Methods and instruments for delivering intervertebral devices
A method comprises selecting an intervertebral implant having a predetermined shape with a height dimension and a width dimension. The implant further comprises an empty or partially filled reservoir. The method further comprises selecting a deformation instrument and inserting the intervertebral implant into the deformation instrument. The deformation instrument comprises at least one joint for moving the deformation instrument between an expanded state and a collapsed state. The method further comprises placing the intervertebral implant in the deformation instrument while in the expanded state and activating the at least one joint to move the deformation instrument into a collapsed state. The method further comprises collapsing the reservoir to reduce one of the dimensions of the implant and moving the implant from the deformation instrument into an intervertebral disc space. The implant is allowed to expand substantially to the predetermined shape within the intervertebral disc space. The method further comprises filling the reservoir and maintaining within the reservoir a volume of filling material.
1 . A method comprising:
selecting an intervertebral implant having a predetermined shape with a height dimension and a width dimension and comprising an empty or partially filled reservoir;
selecting a deformation instrument;
inserting the intervertebral implant into the deformation instrument, wherein the deformation instrument comprises at least one joint for moving the deformation instrument between an expanded state and a collapsed state;
placing the intervertebral implant in the deformation instrument while in the expanded state;
activating the at least one joint to move the deformation instrument into a collapsed state;
collapsing the reservoir to reduce one of the dimensions of the implant;
moving the implant from the deformation instrument into an intervertebral disc space;
allowing the implant to expand substantially to the predetermined shape within the intervertebral disc space; and
filling the reservoir and maintaining within the reservoir a volume of filling material.
2 . The method of claim 1 wherein the deformation instrument comprises at least three joints.
3 . The method of claim 1 further comprising lubricating the deformation instrument.
4 . The method of claim 1 further comprising locking the joint in the collapsed state.
5 . The method of claim 1 wherein the step of activating the joint further comprises sliding a guide tube along the deformation instrument to activate the joint.
6 . The method of claim 1 wherein the implant further comprises an outer portion surrounding the reservoir, the outer portion having an outer portion volume and further wherein the outer portion volume is greater than the volume of filling material.
7 . The method of claim 1 wherein the implant further comprises an outer portion surrounding the reservoir, the outer portion adapted to support a maximum first load and further wherein the volume of filling material is adapted to support a maximum second load less than the maximum first load.
8 . The method of claim 1 wherein the predetermined shape is spherical.
9 . The method of claim 1 wherein the predetermined shape is kidney shaped.
10 . The method of claim 1 wherein the implant further comprises a center portion and opposite arm portions and wherein the opposite arms are folded toward the center portion when in the predetermined shape.
11 . The method of claim 10 wherein the opposite arms extend away from the center portion when the reservoir is collapsed.
12 . The method of claim 1 wherein the step of filling the reservoir comprises injecting the volume of settable filling material.
13 . The method of claim 1 wherein the filling material is an elastomer.
14 . The method of claim 1 wherein the filling material is a hydrogel.
15 . The method of claim 1 wherein the filling material is a curable rigid polymer.
16 . The method of claim 1 wherein the filling material sets to a non-fluid consistency.
17 . A method for treating an intervertebral disc space comprising:
selecting an elastic body, the body having a first end, a second end, a central portion, and a first configuration wherein said first end and said second end are positioned adjacent to said central portion to form at least one inner fold, wherein the elastic body comprises a reservoir for receiving a filling material;
inserting the elastic body into a deformation instrument;
collapsing the reservoir of the elastic body with the deformation instrument to configure the elastic body into a second, straightened configuration;
inserting the elastic body in the second, straightened configuration through an opening in an intervertebral disc annulus fibrosis into the intervertebral disc space, wherein the body returns to said first configuration after said insertion; and
filling the reservoir and maintaining within the reservoir a filling material.
18 . The method of claim 17 wherein the step of collapsing the reservoir collapses the height of the elastic body.
19 . The method of claim 17 wherein the step of collapsing the reservoir collapses the width of the elastic body.
20 . The method of claim 17 wherein the deformation instrument comprises a joint for moving the deformation instrument between an expanded state and a collapsed state and the step of collapsing the reservoir of the elastic body with the deformation instrument includes actuating the joint to move the deformation instrument from the expanded state to the collapsed state.
21 . The method of claim 17 wherein the elastic body has a surface that includes wrinkles, indents or projections that relieve stress and prevent cracking or tearing of the implant when the implant is straightened for implantation.
22 . The method of claim 17 wherein the filling material sets to a non-fluid consistency after entering the reservoir.
23 . A system for implanting an intervertebral implant into an intervertebral disc space, the system comprising:
a deformation instrument adapted to receive the implant and adapted to deform an inner reservoir of the implant from an uncollapsed state to a collapsed state;
an insertion instrument adapted move the implant from the deformation instrument to the intervertebral disc space; and
an injection instrument adapted to receive a volume of filling material and adapted to dispense the volume of filling material into the inner reservoir.
24 . The system of claim 23 wherein the deformation instrument comprises a jointed body having a maximized configuration for receiving the implant and a minimized configuration for deforming the reservoir to the collapsed state.
25 . The system of claim 24 wherein the jointed body includes at least two joints.
26 . The system of claim 23 wherein the deformation instrument comprises a guide tube configured to receive the deformation instrument.
27 . The system of claim 23 wherein the deformation instrument comprises a clamping portion movable by a joint mechanism.
28 . An intervertebral implant for replacing at least part of a natural nucleus pulposus, the implant comprising:
an outer elastic body having a body volume, a predetermined height and a predetermined width;
at least one inner reservoir located at least partially within the outer elastic body; and
a volume of settable filling material for filling the inner reservoir;
wherein the body volume is greater than volume of filling material.
29 . The implant of claim 28 wherein the outer elastic body is firmer than the filling material.
30 . The implant of claim 28 wherein the filling material develops a consistency firmer than the outer elastic body.
31 . The implant of claim 28 wherein the volume of filling material is curable in situ.
32 . The implant of claim 28 further comprising a self-sealing valve.
33 . The implant of claim 28 further comprising a central portion and a pair of opposite arms, wherein the implant has a deformed state in which the opposite arms extend away from the central portion and a undeformed state in which the opposite arms fold in toward the central portion.
34 . The implant of claim 28 wherein the filling material is an elastomer.
35 . The implant of claim 28 wherein the filling material is a hydrogel.
36 . The implant of claim 28 wherein the filling material is a rigid polymer after setting.
37 . The implant of claim 28 wherein the filling material is injectable through a syringe.
38 . The implant of claim 28 wherein the implant has a collapsed state in which the collapsed height is smaller than the predetermined height.
39 . The implant of claim 28 wherein the implant has a collapsed state in which the collapsed width is smaller than the predetermined width.