16 is a front perspective view of the distractor of FIG. 14.
- In accordance with the principles of the present invention, a
distractor 10 is provided with a pair ofhandles jaws distractor 10 may be used for a variety of procedures, a preferred procedure for whichdistractor 10 is used is spinal disc distraction. Thus,distractor 10 is preferably configured such that actuation of handles 12 (12 a, 12 b) moves jaws 14 (14 a, 14 b) apart substantially alongdistraction axis 16 to a working position corresponding to the desired resulting relative position of the endplates. For example, the blades may be moved to a substantially parallel or lordotic position to separate adjacent vertebrae to be treated. - In order to be optimally useful for use in an anterior approach, handles12 and
jaws 14 are configured to movejaws 14 apart along distraction axis 16 a sufficient amount to adequately separate adjacent vertebrae to be treated (typically 5 mm-20 mm, most typically 13 mm-15 mm) yet to occupy a minimal amount of space within the insertion region during the procedure. Thus, handles 12 andjaws 14 preferably are pivotally coupled together in a scissors configuration such that movement ofhandles jaws jaws 14 are positioned. Thus, proximal ends 18 ofhandles 12 are configured to facilitate gripping. In a preferred embodiment, the outer surface of handle proximal ends 18 are contoured to increase user comfort, as shown in FIG. 2. - A biasing
element 20, such as a pair of leaf springs, maintainshandles jaws locking mechanism 22 is provided to counteract biasingelement 20 as desired, such as to maintainjaws 14 at a desired spaced apart position for operation on the distracted vertebral region. Locking element may be in any desired configuration, such as a threadedbolt 24 coupled (typically pivotally) to one handle and slidably passing through the other handle, and a lockingnut 26 threadedly and rotatably mounted on the end ofbolt 24 extending past the other handle (i.e., the portion not between handles 14). Movement ofnut 26, as a result of rotation, alongbolt 24 thus shortens the length ofbolt 24 betweenhandles 14 and prevents the handles from moving apart, thus maintaininghandles 12 in a position closer together than the neutral position. - A
distractor mechanism 30 is provided such that movement ofhandles 12 to actuatedistractor mechanism 30causes jaws 14 to move apart to effect distraction of adjacent elements such as vertebrae.Distractor mechanism 30 may have a simple scissors configuration (such as in FIGS. 14-16 described below) such that handle 12 a andjaw 14 a are at opposite ends of a first lever arm and handle 12 b andjaw 14 b are on opposite ends of a second lever arm pivotally coupled to the first lever arm. In a preferred embodiment,distractor mechanism 30 is in the form of a double-acting scissor configuration having greater than one pivot point, thus reducing the amount of space required alongdistraction axis 16 and laterally away from distractor mechanismlongitudinal axis 31 to effectuate distraction. As may be appreciated with reference to FIGS. 1 and 3, in order to form a double-acting scissor configuration, handles 12 andjaws 14 are provided on separate lever arms which are pivotally coupled together. In particular, handle 12 a is formed at a proximal end ofproximal lever arm 31 a, handle 12 b is formed at a proximal end oflever arm 31 b,jaw 14 a is formed at a distal end ofdistal lever arm 32 a, andjaw 14 b is formed at a distal end ofdistal lever arm 32 b.Distal end 34 a ofproximal lever arm 31 a is pivotally coupled toproximal end 36 a ofdistal lever arm 32 a anddistal end 34 b ofproximal lever arm 31 b is pivotally coupled toproximal end 36 b ofdistal lever arm 32 b. In order to actuate the double-acting mechanism to effectuate distraction and hence movement ofjaws handles distractor mechanism 30 of FIGS. 1 and 3,proximal lever arms distal lever arms proximal lever arm distal lever arms distractor mechanism 30 required alongdistraction axis 16. - An additional feature of
distractor 10 which facilitates use thereof during distraction is the relative offset positions ofjaws distractor mechanism 30 with respect to one another, as may be appreciated in the side elevational view of FIG. 2. In particular, in a preferred embodiment, distal jaw ends 38 a, 38 b are to be positioned to properly distract adjacent vertebrae anddistractor mechanism 30 and handles 12 a, 12 b are offset relative to distal jaw ends 38 a, 38 b to permit optimal visualization of distal jaw ends 38 a, 38 b from the proximal end of distractor 10 (outside the patient's body) during distraction. For example, adistal bend 40 may be provided immediately proximal of distal jaw ends 38 a, 38 b, as may be appreciated with reference to FIG. 2. Thus, the remainder of distractor 10 (i.e., the proximal portions ofdistractor 10 such asdistractor mechanism 30 and handles 12 a, 12 b) is in a different plane from the plane of distal jaw ends 38 a, 38 b and the distraction site. With such an offset, visualization of the distraction site and of insertion of the implant therein is enhanced. Additionally or alternatively, aproximal bend 42 may be provided immediately distal ofhandles bends distractor 10 to be in a plane different from the plane of distal jaw ends 38 a, 38 b and the distraction site such that the line of site to view distraction is not obstructed by the distractor. Moreover, such offset of portions ofdistractor 10, such asdistractor mechanism 30 and handles 12 a, 12 b, from the distal jaw ends 38 accommodate an implant holder for insertion of the implant to permit a substantially straight insertion of the implant holder.Bend 40 may be between 0°-30°, most preferably 10°, and bend 42 maybe between 0°-30°, most preferably 15°, to achieve the desired improved visualization and increased area for the implant holder. - A distractor provided in accordance with the principles of the present invention is configured to distract adjacent vertebrae so that an implant may be inserted therebetween. Preferably, each jaw of a distractor formed in accordance with the principles of the present invention is provided with a blade shaped and configured to contact a vertebral endplate and also to permit insertion of an implant therebetween. Once the implant is properly positioned between the vertebral endplates, the distractor, along with its blades, may be removed from the distraction site in the patient.
- In the embodiment of FIGS.1-3,
blades jaws blades slot 45 in an implant such ascage 46 of FIG. 4 orfemoral ring 48 of FIG. 5. Thus, as the selected implant is moved toward the treatment site with a desired insertion tool,implant contacting surfaces blades respective slots 45. Preferably,implant contacting surfaces blades connection blades respective jaws jaws blades slots 45 and thereby to securely grasp the implant viaslots 45. -
Blades 44 may converge toward each other in a distal direction before actuation ofdistractor mechanism 30 as may be appreciated with reference to FIG. 1. Thus, upon actuation ofdistractor mechanism 30 and pivoting apart ofjaws 14,blades 44, and particularly outwardly facingdistracting surfaces distractor mechanism 30 may movedistracting surfaces - Distracting
surfaces blades surfaces blade 44 in FIG. 6. For instance, distractingsurfaces vertebral engagers Transverse engagement walls vertebral engagers Engagement surface vertebral engagers engagement walls surfaces transverse engagement walls - In accordance with the principles of the present invention, the distractor blades preferably are configured to increase versatility of use of the distractor of the present invention. It will be appreciated that
distractor 10 preferably is formed from a surgical grade sterilizable metal such that the same distractor may be used for different patients. In order to increase the versatility ofdistractor 10 and its usefulness for different patients and situations, at least one ofblades respective jaw jaws socket post 62 of ablade 44, as shown in FIGS. 7 and 8.Post 62 may be releasably held within a bore 60 of ajaw 14 in any desired manner. For example, a ball detent attachment may be formed by providing adepression 64 in post 62 (FIG. 8) for matingly receiving abiased detent ball 66 housed within atransverse bore 68 in jaw 14 (FIG. 9). Blade post 62 preferably is fitted within socket 60 to permit pivotable movement ofblade 44 aboutlongitudinal axis 70 ofblade post 62. Such pivotable movement facilitates manipulation ofblade 44 with respect to the vertebral endplates to ease removal ofblade 44 anddistractor 10. If desired, in order to limit the range of pivotal motion ofblade 44, a stop plate 72 (FIGS. 6-8) may be provided onpost 62 to fit within range limiting groove 74 (FIG. 7) injaw 14. Stopplate 72 extends transversely frompost 62, as may be appreciated with reference to FIG. 6 and has stop surfaces 76 a, 76 b engaging respective range limiting surfaces 78 a, 78 b ofrange limiting groove 74. - Removable attachment of
blades 44 tojaws 14 permits a plurality of differently configured blades to be used withdistractor 10 depending on the situation or application. For example, the size of the blade may be selected based on the implant to be inserted, different implants potentially having differently sized slots for receiving a distractor blade. The size of the blade may also be selected depending on the size of the vertebrae being treated or the curvature of the vertebral column. For example, it may be desirable to select blades of different insertion lengths IL1, IL2, as shown in FIG. 10, to account for spondylolisthesis which results in one vertebra V1 being closer to the distractor than the other vertebra V2. Blade selection may also depend on the vertebral region being treated, which may affect the difficulty of the approach. For example, in the pelvic region organs and bony structures may complicate insertion and the use ofblades 44′ which are angled, such as 20°-30°, with respect to thelongitudinal axis 31 ofdistractor mechanism 30 may be desired. Suchangled blades 44′ would permit an angled approach ofdistractor 10 to avoid bony structures such as the pelvis. - Although the removability of
blades 44 ofdistractor 10 provides a significant versatility advantage over prior art distractors having blades which are rigidly and fixedly connected to the remaining elements of the distractor, versatility is achievable in accordance with the principles of the present invention in other manners as well. For instance,distal end 102 ofdistractor 100 of FIGS. 12 and 13 is curved such thatblades 144 lie in a plane spaced from the remainder of distractor 100 (i.e., the proximal portions ofdistractor 100 such asdistractor mechanism 130 and handles 112). Such curvature provide several advantages over prior art distractors thus increasing versatility thereof. - For instance, in prior art distractors, the insertion hole commonly is sized to accommodate the distance between spaced apart elements of the distractor. However, the gradual and smooth curvature of
jaws 114 andblades 144 permits distractor 100 to be manipulated to fit through the insertion hole such as by “snaking”distractor 100 through. Thus, the curvature ofjaws 114 of distractor is selected and configured such that the insertion hole may be sized based on the single element of the distractor with the largest cross-section. Additionally, the curvature ofjaws 114 andblades 144 is smooth and selected such that upon insertion, no sharp edges are present which may injure vasculature, organs, etc., along the insertion path. The curvature thus is sufficiently gentle and wide such thatjaws 114 andblades 144 are readily manipulated through the patient's body without causing internal injuries or damage. Preferably the curvature has an S-shape to permit such manipulation and rounded surfaces. - In order to provide the above-described curvature in the distal end of
distractor 100, a smooth (e.g., radiused without sharp edges)curve 140 which gradually results in distal jaw ends 138 being at an obtuse angle with respect to proximal jaw ends 136 may be provided injaws 114. Additionally, a similarly smooth andgradual curve 141 preferably is provided between distal jaw ends 138 andblades 144 to result in at least a proximal portion ofdistractor 100 being in a different plane from that ofblades 144 for enhanced visualization as described with respect to bend 40 ofdistractor 10. Preferably,curve 141 results in an angle A betweenblades 144 and proximal jaw ends 136 of between 0°-30° and most preferably 10°. Abend 142 may also be provided inhandles 112 such that proximal handle ends 118 a, 118 b are not in the same plane as distal jaw ends 138 a, 138 b and the distraction site to further enhance visualization, as described above with respect to bend 42 ofdistractor 10. Bend 142 may be between 0°-30° and most preferably 15°. - It will be appreciated that
distractor mechanism 130 is similar todistractor mechanism 30 and the description ofdistractor mechanism 30 thus is applicable todistractor mechanism 130 and is not repeated herein. Preferably, ifdistractor mechanism 130 is similar todistractor mechanism 30, thenblades blades 44 to permit a relative working orientation appropriate for the treatment site, as described above. - Like
blades 44 ofdistractor 10,blades blades slots 45 of an implant (as in FIGS. 4 and 5) to grasp the implant yetjaws 114 permit insertion of an implant therethrough. Additionally,vertebral engagers transverse engagement walls vertebral engagers transverse engagement walls blades distractor 10. However, unlikeblades 44 ofdistractor 10,blades 144 ofdistractor 100 preferably are fixedly secured tojaws 114, such as by formation ofblades 144 andjaws 114 as a unitary piece. Thus,distractor 100 may readily be used in severely calcified areas requiring significant strength and durability of the distractor blades. - The dimensions of
blades distractor 10 andblades distractor 100 are preferably similar. The thickness T (FIGS. 8 and 12) ofblades surfaces blades blades - Versatility of a distractor formed in accordance with the principles of the present invention may alternatively be achieved by the provision of a
distractor 200 as shown in FIGS. 14-16 withjaws 214 which permit insertion of any kind of implant, including those not provided with slots as described above with respect toimplants jaw 214 has a pair ofblades 244 sufficiently spaced apart to permit insertion of an implant therebetween without necessarily contacting the implant. Most preferably,blades - As may be appreciated upon comparison of FIGS. 12 and 13,
blades 244 have a width W alongdistraction axis 216 greater than thickness T perpendicular to distraction axis 216 (along the working surface). Such dimension minimizesdistracting surfaces blades 244 and to permit sufficient space for insertion of an implant betweenblades 244. Thus, contact thickness T of distractingsurfaces blades blades 244 alongdistraction axis 216 preferably is selected to ensure the strength ofblades 244 so thatblades 244 do not deform or buckle during distraction despite the relatively small thickness T of distractingsurfaces blades distractor mechanism 230 is in a neutral configuration (withblades distraction axis 216 occupied byblades blades 244 into the treatment site. The length L ofblades 244, like length L ofblades -
Vertebral engagers transverse engagement walls vertebral engagers transverse engagement walls blades distractor 10.Blades 244 ofdistractor 200 preferably are fixedly secured tojaws 214, such as by formation ofblades 244 andjaws 214 as a unitary piece. Thus,distractor 200 may readily be used in severely calcified areas requiring significant strength and durability of the distractor blades. - It will be appreciated that
distractor mechanism 130 is similar todistractor mechanism 30 and the description ofdistractor mechanism 30 thus is applicable todistractor mechanism 130 and is not repeated herein. - It will also be appreciated that
distractor mechanism 230 ofdistractor 200 may be a simple scissors configuration withhandles 212 andjaws 214 formed along the same lever element, as may be appreciated with reference to FIGS. 12 and 14. However,distractor mechanism 230 may instead have substantially the same configuration asdistractor mechanism 30 ofdistractor 10 ordistractor mechanism 130 ofdistractor 100. The description ofdistractor mechanism 30 thus is applicable todistractor mechanism 230 and is not repeated herein. Conversely, it will be appreciated thatdistractor mechanism 30 ordistractor mechanism 130 may have substantially the same configuration asdistractor mechanism 230. Preferably, ifdistractor mechanism 230 is either scissors-type configuration (single scissors as in FIGS. 12-14 or double-scissors as indistractor mechanisms 30 and 130), thenblades 244 converge towards each other in a distal direction as doblades 44 to permit a relative working orientation appropriate for the treatment site, as described above. - While the foregoing description and drawings represent the preferred embodiments of the present invention, it will be understood that various additions and/or substitutions may be made therein without departing from the spirit and scope of the present invention as defined in the accompanying claims. One skilled in the art will appreciate that the invention may be used with many modifications of structure, forms, arrangement, proportions, materials, and components and otherwise, used in the practice of the invention and which are particularly adapted to specific environments and operative requirements, without departing from the principles of the present invention. The presently disclosed embodiments are therefore to be considered in all respects as illustrative and not restrictive, the scope of the invention being indicated by the appended claims, and not limited to the foregoing description.
Claims (22)
1. A distractor comprising:
first and second handles;
first and second jaws respectively associated with said first and second handles;
a first set of blades extending from said first jaw;
a second set of blades extending from said second jaw; and
a distractor mechanism coupled between said handles and said jaws such that movement of said handles actuates said distractor mechanism to move said jaws apart,
wherein:
said first and second sets of blades each comprise at least first and second blades spaced apart to contact anatomical elements to be distracted and permit insertion of an implant between said first and second set of blades and said anatomical elements.
2. The distractor of , wherein the distractor mechanism includes an open position in which said first set of blades is spaced relative to said second set of blades, and a closed position in which at least a portion of said first set of blades contacts at least a portion of said second set of blades; and
claim 1
the first set of blades includes at least a portion that is spaced from at least a portion of the second set of blades when the distractor is in the closed position to permit placement of an implant therebetween for insertion between said anatomical elements.
3. The distractor of , wherein the distractor mechanism includes an open position in which said first set of blades is spaced relative to said second set of blades, and a closed position in which at least a portion of said first set of blades contacts at least a portion of said second set of blades; and
claim 1
the first jaw includes at least a portion that is spaced relative to at least a portion of the second jaw when the distractor is in the closed position to permit the placement of an implant prior to insertion between the first and second set of blades.
4. The distractor of , wherein the first set of blades lie in the same plane and the second set of blades lie in the same plane; and the at least first and second blades of each set are laterally spaced relative to one another.
claim 1
5. The distractor of , wherein the first set of blades has an insertion length and the second set of blades has an insertion length, and the insertion length of the first set of blades is different from the insertion length of the second set of blades.
claim 1
6. The distractor of , wherein the first and second set of blades are integrally attached to their respective first and second jaws.
claim 1
7. The distractor of , wherein at least one of the first and second sets of blades is removably attached to its respective first and second jaws.
claim 1
8. The distractor of , wherein the distractor mechanism further comprises:
claim 1
a pair of first and second proximal lever arms each having proximal and distal ends; and
a pair of first and second distal lever arms each having proximal and distal ends,
wherein:
said first handle is located at said proximal end of said first proximal lever arm;
said second handle is located at said proximal end of said second proximal lever arm;
said first jaw is located at said distal end of said first distal lever arm;
said second jaw is located at said distal end of said second distal lever arm;
one of said pair of proximal lever arms and said pair of distal lever arms is crosswise pivotally coupled; and
the other of said pair of proximal lever arms and said pair of distal lever arms is laterally pivotally coupled.
9. The distractor of , wherein the first and second jaws each include a mating fixture and the first and second set of blades each include a mating portion, wherein each mating portion is shaped for removable association with each mating fixture.
claim 1
10. The distractor of , wherein each mating portion is a post and each mating fixture is a socket.
claim 9
11. The distractor of , wherein each mating portion is a socket and each mating portion is a post.
claim 9
12. The distractor of , wherein the mating fixture is positioned on an upper surface of the first and second jaws and at least a portion of the first and second blades extends substantially perpendicular to the upper surface of the first and second jaws.
claim 9
13. The distractor of , wherein the first and second jaws are removably associated with the first and second handles.
claim 1
14. The distractor of , wherein the first and second set of blades are removably associated with the first and second jaws.
claim 1
15. The distractor of , further comprising a locking mechanism for locking the position of the mating portion relative to the mating fixture.
claim 9
16. The distractor of , wherein the locking mechanism includes a ball portion.
claim 15
17. The distractor of , wherein at least a portion of the first set of blades extends at a first angle relative to the first jaw and at least a portion of the second set of blades extends at a second angle relative to the second jaw.
claim 1
18. The distractor of , wherein the first angle is substantially the same as the second angle.
claim 17
19. The distractor of , wherein the first and second angles range from about 20° to 30° relative to a longitudinal axis of the distractor mechanism.
claim 17
20. The distractor of , wherein the first and second set of blades include at least one curved portion.
claim 1
21. The distractor of , wherein the first and second jaws include at least one curved portion.
claim 1
22. A method of distracting adjacent vertebrae comprising the steps of:
providing a distractor comprising first and second handles, first and second jaws respectively coupled to said first and second handles, a first set of spaced apart blades extending from said first jaw, a second set of spaced apart blades extending from said second jaw, and a distractor mechanism coupled between said handles and said jaws;
positioning said first set of spaced apart blades against spaced apart ends of a first vertebral endplate;
positioning said second set of spaced apart blades against spaced apart ends of a second vertebral endplate adjacent and facing said first vertebral endplate;
actuating said distractor mechanism to distract said first and second vertebral endplates; and
inserting an implant between said first and second sets of blades and said first and second vertebral endplates.
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
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US09/879,911 US20010029377A1 (en) | 1998-10-02 | 2001-06-14 | Spinal disc space distractor |
US11/108,030 US20050177173A1 (en) | 1998-10-02 | 2005-04-14 | Spinal disc space distractor |
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
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US10266998P | 1998-10-02 | 1998-10-02 | |
US09/411,161 US6261296B1 (en) | 1998-10-02 | 1999-10-01 | Spinal disc space distractor |
US09/879,911 US20010029377A1 (en) | 1998-10-02 | 2001-06-14 | Spinal disc space distractor |
Related Parent Applications (2)
Application Number | Title | Priority Date | Filing Date |
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US09/411,161 Continuation US6261296B1 (en) | 1998-10-02 | 1999-10-01 | Spinal disc space distractor |
US09/411,161 Division US6261296B1 (en) | 1998-10-02 | 1999-10-01 | Spinal disc space distractor |
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Application Number | Title | Priority Date | Filing Date |
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US11/108,030 Continuation US20050177173A1 (en) | 1998-10-02 | 2005-04-14 | Spinal disc space distractor |
Publications (1)
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US20010029377A1 true US20010029377A1 (en) | 2001-10-11 |
Family
ID=22291038
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US09/411,161 Expired - Lifetime US6261296B1 (en) | 1998-10-02 | 1999-10-01 | Spinal disc space distractor |
US09/879,911 Abandoned US20010029377A1 (en) | 1998-10-02 | 2001-06-14 | Spinal disc space distractor |
US09/880,000 Expired - Lifetime US6712825B2 (en) | 1998-10-02 | 2001-06-14 | Spinal disc space distractor |
US11/108,030 Abandoned US20050177173A1 (en) | 1998-10-02 | 2005-04-14 | Spinal disc space distractor |
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US09/411,161 Expired - Lifetime US6261296B1 (en) | 1998-10-02 | 1999-10-01 | Spinal disc space distractor |
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US09/880,000 Expired - Lifetime US6712825B2 (en) | 1998-10-02 | 2001-06-14 | Spinal disc space distractor |
US11/108,030 Abandoned US20050177173A1 (en) | 1998-10-02 | 2005-04-14 | Spinal disc space distractor |
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US (4) | US6261296B1 (en) |
EP (1) | EP1117335B1 (en) |
JP (1) | JP4215400B2 (en) |
AT (2) | ATE413841T1 (en) |
AU (1) | AU760821B2 (en) |
CA (1) | CA2345797C (en) |
DE (2) | DE69940641D1 (en) |
ES (1) | ES2317604T3 (en) |
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US20050177173A1 (en) | 2005-08-11 |
CA2345797A1 (en) | 2000-04-13 |
US6712825B2 (en) | 2004-03-30 |
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ATE426361T1 (en) | 2009-04-15 |
US20010031969A1 (en) | 2001-10-18 |
DE69939914D1 (en) | 2008-12-24 |
AU5725399A (en) | 2000-04-26 |
ES2317604T3 (en) | 2009-04-16 |
CA2345797C (en) | 2006-06-13 |
US6261296B1 (en) | 2001-07-17 |
ATE413841T1 (en) | 2008-11-15 |
EP1117335B1 (en) | 2009-03-25 |
EP1117335A2 (en) | 2001-07-25 |
JP4215400B2 (en) | 2009-01-28 |
WO2000019911A2 (en) | 2000-04-13 |
JP2002526147A (en) | 2002-08-20 |
WO2000019911A3 (en) | 2000-07-13 |
ZA200101615B (en) | 2001-09-17 |
AU760821B2 (en) | 2003-05-22 |
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