Stabilized laterovertically-expanding fusion cage systems with tensioner
An intervertebral scaffolding system is provided having a laterovertically-expanding frame operable for a reversible collapse from an expanded state into a collapsed state, the laterovertically-expanding frame having a stabilizer, one or more tensioners, or a combination of the stabilizer with one or more tensioners. The stabilizer slidably engages with the distal region of the laterovertically-expanding frame and both the stabilizer and the one or more tensioners are configured for retaining the laterovertically-expanding frame from a lateral movement that exceeds the expanded state. The expanded state, for example, can be configured to have an open graft distribution window that at least substantially closes upon the reversible collapse.
1 . An intervertebral scaffolding system, comprising;
a central beam comprising one or more bone graft distribution ports; and
a laterovertically-expanding frame configured to be inserted into an intervertebral space in vivo and configured to expand between a collapsed state and an expanded state, wherein the central beam is inserted into the frame in the expanded state; the frame comprising:
a proximal portion having an end, a distal portion having an end, and a central frame axis;
a first top beam including a proximal portion having an end and a distal portion having an end, a central axis at least substantially on (i) a top plane containing the central axis of the first top beam and a central axis of a second top beam and (ii) a first side plane containing the central axis of the first top beam and a central axis of a first bottom beam;
the second top beam including a proximal portion having an end and a distal portion having an end, the central axis of the second top beam at least substantially on (i) the top plane and (ii) a second side plane containing the central axis of the second top beam and a central axis of a second bottom beam;
the first bottom beam including a proximal portion having an end and a distal portion having an end, the central axis of the first bottom beam at least substantially on (i) a bottom plane containing the central axis of the first bottom beam and the central axis of the second top beam and (ii) the first side plane;
the second bottom beam including a proximal portion having an end and a distal portion having an end, the central axis of the second bottom beam at least substantially on (i) the bottom plane and (ii) a second side plane containing the central axis of the second bottom beam and the central axis of the second top beam;
a plurality of flexible top connector elements configured to expandably connect the first top beam to the second top beam, the expanding consisting of a flexing at least substantially on the top plane;
a plurality of flexible bottom connector elements configured to expandably connect the first bottom beam to the second bottom beam, the expanding consisting of a flexing at least substantially on the bottom plane;
a plurality of flexible first side connector elements configured to expandably connect the first top beam to the first bottom beam, the expanding consisting of a flexing at least substantially on the first side plane;
a plurality of flexible second side connector elements configured to expandably connect the second top beam to the second bottom beam, the expanding consisting of a flexing at least substantially on the second side plane;
a top tensioner operably attaching the first top beam to the second top beam;
a bottom tensioner operably attaching the first bottom beam to the second bottom beam; and,
a stabilizer that slidably engages with the distal portion of the first top beam, the first bottom beam, the second top beam, and the second bottom beam, and is configured for retaining the first top beam, the first bottom beam, the second top beam, and the second bottom beam from a lateral movement that exceeds the expanded state;
wherein, the connector elements are configured to maintain structural stiffness in the laterovertically-expanding frame.
2 . The scaffolding system of claim 1 , wherein the stabilizer is in an X-configuration having a first top leg for slidably-engaging with the first top beam at an angle Θ 1T with the lateral movement of the first top beam, a first bottom leg for slidably engaging with the first bottom beam at an angle Θ 1B with the lateral movement of the first bottom beam, a second top leg for slidably engaging with the second top beam at an angle Θ 2T with the lateral movement of the second top beam, and a second bottom leg for slidably engaging with the second bottom beam at an angle Θ 2B with the lateral movement of the second bottom beam, wherein each of the angles Θ 1T , Θ 1B , Θ 2T , Θ 2B , respectively, provide a tensile force for resisting the first top beam, the first bottom beam, the second top beam, and the second bottom beam from the lateral movement that exceeds the expanded state.
3 . The scaffolding system of claim 1 , wherein the stabilizer is in an X-configuration having a first top leg for slidably-engaging with the first top beam at an angle Θ 1T with the lateral movement of the first top beam, a first bottom leg for slidably engaging with the first bottom beam at an angle Θ 1B with the lateral movement of the first bottom beam, a second top leg for slidably engaging with the second top beam at an angle Θ 2T with the lateral movement of the second top beam, and a second bottom leg for slidably engaging with the second bottom beam at an angle Θ 2B with the lateral movement of the second bottom beam, wherein each of the angles Θ 1T , Θ 1B , Θ 2T , Θ 2B , respectively, provide a tensile force for resisting the first top beam, the first bottom beam, the second top beam, and the second bottom beam from the lateral movement that exceeds the expanded state; wherein, the stabilizer further comprises a point of attachment for releasably attaching a guidewire for guiding the central beam into the laterovertically-expanding frame.
4 . The scaffolding system of claim 1 , wherein the stabilizer is in an X-configuration having a first top leg for slidably-engaging with the first top beam at an angle Θ 1T with the lateral movement of the first top beam, a first bottom leg for slidably engaging with the first bottom beam at an angle Θ 1B with the lateral movement of the first bottom beam, a second top leg for slidably engaging with the second top beam at an angle Θ 2T with the lateral movement of the second top beam, and a second bottom leg for slidably engaging with the second bottom beam at an angle Θ 2B with the lateral movement of the second bottom beam, wherein each of the angles Θ 1T , Θ 1B , Θ 2T , Θ 2B , respectively, provide a tensile force for resisting the first top beam, the first bottom beam, the second top beam, and the second bottom beam from the lateral movement that exceeds the expanded state; wherein, the first top leg, the first bottom leg, the second top leg, and the second bottom leg converge to form a hub having a point of attachment for releasably attaching a guidewire for guiding the central beam into the laterovertically-expanding frame.
5 . The scaffolding system of claim 1 , wherein the stabilizer is in an H-configuration having a first vertical leg, a second vertical leg, and a cross-member that connects the first vertical leg at least substantially parallel to the second vertical leg, the first vertical leg including a retaining surface for engaging with the first top beam and the first bottom beam, the second vertical leg including a retaining surface for engaging with the second top beam and the second bottom beam, and the cross member providing a tensile force for resisting the first top beam, the first bottom beam, the second top beam, and the second bottom beam from the lateral movement that exceeds the expanded state.
6 . The scaffolding system of claim 1 , wherein the stabilizer is in an H-configuration having a first vertical leg, a second vertical leg, and a cross-member that connects the first vertical leg at least substantially parallel to the second vertical leg, the first vertical leg including a retaining surface for engaging with the first top beam and the first bottom beam, the second vertical leg including a retaining surface for engaging with the second top beam and the second bottom beam, and the cross member providing a tensile force for resisting the first top beam, the first bottom beam, the second top beam, and the second bottom beam from the lateral movement that exceeds the expanded state; wherein, the central beam comprises a horizontal groove configured complementary to the cross-member of the stabilizer, and the horizontal groove of the central beam slidably connects with the cross-member in the expanded state.
7 . The scaffolding system of claim 1 , wherein the stabilizer is in an H-configuration having a first vertical leg, a second vertical leg, a cross-member that connects the first vertical leg at least substantially parallel to the second vertical leg, the first vertical leg including a retaining surface for engaging with the first top beam and the first bottom beam, the second vertical leg including a retaining surface for engaging with the second top beam and the second bottom beam, and the cross member providing a tensile force for resisting the first top beam, the first bottom beam, the second top beam, and the second bottom beam from the lateral movement that exceeds the expanded state; wherein, the cross-member further comprises a vertical support member, the central beam having a vertical groove configured complementary to the vertical support member of the stabilizer, and the vertical groove of the central beam slidably connects with the vertical support member in the expanded state.
8 . The scaffolding system of claim 1 , wherein the stabilizer is in an H-configuration having a first vertical leg, a second vertical leg, a cross-member that connects the first vertical leg at least substantially parallel to the second vertical leg, the first vertical leg including a retaining surface for engaging with the first top beam and the first bottom beam, the second vertical leg including a retaining surface for engaging with the second top beam and the second bottom beam, and the cross member providing a tensile force for resisting the first top beam, the first bottom beam, the second top beam, and the second bottom beam from the lateral movement that exceeds the expanded state; wherein, the stabilizer further comprises a point of attachment for releasably attaching a guidewire adapted for guiding the central beam into the laterovertically-expanding frame.
9 . The scaffolding system of claim 1 , wherein the stabilizer is in an H-configuration having a first vertical leg, a second vertical leg, a cross-member that connects the first vertical leg at least substantially parallel to the second vertical leg, the first vertical leg including a retaining surface for engaging with the first top beam and the first bottom beam, the second vertical leg including a retaining surface for engaging with the second top beam and the second bottom beam, and the cross member providing a tensile force for resisting the first top beam, the first bottom beam, the second top beam, and the second bottom beam from the lateral movement that exceeds the expanded state; wherein, the cross-member includes a first pillar and a second pillar that operably connect at a hub that has a point of attachment for releasably attaching a guidewire for guiding the central beam into the laterovertically-expanding frame.
10 . The scaffolding system of claim 1 , further comprising a grafting port.
11 . The scaffolding system of claim 1 , wherein each connector element is a strut; and wherein, the top struts are monolithically integral to the first top beam and the second top beam; the bottom struts are monolithically integral to the first bottom beam and the second bottom beam; the top tensioner is monolithically integral to the first top beam and the second top beam; and the bottom tensioner is monolithically integral to the first bottom beam and the second bottom beam; wherein, the top struts and the bottom struts are each configured to define a graft distribution window upon expansion, extending from the first top beam to the second top beam, the first top beam to the first bottom beam, the second top beam to the second bottom beam, or the first bottom beam to the second bottom beam.
12 . The scaffolding system of claim 1 , wherein the top struts are monolithically integral to the first top beam and the second top beam; the bottom struts are monolithically integral to the first bottom beam and the second bottom beam; the first side struts are monolithically integral to the first top beam and the first bottom beam; the second side struts are monolithically integral to the second top beam and the second bottom beam; the top tensioner is monolithically integral to the first top beam and the second top beam; and, the bottom tensioner is monolithically integral to the first bottom beam and the second bottom beam; wherein the laterovertically-expanding frame is formed monolithically.
13 . A method of fusing an intervertebral space using the intervertebral scaffolding system of claim 1 , the method comprising:
creating a point of entry into an intervertebral disc, the intervertebral disc having a nucleus pulposus surrounded by an annulus fibrosis;
removing the nucleus pulposus from within the intervertebral disc through the point of entry, leaving the intervertebral space for expansion of the intervertebral scaffolding system of claim 1 within the annulus fibrosis, the intervertebral space having a top vertebral plate and a bottom vertebral plate;
inserting the laterovertically-expanding frame in the collapsed state through the point of entry into the intervertebral space;
expanding the laterovertically-expanding frame to form the scaffolding system; and, adding a grafting material to the intervertebral space.
14 . The method of claim 13 , wherein the point of entry comprises a lateral dimension comprising a width ranging from 5 mm to 15 mm, wherein the amount of lateral expansion is selected to exceed the lateral dimension of the point of entry.
15 . The method of claim 13 , wherein the step of expanding includes expanding the laterovertically-expanding frame laterally to a width that exceeds the width of the point of entry; and, expanding the laterovertically-expanding frame vertically to support the intervertebral space in the expanded state.
16 . The method of claim 13 , wherein the step of expanding includes inserting the central beam and engaging a means for preventing the central beam from backing out of the laterovertically-expanding frame after the expanding.
17 . A kit, comprising:
the intervertebral scaffolding system of claim 1 ;
a cannula for inserting the intervertebral scaffolding system into the intervertebral space; and,
a guidewire adapted for guiding the central beam into the laterovertically-expanding frame.
18 . A kit, comprising:
the intervertebral scaffolding system of claim 2 ;
a cannula for inserting the intervertebral scaffolding system into the intervertebral space; and,
a guidewire adapted for guiding the central beam into the laterovertically-expanding frame.
19 . A kit, comprising:
the intervertebral scaffolding system of claim 4 ;
a cannula for inserting the intervertebral scaffolding system into the intervertebral space; and,
a guidewire adapted for guiding the central beam into the laterovertically-expanding frame.
20 . A kit, comprising:
the intervertebral scaffolding system of claim 6 ;
a cannula for inserting the intervertebral scaffolding system into the intervertebral space; and,
a guidewire adapted for guiding the central beam into the laterovertically-expanding frame.