# US 11,076,965 B2 · Surgical implant with guiding rail

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- Number: US 11,076,965 B2
- Document ID: US11076965B2
- Status: Granted
- Kind: B2
- Application number: 16/244,742
- Filed: 2019-01-10
- Published: 2019-05-16
- Granted: 2021-08-03
- Earliest claimed: 2010-09-30
- Assignees: Stryker European Operations Holdings LLC
- Applicants: Stryker European Operations Holdings LLC
- Inventors: Lee L. Thibodeau
- Web page: https://patentgrep.com/patent/US11076965B2

## CPC

- 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 2/4455: {for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages (intervertebral discs A61F2/442)}
- A61F 2/4465: {having a circular or kidney shaped cross-section substantially perpendicular to the axis of the spine}
- A61F 2/4611: {of spinal prostheses}
- 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 2002/3008: {radio-opaque, e.g. radio-opaque markers}
- A61F 2002/30266: {wedge-shaped parallelepipeds}
- A61F 2002/30304: {nose-shaped}
- A61F 2002/30538: {for adjusting angular orientation}
- A61F 2002/30593: {hollow}
- A61F 2002/30777: {Oblong apertures}
- A61F 2002/30779: {arcuate}
- A61F 2002/30785: {parallel}
- A61F 2002/3082: {Grooves}
- A61F 2002/30843: {Pyramidally-shaped}
- A61F 2002/30879: {Ribs}
- A61F 2002/30883: {dovetail-shaped}
- 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: 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)

## Abstract

A prosthetic intervertebral spacer includes a body having a front end, a rear end, an anterior side, a posterior side, a top surface, and a bottom surface, and an arcuate interface extending away from the body and being connected to the rear end and the posterior side of the body. A method of inserting and positioning the spacer includes engaging a tool to the interface, inserting the spacer at least partially into the intervertebral disc space by moving the tool along an insertion direction, and allowing the spacer to rotate with respect to the insertion direction within the intervertebral disc space while continuing to move the tool along the insertion direction.

## Claims

### Claim 1

A surgical method comprising:
positioning a distal end of an arm of a tool adjacent an interface of an implant, the interface defining a rail having a neck portion connected to and extending away from a rear end of a body of the implant, the rail further having a lip portion connected to the neck portion, the lip portion being wider than the neck portion in a direction extending between top and bottom surfaces of the body;
moving an inner surface of a sleeve of the tool over the distal end of the arm to engage the tool to the interface of the implant;
moving the tool along an insertion direction to insert the implant at least partially into an intervertebral disc space between two adjacent vertebrae; and
sliding the tool along the rail while moving the tool further along the insertion direction to allow the implant to rotate with respect to the insertion direction within the intervertebral disc space.

### Claim 2 (depends on 1)

The method of claim 1, wherein the tool maintains its engagement to the interface during the steps of moving and sliding.

### Claim 3 (depends on 2)

The method of claim 2, wherein the step of sliding the tool includes allowing a front end of the implant to interact with an annulus fibrosis of an intervertebral disc to cause rotation of the implant with respect to the insertion direction.

### Claim 4 (depends on 3)

The method of claim 3, further comprising positioning the implant in an anterior aspect of the intervertebral disc space.

### Claim 5 (depends on 3)

The method of claim 3, further comprising positioning the implant such that a longitudinal axis of the implant is substantially perpendicular to the insertion direction.

### Claim 6 (depends on 3)

The method of claim 3, further comprising positioning the implant such that a longitudinal axis of the implant is substantially parallel to a medial-lateral axis of the intervertebral disc space.

### Claim 7 (depends on 3)

The method of claim 3, wherein the step of sliding includes allowing the implant to rotate such that a longitudinal axis of the implant is angled at approximately 80 degrees with respect to the insertion direction.

### Claim 8 (depends on 3)

The method of claim 3, wherein the step of sliding the tool further includes allowing a steering element disposed on the front end of the implant to mate with at least one of the adjacent vertebrae to assist in rotating the implant with respect to the insertion direction.

### Claim 9 (depends on 1)

The method of claim 1, further comprising a step of forming a hole through only a portion of an annulus fibrosis while leaving the remainder of the annulus fibrosis intact, and wherein the step of moving includes inserting the implant through the hole.

### Claim 10 (depends on 1)

The method of claim 1, wherein the insertion direction is substantially parallel to a posterior-anterior axis of the intervertebral disc space.

### Claim 11 (depends on 1)

The method of claim 1, wherein the interface of the implant includes a notch and the tool includes a rod engageable to the notch, and further comprising a step of engaging the rod to the notch to prevent relative rotation between the implant and the tool, and a step of disengaging the rod from the notch to allow relative rotation between the implant and the tool.

### Claim 12 (depends on 11)

The method of claim 11, wherein the sliding step takes place after the rod is disengaged from the notch.

### Claim 13 (depends on 12)

The method of claim 12, wherein the implant is at least partially inserted with the rod engaged to the notch and at least partially inserted with the rod disengaged from the notch.

### Claim 14

A surgical method comprising:
positioning a distal end of an arm of a tool adjacent an interface of an implant, the interface defining a rail having a neck portion connected to and extending away from a rear end of a body of the implant, the rail further having a lip portion connected to the neck portion, the lip portion being wider than the neck portion in a direction extending between top and bottom surfaces of the body;
moving an inner surface of a sleeve of the tool over the distal end of the arm to engage the tool to the interface of the implant;
applying a force along an insertion direction to the tool engaged to the interface of the implant to move the implant in an intervertebral disc space between two adjacent vertebrae; and
allowing a front end of the implant to interact with an annulus fibrosis of the intervertebral disc to cause rotation of the implant with respect to the insertion direction and to cause the tool to slide along the rail while continuing to move the tool along the insertion direction.

### Claim 15 (depends on 14)

The method of claim 14, wherein the engagement between the tool and the interface is maintained during the steps of applying and allowing.

### Claim 16 (depends on 14)

The method of claim 14, wherein the interface of the implant includes a notch and the tool includes a rod engageable to the notch, further comprising a step of engaging the rod to the notch to prevent relative rotation between the implant and the tool, and a step of disengaging the rod from the notch to allow relative rotation between the implant and the tool.

### Claim 17 (depends on 16)

The method of claim 16, wherein the implant is at least partially inserted with the rod engaged to the notch and at least partially inserted with the rod disengaged from the notch.

### Claim 18 (depends on 14)

The method of claim 14, wherein the step of allowing includes allowing a steering element disposed on the front end of the implant to mate with at least one of the adjacent vertebrae to assist in rotating the implant with respect to the insertion direction.

### Claim 19 (depends on 18)

The method of claim 18, wherein the steering element is disposed at an angle with respect to a longitudinal axis of the implant.

### Claim 20 (depends on 14)

The method of claim 14, wherein the step of applying includes the insertion direction being substantially parallel to a longitudinal axis of the implant, and further comprising a step of applying a second force to the implant along a second axis forming an angle with the longitudinal axis of greater than zero degrees.