# US 10,245,159 B1 · Bone graft delivery system and method for using same

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- Number: US 10,245,159 B1
- Document ID: US10245159B1
- Status: Granted
- Kind: B1
- Application number: 16/198,754
- Filed: 2018-11-21
- Granted: 2019-04-02
- Earliest claimed: 2009-09-18
- Applicants: Spinal Surgical Strategies, LLC
- Inventors: Jeffrey B. Kleiner; Edward John Grimberg
- Web page: https://patentgrep.com/patent/US10245159B1

## CPC

- A61F 2/4601: {for introducing bone substitute, for implanting bone graft implants or for compacting them in the bone cavity}
- A61B 17/88: {Osteosynthesis instruments;} Methods or means for implanting or extracting internal {or external} fixation devices {(A61B17/7074 takes precedence)}
- A61F 2/4455: {for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages (intervertebral discs A61F2/442)}
- A61F 2/447: {substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section}
- A61F 2/4611: {of spinal prostheses}
- A61F 2/30767: {Special external or bone-contacting surface, e.g. coating for improving bone ingrowth}
- A61F 2002/2817: {Bone stimulation by chemical reactions or by osteogenic or biological products for enhancing ossification, e.g. by bone morphogenetic or morphogenic proteins [BMP] or by transforming growth factors [TGF]}
- A61F 2002/2835: {Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material}
- A61F 2002/30011: {differing in porosity}
- A61F 2002/30153: {rectangular}
- A61F 2002/30224: {cylindrical}
- A61F 2002/30235: {tubular, e.g. sleeves}
- A61F 2002/30525: {Worm gears}
- A61F 2002/30579: {with mechanically expandable devices, e.g. fixation devices}
- A61F 2002/30593: {hollow}
- A61F 2002/30601: {telescopic}
- A61F 2002/3071: {Identification means; Administration of patients}
- A61F 2002/30784: {Plurality of holes}
- A61F 2002/30785: {parallel}
- A61F 2002/30787: {inclined obliquely with respect to each other}
- A61F 2002/30828: {parallel}
- A61F 2002/30878: {with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts}
- A61F 2002/30904: {serrated profile, i.e. saw-toothed}
- A61F 2002/3093: {for promoting ingrowth of bone tissue}
- A61F 2002/4627: {with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument}
- A61F 2002/4628: {with linear motion along or rotating motion about an axis transverse to the instrument axis or to the implantation direction, e.g. clamping}
- A61F 2002/4635: {using minimally invasive surgery}
- A61F 2002/469: {electrical}
- A61F 2002/4693: {hydraulic}
- A61F 2002/4694: {pneumatic}
- A61F 2310/00017: Iron- or Fe-based alloys, e.g. stainless steel
- A61F 2310/00023: Titanium or titanium-based alloys, e.g. Ti-Ni alloys
- A61F 2310/00029: Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
- A61F 2310/00047: Aluminium or Al-based alloys
- A61F 2310/00059: Chromium or Cr-based alloys
- A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C)
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

The present invention relates to an apparatus and method for near-simultaneous and integrated delivery of bone graft material during the placement of surgical cages or other medical implants in a patient's spine. The integrated fusion cage and graft delivery device according to various embodiments delivers and disperses biologic material through a fusion cage to a disc space and, without withdrawal from the surgical site, may selectively detach the fusion cage for deposit to the same disc space. The integrated fusion cage and graft delivery device is formed such that a hollow tube and plunger selectively and controllably place bone graft material and a fusion cage in or adjacent to the bone graft receiving area. In one embodiment, the integrated fusion cage is an expandable integrated fusion cage.

## Claims

### Claim 1

A bone graft material delivery system, comprising:
an elongate hollow tube constructed to receive bone graft material, said elongate hollow tube being generally linear and having an extended axis, a generally rectangular cross-section, a proximal end, a distal end with at least one opening, a hollow interior extending from said proximal end to said distal end, and indicia formed on an exterior surface of said elongate hollow tube, wherein said distal end of said elongate hollow tube is at least partially closed; and
a plunger adapted to extend in said elongate hollow tube, said plunger having a shaft and a distal portion with an exterior surface contoured to form a substantially congruent fit with said hollow interior of said elongate hollow tube such that said plunger is precluded from rotating within said elongate hollow tube, wherein teeth are formed along a longitudinal axis of said plunger shaft, and wherein said plunger is adapted to urge bone graft material through said elongate hollow tube to deliver bone graft material through said at least one opening of said distal end.

### Claim 2 (depends on 1)

The system of claim 1, wherein said indicia are configured to indicate how far said elongate hollow tube has been inserted into a surgical site.

### Claim 3 (depends on 1)

The system of claim 1, wherein said indicia comprises at least one of a marking, a score, and a groove.

### Claim 4 (depends on 1)

The system of claim 1, wherein said indicia comprises a radiographic marker.

### Claim 5 (depends on 1)

The system of claim 1, wherein said at least one opening comprises two openings.

### Claim 6 (depends on 1)

The system of claim 1, further comprising actuating means for applying pressure to said shaft of said plunger.

### Claim 7 (depends on 1)

The system of claim 1, further comprising an actuator configured to engage said teeth of said plunger to advance said plunger toward said distal end of said elongate hollow tube.

### Claim 8 (depends on 7)

The system of claim 7, further comprising a gear to engage said plunger teeth.

### Claim 9 (depends on 8)

The system of claim 8, wherein rotational motion of said gear is translated into linear movement of said plunger.

### Claim 10 (depends on 1)

The system of claim 1, wherein said distal end of said elongate hollow tube comprises a wedge or a bullet shaped distal tip.

### Claim 11 (depends on 1)

The system of claim 1, wherein said elongate hollow tube is rigid.

### Claim 12 (depends on 1)

The system of claim 1, further comprising a funnel configured to be coupled to said proximal end of said hollow tube.

### Claim 13

A bone graft insertion apparatus comprising:
a hollow tube constructed to receive bone graft, said hollow tube having an extended axis, a proximal end, a distal end that is wedge-shaped, an opening to discharge bone graft, and a generally uniform interior rectangular cross-section from said proximal end to said distal end, wherein said distal end is at least partially closed;
a plunger adapted for inserting into said proximal end of said hollow tube along the extended axis, said plunger having a shaft and a distal portion of rectangular cross-section contoured to said interior rectangular cross-section of said hollow tube, said plunger distal portion forming a congruent fit with said hollow tube uniform interior rectangular cross-section, said shaft having a longitudinal axis and teeth that are formed along said shaft longitudinal axis; and
an actuator configured to engage said teeth of said plunger shaft to advance said plunger from said proximal end toward said distal end of said hollow tube to urge the bone graft through said hollow tube and to deliver the bone graft through said opening.

### Claim 14 (depends on 13)

The apparatus of claim 13, further comprising one or more of:
indicia on said hollow tube that are configured to indicate how far said hollow tube has been inserted into a surgical site;
a gear to engage said plunger teeth, wherein said gear is associated with said actuator and is configured to convert rotational motion of said gear into linear movement of said plunger; and
a funnel configured to be coupled to said proximal end of said hollow tube.

### Claim 15 (depends on 13)

The apparatus of claim 13, wherein said hollow tube is generally linear and rigid, and wherein said opening comprises a first pair of edges and a second pair of edges, wherein the first pair of edges are straight and the second pair of edges are not straight.

### Claim 16

A bone graft delivery device, comprising:
an elongate tube including a first side opposite to a second side, the first and second sides connected by opposing third and fourth sides such that the elongate tube has a hollow interior with a generally rectangular cross-section, wherein the elongate tube includes a proximal end, at least one opening to discharge bone graft, and a distal end that is wedge-shaped, wherein the distal end is at least partially closed;
a plunger with a distal portion and a shaft, the distal portion configured to urge the bone graft through the hollow interior of the elongate tube, the shaft being generally linear and having a plurality of teeth; and
actuating means for applying a force to the plunger to advance the plunger within the elongate tube toward the distal end such that bone graft is delivered through the opening into a surgical site.

### Claim 17 (depends on 16)

The bone graft delivery device of claim 16, wherein the actuating means includes an actuator configured to engage the plurality of teeth of the plunger shaft.

### Claim 18 (depends on 16)

The bone graft delivery device of claim 16, wherein the actuating means includes a gear configured to engage the plurality of teeth of the plunger shaft to convert rotational motion of the gear into linear movement of the plunger.

### Claim 19 (depends on 16)

The bone graft delivery device of claim 16, wherein the at least one opening includes an opening formed through one of the first, second, third, and fourth sides.

### Claim 20 (depends on 16)

The bone graft delivery device of claim 16, wherein the hollow tube is generally linear and is rigid.