# US 2021/0330469 A9 · Bi-directional fixating/locking transvertebral body screw/intervertebral cage stand-alone constructs having a central screw locking lever, and pliers and devices for spinal fusion

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- Number: US 2021/0330469 A9
- Document ID: US20210330469A9
- Status: Published application
- Kind: A9
- Application number: 16/829,246
- Filed: 2020-03-25
- Published: 2021-10-28
- Earliest claimed: 2005-04-12
- Assignees: Moskowitz Family LLC
- Applicants: Moskowitz Family LLC
- Inventors: Ahmnon D. Moskowitz; Nathan C. Moskowitz; Mosheh T. Moskowitz; Pablo A. Valdivia Y. Alvarado
- Web page: https://patentgrep.com/patent/US20210330469A9

## 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)}
- A61B 17/0642: {for bones, e.g. for osteosynthesis or connecting tendon to bone}
- A61B 17/068: Surgical staplers {, e.g. containing multiple staples or clamps}({staplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105;} for performing anastomosis A61B17/115; {staplers in general B25C5/00})
- A61B 17/7064: {Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor}
- A61B 17/7074: {Tools specially adapted for spinal fixation operations other than for bone removal or filler handling (A61B17/7062, A61B17/808, A61B17/8858 take precedence; for spinal image producing devices A61B90/36, A61B34/20; markers A61B90/39)}
- A61B 17/809: {with bone-penetrating elements, e.g. blades or prongs (bone staples A61B17/0642; intramedullary nails with a plate at an end A61B17/7233)}
- A61F 2/447: {substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section}
- A61F 2/4637: {for connecting or disconnecting two parts of a prosthesis}
- A61B 17/8042: {the additional component being a cover over the screw head}
- A61B 17/86: Pins or screws {or threaded wires; nuts therefor (A61B17/72 take precedence)}
- A61B 2017/0641: {having at least three legs as part of one single body}
- A61B 2017/0647: {having one single leg, e.g. tacks}
- A61B 2017/0648: {threaded, e.g. tacks with a screw thread}
- A61B 2017/922: {Devices for impaction, impact element}
- A61F 2002/2835: {Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material}
- A61F 2002/30331: {made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit}
- A61F 2002/30383: {made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove}
- A61F 2002/30476: {locked by an additional locking mechanism}
- A61F 2002/305: {Snap connection}
- A61F 2002/30517: {using a locking plate}
- A61F 2002/30604: {modular}
- A61F 2002/30772: {Apertures or holes, e.g. of circular cross section}
- A61F 2002/30787: {inclined obliquely with respect to each other}
- A61F 2002/30879: {Ribs}
- A61F 2002/448: {comprising multiple adjacent spinal implants within the same intervertebral space or within the same vertebra, e.g. comprising two adjacent spinal implants}
- A61F 2002/4622: {having the shape of a forceps or a clamp}
- A61F 2002/4641: {for disconnecting}
- A61F 2220/0025: Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F 2220/0033: made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
- A61F 2220/0041: using additional screws, bolts, dowels or rivets, e.g. connecting screws
- 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

A bi-directional fixating transvertebral (BDFT) screw/cage apparatus including an intervertebral cage for maintaining disc height, and a method of inserting the same is provided. The intervertebral cage includes a first internal screw guide and a second internal screw guide, a first screw member and a second screw member, and a central screw locking lever coupled to the intervertebral cage, wherein the central screw locking lever prevents the first screw member and the second screw from pulling-out of the first internal screw guide and the second internal screw guide. The central screw locking lever includes a rotatable handle and stem portion, or a screw locking horizontal bracket. A pliers device for inserting and removing the bi-directional fixating transvertebral (BDFT) screw/cage apparatus, a posterior cervical and lumbar facet joint staple, and a staple gun for a posterior cervical and lumbar facet joint staple also are provided.

## Claims

### Claim at position 1

1-20. (canceled)

### Claim 21

A bi-directional fixating transvertebral (BDFT) screw/cage apparatus, comprising:
first and second screw members;
an intervertebral cage for maintaining disc height, wherein the intervertebral cage includes:
a top wall, a bottom wall, and two sidewalls defining an open space capable of receiving bone filling for the biological bone fusion, wherein the open space extends between the top wall and the bottom wall and extends between the two sidewalls;
a first internal screw guide and a second internal screw guide defined by and extending through the top wall, wherein the first internal screw guide and the second internal screw guide each have an internal bore with an entry opening and an exit opening, the entry opening of the internal bore formed at least partially in a top surface of the top wall and the exit opening formed at least partially in a bottom surface of the top wall and at least partially in a side surface of the top wall, wherein each of the first internal screw guide and the second internal screw guide are angled to orient the first screw member and the second screw member bi-directionally; and
a first vertebral body facing surface defined by the intervertebral cage and positioned so as to face a first vertebral body when the intervertebral cage is positioned in a disc space, wherein the first vertebral body facing surface includes a first plurality of ridges extending parallel to the top wall and the bottom wall;
a second vertebral body facing surface defined by the intervertebral cage and positioned so as to face a second vertebral body when the intervertebral cage is positioned in the disc space, wherein the second vertebral body facing surface includes a second plurality of ridges extending parallel to the top wall and the bottom wall;
a central screw locking lever coupled to the intervertebral cage, wherein the central screw locking lever comprises a first end sized and positioned to at least partially block the first screw member and the first internals screw guide, wherein the central screw locking lever comprises a second end sized and positioned to at least partially block the second screw member and the second internal screw guide, wherein the central screw locking lever comprises a middle extension configured to extend into the top wall at a location between the first and second internal screw guides such that the middle extension is rotatable with respect to the top wall of the intervertebral cage, wherein each of the first and second ends of the central screw locking lever are rounded when viewed from a direction perpendicular to the top wall, and wherein the central screw locking lever is configured to prevent the first screw member and the second screw member from pulling-out of the first internal screw guide and the second internal screw guide.

### Claim 22 (depends on 21)

The apparatus of claim 21, wherein the intervertebral cage is a cervical cage sized and configured to be positioned in a cervical disc space.

### Claim 23 (depends on 21)

The apparatus of claim 21, wherein the central screw locking lever has a width from the first end to the second end that is less than a width of the top wall of the intervertebral cage.

### Claim 24 (depends on 21)

The apparatus of claim 21, wherein the first end of the central screw locking lever only partially blocks a first head of the first screw member and the second of the central screw locking lever only partially blocks a second head of the second screw member when the first and second screw members are inserted in the intervertebral cage and the central screw locking lever is positioned to block the first and second screw members.

### Claim 25 (depends on 21)

The apparatus of claim 21, wherein first and second screw heads of the first and second screw members are partially visible behind the central screw locking lever when viewed from the direction perpendicular to the top wall.

### Claim 26 (depends on 21)

The apparatus of claim 21, wherein outer surfaces of the first and second sidewalls each have a substantially flat portion positioned between the top and bottom walls and each have a substantially curved portion proximate the bottom wall.

### Claim 27 (depends on 21)

The apparatus of claim 21, wherein each of the first and second sidewalls define slots that are positioned proximate the top wall.

### Claim 28 (depends on 21)

The apparatus of claim 21, wherein the middle extension of the central screw locking lever has a diameter that is less than a width and a height of the both the first and second ends of the central screw locking lever.

### Claim 29 (depends on 21)

The apparatus of claim 21, wherein the first and second screw members extend partially into the open space of the intervertebral cage when the first and second screw members are positioned in the first and second internal screw guides.

### Claim 30 (depends on 21)

The apparatus of claim 21, wherein the central screw locking lever is pivotable with respect to the top wall of the intervertebral cage.

### Claim 31

A bi-directional fixating transvertebral (BDFT) screw/cage apparatus, comprising:
first and second screw members;
an intervertebral cage for maintaining disc height, wherein the intervertebral cage includes:
a top wall, a bottom wall, and two sidewalls defining an open space capable of receiving bone filling for the biological bone fusion, wherein the open space extends between the top wall and the bottom wall and extends between the two sidewalls;
a first internal screw guide and a second internal screw guide defined by and extending through the top wall, wherein the first internal screw guide and the second internal screw guide each have an internal bore with an entry opening and an exit opening, the entry opening of the internal bore formed entirely in a top surface of the top wall and the exit opening formed at least partially in a bottom surface of the top wall and at least partially in a side surface of the top wall, wherein each of the first internal screw guide and the second internal screw guide are angled to orient the first screw member and the second screw member bi-directionally; and
a first vertebral body facing surface defined by the intervertebral cage and positioned so as to face a first vertebral body when the intervertebral cage is positioned in a disc space, wherein the first vertebral body facing surface includes a first plurality of surface features configured to facilitation integration and fusion;
a second vertebral body facing surface defined by the intervertebral cage and positioned so as to face a second vertebral body when the intervertebral cage is positioned in the disc space, wherein the second vertebral body facing surface includes a second plurality of surface features configured to facilitation integration and fusion;
a central screw locking lever coupled to the intervertebral cage, wherein the central screw locking lever comprises a first end sized and positioned to at least partially block the first screw member and the first internals screw guide, wherein the central screw locking lever comprises a second end sized and positioned to at least partially block the second screw member and the second internal screw guide, wherein the central screw locking lever comprises an extension positioned at or near a central portion between the first and second ends and is configured to extend into the top wall at a location at least partially between the first and second internal screw guides such that the extension is rotatable with respect to the top wall of the intervertebral cage, wherein each of the first and second ends of the central screw locking lever are rounded when viewed from a direction perpendicular to the top wall, and wherein the central screw locking lever is configured to prevent the first screw member and the second screw member from pulling-out of the first internal screw guide and the second internal screw guide.

### Claim 32 (depends on 31)

The apparatus of claim 31, wherein the intervertebral cage is a cervical cage sized and configured to be positioned in a cervical disc space.

### Claim 33 (depends on 31)

The apparatus of claim 31, wherein the central screw locking lever has a width from the first end to the second end that is less than a width of the intervertebral cage from the first sidewall to the second sidewall.

### Claim 34 (depends on 31)

The apparatus of claim 31, wherein the first end of the central screw locking lever only partially blocks a first head of the first screw member and the second of the central screw locking lever only partially blocks a second head of the second screw member when the first and second screw members are inserted in the intervertebral cage and the central screw locking lever is positioned to block the first and second screw members.

### Claim 35 (depends on 31)

The apparatus of claim 31, wherein first and second screw heads of the first and second screw members are partially visible behind the central screw locking lever when viewed from the direction perpendicular to the top wall.

### Claim 36 (depends on 31)

The apparatus of claim 31, and further comprising:
allograft bone fusion material placed in the open space of the intervertebral cage, wherein the bone product is configured to facilitate fusion.

### Claim 37 (depends on 31)

The apparatus of claim 31, wherein each of the first and second sidewalls define slots that are positioned proximate the top wall.

### Claim 38 (depends on 31)

The apparatus of claim 31, wherein the extension of the central screw locking lever has a diameter that is less than a width and a height of the both the first and second ends of the central screw locking lever.

### Claim 39 (depends on 31)

The apparatus of claim 31, wherein the first and second screw members extend partially into the open space of the intervertebral cage when the first and second screw members are positioned in the first and second internal screw guides.

### Claim 40 (depends on 31)

The apparatus of claim 31, wherein the central screw locking lever is pivotable with respect to the top wall of the intervertebral cage.