Expandable Interbody Fusion Cage for Kambin's Triangle Access
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Solution Overview
Problem
Existing expandable interbody fusion devices configured for transforaminal lumbar interbody fusion (TLIF) procedures face challenges in insertion and grafting material introduction due to their small size, particularly when used through Kambin's triangle.
Innovation Solution
An expandable interbody fusion device with a cage and wedge mechanism that expands vertically and laterally to accommodate spinal lordosis, accompanied by an insertion instrument for precise attachment and delivery of graft material, allowing insertion through Kambin's triangle and ensuring optimal contact with vertebral bodies.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Object-affected harmful factors
If expandable interbody fusion devices are sized and configured to fit through Kambin's triangle, then minimally invasive surgery benefits (smaller incision, decreased blood loss, shorter recovery), but the device size becomes too small for effective insertion and grafting material introduction
Solution Approach 1:
The device is divided into two functional states: a compressed configuration for insertion through the small Kambin's triangle passage, and an expanded configuration for providing adequate structural support and grafting space. The cage is segmented into movable arms that can transition between these states, allowing the device to pass through tight surgical corridors while maintaining sufficient size for effective operation once positioned
Solution Approach 2:
The interbody fusion device employs dynamic expandability, transitioning from a small compressed state during insertion to a larger expanded state after positioning. The cage structure includes movable arms that can be actuated to increase the device dimensions, enabling the device to adapt its size to different surgical phases: minimal size for insertion, optimal size for graft delivery and fusion support
2Loss of time
If the interbody fusion device is made smaller to fit through Kambin's triangle, then patient recovery improves, but the contact surface area with vertebral bodies is reduced
Solution Approach 1:
The device dynamically adjusts its contact surface area by expanding after insertion. The movable arms of the cage can be actuated to increase the device dimensions, thereby increasing the contact surface area with the vertebral bodies once the device is properly positioned in the interbody space, while maintaining a small profile during insertion for minimally invasive benefits
3Adaptability or versatility
If expandable interbody fusion devices are used to increase disc space height, then spinal anatomy accommodation improves, but device complexity increases
Solution Approach 1:
The cage is segmented into multiple movable arms that can independently adjust to accommodate spinal anatomy variations. This segmentation allows the device to adapt to different disc space heights and vertebral configurations while using relatively simple mechanical components (hinges, actuators) rather than a complex monolithic structure
Solution Approach 2:
The expandable cage design serves multiple functions: it provides structural support, accommodates varying spinal anatomy through expansion, creates space for graft material, and maintains accessibility for insertion through small incisions. This multi-functionality is achieved through the movable arm mechanism that can be actuated to achieve the desired configuration
Data Source
AI summary
An expandable interbody fusion device and an associated instrument for inserting the device into an intervertebral disc space, expanding the device and for use in delivering graft material into the device once expanded in the disc space. The device is small enough to fit through Kambin's triangle yet is capable of expanding both in the vertical direction to accommodate spinal lordosis and in the lateral direction to provide sufficient structural support for opposing vertebral bodies laterally within the disc space. A process of forming textured top and bottom surfaces of the device by initially laser ablating each surface with a nano-second pulsed laser followed by laser ablating those surfaces with a femto-second pulsed laser.