Expandable spinal fusion device and methods of promoting spinal fusion
An intervertebral disc space implant includes spaced-apart bone engagement portions that define an intermediate chamber that holds bone growth inducing material into contact with adjacent vertebral bodies. The implant is expandable to establish and maintain desired intervertebral spacing during fusion. The implant includes a first member and a second member arranged to move relative to each other by action of an expansion member, the first member being engageable with the vertebral body below the disc space.
1. An expandable spinal implant positionable in an intervertebral disc space between adjacent vertebral bodies in a spine and comprising:
a first member for contacting an endplate of one of the adjacent vertebral bodies, the first member defining a first bore, the first bore having a first threaded bore portion;
a second member for contacting an endplate of the other of the adjacent vertebral bodies;
a screw having a first threaded screw portion and a gear tooth screw portion, the first threaded screw portion being at least partially threaded into the first bore, the screw contacting the second member in a manner permitting the screw to rotate;
an axle having a threaded axle portion, the threaded axle portion contacting the gear tooth screw portion such that rotation of the axle moves the first and second members from a first relative spacing to a second relative spacing, to simultaneously expand the implant in the intervertebral space and against the endplates; and
a locking cap having a first protruding element capable of engaging the axle and a second protruding element configured for disposal in an aperture in one of the first member and the second member to prevent the axle from rotating.
2. The implant of claim 1 and further comprising:
a third member for contacting the endplate of the one of the adjacent vertebral bodies, the third member having a bore;
a fourth member for contacting the endplate of the other of the adjacent vertebral bodies;
a second screw having a threaded screw portion and a gear tooth screw portion, the threaded screw portion of the second screw being at least partially threaded into the bore of the third member, and the second screw contacting the fourth member in a manner permitting the second screw to rotate;
the first member and the second member being spaced apart from the third member and the fourth member, respectively, for defining in the intervertebral disc space between the adjacent vertebral bodies, walls of an intermediate chamber in communication with said endplates of both of the adjacent vertebral bodies.
3. The implant of claim 2 and further comprising:
a bone growth inducing material disposed in the space between the first and third member and in the space between the second and fourth member for communication through the chamber with the said endplates of both adjacent vertebral bodies.
4. The implant of claim 1 wherein:
the second member defines a second bore;
the screw is partially disposed within said second bore.
5. The implant of claim 4 wherein:
the second bore has a second threaded bore portion; and
the screw has a second threaded screw portion, the second threaded screw portion being at least partially threaded into the second bore.
6. The implant of claim 5 wherein:
the screw is one of a plurality of screws having threaded screw portions and gear tooth portions;
the first bore is one of a first plurality of bores defined by the first member;
the second bore is one of a second plurality of bores defined by the second member;
each of the screws has its first threaded screw portion at least partially threaded into one of the first plurality of bores, and each of the screws has its second threaded screw portion at least partially threaded into one of the second plurality of bores;
the threaded axle region contacts the gear tooth portion of each of the screws.
7. A method of promoting osteogenic fusion of adjacent spinal vertebral bodies comprising:
providing an implant that defines a chamber intermediate spaced portions of the implant and both of the adjacent vertebral bodies wherein the implant expands by adjusting a screw having a first threaded screw portion at least partially threaded into one of a first plurality of bores in the implant such that the screw contacts a spinal vertebral body in a manner permitting the screw to rotate, and a gear tooth portion which contacts a threaded axle region in an axle within the implant such that rotation of the axle expands the implant;
providing the implant substantially intermediate the adjacent vertebral bodies;
expanding the implant in a manner that substantially maintains communication of the adjacent vertebral bodies through the intermediate chamber; and
connecting a locking cap having a first protruding element configured for engaging the axle and a second protruding element configured for disposal in an aperture in the implant to prevent the axle from rotating.
8. The method of claim 7 further comprising:
placing osteogenic fusion promoting material into the chamber.
9. The method of claim 8 wherein:
at least a portion of the osteogenic fusion promoting material is bone.
10. The method of claim 8 wherein:
one of the spaced portions comprises a first end portion, one of the spaced portions comprises a second end portion and the implant includes an elongate central portion extending intermediate the first and second end portions, with the central portion of the implant extending intermediate the first and second end portions and through the chamber; and
the fusion promoting material is selected from a group including bone chips, demineralized bone matrix, hydroxy apatite, and calcium phosphate.
11. The method of claim 10 and wherein:
expanding the implant is performed by changing its state from a first state to a second state by changing the height of the implant in the space between the adjacent vertebral bodies without translation of the implant relative to the vertebral bodies.