# US 10,369,007 B2 · Intervertebral implant with blades for connecting to adjacent vertebral bodies

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- Number: US 10,369,007 B2
- Document ID: US10369007B2
- Status: Granted
- Kind: B2
- Application number: 15/637,570
- Filed: 2017-06-29
- Published: 2017-10-19
- Granted: 2019-08-06
- Earliest claimed: 2008-09-02
- Assignees: DePuy Synthes Products, Inc.
- Applicants: DePuy Synthes Products, Inc.
- Inventors: Lawton Laurence; David T. Banks; Vincent Mandes; Heather Cannon; Joshua McManus
- Web page: https://patentgrep.com/patent/US10369007B2

## CPC

- 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)}
- A61B 17/1671: {for the spine}
- A61B 17/68: Internal fixation devices {, including fasteners and spinal fixators, even if a part thereof projects from the skin (bone staples A61B17/0642)}
- A61F 2/30767: {Special external or bone-contacting surface, e.g. coating for improving bone ingrowth}
- A61F 2/442: {Intervertebral or spinal discs, e.g. resilient (non-disc-shaped intervertebral inflatable pockets A61F2/441; non-disc-shaped intervertebral fusion implants A61F2/4455)}
- A61F 2/4465: {having a circular or kidney shaped cross-section substantially perpendicular to the axis of the spine}
- A61F 2/4611: {of spinal prostheses}
- A61B 17/86: Pins or screws {or threaded wires; nuts therefor (A61B17/72 take precedence)}
- A61F 2/28: Bones
- A61F 2002/2835: {Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material}
- A61F 2002/30062: {(bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive}
- A61F 2002/30131: {horseshoe- or crescent- or C-shaped or U-shaped}
- A61F 2002/30133: {kidney-shaped or bean-shaped}
- A61F 2002/30179: {X-shaped}
- A61F 2002/30383: {made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove}
- A61F 2002/30507: {using a threaded locking member, e.g. a locking screw or a set screw}
- A61F 2002/30517: {using a locking plate}
- A61F 2002/30593: {hollow}
- A61F 2002/30604: {modular}
- A61F 2002/30607: {Kits of prosthetic parts to be assembled in various combinations for forming different prostheses}
- A61F 2002/30616: {Sets comprising a plurality of prosthetic parts of different sizes or orientations}
- A61F 2002/30774: {internally-threaded}
- A61F 2002/30843: {Pyramidally-shaped}
- A61F 2002/30845: {with cutting edges}
- A61F 2002/30884: {Fins or wings, e.g. longitudinal wings for preventing rotation within the bone cavity}
- A61F 2002/30904: {serrated profile, i.e. saw-toothed}
- A61F 2002/4619: {for extraction}
- A61F 2210/0004: bioabsorbable
- A61F 2220/0025: Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F 2230/0013: Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped
- A61F 2230/0015: Kidney-shaped, e.g. bean-shaped
- A61F 2230/0058: X-shaped
- 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 2310/00041: Magnesium or Mg-based alloys
- A61F 2310/00047: Aluminium or Al-based alloys
- A61F 2310/00131: Tantalum or Ta-based alloys
- A61F 2310/00329: Glasses, e.g. bioglass
- A61F 2310/00359: Bone or bony tissue
- A61F 2310/00407: Coating made of titanium or of Ti-based alloys
- A61F 2310/00796: Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite
- 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

An intervertebral implant for insertion into an intervertebral disc space between adjacent vertebral bodies or between two bone portions. The implant includes a spacer portion, a plate portion operatively coupled to the spacer portion and one or more blades for securing the implant to the adjacent vertebral bodies. The blades preferably include superior and inferior cylindrical pins for engaging the adjacent vertebral bodies. The implant may be configured to be inserted via a direct lateral trans-psoas approach. Alternatively, the implant may be configured for insertion via an anterior approach.

## Claims

### Claim 1

A method of fusing a first vertebral body and a second vertebral body, the method comprising the steps of:
moving a first portion of an intervertebral implant through a psoas muscle adjacent a disc space between the first vertebral body and the second vertebral body;
inserting the first portion into the disc space, such that a superior surface of the first portion abuts an inferior surface of the first vertebral body, and an inferior surface of the first portion abuts a superior surface of the second vertebral body, the superior surface spaced from the inferior surface along a superior direction;
securing the intervertebral implant to the first vertebral body, the securing step including the steps of:
moving a blade element through the psoas muscle, and inserting the blade element into the first vertebral body, wherein the blade element has a blade portion that is spaced from the superior surface so as to define a gap that extends from the superior surface to the blade portion along the superior direction;
moving a first and second bone screws of the intervertebral implant through the psoas muscle;
driving the first bone screw through the first portion of the intervertebral implant and into the first vertebral body so as to secure the first portion of the intervertebral implant to the first vertebral body; and
driving the second bone screw through the first portion of the intervertebral implant and into the second vertebral body so as to secure the first portion of the intervertebral implant to the second vertebral body, such that a head of the second bone screw is disposed between the inferior and superior surfaces,
wherein respective heads of all bone screws that attach the intervertebral implant to either of the first and second vertebral bodies are disposed between the inferior and superior surfaces, and
wherein the method is devoid of a step of inserting supplemental fixation into the first vertebral body along a path that does not pass through the psoas muscle.

### Claim 2 (depends on 1)

The method of claim 1, wherein the step of securing the intervertebral implant to the first vertebral body further includes the steps of:
moving a second portion of the intervertebral implant through the psoas muscle; and
inserting the second portion into the first vertebral body.

### Claim 3 (depends on 2)

The method of claim 2, wherein the step of securing the intervertebral implant to the second vertebral body further includes the steps of:
moving a third portion of the intervertebral implant through the psoas muscle; and
inserting the third portion into the second vertebral body.

### Claim 4 (depends on 3)

The method of claim 3, wherein:
the second portion includes a shaft of a third bone screw, and the step of inserting the second portion includes the step of rotating the shaft of the third bone screw; and
the third portion includes a shaft of a fourth bone screw, and the step of inserting the third portion includes the step of rotating the shaft of the fourth bone screw.

### Claim 5 (depends on 1)

The method of claim 1, wherein the step of moving the first portion includes the step of advancing the first portion toward the disc space in a first direction, and the step of moving the blade element includes the step of advancing the blade element toward the disc space in the first direction.

### Claim 6 (depends on 1)

The method of claim 1, wherein the blade element includes an intermediate portion, an inferior portion extending from the intermediate section along the inferior surface of the first portion, and a superior portion extending from the intermediate section along the superior surface of the first portion, wherein respective entireties of the inferior portion and the superior portion are spaced from the first portion of the intervertebral implant so as to define a gap therebtween.

### Claim 7 (depends on 6)

The method of claim 6, further comprising the step of inserting the blade element into a receiving slot of the first portion of the intervertebral implant.

### Claim 8

A method of inserting an intervertebral implant into a disc space between a first vertebral body and a second vertebral body, the method comprising the steps of:
moving a first portion of the intervertebral implant through a psoas muscle adjacent the disc space, whereby the intervertebral implant further comprises a blade element coupled to the first portion;
inserting the first portion into the disc space, such that a first surface of the first portion abuts a first vertebral surface of the first vertebral body, and a second surface of the first portion that is opposite the first surface along a vertical direction abuts the second vertebral surface of the second vertebral body, wherein the inserting step comprises inserting the blade element into at least one of the first and second vertebral bodies, wherein the blade element includes at least one blade portion that is spaced from the first portion along the vertical direction so as to define a gap therebetween;
moving a second portion of the intervertebral implant through the psoas muscle; and
inserting the second portion through the first vertebral surface and into the first vertebral body, thereby securing the intervertebral implant to the first vertebral body,
wherein the method is devoid of a step of inserting a fixation element into the first vertebral body along a path that does not pass through the psoas muscle.

### Claim 9 (depends on 8)

The method of claim 8, further comprising the steps of:
moving a third portion of the intervertebral implant through the psoas muscle; and
inserting the third portion through the second vertebral surface and into the second vertebral body, thereby securing the intervertebral implant to the second vertebral body.

### Claim 10 (depends on 9)

The method of claim 9, wherein the second and third portions comprise bone screws.

### Claim 11 (depends on 10)

The method of claim 10, wherein the step of inserting the blade element includes the step of compressing the at least one of the first and second vertebral bodies against the first portion.

### Claim 12 (depends on 8)

The method of claim 8, wherein the blade element includes a cutting feature, and the step of inserting the second portion includes the step of urging the cutting feature into the first vertebral body.

### Claim 13 (depends on 9)

The method of claim 9, wherein each of the second and third portions includes a bone screw, and the steps of inserting the second and third portions rotating the bone screws.

### Claim 14 (depends on 8)

The method of claim 8, wherein the first portion is a spacer portion, the method further comprising the step of coupling a plate portion of the intervertebral implant to the spacer portion.

### Claim 15 (depends on 14)

The method of claim 14, wherein the coupling step includes the step of inserting a projection of one of the spacer portion and the plate portion into a groove of the other of the spacer portion and the plate portion, and the step of inserting the projection is performed before the step of inserting the first portion into the disc space.

### Claim 16 (depends on 14)

The method of claim 14, wherein the second portion includes a shaft of a bone screw, and the step of inserting the second portion includes the steps of:
moving the shaft through a hole defined by an inner surface of the plate portion; and
abutting a head of the bone screw with the inner surface.

### Claim 17 (depends on 8)

The method of claim 8, wherein the step of inserting the first portion includes the step of aligning an opening of the first portion with both the first vertebral body and the second vertebral body, wherein the opening extends from a top surface of the first portion to a bottom surface of the first portion such that the opening is configured to receive bone graft material.

### Claim 18 (depends on 17)

The method of claim 17, further comprising the steps of inserting bone graft material into the opening such that the step of inserting the first portion results in the bone graft material facing both the first vertebral body and the second vertebral body.

### Claim 19 (depends on 8)

The method of claim 8, wherein the blade element comprise an intermediate portion, and the at least one blade portion comprises an inferior portion extending from the intermediate section along the inferior surface of the first portion, and a superior portion extending from the intermediate section along the superior surface of the first portion, wherein respective entireties of the inferior portion and the superior portion are spaced from the first portion of the intervertebral implant so as to define a gap therebtween.

### Claim 20 (depends on 19)

The method of claim 19, further comprising the step of inserting the blade element into a receiving slot of the first portion of the intervertebral implant.