Spinal implant system and method

Abstract

A spinal implant includes a body having opposed first and second end walls and opposed first and second side walls. The side walls each extend from the first end wall to the second end wall. A first cap is coupled to a top end of the walls. A second cap is coupled to a bottom end of the walls. The implant includes an opening extending through the caps such that the first cap defines a first ledge extending from the walls to the opening and the second cap defines a second ledge extending from the walls to the opening. Systems and methods of use are disclosed.

Description

Technical Field

[0001] This disclosure generally relates to medical devices for treating musculoskeletal disorders, and more specifically to spinal implant systems including implants and instruments configured to deliver the implants during surgical procedures. Background Technology

[0002] Spinal disorders and conditions, such as scoliosis and other curvature abnormalities, kyphosis, degenerative disc disease, herniated discs, osteoporosis, anterior spinal displacement, stenosis, tumors, and fractures, can be caused by factors including trauma, disease, and degenerative conditions resulting from injury and aging. Spinal disorders typically lead to symptoms including deformities, pain, nerve damage, and partial or complete loss of mobility.

[0003] Non-surgical treatments (such as medication, rehabilitation, and exercise) may be effective, however, they may not relieve the symptoms associated with these conditions. Surgical treatments for these spinal conditions include correction, fusion, fixation, discectomy, laminectomy, and implantable prostheses. As part of these surgical treatments, spinal constructs (such as bone fasteners, plates, and intervertebral devices) can be used to provide stability to the treated area. For example, during surgical treatment, an intervertebral implant can be delivered to the surgical site to fix it to the bone to immobilize the joint. Bone fasteners extend through the plate and / or intervertebral device and into the bone to secure at least a portion of the plate and / or intervertebral device to the bone. This disclosure describes improvements to these prior art. Summary of the Invention

[0004] In one embodiment, according to the principles of this disclosure, a surgical instrument includes a sleeve extending along a longitudinal axis between opposing proximal and distal ends. An inner surface of the sleeve defines a channel. The distal end defines an engagement portion. The engagement portion includes an engagement surface extending from a first end to an opposing second end. The engagement portion includes a stud extending outwardly from the first end. The engagement portion includes an opening extending through the second end. The opening communicates with the channel. A knob is coupled to the proximal end of the sleeve. A shaft includes a proximal end and an opposing distal end. The distal end of the shaft includes a mating portion extending through the opening. The proximal end of the shaft is coupled to the knob. The knob is rotatable relative to the sleeve to rotate the shaft relative to the sleeve.

[0005] In one embodiment, according to the principles of this disclosure, a surgical system includes a spinal implant comprising opposing first and second vertebral engagement surfaces. The implant includes opposing posterior and anterior surfaces, each extending from the first and second vertebral engagement surfaces. The anterior surface includes a spaced-apart first and second cavity. A surgical instrument includes a sleeve extending along a longitudinal axis between opposing proximal and distal ends. An inner surface of the sleeve defines a channel. The distal end defines an engagement portion. The engagement portion includes an engagement surface extending from the first end to the opposing second end. The engagement portion includes a stud extending outwardly from the first end. The stud is positioned within the first cavity. The engagement portion includes an opening extending through the second end. The opening communicates with the channel. A knob is coupled to the proximal end of the sleeve. A shaft includes a proximal end and an opposing distal end. The distal end of the shaft includes a mating portion. The proximal end of the shaft is coupled to the knob. The knob can be rotated relative to the sleeve to translate the axis between a first orientation in which the sleeve is positioned within the channel relative to the mating portion and a second orientation in which the mating portion mates with the mating surface of the second cavity.

[0006] In one embodiment, according to the principles of this disclosure, a surgical instrument includes an outer sleeve extending along a longitudinal axis between opposing proximal and distal ends. An inner surface of the sleeve defines a channel. The distal end defines an engagement portion. The engagement portion includes an engagement surface extending from a first end to an opposing second end. The first end includes a first cavity communicating with the channel. The second end includes a second cavity. An inner sleeve is rotatably positioned within the channel. The inner sleeve includes an outer surface engaging with the inner surface of the outer sleeve and an inner surface defining a female thread. A knob is coupled to the proximal end of the sleeve. The knob is rotatable relative to the outer sleeve to rotate the inner sleeve relative to the outer sleeve.

[0007] In one embodiment, according to the principles of this disclosure, a spinal implant includes a body comprising opposing first and second end walls and opposing first and second side walls. Each side wall extends from the first end wall to the second end wall. A first cap is coupled to a top end of a wall. A second cap is coupled to a bottom end of a wall. The implant includes an opening extending through the caps, such that the first cap defines a first ledge extending from the wall to the opening and the second cap defines a second ledge extending from the wall to the opening.

[0008] In one embodiment, according to the principles of this disclosure, a spinal implant includes a body comprising opposing first and second end walls and opposing first and second side walls. Each side wall extends from the first end wall to the second end wall. The first side wall defines a first window. The second side wall defines a second window. An inner surface of the wall defines a cavity. A core is positioned within the cavity such that the core is visible through the window. A first cap is coupled to a top end of the wall. A second cap is coupled to a bottom end of the wall. The implant includes an opening extending through the cap, such that the first cap defines a first ledge extending from the wall to the opening and the second cap defines a second ledge extending from the wall to the opening.

[0009] In one embodiment, according to the principles of this disclosure, a spinal implant includes a body comprising opposing first and second end walls and opposing first and second side walls. Each side wall extends from the first end wall to the second end wall. The first side wall defines a first window. The second side wall defines a second window. An inner surface of the wall defines a cavity. A core is positioned within the cavity such that the core is visible through the window. The core has a lattice configuration. A first cap is coupled to a top end of the wall. A second cap is coupled to a bottom end of the wall. The implant includes an opening extending through the cap, such that the first cap defines a first ledge extending from the wall to the opening and the second cap defines a second ledge extending from the wall to the opening. Each ledge extends circumferentially around the opening. A bone graft is positioned between the first and second ledges. Each cap includes a plurality of holes. The holes have a hexagonal configuration. The core is fused to the body and the cap. The maximum diameter of the cavity is greater than the maximum diameter of the opening. Attached Figure Description

[0010] This disclosure will become more apparent from the specific description of the following diagrams, in which:

[0011] Figure 1 This is a side view of the first and second components of the spinal system according to the principles of this disclosure;

[0012] Figure 2 It is based on the principles of this disclosure. Figure 1 A side cross-sectional view of a first component of the spinal system shown, wherein the first component is connected to a second component of the spinal system in one embodiment;

[0013] Figure 3 yes Figure 1 An exploded perspective view of the first component of the spinal system, with some parts depicted as dashed lines;

[0014] Figure 4 yes Figure 1 An exploded perspective view of the first component of the spinal system shown, with the parts separated;

[0015] Figure 4A yes Figure 1 An exploded side view of the first component of the spinal system shown.

[0016] Figure 4B yes Figure 1 A side-view exploded section of the first component of the spinal system shown;

[0017] Figure 5 yes Figure 1 A side view of the first component of the spinal system shown, with some parts depicted as dashed lines;

[0018] Figure 6 yes Figure 1 A side view of the first component of the spinal system shown, with some parts depicted as dashed lines;

[0019] Figure 7 yes Figure 1 An exploded perspective view of the first component of the spinal system shown.

[0020] Figure 8 yes Figure 1 Side view of the first and second components of the spinal system shown;

[0021] Figure 9 yes Figure 2 Side view of the first and second components of the spinal system shown;

[0022] Figure 10 yes Figure 2 Side view of the first and second components of the spinal system shown;

[0023] Figure 11 It is shown Figure 1 The diagram shows a plan view of the first and second components of the spinal system, in which vertebrae are arranged in different orientations. Figure 1 The first and second components of the spinal system are shown.

[0024] Figure 12 It is based on the principles of this disclosure. Figure 1 An exploded perspective view of one embodiment of the distal end of the first component of the spinal system shown.

[0025] Figure 13 It is based on the principles of this disclosure. Figure 1 An exploded perspective view of one embodiment of the distal end of the first component of the spinal system shown.

[0026] Figure 14 It is based on the principles of this disclosure. Figure 1 A side view of one embodiment of the second component of the spinal system shown;

[0027] Figure 15 yes Figure 14The exploded side view of the second component shown shows the second component connected to... Figure 1 The first component of the spinal system shown;

[0028] Figure 16 yes Figure 14 The exploded side view of the second component shown shows the second component connected to... Figure 1 The first component of the spinal system shown;

[0029] Figure 17 yes Figure 14 The exploded perspective view of the second component is shown, and the second component is connected to... Figure 1 The first component of the spinal system shown;

[0030] Figure 18 It is based on the principles of this disclosure. Figure 1 A perspective view of one embodiment of the second component of the spinal system shown;

[0031] Figure 19 It is based on the principles of this disclosure. Figure 1 An exploded perspective view of one embodiment of the first component of the spinal system shown.

[0032] Figure 20 yes Figure 19 The perspective view of the first component shown, the first component being connected to Figure 18 The second component shown;

[0033] Figure 21 yes Figure 19 The perspective view of the first component shown, the first component being connected to Figure 18 The second component shown;

[0034] Figure 22 It is based on the principles of this disclosure. Figure 1 A perspective view of one embodiment of the second component of the spinal system shown;

[0035] Figure 23 yes Figure 19 The perspective view of the first component shown, the first component being connected to Figure 22 The second component shown;

[0036] Figure 24 yes Figure 19 The perspective view of the first component shown, the first component being connected to Figure 22 The second component shown;

[0037] Figure 25 It is based on the principles of this disclosure. Figure 1 An exploded perspective view of one embodiment of the first component of the spinal system shown.

[0038] Figure 26 It is based on the principles of this disclosure. Figure 1 A perspective view of one embodiment of the second component of the spinal system shown;

[0039] Figure 27 yes Figure 25 The top exploded view of the first component shown, which is connected to... Figure 26 The second component shown;

[0040] Figure 28 It is based on the principles of this disclosure. Figure 1 A perspective view of one embodiment of the second component of the spinal system shown;

[0041] Figure 29 yes Figure 28 The top exploded view of the second component shown, which is connected to... Figure 1 The first component of the spinal system shown;

[0042] Figure 30 yes Figure 28 The top exploded view of the second component shown, which is connected to... Figure 1 The first component of the spinal system shown;

[0043] Figure 31 yes Figure 28 The top exploded view of the second component shown, which is connected to... Figure 1 The first component of the spinal system shown;

[0044] Figure 32 yes Figure 28 The top exploded view of the second component shown, which is connected to... Figure 1 The first component of the spinal system shown;

[0045] Figure 33 It is based on the principles of this disclosure. Figure 1 A top exploded view of one embodiment of the first component of the spinal system shown, the first component being coupled to Figure 1 One embodiment of the second component of the spinal system shown;

[0046] Figure 34 It is based on the principles of this disclosure. Figure 1 A top exploded view of one embodiment of the first component of the spinal system shown, the first component being coupled to Figure 1 One embodiment of the second component of the spinal system shown;

[0047] Figure 35 It is based on the principles of this disclosure. Figure 1 A top exploded view of one embodiment of the spinal system components shown, the components being coupled to Figure 1One embodiment of the second component of the spinal system shown;

[0048] Figure 36 It is based on the principles of this disclosure. Figure 1 A perspective view of one embodiment of the second component of the spinal system shown;

[0049] Figure 37 yes Figure 36 Perspective view of the second component shown;

[0050] Figure 38 yes Figure 36 The perspective cross-sectional view of the second component shown;

[0051] Figure 39 yes Figure 36 The perspective view of the second component shown, with the parts separated;

[0052] Figure 40 yes Figure 36 The perspective view of the second component shown, with the parts separated;

[0053] Figure 40A yes Figure 36 Detailed view of a portion of the second component shown;

[0054] Figure 40B It is shown Figure 36 A diagram showing the structural characteristics of a portion of the second component;

[0055] Figure 40C It is shown Figure 36 The user interface showing the structural characteristics of a portion of the second component;

[0056] Figure 41 yes Figure 36 The perspective view of the second component shown, with the parts separated;

[0057] Figure 42 It is based on the principles of this disclosure. Figure 1 A perspective view of one embodiment of the second component of the spinal system shown;

[0058] Figure 43 yes Figure 42 The front view of the second component is shown;

[0059] Figure 44 yes Figure 42 A top view of the second component shown;

[0060] Figure 45 yes Figure 42 The bottom view of the second component shown;

[0061] Figure 46 yes Figure 42The side view of the second component shown;

[0062] Figure 47 yes Figure 42 The rear view of the second component shown;

[0063] Figure 48 It is based on the principles of this disclosure. Figure 1 A perspective view of one embodiment of the second component of the spinal system shown;

[0064] Figure 49 yes Figure 48 The front view of the second component is shown;

[0065] Figure 50 yes Figure 48 A top view of the second component shown;

[0066] Figure 51 yes Figure 48 The bottom view of the second component shown;

[0067] Figure 52 yes Figure 48 The side view of the second component shown;

[0068] Figure 53 yes Figure 48 The rear view of the second component shown;

[0069] Figure 54 It is based on the principles of this disclosure. Figure 1 A perspective view of one embodiment of the second component of the spinal system shown;

[0070] Figure 55 yes Figure 54 The front view of the second component is shown;

[0071] Figure 56 yes Figure 54 A top view of the second component shown;

[0072] Figure 57 yes Figure 54 The bottom view of the second component shown;

[0073] Figure 58 yes Figure 54 The side view of the second component shown;

[0074] Figure 59 yes Figure 54 The rear view of the second component shown;

[0075] Figure 60 It is based on the principles of this disclosure. Figure 1 A perspective view of one embodiment of the second component of the spinal system shown;

[0076] Figure 61 yes Figure 60 The front view of the second component is shown;

[0077] Figure 62 yes Figure 60 A top view of the second component shown;

[0078] Figure 63 yes Figure 60 The bottom view of the second component shown;

[0079] Figure 64 yes Figure 60 The side view of the second component shown;

[0080] Figure 65 yes Figure 60 The rear view of the second component shown;

[0081] Figure 66 It is based on the principles of this disclosure. Figure 1 A perspective view of one embodiment of the second component of the spinal system shown;

[0082] Figure 67 yes Figure 66 The front view of the second component is shown;

[0083] Figure 68 yes Figure 66 A top view of the second component shown;

[0084] Figure 69 yes Figure 66 The bottom view of the second component shown;

[0085] Figure 70 yes Figure 66 The side view of the second component shown;

[0086] Figure 71 yes Figure 66 The rear view of the second component shown;

[0087] Figure 72 It is based on the principles of this disclosure. Figure 1 A perspective view of one embodiment of the second component of the spinal system shown;

[0088] Figure 73 yes Figure 72 The front view of the second component is shown;

[0089] Figure 74 yes Figure 72 A top view of the second component shown;

[0090] Figure 75 yes Figure 72 The bottom view of the second component shown;

[0091] Figure 76 yes Figure 72 The side view of the second component shown;

[0092] Figure 77 yes Figure 72 The rear view of the second component shown;

[0093] Figure 78 It is based on the principles of this disclosure. Figure 1 A perspective view of one embodiment of the second component of the spinal system shown;

[0094] Figure 79 yes Figure 78 The front view of the second component is shown;

[0095] Figure 80 yes Figure 78 A top view of the second component shown;

[0096] Figure 81 yes Figure 78 The bottom view of the second component shown;

[0097] Figure 82 yes Figure 78 The side view of the second component shown; and

[0098] Figure 83 yes Figure 78 The rear view of the second component shown. Detailed Implementation

[0099] Exemplary embodiments of the disclosed spinal systems and related methods of use are discussed in relation to medical devices for treating musculoskeletal disorders, and more particularly to surgical systems and methods for treating the spine. In some embodiments, the systems and methods of this disclosure include medical devices comprising surgical instruments and implants for surgical treatment, for example, of the cervical, thoracic, lumbar, and / or sacral vertebrae of the spine, as described herein.

[0100] In some embodiments, this surgical system includes a spinal implant with graft-receiving pendants. The pendants hold the graft in place to prevent loss during occlusion. In some embodiments, the implant includes a porous lattice optimized for strength while allowing large graft volumes to be positioned between the graft-receiving pendants. In some embodiments, the implant includes fully enclosed screw slots to prevent bone screws inserted into the slots from interfering with the graft, and vice versa.

[0101] In some embodiments, the implant includes a solid body having edges, markings, a nose, an inserter, and a bone screw attachment geometry. The implant includes a core configured to be positioned within a cavity of the body. The core includes a structural lattice that reduces stiffness and opacity while maintaining strength. The implant includes a top cap and a bottom cap, each coupled to the body when the core is positioned within it. In some embodiments, at least one of the caps includes a trabecular structure having an interconnected porosity optimized for inward and outward growth. In some embodiments, the cap is fused to the core and body to prevent implant delamination. In some embodiments, the structural lattice of the core is a diamond lattice produced by 3D printing to provide superior buildability, superior strength, reduced internal stress, and adaptability to various spinal implant types.

[0102] The surgical system includes an inserter configured to insert an implant between vertebrae during surgical procedures using a selected surgical approach and / or at a selected angle. For example, in some embodiments, a single implant may be inserted between vertebrae using a single inserter via four different surgical approaches (e.g., an approach for anterior lumbar interbody fusion (ALIF), an approach for oblique interbody fusion at L5-S1 (OLIF 5-1), an approach for oblique interbody fusion at L2-L5 (OLIF 2-5), and an approach for direct interbody fusion (DLIF), as described herein. Indeed, the inserter includes a low-profile attachment geometry suitable for navigation and allows for multiple insertion angles and designs. That is, a single inserter can be used to deliver multiple different implants to the target site using different surgical approaches and / or at different angles. In some embodiments, the inserter includes a ratchet mechanism that prevents the implant from improperly dislodging from the inserter before and during obstruction.

[0103] In some embodiments, the implant includes an arcuate surface configured to engage with an arcuate surface of the inserter to attach the inserter to the implant. In some embodiments, when the arcuate surface of the inserter engages with the arcuate surface of the implant, the inserter's studs and shaft are positioned within a cavity (e.g., a threaded cavity of the implant). Lines intersecting the endpoints and arcuate center of the arcuate surface of the implant can be flipped. Therefore, if the implant is attached to the handle of the inserter, a given attachment angle will change. In practice, the arcuate surface of the implant can be flipped after the inserter is attached to the implant to change the insertion angle of the inserter. In some embodiments, the inserter's studs and shaft are configured to be positioned within the threaded cavity of the implant before and after the inserter is flipped. In some embodiments, the geometry of the implant configured for OLIF 5-1 surgery and the geometry of the implant configured for OLIF 2-5 surgery allow the insertion of two implants using a single inserter, thereby allowing for further instrument integration. That is, the arcuate surface of a single inserter can be matched with the arcuate surface of an implant configured for OLIF 5-1 surgery and the arcuate surface of an implant configured for OLIF 2-5 surgery. When the arcuate surface of the inserter engages with the arcuate surface of an implant configured for OLIF 5-1 surgery, the inserter's studs and rods are positioned within the threaded cavity of the implant configured for OLIF 5-1, and when the arcuate surface of the inserter engages with the arcuate surface of an implant configured for OLIF 2-5 surgery, the inserter's rods and studs are positioned within the threaded cavity of the implant configured for OLIF 2-5 surgery. In some embodiments, the inserter's studs provide connection strength between the inserter and the implant.

[0104] In some embodiments, the inserter engages the implant such that when the inserter engages the implant, it can access an external bone screw extending through the implant, as discussed herein. In some embodiments, the inserter includes a planar contact that engages with a surface of the implant, while the inserter's rod and stud are positioned within a threaded cavity of the implant to attach the inserter to the implant.

[0105] In some embodiments, the inserter has features opposite to those of the implant. For example, the implant may include one or more studs, such as threaded studs extending outward from the body of the implant. The studs may be received within a cavity of the inserter. When the studs are received within the cavity, the arcuate surface of the inserter engages with the arcuate surface of the implant to attach the inserter to the implant. In some embodiments, this allows for the use of larger threads. Internal thread forms: In some embodiments, a cannula of a female thread form is rotatably positioned within one of the cavities of the inserter such that the female thread form mates with the male thread form of one of the studs of the inserter to attach the inserter to the implant, as discussed herein.

[0106] In some embodiments, the curved surface of the inserter may be opposite to the curved surface of the implant. For example, in some embodiments, the inserter may include a concave curved surface that engages a convex curved surface of the implant to attach the inserter to the implant. Alternatively, the inserter may include a convex curved surface that engages a concave curved surface of the implant to attach the inserter to the implant.

[0107] In some embodiments, the arcuate surface of the implant may include two or more cavities configured to handle the inserter's studs and shaft. For example, in one embodiment, the implant includes two cavities configured to handle the inserter's studs and shaft. In one embodiment, the implant includes three cavities configured to handle the inserter's studs and shaft, such that one of the cavities is empty or unoccupied when the inserter's studs and shaft are disposed in the other two cavities. This allows the implant to be positioned at three different angles relative to the inserter, as discussed herein. In some embodiments, the cavities are all positioned along the same arcuate path of the implant, which coincides with the arcuate center of the inserter. In some embodiments, at least one of the cavities is threaded.

[0108] In some embodiments, the arcuate surface of the inserter includes a central incision configured to dispose of a flap, such as a plate attached to an implant, allowing the inserter to be used to insert the implant via the plate attached to it, as discussed herein. In some embodiments, the arcuate surface of the inserter includes a central incision configured to allow access to an internal thread extending into or through the implant, such that the internal thread is rotatable relative to the implant when it extends into or through it, and the inserter is attached to the implant.

[0109] In some embodiments, the inserter includes a ratchet knob comprising a first member or plate, such as a float plate that engages a groove on a second plate of the inserter. Specifically, a spring actuates the float plate such that an extension of the float plate engages a groove on the second plate to prevent improper loosening of the implant in case of obstruction. When the user rotates the ratchet knob, the float plate moves within the groove, creating ratchet-like resistance, as discussed herein.

[0110] In some embodiments, the surgical system of this disclosure can be used to treat spinal conditions such as intervertebral disc degeneration, intervertebral disc herniation, osteoporosis, spondylolisthesis, stenosis, scoliosis and other curvature abnormalities, kyphosis, tumors, and fractures. In some embodiments, the surgical system of this disclosure can be used in conjunction with other bony and skeletal applications, including those associated with diagnosis and treatment. In some embodiments, the disclosed surgical system can alternatively be used in surgical procedures performed with the patient in a prone or supine position, and / or using various surgical approaches (including anterior, posterolateral, posterior midline, direct lateral, posterolateral, and / or anterolateral approaches) to reach the spine and other body regions. The surgical system of this disclosure can also alternatively be used in conjunction with surgeries for treating the lumbar, cervical, thoracic, sacral, and pelvic regions of the spine. The surgical system of this disclosure can also be used in animals, skeletal models, and other non-biological substrates, for example, in training, testing, and demonstration.

[0111] The surgical system of this disclosure can be more readily understood through the following detailed description of embodiments, taken in conjunction with the accompanying drawings that form a part of this disclosure. It should be understood that this application is not limited to the specific apparatus, methods, conditions, or parameters described and / or shown herein, and the terminology used herein is for the purpose of describing particular embodiments by way of example only and is not intended to be limiting. In some embodiments, as used in the specification and including the appended claims, the singular forms “a,” “an,” and “the” include the plural, and unless the context explicitly states otherwise, references to a particular numerical value include at least the stated particular value. Ranges may be expressed herein as from “about” or “approximately” one particular value and / or to “about” or “approximately” another particular value. When expressing such ranges, another embodiment includes from one particular value and / or to another particular value. Similarly, when a value is expressed as an approximation using the antecedent “about,” it should be understood that the stated particular value constitutes another embodiment. It should also be understood that all spatial references (e.g., horizontal, vertical, top, upper, lower, bottom, left, and right) are for illustrative purposes only and may vary within the scope of this disclosure. For example, the references “upper” and “lower” are relative and used only in context, and need not be “higher” and “lower”.

[0112] As used in the specification and including the appended claims, “treating” a disease or condition means performing surgery, which may include administering one or more medications to a patient (normal or abnormal human or other mammal), using an implantable device and / or using instruments for treating the disease (e.g., microdissection instruments for removing protruding portions or herniated discs and / or osteophytes) to aim at relieving the signs or symptoms of the disease or condition. Relief may occur before and after the onset of signs or symptoms of the disease or condition. Therefore, treatment includes preventing the disease or adverse condition (e.g., preventing the development of the disease in patients who may be susceptible to it but have not yet been diagnosed with it). Furthermore, treatment does not require complete relief of signs or symptoms, does not require a cure, and particularly includes surgery with only marginal effects on the patient. Treatment may include suppressing the disease, such as inhibiting its development, or alleviating the disease, such as causing relapse. For example, treatment may include reducing acute or chronic inflammation; relieving pain and reducing and inducing the regrowth of new ligaments, bone, and other tissues; as an adjunct to surgery; and / or any reparative surgery. In some embodiments, unless otherwise explicitly indicated, as used in the specification and including the appended claims, the term "tissue" includes soft tissue, ligaments, tendons, cartilage, and / or bone.

[0113] The following discussion includes a description of a surgical system including an implant, related components, and methods of using said surgical system, based on the principles of this disclosure. Alternative embodiments are also disclosed. Exemplary embodiments of the surgical system 100 illustrated in the accompanying drawings are given in detail.

[0114] Components of the surgical system 100 may be manufactured from bioacceptable materials suitable for medical applications, including metals, synthetic polymers, ceramics, bone materials, and / or composites thereof. For example, components of the surgical system 100 may be manufactured individually or collectively from materials such as: stainless steel alloys; aluminum; industrially pure titanium; titanium alloys; grade 5 titanium; hyperelastic titanium alloys; cobalt-chromium alloys; and hyperelastic metal alloys (e.g., Nitinol, such as GUM). Superelastic and malleable metals); ceramics and their composites, such as calcium phosphate (e.g., SKELITE). TMExamples include thermoplastics of polyaryletherketone (PAEK), including polyetheretherketone (PEEK), polyetherketoneketone (PEKK), and polyetherketone (PEK); carbon-PEEK composites; PEEK-BaSO4 polymer rubber; polyethylene terephthalate (PET); fabrics; silicones; polyurethanes; silicone-polyurethane copolymers; polymer rubbers; polyolefin rubbers; hydrogels; semi-rigid and rigid materials; elastomers; rubbers; thermoplastic elastomers; thermosetting elastomers; elastic composites; rigid polymers, including polystyrene, polyamides, polyimides, polyetherimides, polyethylene, and epoxy groups; and bone materials, including... Autologous transplantation, allogeneic transplantation, xenogeneic transplantation, or transgenic cortex and / or corticomena, and tissue growth or differentiation factors; partially absorbable materials, such as composites of metals and calcium-based ceramics, composites of PEEK and calcium-based ceramics, and composites of PEEK and absorbable polymers; fully absorbable materials, such as calcium-based ceramics, such as calcium phosphate, tricalcium phosphate (TCP), hydroxyapatite (HA)-TCP, calcium sulfate, or other absorbable polymers, such as polylactide, polyglycolic acid, polytyrosine carbonate, polycaprolactone; and combinations thereof.

[0115] The various components of the surgical system 100 may have material composites including the materials described above to achieve various desired properties such as strength, stiffness, elasticity, compliance, biomechanical properties, durability, and radiopaqueness or imaging preference. The components of the surgical system 100 may also be made individually or collectively of heterogeneous materials, such as combinations of two or more of the materials described above. The components of the surgical system 100 may be integrally formed, integrally connected, or include fastening elements and / or instruments, as described herein.

[0116] Surgical system 100 is used in conjunction with techniques such as open laparotomy, minimally invasive surgery including percutaneous techniques, and micro-laparotomy to deliver and introduce instruments and / or one or more spinal implants (e.g., one or more components of a bone fastener) at a surgical site (e.g., the spine) within a patient. In some embodiments, the spinal implant may include one or more components of one or more spinal structures (e.g., intervertebral devices, interbody fusion devices, bone fasteners, spinal rods, tethers, connectors, plates, and / or bone grafts) and may be used in conjunction with a variety of surgical procedures, including surgical treatment of the cervical, thoracic, lumbar, and / or sacral regions of the spine.

[0117] Surgical system 100 includes implants, such as spinal implant 102, and instruments, such as surgical instruments 104 configured to insert implant 102 into an intervertebral space defined by adjacent vertebrae, as discussed herein. In some embodiments, instrument 104 may be used to insert implant 102 and / or other implants similar to implant 102 into an intervertebral space defined by adjacent vertebrae. For example, Figure 1 The image shows a device 104, which is coupled to an implant 102 to allow the device 104 to insert the implant 102 into the intervertebral space. Figure 2 The device 104 is shown, wherein the device is coupled to an implant 106 similar to implant 104 to allow the device 104 to insert implant 106 into the intervertebral space. However, it should be understood that the device 104 can be used to insert implants other than implants 102, 106 into the intervertebral space, as discussed herein.

[0118] Instrument 104 includes a sleeve 108 extending along a longitudinal axis X1 between a proximal end 110 and a relatively distal end 112. An inner surface 114 of the sleeve 108 defines a channel 116. The insertion port 116 is coaxial with the axis X1. End 110 is coupled to a handle 118 of instrument 104 such that the body 125 of the handle 118 is fixed relative to the sleeve 108. In some embodiments, the maximum diameter of the handle 118 is larger than the maximum diameter of the sleeve 108 to facilitate gripping of the handle 118, for example, by a licensed physician's hand. In some embodiments, the handle 118 includes gripping features, such as indentations and / or protrusions configured to facilitate gripping. An inner surface 120 of the handle 118 defines a passage 122 coaxial with the channel 116 and the axis X1. The passage 122 communicates with the channel 116 such that an axis 124 of instrument 104 extends through the passage 122 and into the channel 116. As discussed herein, shaft 124 is rotatable about axis X1 relative to sleeve 108 and handle 118. In some embodiments, the diameter of channel 116 is slightly larger than the diameter of shaft 124, such that when shaft 124 is positioned within channel 116, the outer surface 126 of shaft 124 directly engages the surface 114 of sleeve 108. It is envisioned that the engagement of surface 126 with surface 114 maintains the orientation of shaft 124 relative to sleeve 108 and / or handle 118, such that shaft 124 remains coaxial with axis X1 when positioned within channel 116. That is, when shaft 124 is positioned within channel 116, the engagement of surface 126 with surface 114 prevents shaft 124 from extending at an acute angle relative to axis X1. In some embodiments, the diameter of channel 116 is larger than the diameter of shaft 124, such that when sleeve 108 is positioned within channel 116, surface 126 of shaft 124 is spaced apart from surface 114 of shaft 124. In some embodiments, channel 116 has a uniform diameter along its entire length, and / or passage 122 has a uniform diameter along its entire length. In some embodiments, channel 116 and / or passage 122 can be of various shapes, such as circular, elliptical, oblong, triangular, square, polygonal, irregular, uniform, non-uniform, offset, interlaced, wavy, arcuate, variable, and / or conical.

[0119] The proximal end 128 of shaft 124 is coupled to knob 130, and the opposite distal end 132 of shaft 124 includes mating surface 132, for example configured to engage a male threaded form of an implant to engage the implant to shaft 124. Specifically, as discussed herein, the male threaded form of mating surface 132 is configured to mate with a female threaded form of the implant to engage the implant to shaft 124. The proximal end 128 of shaft 124 is secured to knob 130 such that rotation of knob 130 about axis X1 also causes shaft 124 to rotate about axis X1, as discussed herein. In some embodiments, knob 130 is integrally and / or monolithically formed with shaft 124. In some embodiments, shaft 124 is welded to knob 130. It is conceivable that shaft 124 may be hollow or non-hollow, depending on the requirements of the specific application.

[0120] The distal end 112 of the sleeve 108 defines an engagement portion 136, which includes an engagement surface 138 extending from a first end 140 to an opposite second end 142. In some embodiments, the engagement portion 136 includes a stud 144 extending outwardly from end 140 and an opening 146 extending through end 136. In some embodiments, the engagement portion 136 does not include a stud or any other structure extending from the engagement surface 138, and the engagement portion 136 includes only the opening 146, which can be positioned differently relative to the engagement surface 138. The opening 146 communicates with a channel 116 such that the shaft 124 can be axially translated within the channel 116 along axis X1 to move the mating surface 134 through the opening 146 to engage with the implant, as discussed herein. The stud 144 is permanently fixed relative to surface 138. In some embodiments, the opening 146 is coaxial with the channel 116 and axis X1, and the stud 144 extends at an acute angle relative to axis X1. The stud 144 has a solid configuration without any gaps or openings to provide strength and rigidity to the stud 144. In some embodiments, the stud 144 has a beveled tip 148 to facilitate insertion of the stud 144 into the cavity of an implant, for example, to attach the device 104 to the implant, as discussed herein.

[0121] The handle 118 includes, for example, a plate 135, which is connected to the body 125 of the handle 118 such that the plate 135 is fixed relative to the body 125. The diameter of the plate 135 is larger than the diameter of the passage 122. An end face 150 of the plate 135 directly engages an end face 152 of the body 125 to attach the plate 135 to the body 125. In some embodiments, the end face 152 is integrally and / or integrally formed with the end face 150. In some embodiments, the end face 152 is welded to or otherwise coupled to the end face 150 to fix the plate 135 relative to the body 125. The plate 135 includes a hole 154 extending through the thickness of the plate 135, the thickness being defined by the distance between the end face 150 and the opposite end face 156. The hole 154 is coaxial with the shaft 124 and the axis X1. The proximal end 128 of the shaft 124 extends through the hole 154, such as... Figure 4B As best shown herein. Plate 135 includes a plurality of spaced recesses 158 that are radially positioned around aperture 154. That is, the recesses 158 extend circumferentially around aperture 154. The recesses 158 extend parallel to axis X1 and are each configured to handle extensions 160 of knob 130 to prevent shaft 124 from rotating about axis X1 relative to handle 118 and sleeve 108, as discussed herein.

[0122] In some embodiments, the groove 158 includes a bevel 158a to facilitate insertion of the extension 160 into the groove 158. Specifically, the diameter of the tapered bevel 158a extending into the end face 156 is larger than the diameter of the cylindrical second portion of the groove 158 positioned between the end face 156 and the end face 150. In some embodiments, the extension 160 includes a tapered tip 160a configured to facilitate insertion of the extension 160 into the groove 158. In some embodiments, the tip 160a terminates at a cusp. In some embodiments, at least one extension in the groove 158 extends through the end face 156 but not through the end face 150. In some embodiments, at least one extension in the groove 158 extends through both the end face 156 and the end face 150. In some embodiments, the plate 135 has a uniform thickness. In some embodiments, the holes 154 and / or the grooves 158 are of various shapes, such as circular, elliptical, oblong, triangular, square, polygonal, irregular, uniform, non-uniform, offset, staggered, wavy, arc-shaped, variable, and / or conical.

[0123] The knob 130 includes a hub 164, which includes a cylindrical body 166. A proximal end 128 of the shaft 124 is coupled to a distal end of the hub 164, such that end 128 is fixed relative to the hub 164, as... Figure 4BAs best shown. In some embodiments, end 128 is integrally and / or integrally formed with hub 164. In some embodiments, end 128 is welded to hub 164 such that rotation of hub 164 also rotates shaft 124. Grip portion 172 of knob 130 includes disc 170 fixed to hub 164. In some embodiments, disc 170 is integrally and / or integrally formed with grip portion 172 such that rotation of grip portion 172 also rotates disc 170. In some embodiments, disc 170 is welded to grip portion 172. In some embodiments, disc 170 is integrally and / or integrally formed with hub 164 such that rotation of grip portion 172 also rotates both disc 170 and hub 164. In some embodiments, disc 170 is welded to hub 164. Grip portion 172 also includes, for example, a plate 168 fixed to hub 164, such as plate 170 and members of grip portion 172. In some embodiments, plate 168 is integrally and / or monolithically formed with hub 164, plate 170, and / or gripping portion 172, such that rotation of plate 168 also causes hub 164 to rotate. In some embodiments, plate 168 is welded to hub 164.

[0124] The inner surface 174 of the gripping portion 172 defines a cavity 176. A floating member or plate, such as plate 178, is movably disposed within the cavity 176. An extension 160 extends outwardly from the distal end of plate 178. Plate 168 includes a hole 188 and plate 178 includes a hole 190. Holes 188 and 190 are each coaxial with axis X1 such that holes 188 and 190 are aligned with holes 154 of plate 135, and end 128 of shaft 124 extends through holes 154, 188, and 190 to connect with hub 164.

[0125] The extension 160 is configured to move through the groove 180 in the plate 178 and into the groove 158 in the plate 135. Specifically, the knob 130 is rotatable between a first configuration and a second configuration, in which the extension 160 is spaced apart from the groove 158 or only the tip 160a of the extension 160 is positioned within the groove 158, while in the second configuration the extension 160 is disposed within the groove 158. That is, when the knob 130 is in the first configuration, the extension 160 is spaced apart from the groove 158 or only partially positioned within the groove 158, while when the knob 130 is in the second configuration, the extension 160 is fully disposed within the groove 158. In some embodiments, when the extension 160 is fully disposed within the groove 158 and the knob 130 is in the second configuration, the cylindrical portion 160b of the extension 160 is positioned within the groove 158. When the knob 130 is in the first and second configurations, the cylindrical portion 160b of the extension 160 is positioned in the recess 180, and the tip 160a of the extension 160 is positioned outside the recess 180. When the knob 130 is in the first configuration, the knob 130 is rotatable relative to the sleeve 108 and the handle 118. When the knob 130 is in the second configuration, rotation of the knob 130 relative to the sleeve 108 and the handle 118 is prevented. Therefore, when the knob 130 is in the first configuration, the shaft 124 is rotatable relative to the sleeve 108 and the handle 118, and when the knob 130 is in the second configuration, rotation of the shaft 124 relative to the sleeve 108 and the handle 118 is prevented. In practice, when only the tip 160a of the extension 160 is positioned within the recess 158, as the knob 130 rotates relative to the sleeve 108 and the handle 118, the tapered configuration of the tip 160a allows the tip 160a to move into and out of the adjacent recess 158. When the extension 160 is further inserted into the groove 158 such that the cylindrical portion 160b of the extension is positioned within the groove 158, the knob 130s is prevented from rotating relative to the sleeve 108 and the handle 118, because the extension 160 is prevented from moving from one groove 158 to another.

[0126] In some embodiments, the knob 130 is biased to a second configuration by a biasing member, such as a spring 182 positioned around the hub 164. Specifically, the spring 182 has a first end 184 that directly engages the disc 170 and a plate 178 that directly engages the plate 178 to displace the plate 170 from its opposing second end 186, such that the extension 160 moves through the recess 180 and into the recess 158. In some embodiments, the force applied to the plate 178 by the spring 182 is sufficient to move the knob 130 from the first configuration to the second configuration. In some embodiments, the force applied to the plate 178 by the spring 182 is insufficient to move the knob 130 from the first configuration to the second configuration. For example, in one embodiment, the knob 130 will remain in the first configuration unless and until the mating surface 134 engages with the mating surface of an implant, such as implant 104 or implant 106. When mating surface 134 mates with the mating surface of the implant, rotation of knob 130 relative to sleeve 108 and handle 118 causes shaft 124 to translate axially relative to sleeve 108 and handle 118. As shaft 124 translates axially relative to sleeve 108 and handle 118, knob 130 translates axially relative to plate 135 to move knob 130 toward plate 135, such that extension 160 is fully disposed in recess 158 and knob 130 is in a second configuration.

[0127] In assembly, operation, and use, a surgical system 100 similar to the systems and methods described herein is used in conjunction with surgical procedures for treating spinal conditions affecting a portion of a patient's spine, as discussed herein. Components of the surgical system 100 are used in conjunction with surgical procedures for treating conditions or injuries to the affected portion of the spine (e.g., vertebrae).

[0128] In use, to treat selected portions of the vertebrae, the physician accesses the surgical site in any appropriate manner (such as through an incision and tissue retraction). In some embodiments, the surgical system 100 can be used in any existing surgical method or technique, including open surgery, micro-open surgery, minimally invasive surgery, and percutaneous implantation, thereby accessing the vertebrae through a small incision or cannula providing a protected passage to the area. Once access to the surgical site is achieved, specific surgical procedures can be performed to treat spinal conditions.

[0129] An incision is made inside the patient's body, and cutting instruments create a surgical path for the implantation of components for the surgical system 100. Preparatory instruments may be used to prepare the tissue surface of the vertebrae and to aspirate and irrigate the surgical area. Instrument 104 is coupled to an implant, such as implant 192, which is configured for insertion into a target site, such as the intervertebral space IS between the first vertebra V1 and the second vertebra V2. Figure 11 As shown. Figure 14-17As shown, implant 192 includes opposing first vertebral engagement surfaces 194 and 196. Vertebral engagement surface 194 is configured to engage the endplate of vertebra V1, while vertebral engagement surface 196 is configured to engage the endplate of vertebra V2. Implant 192 includes a posterior surface 198 and an anterior surface 200 opposite to surface 198. Surfaces 198 and 200 each extend from surface 194 to surface 196. Surface 200 defines a cavity 202 and a cavity 204 spaced apart from cavity 202. Cavity 202 includes a female thread form 202a, and cavity 204 includes a female thread form 204a.

[0130] In one embodiment, implant 192 is configured for ALIF surgery. Implant 192 is connected to instrument 104 by inserting studs 144 into cavity 204 such that opening 146 is aligned with cavity 202, as... Figure 15 As shown. When the stud 144 is inserted into the cavity 204, the knob 130 is in the first configuration, allowing the knob 130 to... Figure 1 The direction indicated by the middle arrow A and / or Figure 1 The knob 130 is translated along axis X1 relative to sleeve 108 and handle 118 in the direction indicated by the middle arrow B. Figure 1 The shaft 124 is translated along axis X1 in the direction indicated by the middle arrow A to move it from a first position to a second position. In the first position, the mating surface 134 is fully positioned within the channel 116, while in the second position, the mating surface 134 extends through the opening 146 and into the cavity 202, as shown by the middle arrow A. Figure 15 As shown. When the knob 130 is relative to the sleeve 108 and the handle 118 at... Figure 1 When the knob 130 is translated along axis X1 in the direction indicated by the middle arrow A, it rotates about axis X1 in the first rotational direction, for example, clockwise, so that the male thread of mating surface 134 engages with the female thread 202a. When the male thread of mating surface 134 engages with the female thread 202a, further rotation of the knob 130 relative to sleeve 108 and handle 118 in the first rotational direction causes shaft 124 to... Figure 1 The knob 130 is axially translated relative to the sleeve 108 and handle 118 in the direction indicated by the middle arrow A. Because the knob 130 is in the first configuration, it can rotate relative to the sleeve 108 and handle 118 to axially translate the shaft 124 relative to the sleeve 108 and handle 118. When the shaft 124 is relative to the sleeve 108 and handle 118... Figure 1 When the knob 130 is axially translated in the direction indicated by the middle arrow A, the knob moves along... Figure 1 The knob 130 is axially translated relative to the plate 135 in the direction indicated by the middle arrow A, so that the extension 160 is fully disposed in the groove 158 and the knob 130 is in the second configuration.

[0131] The implant 192 is guided into the intervertebral space IS using instrument 104. Once the implant 192 is selectively positioned within the intervertebral space IS, knob 130 is rotated about axis X1 in a second rotational direction relative to sleeve 108 and handle 118, for example, counterclockwise. Rotation of knob 130 about axis X1 in the second rotational direction relative to sleeve 108 and handle 118 is sufficient to overcome the force of spring 182 to move knob 130 from a second configuration to a first configuration. As knob 130 moves from the second configuration to the first configuration, shaft 124 moves from a second position to a first position, wherein in the second position, mating surface 134 extends through opening 146 and into cavity 202, while in the first position, mating surface 134 is fully positioned within channel 116. When shaft 124 is in the first position, stud 144 is removed from cavity 204.

[0132] Following the completion of the procedure, as described herein, the surgical instruments, assemblies, and non-implantable components of the surgical system 100 are removed, and one or more incisions are closed. One or more components of the system 100 may be made of a radiation-permeable material, such as a polymer. Radioactive markers may be included for identification under X-ray, fluoroscopy, CT, or other imaging techniques. In some embodiments, the surgical system 100 may include one or more spinal rods, plates, connectors, and / or bone fasteners for use with a single vertebra or multiple vertebral segments.

[0133] In some embodiments, as described herein, one or more bone screws may engage tissue in various orientations (e.g., tandem, parallel, offset, staggered, and / or alternating vertebral segments). In some embodiments, one or more of the bone screws may include multiaxial screws, sagittal plane adjusting screws, pedicle screws, uniaxial screws, single-plane screws, articular screws, fixation screws, tissue-penetrating screws, conventional screws, expansion screws, wedges, anchors, buttons, clips, snaps, friction fittings, compression fittings, expansion rivets, staples, nails, adhesives, struts, fixation plates, and / or supports.

[0134] In one embodiment, the surgical system 100 includes an agent that may be disposed, packaged, coated, or layered within, on, or around components and / or surfaces of the surgical system 100. In some embodiments, the agent may include a bone growth-promoting material, such as a bone graft, to enhance fixation of components and / or surfaces of the surgical system 100 to the vertebrae. In some embodiments, the agent may include one or more therapeutic agents and / or pharmacological agents for release (including sustained release) to treat, for example, pain, inflammation, and degeneration.

[0135] As shown above, the instrument 104 is used to insert the implant 192 in conjunction with an ALIF procedure. To demonstrate that the instrument 104 can be used to insert the implant 192 using different approaches, the implant 192 is attached to the instrument 104 by inserting the stud 144 into the cavity 202 so that the opening 146 is aligned with the cavity 204, as shown above. Figure 16 As shown, implant 192 is configured for OLIF 5-1 surgery. Figure 17 As shown, the implant 192 includes screw holes 195a and 195b, which are accessible when the stud 144 is inserted into the cavity 202 and the opening 146 is aligned with the cavity 204. This allows fastener 205a to be inserted into and / or removed from hole 195a, and fastener 205b to be inserted into and / or removed from hole 195b, when the stud 144 is inserted into the cavity 202 and the opening 146 is aligned with the cavity 204. When the stud 144 is inserted into the cavity 202, the knob 130 is in a first configuration, allowing the knob 130 to... Figure 1 The direction indicated by the middle arrow A and / or Figure 1 The knob 130 is translated along axis X1 relative to sleeve 108 and handle 118 in the direction indicated by the middle arrow B. Figure 1 The shaft 124 is translated along axis X1 in the direction indicated by the middle arrow A to move it from a first position to a second position. In the first position, the mating surface 134 is fully positioned within the channel 116, while in the second position, the mating surface 134 extends through the opening 146 and into the cavity 204, as shown by the middle arrow A. Figure 16 As shown. When the knob 130 is relative to the sleeve 108 and the handle 118 at... Figure 1 When the knob 130 is translated along axis X1 in the direction indicated by the middle arrow A, it rotates about axis X1 in the first rotational direction, for example, clockwise, so that the male thread of mating surface 134 engages with the female thread 204a. When the male thread of mating surface 134 engages with the female thread 204a, further rotation of the knob 130 relative to sleeve 108 and handle 118 in the first rotational direction causes shaft 124 to... Figure 1 The knob 130 is axially translated relative to the sleeve 108 and handle 118 in the direction indicated by the middle arrow A. Because the knob 130 is in the first configuration, it can rotate relative to the sleeve 108 and handle 118 to axially translate the shaft 124 relative to the sleeve 108 and handle 118. When the shaft 124 is relative to the sleeve 108 and handle 118... Figure 1 When the knob 130 is axially translated in the direction indicated by the middle arrow A, the knob moves along... Figure 1 The knob 130 is axially translated relative to the plate 135 in the direction indicated by the middle arrow A, so that the extension 160 is fully disposed in the groove 158 and the knob 130 is in the second configuration.

[0136] The implant 192 is guided into the intervertebral space IS using instrument 104. Once the implant 192 is selectively positioned within the intervertebral space IS, knob 130 is rotated about axis X1 in a second rotational direction relative to sleeve 108 and handle 118, for example, counterclockwise. Rotation of knob 130 about axis X1 in the second rotational direction relative to sleeve 108 and handle 118 is sufficient to overcome the force of spring 182 to move knob 130 from a second configuration to a first configuration. As knob 130 moves from the second configuration to the first configuration, shaft 124 moves from a second position to a first position, wherein in the second position, mating surface 134 extends through opening 146 and into cavity 202, while in the first position, mating surface 134 is fully positioned within channel 116. When shaft 124 is in the first position, stud 144 is removed from cavity 202.

[0137] It should be understood that, in addition to implant 192, device 104 can also be used to insert other implants for various techniques, such as ALIF, OLIF 5-1, OLIF 2-5, and DLIF. For example, Figure 1 The image shows a device 104, which is connected to an implant 102 for insertion into the implant 102 in conjunction with a DLIF procedure. Figure 8 The image shows a device 104, which is connected to an implant 102 for insertion into the implant 102 in conjunction with an OLIF 2-5 procedure. Figure 9 The image shows a device 104, which is connected to an implant 106 for insertion into the implant 106 in conjunction with an OLIF 5-1 procedure. Figure 10 The image shows device 104, which is connected to implant 106 for insertion into implant 106 in conjunction with ALIF surgery. However, it is conceivable that device 104 may be connected to a variety of implants that are the same as or similar to implants 102, 106, 192 for a variety of different surgeries and / or approaches.

[0138] In the embodiments discussed above, the device 104 includes a shaft 124 and a stud 144, which are inserted into the cavity of the implant to attach the device 104 to the implant. In other embodiments, an implant is disclosed that includes a portion received within the cavity of the device to attach the implant to a protrusion or extension of the device. For example, in one embodiment, such as... Figure 18-21 As shown, the surgical system 100 includes an implant 206 similar to implants 102, 106, 192 and an instrument 208 similar to instrument 104, and is configured to connect to the implant 206 to insert the implant 206 into a target area of ​​the patient's body, as discussed herein.

[0139] The implant 206 includes a body 210 having opposing first vertebral engagement surfaces 212 and second vertebral engagement surfaces 214. (As...) Figure 22-24 As shown, the body 210 of the implant 206 can have various shapes and sizes. An end face 216 of the body 210 extends from the vertebral conjoint surface 212 to the vertebral conjoint surface 214. The implant 206 includes studs 218 and 220 extending from the surface 216, such that studs 220 are spaced apart from studs 218. Stud 218 includes a male thread type 218a, and stud 220 includes a male thread type 220a.

[0140] Instrument 208 includes a sleeve 108. Instead of positioning the shaft 124 in the channel 116, instrument 208 includes an inner sleeve 222 rotatably positioned within 116 such that the sleeve 222 can be axially translated relative to axis X1 in the opposite direction to the sleeve 108. In one embodiment, when the sleeve 222 is positioned in the channel 116, the outer surface of the sleeve 222 directly engages the surface 114. The proximal end of the sleeve 222 is coupled to a knob 130 to allow the knob 130 to move the sleeve 222 relative to the sleeve 108 and handle 118 in the same manner as the knob 130 moves the shaft 124 relative to the sleeve 108 and handle 118 in the embodiment of instrument 104 discussed above. The engagement portion 136 of instrument 208 is similar to the engagement portion 136 of instrument 104, except that the engagement portion 136 of instrument 208 includes a hole 224 instead of a stud 144. Sleeve 222 includes an inner surface 226 that defines a female thread form 228, which is configured to engage a male thread form 218a or a male thread form 220a to attach the implant 206 to the device 208, as discussed herein.

[0141] During assembly, operation, and use, the device 208 is coupled to an implant, such as implant 206, which is configured for insertion into a target site, such as the intervertebral space (IS). In one embodiment, implant 206 is configured for ALIF surgery. Implant 206 is coupled to the device 208 by inserting studs 218 into holes 224 such that opening 146 is aligned with studs 220. When studs 218 are inserted into holes 224, knob 130 is in a first configuration such that knob 130 can... Figure 1 The direction indicated by the middle arrow A and / or Figure 1 The sleeve 222 is translated relative to the sleeve 108 and handle 118 along axis X1 in the direction indicated by the middle arrow B. The knob 130 is positioned relative to the sleeve 108 and handle 118 in... Figure 1The sleeve 222 is translated along axis X1 in the direction indicated by the middle arrow A to move the sleeve 222 from a first position to a second position, wherein in the first position the sleeve 222 is fully positioned within the channel 116, and in the second position the sleeve 222 extends through the opening 146 and engages the stud 220.

[0142] When the knob 130 is relative to the sleeve 108 and the handle 118 at Figure 1 When the knob 130 is translated along axis X1 in the direction indicated by the middle arrow A, it rotates around axis X1 in the first rotational direction, for example, clockwise, causing thread type 228 to engage with female thread type 220a. When female thread type 228 engages with male thread type 220a, further rotation of the knob 130 relative to sleeve 108 and handle 118 in the first rotational direction causes sleeve 222 to... Figure 1 The sleeve 222 is axially translated relative to the sleeve 108 and handle 118 in the direction indicated by the middle arrow A. Because the knob 130 is in the first configuration, it can rotate relative to the sleeve 108 and handle 118 to axially translate the sleeve 222 relative to the sleeve 108 and handle 118. When the sleeve 222 is in the direction indicated by the middle arrow A, it is axially translated relative to the sleeve 108 and handle 118. Figure 1 When the knob 130 is axially translated in the direction indicated by the middle arrow A, the knob moves along... Figure 1 The knob 130 is axially translated relative to the plate 135 in the direction indicated by the middle arrow A, so that the extension 160 is fully disposed in the groove 158 and the knob 130 is in the second configuration.

[0143] The implant 206 is guided into the intervertebral space IS using instrument 208. Once the implant 206 is selectively positioned within the intervertebral space, the IS knob 130 is rotated relative to the sleeve 108 and handle 118 in a second rotational direction, for example, counterclockwise, about axis X1. The knob 130 rotates about axis X1 relative to the sleeve 108 and handle 118 in the second rotational direction with a force sufficient to overcome the force of the spring 182 to move the knob 130 from a second configuration to a first configuration. As the knob 130 moves from the second configuration to the first configuration, the sleeve 222 moves from a second position to a first position, wherein in the second position the sleeve 222 extends through the opening 146 and engages the stud 220, while in the first position the sleeve 222 is fully positioned within the channel 116.

[0144] As shown above, the instrument 208 is used to insert the implant 206 in conjunction with an ALIF procedure. To demonstrate that the instrument 208 can be used to insert the implant 206 using different approaches, the implant 206 is attached to the instrument 208 by inserting a stud 220 into a hole 224 such that the opening 146 is aligned with the stud 218. When the stud 220 is inserted into the hole 224, the knob 130 is in a first configuration, allowing the knob 130 to... Figure 1 The direction indicated by the middle arrow A and / or Figure 1 The sleeve 222 is translated relative to the sleeve 108 and handle 118 along axis X1 in the direction indicated by the middle arrow B. The knob 130 is positioned relative to the sleeve 108 and handle 118 in... Figure 1 The sleeve 222 is translated along axis X1 in the direction indicated by the middle arrow A to move it from a first position to a second position, wherein in the first position the sleeve 222 is fully positioned within channel 116, and in the second position the sleeve 222 extends through opening 146 and engages stud 218. When the knob 130 is relative to the sleeve 108 and handle 118... Figure 1 When the knob 130 is translated along axis X1 in the direction indicated by the middle arrow A, it rotates around axis X1 in the first rotational direction, for example, clockwise, causing thread type 228 to engage with female thread type 218a. When female thread type 228 engages with male thread type 218a, further rotation of the knob 130 relative to sleeve 108 and handle 118 in the first rotational direction causes sleeve 222 to... Figure 1 The sleeve 222 is axially translated relative to the sleeve 108 and handle 118 in the direction indicated by the middle arrow A. Because the knob 130 is in the first configuration, it can rotate relative to the sleeve 108 and handle 118 to axially translate the sleeve 222 relative to the sleeve 108 and handle 118. When the sleeve 222 is in the direction indicated by the middle arrow A, it is axially translated relative to the sleeve 108 and handle 118. Figure 1 When the knob 130 is axially translated in the direction indicated by the middle arrow A, the knob moves along... Figure 1 The knob 130 is axially translated relative to the plate 135 in the direction indicated by the middle arrow A, so that the extension 160 is fully disposed in the groove 158 and the knob 130 is in the second configuration.

[0145] The implant 206 is guided into the intervertebral space IS using instrument 208. Once the implant 206 is selectively positioned within the intervertebral space, the IS knob 130 is rotated relative to the sleeve 108 and handle 118 in a second rotational direction, for example, counterclockwise, about axis X1. The knob 130 rotates about axis X1 relative to the sleeve 108 and handle 118 with sufficient force to overcome the force of the spring 182 to move the knob 130 from a second configuration to a first configuration. As the knob 130 moves from the second configuration to the first configuration, the shaft 124 moves from a second position to a first position, wherein in the second position the sleeve 222 extends through the opening 146, while in the first position the sleeve 222 is fully positioned within the channel 116. It should be understood that, in addition to implant 206, instrument 208 can also be used to insert other implants for various techniques, such as ALIF, OLIF 5-1, OLIF 2-5, and DLIF.

[0146] As described above, the engagement portion 136 can be configured differently to engage with multiple different implants. That is, the configuration of the engagement portion 136 can be adapted to match the configuration of the implants. For example, in one embodiment, such as Figure 12 As shown, the mating surface 138 is concavely curved from end 140 to end 142. In some embodiments, the mating surface 138 is continuously curved from end 140 to end 142 and / or the mating surface 138 has a continuous radius of curvature. Figure 11 The configuration of the engagement surface 138 can be used in conjunction with implants that include a convex or curved surface engaging the engagement surface 138 (e.g., the engagement surface 230 of implant 192). In another embodiment, such as Figure 13 As shown, the mating surface 138 includes a first planar portion 138a, a second planar portion 138b, and a third planar portion 138c located between portions 138a and 138b. A stud 144 extends from portion 138a and an opening 146 extends through portion 138b. Portion 138c extends at an acute angle relative to portions 138a and 138b. In one embodiment, as... Figure 25 As shown, the mating surface 138 protrudes and curves from end 140 to end 142. In some embodiments, the mating surface 138 is continuously curved from end 140 to end 142 and / or the mating surface 138 has a continuous radius of curvature. Figure 25 The configuration of the mating surface 138 in the middle can be with including Figure 26 The implant 232 is used in conjunction with the recessed curved surface 234, which is configured to engage with the engagement surface 138, such as... Figure 27 As shown.

[0147] The implants discussed above each include two threaded cavities along the engagement surface (e.g., cavities 202, 204 along surface 200) for disposing of the stud 144 and shaft 124, respectively. However, it is conceivable that the implants discussed herein may include three or more threaded cavities along the engagement surface. In some embodiments, the threaded cavities are all on an arcuate path defined by the engagement surface. For example, cavities 202, 204 of implant 192 are on the arcuate path of surface 200 and coincide with the arcuate center of surface 200. It is conceivable that providing an implant with at least three cavities would allow practitioners more options for attaching the implant to device 104. For example, three or more cavities allow device 104 to be attached to the implant at different angles or in different ways at the same angle. In one embodiment, as Figure 28 As shown, the implant 238 includes a front surface 238, said front surface including threaded cavities 240, 242, 244 spaced apart along an arcuate path along the surface 238. In one embodiment, as Figure 29As shown, the stud 144 is disposed in the cavity 242 and the end 132 of the shaft 124 is disposed in the cavity 240, such that the axis X2 of the implant 236 is set at an angle α1 relative to the axis X1. In one embodiment, as Figure 30 As shown, the stud 144 is disposed in the cavity 244 and the end 132 of the shaft 124 is disposed in the cavity 242, such that the axis X2 of the implant 236 is set at an angle α2 relative to the axis X1. In one embodiment, as Figure 31 As shown, the stud 144 is disposed in the cavity 240 and the end 132 of the shaft 124 is disposed in the cavity 242, such that the axis X2 of the implant 236 is arranged at an angle α2 relative to the axis X1. In one embodiment, as Figure 32 As shown, the stud 144 is disposed in the cavity 242 and the end 132 of the shaft 124 is disposed in the cavity 244, such that the axis X2 is parallel and / or coaxial with the axis X1. In some embodiments, the angle α1 is approximately 40 degrees and the angle α2 is approximately 20 degrees.

[0148] In some implementations, such as Figure 33-35 As shown, the mating surface 138 includes a gap 246 between end 140 and end 142. That is, end 142 and end 140 are spaced apart by the gap 246. In one embodiment, as... Figure 33 As shown, gap 246 is configured to handle plate 248 attached to implant 250 to allow implant 250 to be inserted together with device 104, while plate 248 is attached to implant 250. That is, plate 248 can be attached to implant 250 before device 104 engages implant 250 to deliver implant 250 to target site. In one embodiment, as... Figure 34 As shown, the gap 246 is configured to allow access to the screw hole 252 of the implant 254 when the device 104 is attached to the implant 254. That is, while the device 104 is attached to the implant 254, a fastener can be inserted through the hole 252 and into tissue, such as bone, to secure the implant 254 relative to the tissue. Once the fastener is inserted through the hole 252 and into the tissue, the device 104 can be removed from the implant 254. Similarly, in one embodiment, as... Figure 35 As shown, the gap 246 is configured to allow access to the screw hole 256 of the implant 258 when the device 104 is attached to the implant 258. That is, while the device 104 is attached to the implant 258, a fastener can be inserted through the hole 256 and into tissue, such as bone, to secure the implant 258 relative to the tissue. Once the fastener is inserted through the hole 256 and into the tissue, the device 104 can be removed from the implant 258.

[0149] As discussed herein, device 104 can be used to insert multiple different implants. In one embodiment, such as Figure 36-41 As shown, system 100 includes an implant 260 having a solid body 262 extending along a longitudinal axis X3 between an end wall 264 and an opposite end wall 266. The body 262 includes a side wall 268 and a side wall 270 opposite to the side wall 268. Walls 268 and 270 each extend from wall 264 to wall 266. In some embodiments, at least one of walls 268 and 270 is planar from wall 264 to wall 270. In some embodiments, at least one of walls 268 and 270 extends parallel to axis X3. In some embodiments, at least one of walls 264 and 266 is convexly curved from wall 268 to wall 270. In some embodiments, at least one of walls 264 and 266 has a continuous radius of curvature from wall 268 to wall 270. However, it is conceivable that walls 264, 266 can be of various shapes and / or curved to match the shape and / or curve of the mating surface of an instrument engaging one of walls 264, 266, such as mating surface 138 of instrument 104. In some embodiments, the maximum length of each of walls 264, 266 is less than the maximum length of walls 268, 270. In some embodiments, wall 264 extends perpendicular to wall 268, wall 268 extends perpendicular to wall 266, wall 266 extends perpendicular to wall 270, and wall 270 extends perpendicular to wall 264.

[0150] The inner surfaces of walls 264, 266, 268, and 270 define a cavity 272. In some embodiments, the body 262 includes a support 274 positioned within the cavity 272. The support 274 includes a top wall 276 and an opposing bottom wall 278. Wall 278 is connected to wall 276 by a plurality of spaced-apart ribs 280. The support 274 is connected to wall 268 by support members 282 and to wall 270 by support members 284. The support 274 is spaced apart from walls 264 and 266 and is connected to walls 268 and 270 only by support members 282 and 284. The support 274 includes an opening 286 extending through wall 276 and an opening 288 extending through wall 278. Openings 286 and 288 extend perpendicular to axis X3. The support 274 includes a plurality of holes 290 extending through the thickness of wall 276 and a plurality of holes 292 extending through the thickness of wall 278. In some embodiments, body 262 includes a window 294 extending through wall 268 and a window 296 extending through wall 270. In some embodiments, holes 290, 292, windows 294, and / or windows 296 can be of various shapes, such as ellipse, oblong, triangular, square, polygonal, irregular, uniform, non-uniform, offset, staggered, wavy, arcuate, variable, and / or conical. In some embodiments, walls 268 and / or 270 can be arranged with respect to axis X3 in alternative orientations, such as lateral, vertical, and / or other angular orientations, such as acute or obtuse angles, coaxial, and / or offset or staggered. In some embodiments, holes 290 and / or 292 can be of various shapes, such as circular, elliptical, rectangular, triangular, square, hexagonal, polygonal, honeycomb, irregular, uniform, non-uniform, offset, staggered, wavy, arcuate, variable, and / or conical.

[0151] The body 262 includes a cavity 298 and a cavity 300 spaced apart from the cavity 298. Cavities 298 and 300 each extend into a wall 264. In some embodiments, the cavity 298 communicates with a channel 302 defined by a cylindrical wall 304 of the body 262 connected to the wall 264, such as... Figure 39 As best shown. Wall 304 includes a closed end 306 such that cavity 298 and channel 302 are not in communication with cavity 272. That is, an object must pass through wall 264 to be inserted into cavity 298 and channel 302. Similarly, cavity 300 communicates with channel 308 defined by cylindrical wall 310 of body 262 connected to wall 264, as shown. Figure 39As best shown. Wall 310 includes a closed end 312 such that cavity 300 and channel 308 are not in communication with cavity 272. That is, an object must be inserted into cavity 300 and channel 308 through wall 264. Cavities 298, 300 and channels 302, 308 are configured to engage components of an instrument, such as stud 144 and shaft 124 of instrument 104, as discussed herein. Thus, channels 302, 308 each include a female thread form configured to mate with a male thread form of mating surface 134 to connect the instrument to implant 260, as discussed herein. Walls 304, 310 are permanently fixed relative to body 262. That is, walls 304 and 310 cannot move relative to walls 264, 266, 268, and 270, such that when pin 144 is positioned in channel 308, wall 304 does not move to allow mating surface 134 to engage the female thread of channel 302, and / or when pin 144 is positioned in channel 302, wall 310 does not move to allow mating surface to engage the female thread of channel 308. In effect, permanently fixing walls 304 and 310 relative to body 262 allows device 104 to be manipulated relative to implant 260 to attach implant 260 to device 104, as discussed herein. Compared to systems that include devices configured to move the implant relative to the device when the implant is attached, when device 104 is attached to implant 260, implant 260 is fixed to device 104. Therefore, when implant 260 is fixed to device 104, the practitioner must manually manipulate handle 118 to selectively position implant 260 in the patient's body. In some embodiments, cavities 298, 300, channels 302, 308, openings 320, 322, and / or channels 324 may be arranged relative to axis X3 in alternative orientations, such as lateral, vertical, and / or other angular orientations, such as acute or obtuse angles, coaxial, and / or may be offset or staggered.

[0152] In some embodiments, body 262 includes a tunnel 314 having an end 316 fixed to wall 264 and an opposite end 318. Tunnel 314 extends at an oblique angle relative to axis X3 and is located between cavity 298 and cavity 300, including an opening 320 extending through end 316 and wall 264 and an opening 322 extending through end 318. Tunnel 314 extends continuously from opening 320 to opening 322 such that there are no gaps or openings between openings 320 and 322, and the aperture of channel 324, defined by the inner surface of tunnel 314, does not communicate with cavity 272, cavity 298, cavity 300, channel 304, or channel 308. Channel 324 is configured for disposing of fasteners, such as bone screws, such that the bone screws extend through openings 320, 322 to engage with tissue, such as bone, as discussed herein. It is conceivable that, in addition to tunnel 314, body 262 may also include one or more tunnels, each of which is configured to handle additional bone screws, allowing the implant 260 to be attached to the bone using more than one bone screw. In some embodiments, tunnel 314 may be arranged in an alternative orientation relative to axis X3, such as parallel, transverse, vertical, and / or other angular orientations, such as acute or obtuse angles, coaxial, and / or may be offset or staggered.

[0153] The core 326 is positioned within the cavity 272 such that it surrounds the support 274 and is visible through windows 294, 296. The core 326 includes a body 328 having a lattice configuration that reduces stiffness and opacity while maintaining strength. The body 328 extends from the inner surface of wall 264, from the inner surface of wall 266, from the inner surface of wall 268, and from the inner surface of wall 270 to the support 274. In some embodiments, when the core 326 is positioned within the cavity 272, the uppermost surface of the body 328 is flush with the uppermost surface of the body 262, and the lowermost surface of the body 328 is flush with the lowermost surface of the body 262. The core 326 extends a central passage 330 that extends through the thickness of the body 328, defined by the distance between the uppermost and lowermost surfaces of the body 328. When the core 326 is positioned within the cavity 272, the passage 330 is aligned with the openings 286, 288. In some embodiments, the core 326 is fused to the body 262. In some embodiments, the core 326 is welded to the body 262. In some embodiments, the core 326 is integrally and / or monolithically formed with the body 262.

[0154] In some embodiments, the lattice configuration of the body 328 is a diamond lattice, which provides excellent constructability, strength, reduced internal stress, and suitability for various spinal implant geometries. Specifically, the lattice configuration of the body 328 is formed by a plurality of rhombuses 332, which are interconnected to form the body 328. The parameters of the rhombuses 332 are as follows: Figure 40B As shown in the diagram. However, it is conceivable that the parameters of rhombus 332 can be changed by altering the x, y, and z values ​​in the user interface, such as... Figure 40C As shown. In some embodiments, the lattice configuration of the body 328 is formed using 3D printing.

[0155] Implant 26 includes a cap 334 attached to the top of walls 264, 266, 268, 270 and support 274, and a cap 336 attached to the opposite bottom of walls 264, 266, 268, 270 and support 274. Cap 334 includes an opening 338 aligned with opening 286 and passage 330 when cap 334 is attached to bodies 262, 328, and cap 336 includes an opening 340 aligned with opening 288 and passage when cap 336 is attached to bodies 262, 328. Opening 338 is surrounded by a plurality of holes 342, and opening 340 is surrounded by a plurality of holes 344. When cap 334 is attached to bodies 262, 328, holes 342 are aligned with holes 290, and when cap 336 is attached to bodies 262, 328, holes 344 are aligned with holes 292. In some embodiments, hole 342 has the same size and shape as hole 290, and / or hole 344 has the same size and shape as hole 292. In some embodiments, caps 334, 336 are fused to body 262 and / or body 328. In some embodiments, caps 334, 336 are welded to body 262 and / or body 328. In some embodiments, caps 334, 336 are integrally and / or monolithically formed with body 262 and / or body 328.

[0156] Wall 276 and cap 334 define a ledge 346 extending from rib 280 of support 274 to openings 286, 338, and wall 279 and cap 336 define a ledge 348 extending from rib 280 to openings 288, 340. The ledge 346 extends circumferentially around openings 286, 338, such that the ledge 246 surrounds openings 286, 338. Similarly, the ledge 348 extends circumferentially around openings 288, 340, such that the ledge 246 surrounds openings 288, 340. Implant 260 includes a cavity 350 defined by the inner surface of rib 280. Figure 38As shown, the maximum diameter D1 of each of the openings 286, 288, 338, and 340 is smaller than the maximum diameter D2 of the cavity 350. The cavity 350 defines the graft receiving area. Specifically, it is conceivable that material such as a bone graft BG can be inserted through openings 286 and 338 into the cavity 350, or through openings 388 and 340 into the cavity 350 to position the bone graft BG between the ledges 346 and 348, as... Figure 36 As shown.

[0157] In one implementation, such as Figure 42-47 As shown, system 100 includes an implant 352 similar to implant 260. The wall 264 of implant 352 includes a recess 354 configured to dispose of at least a portion of the engagement portion 136 of device 104. Implant 352 also includes a threaded hole 356 located between the wall 268 of implant 352 and the cavity 298 of implant 352, and a threaded hole 358 located between the wall 270 of implant 352 and the cavity 300 of implant 352. Holes 356 and 358 are each configured to dispose of fasteners, such as bone screws. Holes 356 and 358 each extend at an angle relative to axis X3 such that holes 356 and 358 each extend through the patina 346 and 348 of implant 352. In some embodiments, hole 356 includes an opening 356a extending through cap 334 of implant 352 and an opening 356b extending through cap 336 of implant 352 and wall 264 of implant 352. Hole 356 has no gaps or openings such that hole 356 does not communicate with cavity 350 of implant 352. In some embodiments, hole 358 includes an opening 358a extending through cap 334 of implant 352 and an opening 358b extending through cap 336 of implant 352 and wall 264 of implant 352. Hole 358 has no gaps or openings such that hole 358 does not communicate with cavity 350 of implant 352. In some embodiments, the maximum length of each of walls 264, 266 of implant 352 is greater than the maximum length of walls 268, 270 of implant 352. In some embodiments, the implant 352 is circular at the interface between the wall 264 and the wall 268 of the implant 352, at the interface between the wall 268 and the wall 266 of the implant 352, at the interface between the wall 266 and the wall 270 of the implant 352, and at the interface between the wall 270 and the wall 264 of the implant 352.

[0158] In one implementation, such as Figures 48-53As shown, system 100 includes an implant 360 similar to implants 260 and 352. The height of the wall 268 of implant 360 is greater than the height of the sidewall 270 of implant 360, such that the cap 334 of implant 360 is positioned relative to the cap 336 of implant 360 at an angle α3, as shown. Figure 49 As shown. Angle α3 provides a wedge shape for implant 360. In some embodiments, angle α3 is between 0 degrees and 90 degrees. In some embodiments, angle α3 is between 1 degree and 89 degrees. In some embodiments, angle α3 is between 1 degree and 45 degrees. In some embodiments, angle α3 is between 10 degrees and 45 degrees. In some embodiments, angle α3 is between 10 degrees and 30 degrees. In some embodiments, angle α3 is between 15 degrees and 25 degrees. However, it is contemplated that angle α3 can be selected at any angle to achieve proper lordosis when implant 360 is positioned between adjacent vertebrae. In some embodiments, the maximum length of each of walls 264, 266 of implant 360 is less than the maximum length of walls 268, 270 of implant 360. In some embodiments, the wall 264 of the implant 360 extends at an acute angle relative to the wall 268 of the implant 360, the wall 268 of the implant 360 extends at an acute angle relative to the wall 266 of the implant 360, the wall 266 of the implant 360 extends at an acute angle relative to the wall 270 of the implant 360, and the wall 270 of the implant 360 extends at an acute angle relative to the wall 264 of the implant 360.

[0159] In one implementation, such as Figures 54-59 As shown, system 100 includes an implant 362 similar to implants 260, 352, and 360. The height of the wall 268 of implant 362 is greater than the height of the sidewall 270 of implant 362, such that the cap 334 of implant 362 is positioned relative to the cap 336 of implant 362 at an angle α4, as shown. Figure 55As shown. Angle α4 is less than angle α3. In some embodiments, angle α4 is between 0 degrees and 15 degrees. In some embodiments, angle α4 is between 1 degree and 15 degrees. In some embodiments, angle α4 is between 1 degree and 10 degrees. In some embodiments, angle α4 is between 1 degree and 5 degrees. However, it is conceivable that when the implant 362 is positioned between adjacent vertebrae, angle α4 can be selected at any angle to achieve proper lordosis. In some embodiments, the maximum length of each of the walls 264 and 266 of the implant 362 is less than the maximum length of the walls 268 and 270 of the implant 362. In some embodiments, the wall 264 of the implant 362 extends at an acute angle relative to the wall 268 of the implant 362, the wall 268 of the implant 362 extends at an acute angle relative to the wall 266 of the implant 362, the wall 266 of the implant 362 extends at an acute angle relative to the wall 270 of the implant 362, and the wall 270 of the implant 362 extends at an acute angle relative to the wall 264 of the implant 362.

[0160] In one implementation, such as Figures 60-65 As shown, system 100 includes an implant 364 similar to implants 260, 352, 360, and 362. The wall 264 of implant 364 includes a recess 366 configured to dispose of at least a portion of the engagement portion 136 of device 104. Implant 364 also includes a threaded hole 356 located between the wall 268 of implant 364 and the cavity 298 of implant 364, and a threaded hole 358 located between the wall 270 of implant 364 and the cavity 300 of implant 364. Holes 356 and 358 are each configured to dispose of fasteners, such as bone screws. Holes 356 and 358 each extend at an angle relative to axis X3 such that holes 356 and 358 each extend through the pilaster 346 and 348 of implant 364. In some embodiments, hole 356 includes an opening 356a extending through the cap 334 of implant 364 and an opening 356b extending through the wall 264 of implant 364. Hole 356 has no gaps or openings such that hole 356 does not communicate with cavity 350. In some embodiments, hole 358 includes an opening 358a extending through the cap 334 of implant 364 and an opening 358b extending through the wall 264 of implant 364. Hole 358 has no gaps or openings such that hole 358 does not communicate with cavity 350. In some embodiments, neither hole 356 nor hole 358 extends through the cap 336 of implant 364, such as... Figure 63As shown. In some embodiments, the maximum length of each of the walls 264 and 266 of the implant 364 is greater than the maximum length of the walls 268 and 270 of the implant 364. In some embodiments, the implant 364 is circular at the interface between the walls 264 and 268 of the implant 364, at the interface between the walls 268 and 266 of the implant 364, at the interface between the walls 266 and 270 of the implant 364, and at the interface between the walls 270 and 264 of the implant 364. In some embodiments, the walls 264, 266, 268, 270 of the implant 364 each have a height from the cap 334 of the implant 364 to the cap 336 of the implant 364, said height being greater than the height of the walls 264, 266, 268, 270 of the implant 352 from the cap 334 of the implant 352 to the cap 336 of the implant 352.

[0161] In one implementation, such as Figure 66-71 As shown, system 100 includes an implant 368 similar to implants 260, 352, 360, 362, and 364. The height of the wall 268 of implant 368 is greater than the height of the sidewall 270 of implant 368, such that the cap 334 of implant 368 is positioned relative to the cap 336 of implant 368 at an angle α5. Figure 67As shown. Angle α5 provides a wedge shape for implant 368. In some embodiments, angle α5 is between 0 degrees and 90 degrees. In some embodiments, angle α5 is between 1 degree and 89 degrees. In some embodiments, angle α5 is between 1 degree and 45 degrees. In some embodiments, angle α5 is between 10 degrees and 45 degrees. In some embodiments, angle α5 is between 10 degrees and 30 degrees. In some embodiments, angle α5 is between 15 degrees and 25 degrees. However, it is contemplated that angle α5 can be selected at any angle to achieve proper lordosis when implant 368 is positioned between adjacent vertebrae. In some embodiments, the maximum length of each of walls 264, 266 of implant 368 is less than the maximum length of walls 268, 270 of implant 368. In some embodiments, the wall 264 of the implant 368 extends at an acute angle relative to the wall 268 of the implant 368, the wall 268 of the implant 368 extends at an acute angle relative to the wall 266 of the implant 368, the wall 266 of the implant 368 extends at an acute angle relative to the wall 270 of the implant 368, and the wall 270 of the implant 368 extends at an acute angle relative to the wall 264 of the implant 368. In some embodiments, the wall 264 of the implant 368 includes a planar portion 264a, a planar portion 264b, and a planar portion 264c located between the planar portions 264a and 264b. The planar portion 264b extends at an acute angle relative to the planar portion 264a, and the planar portion 264c extends at an acute angle relative to the planar portion 264b. In some embodiments, the planar portions 264a, 264b, and 264c are configured to... Figure 13 The planar portions 138a, 138b, and 138c of the device 104 shown are joined.

[0162] In one implementation, such as Figures 72-77 As shown, system 100 includes an implant 370 similar to implants 260, 352, 360, 362, 364, and 368. The height of the sidewall 268 of implant 370 is greater than the height of the sidewall 270 of implant 370, such that the cap 334 of implant 370 is positioned relative to the cap 336 of implant 370 at an angle α6. Figure 73As shown. Angle α6 provides a wedge shape for implant 370. Angle α6 is less than angle α5. In some embodiments, angle α6 is between 0 degrees and 15 degrees. In some embodiments, angle α6 is between 1 degree and 15 degrees. In some embodiments, angle α6 is between 1 degree and 10 degrees. In some embodiments, angle α6 is between 1 degree and 5 degrees. However, it is contemplated that when implant 370 is positioned between adjacent vertebrae, angle α6 can be selected at any angle to achieve proper lordosis. In some embodiments, the maximum length of each of walls 264, 266 of implant 370 is less than the maximum length of walls 268, 270 of implant 370. In some embodiments, the wall 264 of the implant 370 extends at an acute angle relative to the wall 268 of the implant 370, the wall 268 of the implant 370 extends at an acute angle relative to the wall 266 of the implant 370, the wall 266 of the implant 370 extends at an acute angle relative to the wall 270 of the implant 370, and the wall 270 of the implant 370 extends at an acute angle relative to the wall 264 of the implant 370. In some embodiments, the wall 264 of the implant 370 includes a planar portion 264a, a planar portion 264b, and a planar portion 264c located between the planar portions 264a and 264b. The planar portion 264b extends at an acute angle relative to the planar portion 264a, and the planar portion 264c extends at an acute angle relative to the planar portion 264b. In some embodiments, the planar portions 264a, 264b, and 264c are configured to... Figure 13 The planar portions 138a, 138b, and 138c of the device 104 shown are joined.

[0163] In one implementation, such as Figures 78-83As shown, system 100 includes implant 372 similar to implants 260, 352, 360, 362, 364, 368, and 370. The wall 264 of implant 372 includes a recess 354 configured to dispose of at least a portion of the engagement portion 136 of device 104. Implant 372 also includes a threaded hole 356 located between the wall 268 of implant 372 and the cavity 298 of implant 372, and a threaded hole 358 located between the wall 270 of implant 372 and the cavity 300 of implant 372. Holes 356 and 358 are each configured to dispose of fasteners, such as bone screws. Holes 356 and 358 each extend at an oblique angle relative to axis X3, such that holes 356 and 358 each extend through the patina 346 and 348 of implant 372. In some embodiments, hole 356 includes an opening 356a extending through cap 334 of implant 372 and an opening 356b extending through cap 336 of implant 372 and wall 264 of implant 372. Hole 356 has no gaps or openings such that hole 356 does not communicate with cavity 350 of implant 372. In some embodiments, hole 358 includes an opening 358a extending through cap 334 of implant 372 and an opening 358b extending through cap 336 of implant 372 and wall 264 of implant 372. Hole 358 has no gaps or openings such that hole 358 does not communicate with cavity 350 of implant 372. In some embodiments, the maximum length of each of walls 264, 266 of implant 372 is greater than the maximum length of walls 268, 270 of implant 372. In some embodiments, the implant 372 is circular at the interface between the wall 264 and the wall 268 of the implant 372, at the interface between the wall 268 and the wall 266 of the implant 372, at the interface between the wall 266 and the wall 270 of the implant 372, and at the interface between the wall 270 and the wall 264 of the implant 372.

[0164] It should be understood that various modifications can be made to the embodiments disclosed herein. Therefore, the above description should not be construed as limiting, but merely as examples of various embodiments. Other modifications can be conceived by those skilled in the art within the scope and spirit of the appended claims.

Claims

1. A spinal implant, comprising: A body comprising opposing first end walls and second end walls, and opposing first side walls and second side walls, each side wall extending from the first end wall to the second end wall, the inner surfaces of the walls defining a cavity, the body comprising a support positioned within the cavity, the support comprising a top wall and opposing bottom walls; A first cap, the first cap being attached to the top of the wall; and A second cap, the second cap being attached to the bottom end of the wall, The implant includes an opening extending through the cap, a bottom wall connected to the top wall by a plurality of spaced-apart ribs, the top wall and the first cap defining a first ledge extending from the ribs to the opening, and the bottom wall and the second cap defining a second ledge extending from the ribs to the opening, wherein the first ledge surrounds the opening and the second ledge surrounds the opening.

2. The spinal implant of claim 1, wherein the inner surface of the wall defines a cavity, the maximum diameter of which is greater than the maximum diameter of the opening.

3. The spinal implant of claim 1, wherein at least one of the caps comprises a plurality of holes.

4. The spinal implant according to claim 1, characterized in that... Each of the wall shelves extends circumferentially around the opening.

5. The spinal implant of claim 1, wherein the inner surface of the wall defines a cavity, the implant including a core positioned in the cavity, the opening extending through the thickness of the core.

6. The spinal implant of claim 5, wherein the core has a lattice configuration.

7. The spinal implant of claim 5, wherein the core is fused together with the body and the cap.

8. The spinal implant of claim 1, wherein the body includes an inner surface defining a hole extending through the first end wall.

9. The spinal implant of claim 8, wherein the hole is closed by the inner surface between the first ledge and the second ledge.

10. The spinal implant of claim 8, wherein the hole is not in communication with the opening.

11. The spinal implant of claim 8, wherein the hole extends through at least one of the pilasters.

12. The spinal implant of claim 8, wherein the hole is a first hole and the body includes a second inner surface defining a second hole and a third inner surface defining a third hole positioned between the first hole and the second hole, the second hole and the third hole extending through the first end wall.

13. The spinal implant of claim 12, wherein the body comprises a first cavity positioned between the first hole and the third hole and a second cavity positioned between the second hole and the third hole.

14. The spinal implant of claim 13, wherein the cavity is threaded.

15. The spinal implant of claim 1, further comprising a bone graft positioned between the first ledge and the second ledge.

16. A spinal implant, comprising: A body comprising opposing first end walls and second end walls, and opposing first side walls and second side walls, each side wall extending from the first end wall to the second end wall, the first side wall defining a first window, the second side wall defining a second window, and an inner surface of the walls defining a cavity, the body comprising a support positioned within the cavity, the support comprising a top wall and opposing bottom walls; A core, positioned within the cavity such that the core is visible through the window; A first cap, the first cap being attached to the top of the wall; and A second cap, the second cap being attached to the bottom end of the wall, The implant includes an opening extending through the cap, a bottom wall connected to the top wall by a plurality of spaced-apart ribs, the top wall and the first cap defining a first ledge extending from the ribs to the opening, and the bottom wall and the second cap defining a second ledge extending from the ribs to the opening, wherein the first ledge surrounds the opening and the second ledge surrounds the opening.

17. The spinal implant of claim 16, wherein the maximum diameter of the cavity is greater than the maximum diameter of the opening.

18. The spinal implant of claim 16, wherein the core is fused together with the body and the cap.

19. The spinal implant according to claim 16, wherein: The body includes an inner surface defining a hole; and The main body includes a first threaded cavity and a second threaded cavity spaced apart, and the hole is positioned between the cavities.

20. A spinal implant, comprising: A body comprising opposing first end walls and second end walls, and opposing first side walls and second side walls, each side wall extending from the first end wall to the second end wall, the first side wall defining a first window, the second side wall defining a second window, and an inner surface of the walls defining a cavity, the body comprising a support positioned within the cavity, the support comprising a top wall and opposing bottom walls; A core, positioned within the cavity such that the core is visible through the window, the core having a lattice configuration; A first cap, the first cap being attached to the top of the wall; A second cap is attached to the bottom end of the wall, the implant includes an opening extending through the cap, the bottom wall is connected to the top wall by a plurality of spaced-apart ribs, the top wall and the first cap define a first ledge extending from the ribs to the opening, the bottom wall and the second cap define a second ledge extending from the ribs to the opening, each ledge extending circumferentially around the opening; and A bone graft, wherein the bone graft is located between the first ledge and the second ledge. Each of the caps includes a plurality of holes arranged in a hexagonal pattern. The core is fused together with the body and the cap. The maximum diameter of the cavity is greater than the maximum diameter of the opening.

Images