# US 2014/0156009 A1 · Interbody device and plate for spinal stabilization and instruments for positioning same

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- Number: US 2014/0156009 A1
- Document ID: US20140156009A1
- Status: Published application
- Kind: A1
- Application number: 14/175,014
- Filed: 2014-02-07
- Published: 2014-06-05
- Earliest claimed: 2011-03-03
- Assignees: Warsaw Orthropedic, Inc.
- Applicants: Warsaw Orthropedic, Inc.
- Inventors: William Armstrong; Thomas Carls; John A. Cowan; James Duncan; Richard A. Hynes; Anthony J. Melkent; Jean-Pierre Mobasser; D. Hal Silcox
- Web page: https://patentgrep.com/patent/US20140156009A1

## CPC

- A61F 2/447: {substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section}
- A61B 17/7059: {Cortical plates (A61B17/7007, A61B17/7058 take precedence)}
- A61B 17/808: {Instruments for holding or positioning bone plates, or for adjusting screw-to-plate locking mechanisms}
- A61F 2/30771: {applied in original prostheses, e.g. holes or grooves}
- 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 2/4611: {of spinal prostheses}
- A61F 2/30965: {Reinforcing the prosthesis by embedding particles or fibres during moulding or dipping}
- A61F 2/4603: {for insertion or extraction of endoprosthetic joints or of accessories thereof}
- 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 2002/30365: {with additional means for limiting said rotation}
- A61F 2002/30383: {made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove}
- A61F 2002/30517: {using a locking plate}
- A61F 2002/3054: {about a connection axis or implantation axis for selecting any one of a plurality of radial orientations between two modular parts, e.g. Morse taper connections, at discrete positions, angular positions or continuous positions}
- A61F 2002/30576: {with extending fixation tabs}
- A61F 2002/30578: {having apertures, e.g. for receiving fixation screws}
- A61F 2002/30593: {hollow}
- A61F 2002/30624: {Hinged joint, e.g. with transverse axle restricting the movement}
- A61F 2002/30777: {Oblong apertures}
- A61F 2002/30779: {arcuate}
- A61F 2002/3082: {Grooves}
- A61F 2002/30904: {serrated profile, i.e. saw-toothed}
- A61F 2002/3093: {for promoting ingrowth of bone tissue}
- A61F 2002/4622: {having the shape of a forceps or a clamp}
- 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 2220/0008: Fixation appliances for connecting prostheses to the body
- 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 2310/00293: containing a phosphorus-containing compound, e.g. apatite
- A61F 2310/00329: Glasses, e.g. bioglass
- A61F 2310/00353: Bone cement, e.g. polymethylmethacrylate or PMMA
- A61F 2310/00359: Bone or bony tissue
- A61F 2310/00365: Proteins; Polypeptides; Degradation products thereof
- A61F 2310/00371: Collagen
- A61F 2310/00377: Fibrin
- 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

Systems, methods and devices for providing stabilization between first and second vertebrae are provided. More particularly, in one form a system includes an implant configured to be positioned in a disc space between the first and second vertebrae and a freestanding plate for engagement with extradiscal surfaces of the first and second vertebrae. The system also includes an insertion instrument with an engaging portion configured to releasably engage with the implant and the plate such that the implant and plate can be positioned together relative to the first and second vertebrae. In one aspect, an angular orientation of the implant relative to the plate is adjustable when the implant and the plate are engaged by the instrument. In this or another aspect, the implant and plate are held in a contiguous relationship when engaged by the instrument. However, different forms and applications are also envisioned.

## Claims

### Claim at position 1

1-43. (canceled)

### Claim 44

A system for providing spinal stabilization, comprising:
a plate including a body having a top surface and an opposite bottom surface, the body including a superior first pair of holes extending through the top and bottom surfaces at a cephalad end of the plate and an inferior second pair of holes extending through the top and bottom surfaces at a caudal end of the plate, the plate including a retaining element rotatably disposed on an outer surface of the plate, the retaining element comprising a plurality of arms separated by gaps, the retaining element being rotatable between a first position where the gaps are aligned with the holes and a second position where the arms overlap the holes.

### Claim 45 (depends on 44)

A system as recited in claim 44, wherein each of the holes is configured for disposal of a bone screw such that the bone screw extends obliquely through and away from the body.

### Claim 46 (depends on 44)

A system as recited in claim 44, wherein:
each of the first pair of holes is configured for disposal of a bone screw such that the bone screw extends obliquely through and away from the body in a lateral, cephalad direction; and
each of the second pair of holes is configured for disposal of a bone screw such that the bone screw extends obliquely through and away from the body in a lateral, caudal direction.

### Claim 47 (depends on 44)

A system as recited in claim 44, further comprising a bone screw extending through each of the holes when the retaining element is in the second position.

### Claim 48 (depends on 47)

A system as recited in claim 47, wherein the arms contact heads of the bone screws to prevent the bone screws from backing out of the holes.

### Claim 49 (depends on 44)

A system as recited in claim 44, wherein a tip of one of the arms has a width that is greater than a width of a tip of an adjacent one of the arms.

### Claim 50 (depends on 44)

A system as recited in claim 44, wherein the retaining element includes a cross-like configuration such that two of the arms extend along a first axis and two of the arms extend along a second axis that is transverse to the first axis.

### Claim 51 (depends on 44)

A system as recited in claim 44, wherein the retaining element is positioned equidistant between the cephalad and caudal ends of the plate and equidistant between opposite sides of the plate extending between the cephalad and caudal ends such that the retaining element is centrally disposed between the holes.

### Claim 52 (depends on 44)

A system as recited in claim 44, wherein the holes each have a radius of curvature that is substantially equivalent to a radius of curvature of each of the gaps.

### Claim 53 (depends on 44)

A system as recited in claim 44, wherein:
the system includes an implant extending from a leading end to an opposite trailing end, the implant including a superior bone engaging surface and an opposite inferior bone engaging surface, the trailing end being convexly curved between the superior and inferior bone engaging surfaces; and
the bottom surface includes an intermediate portion that is concavely curved between the cephalad and caudal ends, the trailing end engaging the intermediate portion to couple the plate to the implant.

### Claim 54 (depends on 53)

A system as recited in claim 53, wherein:
the bottom surface includes a first portion and a second portion, the intermediate portion being positioned between the first and second portions; and
the intermediate portion has a maximum height defined by a distance between the top and bottom surfaces that is greater that than of the first portion or the second portion.

### Claim 55 (depends on 53)

A system as recited in claim 53, further comprising an insertion instrument including an engaging portion that releasably engages the implant and the plate, wherein an angular orientation of the implant relative to the plate is adjustable when the implant and the plate are engaged by the instrument.

### Claim 56 (depends on 55)

A system as recited in claim 55, wherein engagement of the implant and the plate with the instrument prevents displacement of the implant relative to the plate and upon disengagement of the implant and the plate from the instrument the implant is freely displaceable relative to the plate.

### Claim 57

A system for providing spinal stabilization, comprising:
a plate including a body having a top surface and an opposite bottom surface, the body including a superior first pair of holes extending through the top and bottom surfaces at a cephalad end of the plate and an inferior second pair of holes extending through the top and bottom surfaces at a caudal end of the plate, the plate including a concavely curved intermediate portion positioned between the cephalad and caudal ends, the intermediate portion extending distal to the bottom surface, the plate including a retaining element rotatably disposed on an outer surface of the plate, the retaining element comprising a plurality of spaced apart arms that are connected by concave sections that each define a gap, the retaining element being rotatable between a first position where the gaps are aligned with the holes and a second position where the arms overlap the holes.

### Claim 58 (depends on 57)

A system as recited in claim 57, wherein the holes have a radius of curvature that is substantially equivalent to a radius of curvature of the gaps.

### Claim 59 (depends on 57)

A system as recited in claim 57, wherein the retaining element is secured to the plate with a threaded shaft.

### Claim 60 (depends on 57)

A system as recited in claim 57, wherein the retaining element includes a tool receptacle centrally disposed between the arms configured to rotate the retaining element relative to the plate.

### Claim 61

A method for providing spinal stabilization between first and second vertebrae, comprising:
providing a plate including a body having a top surface and an opposite bottom surface, the body including a superior first pair of holes extending through the top and bottom surfaces at a cephalad end of the plate and an inferior second pair of holes extending through the top and bottom surfaces at a caudal end of the plate, the plate including a retaining element rotatably disposed on an outer surface of the plate, the retaining element comprising a plurality of arms separated by gaps;
rotating the retaining element relative to the body such that the gaps are aligned with the holes;
inserting a bone fastener through one of the holes such that a head of the bone fastener is disposed in a respective one of the holes; and
rotating the retaining element such that the arms overlap the holes.

### Claim 62 (depends on 61)

A method as recited in claim 61, wherein one of the arms contacts the head of the bone fastener when the bone fastener is disposed in the respective one of the holes.

### Claim 63 (depends on 61)

A method as recited in claim 61, wherein inserting a bone fastener through one of the holes includes threading the bone fastener into a vertebra.