# US 2014/0207239 A1 · Lateral approach expandable spinal implant and method

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- Number: US 2014/0207239 A1
- Document ID: US20140207239A1
- Status: Published application
- Kind: A1
- Application number: 14/342,563
- Filed: 2012-09-07
- Published: 2014-07-24
- Earliest claimed: 2011-09-09
- Assignees: Spine Wave, Inc.
- Inventors: Peter Barreiro
- Web page: https://patentgrep.com/patent/US20140207239A1

## CPC

- A61F 2/447: {substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section}
- 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 2/4601: {for introducing bone substitute, for implanting bone graft implants or for compacting them in the bone cavity}
- A61F 2/4611: {of spinal prostheses}
- A61B 2017/0256: {for the spine}
- A61F 2/4465: {having a circular or kidney shaped cross-section substantially perpendicular to the axis of the spine}
- 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 2002/305: {Snap connection}
- A61F 2002/3052: {unrestrained in only one direction, e.g. moving unidirectionally}
- A61F 2002/30556: {for adjusting thickness}
- A61F 2002/30579: {with mechanically expandable devices, e.g. fixation devices}
- A61F 2002/30599: {stackable}
- A61F 2002/30601: {telescopic}
- A61F 2002/30843: {Pyramidally-shaped}
- A61F 2002/30904: {serrated profile, i.e. saw-toothed}
- 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 expandable interbody fusion device configured for placement into the intradiscal space between vertebral bodies in a lumbar spine from a lateral approach. The device is expanded by the insertion of a plurality of wafers into the device in situ. The length of the device is configured to extend on the vertebral body endplate from pedicle to pedicle and to reside interiorly of the ring apophysis with at least a portion of the device resting on the area of increased bone density at the posterior portion of the endplate between the pedicles.

## Claims

### Claim 1

An expandable interbody fusion device for insertion into the intradiscal space of a lumbar spine to reside at least in part on the area of increased bone density at the posterior portion of the endplate of the vertebral body between a lateral spacing defined as the pedicle-to-pedicle dimension and laterally within the interior of the ring apophysis extending peripherally around the endplate, comprising an elongate device having an upper surface for engaging the endplate of a vertebral body and a lower surface for engaging the endplate of an opposing vertebral body, the upper surface and a lower surface being separable increasingly upon expansion of the device, the device having a length configured to be less than the lateral spacing within the ring apophysis and not less than the pedicle-to-pedicle dimension.

### Claim 2 (depends on 1)

The expandable interbody fusion device of claim 1, wherein said device comprises a superior endplate including said upper surface, an inferior endplate including said lower surface and an expansion structure therebetween.

### Claim 3 (depends on 2)

The expandable interbody fusion device of claim 2, wherein said expansion structure comprises a plurality of elements stacked between said superior endplate and said inferior endplate.

### Claim 4 (depends on 3)

The expandable interbody fusion device of claim 3, wherein said elements each comprise a generally planar wafer.

### Claim 5 (depends on 4)

The expandable interbody fusion device of claim 4, wherein said wafers are each configured to be introduced between said superior endplate and said inferior endplate individually consecutively.

### Claim 6 (depends on 5)

The expandable interbody fusion device of claim 5, wherein each of said wafers comprises a leading end defining a lifting surface for engaging a trailing end of an earlier introduced wafer so as to displace and lift said earlier introduced wafer in said stack of wafers.

### Claim 7 (depends on 5)

The expandable interbody fusion device of claim 5, wherein each of said wafers comprises structure for interlocking said wafers to each other.

### Claim 8 (depends on 1)

The expandable interbody fusion device of claim 1, wherein said device comprises a radiopaque marker at least on said upper surface and said lower surface.

### Claim 9 (depends on 1)

The expandable interbody fusion device of claim 1, wherein said upper surface and said lower surface each comprises a convex surface along a length of said device.

### Claim 10 (depends on 9)

The expandable interbody fusion device of claim 9, wherein said upper surface and said lower surface each comprises a convex surface along a width of said device.

### Claim 11 (depends on 1)

The expandable interbody fusion device of claim 1, wherein said upper surface and said lower surface defined a lordotic angle therebetween.

### Claim 12 (depends on 1)

The expandable interbody fusion device of claim 1, wherein said device has an unexpanded height between said upper surface and said lower surface and an expanded height therebetween, the expanded height being at least 50% greater than said unexpanded height.

### Claim 13 (depends on 12)

The expandable interbody fusion device of claim 12, wherein said device has an unexpanded height of about 8 mm ranging to an expanded height of about 17 mm.

### Claim 14 (depends on 1)

The expandable interbody fusion device of claim 1, wherein said device has a length for use in the L1 to L5 region of the lumbar spine ranging from about 31 mm to 48 mm.

### Claim 15 (depends on 1)

The expandable interbody fusion device of claim 1, wherein said device has a width ranging from about 14 mm to 20 mm.

### Claim 16 (depends on 1)

The expandable interbody fusion device of claim 1, wherein said device has a length of about 37 mm, a width of about 16 mm and unexpanded height of about 8 mm.

### Claim 17

A method of inserting an expandable interbody fusion device from the lateral approach into the intradiscal space of the lumbar spine, comprising the steps of:
providing an access corridor to the spine from the lateral approach;
providing an elongate expandable device having a length less than the lateral width of the vertebral endplate between the peripheral ring apophysis and not less than the pedicle-to pedicle spacing of the vertebral body;
inserting said device into the intradiscal space between opposing vertebral bodies and within the ring apophysis of said endplate with at least a portion of said device residing on the area of endplate increased bone density at the posterior portion of the endplates between the pedicles; and then
expanding the expandable device in situ to increase the height of the intradiscal space and stabilize the spine.

### Claim 18 (depends on 17)

The method of claim 17, wherein said elongate expandable device comprises a superior endplate, an inferior endplate and an expansion structure therebetween, and wherein said expansion structure is expanded to increase the height of said device.

### Claim 19 (depends on 18)

The method of claim 18, wherein said expansion structure comprises a plurality of elements that are introduced into said device individually consecutively to form a stack of elements between said superior endplate and said inferior endplate.

### Claim 20 (depends on 18)

The method of claim 18, wherein the height of said device is increased from an unexpanded height to an expanded height, said expanded height being at least 50% greater than said unexpanded height.

### Claim 21 (depends on 17)

The method of claim 17, wherein said device is inserted generally along a transverse center line extending across the lateral width of a vertebral endplate of the lumbar spine.

### Claim 22 (depends on 21)

The method of claim 21, wherein said device is positioned to reside within said intradiscal space more posterior than anterior.

### Claim 23 (depends on 17)

The method of claim 17, wherein said access corridor is created with the use of intraoperative nerve monitoring instruments.

### Claim 24 (depends on 23)

The method of claim 23, wherein said access corridor is created with the use of tissue dilators.

### Claim 25 (depends on 24)

The method of claim 24, wherein a retractor having a plurality of blades is used to enlarge the access corridor, and wherein said device is inserted through said retractor.

### Claim 26 (depends on 24)

The method of claim 24, wherein a cannula of fixed dimension is placed over a last and largest dilator, and wherein said device is inserted through said cannula.

### Claim 27 (depends on 17)

The method of claim 17, wherein a bone filler is inserted into said intradiscal space adjacent said expanded device.

### Claim 28 (depends on 27)

The method of claim 27, wherein said bone filler is injected with a graft insertion instrument to inject said filler under pressure to stress load the filler against the vertebral endplates of opposing vertebral bodies communicating with said intradiscal space.