# US 7,608,105 B2 · Methods of inserting conically-shaped fusion cages

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- Number: US 7,608,105 B2
- Document ID: US7608105B2
- Status: Granted
- Kind: B2
- Application number: 11/185,418
- Filed: 2005-07-20
- Published: 2005-11-17
- Granted: 2009-10-27
- Earliest claimed: 1994-09-15
- Assignees: Howmedica Osteonics Corp.
- Inventors: Paul W. Pavlov; Charles J. Winslow; Kirk Jayne; Henry A. Klyce
- Web page: https://patentgrep.com/patent/US7608105B2

## CPC

- A61F 2/446: {having a circular or elliptical cross-section substantially parallel to the axis of the spine, e.g. cylinders or frustocones}
- A61B 17/862: {at the periphery of the screw head}
- A61B 17/8883: {the driver bit acting on the periphery of the screw head}
- 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}
- A61F 2/4637: {for connecting or disconnecting two parts of a prosthesis}
- A61F 2/30744: {End caps, e.g. for closing an endoprosthetic cavity}
- 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 2/4603: {for insertion or extraction of endoprosthetic joints or of accessories thereof}
- A61F 2002/2835: {Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material}
- A61F 2002/30121: {with lobes}
- A61F 2002/30143: {hexagonal}
- A61F 2002/30154: {square}
- A61F 2002/3021: {frustoconical}
- A61F 2002/30217: {hollow cones, e.g. tubular-like cones}
- A61F 2002/30235: {tubular, e.g. sleeves}
- A61F 2002/30327: {differing in diameter}
- A61F 2002/30331: {made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit}
- A61F 2002/30405: {made by screwing complementary threads machined on the parts themselves}
- A61F 2002/30593: {hollow}
- A61F 2002/30617: {Visible markings for adjusting, locating or measuring}
- A61F 2002/30774: {internally-threaded}
- A61F 2002/30777: {Oblong apertures}
- A61F 2002/30785: {parallel}
- A61F 2002/30787: {inclined obliquely with respect to each other}
- A61F 2002/30797: {internally-threaded}
- A61F 2002/30813: {Stepped or enlarged blind bores, e.g. having discrete diameter changes}
- A61F 2002/3082: {Grooves}
- A61F 2002/3085: {with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface}
- A61F 2002/30863: {the entry end surface having flutes, relief grooves, starter notches or bevelled indentations}
- A61F 2002/30873: {Threadings machined on non-cylindrical external surfaces}
- A61F 2002/30968: {Sintering}
- 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 2002/4627: {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 2220/0025: 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 2230/0006: circular
- A61F 2230/0017: Angular shapes
- A61F 2230/0021: square
- A61F 2230/0067: conical
- A61F 2230/0069: cylindrical
- A61F 2250/0039: differing in diameter
- A61F 2250/0097: Visible markings, e.g. indicia
- A61F 2310/00023: Titanium or titanium-based alloys, e.g. Ti-Ni 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)
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

A method of promoting fusion of adjacent vertebral bodies include providing a conically-shaped cage body having bone engaging projections on an outer surface thereof, the cage body including a leading end having a first diameter and a trailing end having a second diameter that is larger than the first diameter. The method also includes positioning the leading end of the cage body adjacent an intervertebral disc space between an upper vertebral body and a lower vertebral body, whereby the upper and lower vertebral bodies have opposing end faces that define upper and lower limits of the intervertebral disc space. While urging the leading end of the cage body into the intervertebral disc space, the cage body is turned so that the bone engaging projections bite into the opposing end faces of the upper and lower vertebral bodies for anchoring the cage body to the upper and lower vertebral bodies.

## Claims

### Claim 1

A method of promoting fusion of adjacent vertebral bodies comprising:
providing a conically-shaped cage body having threading on an outer surface thereof and a plurality of apertures extending through said outer surface thereof, said cage body including a leading end having a first diameter and a trailing end having a second diameter that is larger than said first diameter, wherein said apertures increase in size from said leading end toward said trailing end;
positioning said leading end of said cage body adjacent an intervertebral disc space between an upper vertebral body and a lower vertebral body, wherein said upper and lower vertebral bodies have opposing end faces that define upper and lower limits of said intervertebral disc space;
while urging said leading end of said cage body into said intervertebral disc space, turning said cage body so that said threading bites into said opposing end faces of said upper and lower vertebral bodies for anchoring said cage body to said upper and lower vertebral bodies.

### Claim 2 (depends on 1)

The method as claimed in claim 1, further comprising fully inserting said cage body between said opposing end faces of said upper and lower vertebral bodies so that spacing between said opposing end faces is greater at said trailing end of said cage body than at said leading end of said cage body.

### Claim 3 (depends on 1)

The method as claimed in claim 1, wherein said opposing end faces of said upper and lower vertebral bodies have first ends and second ends, and wherein said urging step causes said opposing end faces to pivot about said second ends of said opposing end faces.

### Claim 4 (depends on 1)

The method as claimed in claim 1, wherein said opposing end faces of said upper and lower vertebral bodies have first ends and second ends, and wherein said urging step causes greater distraction at said first ends of said opposing end faces than at said second ends of said opposing end faces.

### Claim 5 (depends on 1)

The method as claimed in claim 1, wherein said threading is continuous threading that extends between said leading end and said trailing end of said cage body.

### Claim 6 (depends on 1)

The method as claimed in claim 1, wherein said cage body has a longitudinal axis extending between said leading and trailing ends thereof and a transverse axis extending in a direction that is substantially perpendicular to said longitudinal axis, and wherein said plurality of apertures are clustered about said transverse axis.

### Claim 7 (depends on 6)

The method as claimed in claim 6, further comprising inserting said cage body between said upper and lower vertebral bodies so that said clustered apertures confront said opposing end faces of said vertebral bodies.

### Claim 8 (depends on 1)

The method as claimed in claim 1, wherein said cage body includes an internal cavity surrounded by said outer surface of said cage body, the method further comprising providing a bone-growth inducing material in said internal cavity of said cage body.

### Claim 9 (depends on 8)

The method as claimed in claim 8, wherein said trailing end of said cage body includes an opening in communication with said internal cavity of said cage body for providing said bone-growth inducing material in said internal cavity of said cage body.

### Claim 10 (depends on 1)

The method as claimed in claim 1, wherein said cage body is continuously tapered between said leading end and said trailing end thereof.

### Claim 11 (depends on 1)

The method as claimed in claim 1, wherein said leading end of said cage body has a rounded nose.

### Claim 12 (depends on 1)

The method as claimed in claim 1, wherein said outer surface of said cage body has at least one flute extending from said leading end toward said trailing end of said cage body.

### Claim 13 (depends on 1)

The method as claimed in claim 1, wherein said cage body is devoid of a flange so that said cage body is anchored to said upper and lower vertebral bodies solely by said threading on said outer surface thereof.

### Claim 14

A method of promoting fusion of adjacent vertebral bodies comprising:
providing a conically-shaped cage body having an outer surface surrounding an internal cavity of said cage body, at least one thread provided on said outer surface and a plurality of apertures extending through said outer surface, said cage body including a leading end having a first diameter and a trailing end having a second diameter that is larger than said first diameter, wherein said apertures increase in size from said leading end toward said trailing end of said cage body;
positioning said leading end of said cage body adjacent an intervertebral disc space between an upper vertebral body and a lower vertebral body, wherein said upper and lower vertebral bodies have opposing end faces that define upper and lower limits of said intervertebral disc space;
while urging said leading end of said cage body into said intervertebral disc space, turning said cage body so that said at least one thread bites into said opposing end faces of said upper and lower vertebral bodies for anchoring said cage body to said upper and lower vertebral bodies.

### Claim 15 (depends on 14)

The method as claimed in claim 14, further comprising fully inserting said cage body between said opposing end faces of said upper and lower vertebral bodies so that spacing between said opposing end faces at said trailing end of said cage body is greater than spacing between said opposing end faces at said leading end of said cage body.

### Claim 16 (depends on 14)

The method as claimed in claim 14, wherein said opposing end faces of said upper and lower vertebral bodies have first ends and second ends, and wherein said urging step causes greater distraction at said first ends of said opposing end faces than at said second ends of said opposing end faces.

### Claim 17 (depends on 14)

The method as claimed in claim 14, further comprising providing a bone-growth inducing material in said internal cavity of said cage body.

### Claim 18 (depends on 17)

The method as claimed in claim 17, wherein said trailing end of said cage body includes an opening in communication with said internal cavity of said cage body for providing said bone-growth inducing material in said internal cavity of said cage body.

### Claim 19 (depends on 18)

The method as claimed in claim 18, further comprising covering said opening with a cap for retaining said bone-growth inducing material in said internal cavity of said cage body.

### Claim 20 (depends on 19)

The method as claimed in claim 19, wherein said opening at said proximal end of said cage body includes internal threads and said end cap has external threads adapted for meshing with said internal threads of said opening.

### Claim 21 (depends on 14)

The method as claimed in claim 14, wherein said cage body has a longitudinal axis extending between said leading and trailing ends thereof and a transverse axis extending in a direction that is substantially perpendicular to said longitudinal axis, and wherein said plurality of apertures are clustered about said transverse axis.

### Claim 22 (depends on 21)

The method as claimed in claim 21, further comprising turning said cage body between said upper and lower vertebral bodies so that said clustered apertures confront said opposing end faces of said upper and lower vertebral bodies.

### Claim 23 (depends on 14)

The method as claimed in claim 14, wherein said leading end of said cage body has a rounded nose, and said outer surface of said cage body has at least one flute extending from said leading end toward said trailing end of said cage body.

### Claim 24 (depends on 14)

The method as claimed in claim 14, wherein said cage body is devoid of a flange so that said cage body is anchored to said upper and lower vertebral bodies solely by said at least one thread on said outer surface thereof.

### Claim 25 (depends on 14)

The method as claimed in claim 14, wherein said cage body is continuously tapered between said leading end and said trailing end of said cage body.

### Claim 26 (depends on 14)

The method as claimed in claim 14, wherein said at least one thread is a continuous thread extending between said leading and trailing ends of said cage body.