# US 11,298,243 B2 · Angling inserter tool for expandable vertebral implant

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- Number: US 11,298,243 B2
- Document ID: US11298243B2
- Status: Granted
- Kind: B2
- Application number: 16/664,980
- Filed: 2019-10-28
- Published: 2020-02-20
- Granted: 2022-04-12
- Earliest claimed: 2010-04-12
- Assignees: Globus Medical, Inc.
- Applicants: Globus Medical, Inc.
- Inventors: James Himmelberger; Colm McLaughlin; Mark Weiman
- Web page: https://patentgrep.com/patent/US11298243B2

## CPC

- A61F 2/4611: {of spinal prostheses}
- A61F 2/44: for the spine, e.g. vertebrae or spinal discs
- A61F 2/4425: {made of articulated components}
- 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 2/4603: {for insertion or extraction of endoprosthetic joints or of accessories thereof}
- A61F 2/4684: {Trial or dummy 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 2002/30383: {made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove}
- A61F 2002/30393: {with additional means for limiting said rotation}
- A61F 2002/30395: {with additional means for preventing or locking said rotation}
- A61F 2002/30405: {made by screwing complementary threads machined on the parts themselves}
- A61F 2002/30477: {using sharp protrusions, e.g. spikes, for anchoring into connecting prosthetic part}
- A61F 2002/30495: {using a locking ring}
- A61F 2002/305: {Snap connection}
- A61F 2002/30505: {spring biased}
- A61F 2002/30507: {using a threaded locking member, e.g. a locking screw or a set screw}
- A61F 2002/30523: {by means of meshing gear teeth}
- A61F 2002/3055: {for adjusting length}
- A61F 2002/30571: {Leaf springs}
- A61F 2002/30576: {with extending fixation tabs}
- A61F 2002/30578: {having apertures, e.g. for receiving fixation screws}
- A61F 2002/30579: {with mechanically expandable devices, e.g. fixation devices}
- A61F 2002/30593: {hollow}
- A61F 2002/30594: {slotted, e.g. radial or meridian slot ending in a polar aperture, non-polar slots, horizontal or arcuate slots}
- A61F 2002/30601: {telescopic}
- A61F 2002/30604: {modular}
- A61F 2002/30828: {parallel}
- A61F 2002/30843: {Pyramidally-shaped}
- A61F 2002/30845: {with cutting edges}
- A61F 2002/30858: {Threads interrupted by grooves or sidewalls, e.g. flat sidewalls}
- A61F 2002/4625: {with relative movement between parts of the instrument during use}
- 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 2002/4629: {connected to the endoprosthesis or implant via a threaded connection}
- A61F 2002/4658: {for measuring dimensions, e.g. length}
- A61F 2002/4661: {for measuring thickness}
- A61F 2002/4668: {for measuring angles}
- A61F 2310/00011: Metals or alloys
- A61F 2310/00023: Titanium or titanium-based alloys, e.g. Ti-Ni alloys
- A61F 2310/00131: Tantalum or Ta-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)

## Abstract

The present invention relates to a method of inserting an implant comprising providing an expandable vertebral implant. The method further may comprise providing an angling inserter tool. The angling inserter tool comprises a handle portion, a base portion, and a tip assembly, the base portion being disposed between the handle portion and the tip assembly. The method further may comprise distally advancing a central shaft of the tip assembly with rotation into an opening in the expandable vertebral implant to secure the angling inserter tool to the expandable vertebral implant. The method further may comprise positioning the expandable vertebral implant in a patient's spine. The method further may comprise for causing the tip assembly to angulate with respect to a longitudinal axis of the angling inserter tool, wherein the internal shaft is coaxial with an outer cylinder of the base portion.

## Claims

### Claim 1

A method for inserting an implant, comprising:
attaching an inserter tool to a vertebral implant having a first member, a second member movable relative to the first member along a longitudinal axis, and a gear member positioned coaxially to the first and second members and having an array of gear teeth, rotation of the gear member causing movement of the first member relative to the second member along the longitudinal axis;
positioning the attached vertebral implant between two adjacent vertebral bodies;
expanding the positioned vertebral implant with the inserter tool by rotating a toothed gear disposed in the inserter tool, rotation of the toothed gear causing rotation of the gear teeth of the gear member in mesh with the toothed gear which in turn causes movement of the first member relative to the second member,
wherein the inserter tool includes a central shaft having a threaded distal tip portion and the step of attaching an inserter tool includes threading the threaded distal tip portion into a threaded opening in the vertebral implant, and
wherein the vertebral implant includes a lock for locking rotation of the gear member and the step of threading the threaded distal tip portion unlocks the lock.

### Claim 2 (depends on 1)

The method of claim 1, wherein the inserter tool includes a base portion and a tip assembly rotatably secured to the base portion, the method further comprising rotating the tip assembly while the vertebral implant is attached to the tip assembly of the inserter tool.

### Claim 3 (depends on 1)

The method of claim 1, wherein the lock is biased to lock the rotation of the gear member, the method further comprising, after the step of expanding the vertebral implant, detaching the inserter tool from the vertebral implant to automatically lock the lock to prevent rotation of the vertebral implant.

### Claim 4 (depends on 1)

The method of claim 1, wherein the inserter tool comprises:
a base portion including an internal shaft and a primary drive shaft;
a tip assembly rotatably secured to the base portion by a pin having a pin axis, wherein the tip assembly includes a tip portion and a central shaft disposed in a through-bore in the tip portion; and
a primary gear mechanism to drive the gear member and a secondary gear mechanism to securely attach the tip assembly to the vertebral implant, the secondary gear mechanism transferring rotation of the primary drive shaft to the central shaft, wherein the tip assembly rotates about the pin axis upon longitudinal advancement of the internal shaft;
wherein the step of expanding the positioned vertebral implant includes driving the primary gear mechanism to rotate the gear member in order to cause movement of the first member relative to the second member;
the method further comprising translating the internal shaft to cause rotation of the tip assembly about the pin axis.

### Claim 5 (depends on 4)

The method of claim 4, wherein the central shaft has a threaded distal tip portion and the step of attaching an inserter tool includes rotating the central shaft to thread the threaded distal tip portion into a threaded opening in the vertebral implant.

### Claim 6 (depends on 4)

The method of claim 4, wherein the central shaft has a threaded distal tip portion and the step of attaching an inserter tool includes driving the secondary gear mechanism to thread the threaded distal tip portion into a threaded opening in the vertebral implant.

### Claim 7 (depends on 4)

The method of claim 4, wherein the vertebral implant includes a lock for locking rotation of the gear member and the step of rotating the central shaft to thread the threaded distal tip portion unlocks the lock.

### Claim 8 (depends on 7)

The method of claim 7, wherein the lock is biased to lock the rotation of the gear member, the method further comprising, after the step of expanding the vertebral implant, detaching the inserter tool from the vertebral implant to automatically lock the lock to prevent rotation of the vertebral implant.

### Claim 9

A method for inserting an implant, comprising:
attaching an angling inserter tool to a vertebral implant having a first member, a second member movable relative to the first member along a longitudinal axis, and a gear member positioned coaxially to the first and second members and having an array of gear teeth, rotation of the gear member causing movement of the first member relative to the second member along the longitudinal axis, wherein the angling inserter tool includes a base portion and a tip assembly rotatably secured to the base portion by a pin having a pin axis;
angling the attached vertebral implant by rotating the tip assembly about the pin axis;
positioning the attached vertebral implant in between two adjacent vertebral bodies;
expanding the positioned vertebral implant with the angling inserter tool by rotating a toothed gear disposed in the tip assembly, rotation of the toothed gear causing rotation of the gear teeth of the gear member in mesh with the toothed gear which in turn causes movement of the first member relative to the second member,
wherein the angling inserter tool includes a central shaft having a threaded distal tip portion and the step of attaching an inserter tool includes threading the threaded distal tip portion into a threaded opening in the vertebral implant, and
wherein the vertebral implant includes a lock for locking rotation of the gear member and the step of threading the threaded distal tip portion unlocks the lock.

### Claim 10 (depends on 9)

The method of claim 9, wherein the lock is biased to lock the rotation of the gear member, the method further comprising, after the step of expanding the vertebral implant, detaching the angling inserter tool from the vertebral implant to automatically lock the lock to prevent rotation of the expanded vertebral implant.

### Claim 11 (depends on 9)

The method of claim 9, wherein:
the base portion includes an internal shaft and a primary drive shaft;
the tip assembly includes a tip portion and a central shaft disposed in a through-bore in the tip portion; and
the angling inserter tool further includes:
a primary gear mechanism to drive the gear member and a secondary gear mechanism to securely attach the tip assembly to the vertebral implant, the secondary gear mechanism transferring rotation of the primary drive shaft to the central shaft, wherein the tip assembly rotates about the pin axis upon longitudinal advancement of the internal shaft;
the step of expanding the positioned vertebral implant includes driving the primary gear mechanism to rotate the gear member in order to cause movement of the first member relative to the second member;
the step of angling the attached vertebral implant includes translating the internal shaft to cause rotation of the tip assembly about the pin axis.

### Claim 12 (depends on 11)

The method of claim 11, wherein the central shaft has a threaded distal tip portion and the step of attaching an angling inserter tool includes rotating the central shaft to thread the threaded distal tip portion into a threaded opening in the vertebral implant.

### Claim 13 (depends on 11)

The method of claim 11, wherein the central shaft has a threaded distal tip portion and the step of attaching an inserter tool includes driving the secondary gear mechanism to thread the threaded distal tip portion into a threaded opening in the vertebral implant.

### Claim 14 (depends on 11)

The method of claim 11, wherein the vertebral implant includes a lock for locking rotation of the gear member and the step of rotating the central shaft to thread the threaded distal tip portion unlocks the lock.

### Claim 15 (depends on 14)

The method of claim 14, wherein the lock is biased to lock the rotation of the gear member, the method further comprising, after the step of expanding the vertebral implant, detaching the inserter tool from the vertebral implant to automatically lock the lock to prevent rotation of the vertebral implant.

### Claim 16 (depends on 9)

The method of claim 9, wherein the step of attaching an angling inserter tool includes engaging a pair of engaging arms in the angling inserter tool with corresponding slots of the vertebral implant.