Steerable TLIF spine implant, installer, and method of installation

A kit for a TLIF spine procedure comprising:

• a TLIF spine implant comprising:
• a cage having an upper side, a lower side opposite to the upper side, a first lateral side, a second lateral side opposite to the first lateral side, a first end, a second end opposite the first end, a medial cavity extending through the cage from the upper side to the lower side, an arcuate opening in the second end defining an upper shelf extending longitudinally from the upper side and a lower shelf extending longitudinally from the lower side, the upper shelf having a first edge and a lower surface, the lower shelf having a second edge and an upper surface, a rounded bore in the upper side adjacent the upper shelf and extending axially from the upper side to the lower surface, a round seat in the upper surface of the lower shelf and axially below the rounded bore, a lower arcuate groove in the upper surface of the lower shelf adjacent the second edge, an upper arcuate groove in the lower surface of the upper shelf adjacent the first edge, the lower arcuate groove and the upper arcuate groove axially aligned with one another and forming an arcuate channel of a first arcuate length for receipt and guidance of a distal protrusion on a distal end of a spine implant installation instrument for a TLIF surgical procedure along the arcuate channel during pivotal movement of the cage during implantation of the TLIF implant, and a cylindrical bore in the second lateral side of the cage in communication with the rounded bore;
• a cylindrical pivot post disposed in the rounded bore of the cage and rotationally supported on the rounded seat, the cylindrical pivot post having a central axis, a threaded bore in a radial side thereof that extends radially inward toward the central axis, and a receptor disposed in an exterior surface of the cylindrical pivot post opposite to the threaded bore;
• and
• a cylindrical retention pin received in the cylindrical bore in the second lateral side of the cage and in contact with the cylindrical pivot post to constrain the cage to a range of rotation about the cylindrical post and along the arcuate channel;
• and
• an installation instrument for the TLIF spine implant comprising:
• a handle having a proximal end and a distal end;
• a frame having a proximal end and a distal end, the proximal end of the frame attached to the distal end of the handle;
• a hollow shaft having a proximal end and a distal end, the proximal end of the shaft attached to the distal end of the frame, the distal end of the hollow shaft is open;
• a second controller longitudinally movably disposed on the proximal end of the hollow shaft;
• a rod having a proximal end and a threaded distal end, the rod extending through the hollow shaft wherein the threaded distal end extends from the open distal end of the hollow shaft and is configured to threadedly engage and disengage the threaded bore of the pivot post;
• a first controller attached to the distal end of the rod and retained in the frame, wherein rotation of the first controller rotates the rod to threadedly attach or detach the threaded end of the rod from the pivot post;
• a flat push bar having a proximal end and a distal end and movably retained in a lateral side of the hollow shaft, the proximal end of the flat push bar attached to the second controller whereby longitudinal translation of the second controller longitudinally translates the flat push bar relative to the hollow shaft to move the flat push bar relative to the hollow shaft to extend and retract the distal end of the flat push bar to change the angular position of the attached cage through rotation of the cage about the pivot post;
• a second lateral bar disposed on and stationary relative to a second lateral side of the hollow shaft;
• and
• a protrusion situated on a distal face of the distal end of the insertion instrument adjacent the stationary second lateral bar.

A method of implanting an impacted blade TLIF implant comprising the steps of:

• providing a TLIF spine implant comprising:
• a cage having an upper side, a lower side opposite to the upper side, a first lateral side, a second lateral side opposite to the first lateral side, a first end, a second end opposite the first end, a medial cavity extending through the cage from the upper side to the lower side, an arcuate opening in the second end defining an upper shelf extending longitudinally from the upper side and a lower shelf extending longitudinally from the lower side, the upper shelf having a first edge and a lower surface, the lower shelf having a second edge and an upper surface, a rounded bore in the upper side adjacent the upper shelf and extending axially from the upper side to the lower surface, a round seat in the upper surface of the lower shelf and axially below the rounded bore, a lower arcuate groove in the upper surface of the lower shelf adjacent the second edge, an upper arcuate groove in the lower surface of the upper shelf adjacent the first edge, the lower arcuate groove and the upper arcuate groove axially aligned with one another and forming an arcuate channel of a first arcuate length for receipt and guidance of a distal protrusion on a distal end of a spine implant installation instrument for a TLIF surgical procedure along the arcuate channel during pivotal movement of the cage during implantation of the TLIF implant, and a cylindrical bore in the second lateral side of the cage in communication with the rounded bore;
• a cylindrical pivot post disposed in the rounded bore of the cage and rotationally supported on the rounded seat, the cylindrical pivot post having a central axis, a threaded bore in a radial side thereof that extends radially inward toward the central axis, and a receptor disposed in an exterior surface of the cylindrical pivot post opposite to the threaded bore;
• and
• a cylindrical retention pin received in the cylindrical bore in the second lateral side of the cage and in contact with the cylindrical pivot post to constrain the cage to a range of rotation about the cylindrical post and along the arcuate channel.
• providing an insertion instrument for installing the TLIF spine implant, the insertion instrument comprising:
• a handle having a proximal end and a distal end;
• a frame having a proximal end and a distal end, the proximal end of the frame attached to the distal end of the handle;
• a hollow shaft having a proximal end and a distal end, the proximal end of the shaft attached to the distal end of the frame, the distal end of the hollow shaft is open;
• a second controller longitudinally movably disposed on the proximal end of the hollow shaft;
• a rod having a proximal end and a threaded distal end, the rod extending through the hollow shaft wherein the threaded distal end extends from the open distal end of the hollow shaft and is configured to threadedly engage and disengage the threaded bore of the pivot post;
• a first controller attached to the distal end of the rod and retained in the frame, wherein rotation of the first controller rotates the rod to threadedly attach or detach the threaded end of the rod from the pivot post;
• a flat push bar having a proximal end and a distal end and movably retained in a lateral side of the hollow shaft, the proximal end of the flat push bar attached to the second controller whereby longitudinal translation of the second controller longitudinally translates the flat push bar relative to the hollow shaft to move the flat push bar relative to the hollow shaft to extend and retract the distal end of the flat push bar to change the angular position of the attached cage through rotation of the cage about the pivot post;
• a second lateral bar disposed on and stationary relative to a second lateral side of the hollow shaft;
• and
• a protrusion situated on a distal face of the distal end of the insertion instrument adjacent the stationary second lateral bar;
• and
• guiding the TLIF spine implant into a vertebral space using the insertion instrument.