Posterio spinal device and method
An intervertebral joint assembly includes an upper support and a lower support, each of which has two or more components. The upper and lower support components are arranged in situ to form the upper and lower supports, respectively. By arranging the supports in situ, the supports can be introduced from the back of the patient, for example with an arthroscope. Each of the upper and lower supports has a surface adapted to engage a vertebra and a surface adapted to engage the other support or an intermediate member to form an articulate joint which articulates the joint assembly. In some embodiments, the components of the upper and lower supports are assembled in situ, for example with pivoting, telescoping or bending, to form the upper and lower supports, respectively. The supports can be attached to vertebrae with pedicles screws, and/or other anchors attached to the supports.
1. A method for assembling an intervertebral implant in situ, the method comprising:
introducing an implantable member into an intervertebral space from a posterior side thereof, while the implantable member is in a narrow profile, wherein the implantable member has a first segment, a second segment, and a third segment, wherein the first segment is coupled to the second segment with a first pivot joint and the second segment is coupled to the third segment with a second pivot joint; and
sequentially pivoting the first segment to form an acute angle with respect to the second segment then pivoting the third segment to form an acute angle with respect to the second segment such that each of the first, second, and third segments is not parallel with the other segments and the three segments together form three sides of a triangle to deploy the implantable member from the narrow profile to a wide profile.
2. The method of claim 1 , wherein the step of sequentially pivoting is performed by an insertion instrument removably attached to the implantable member and configured to sequentially pivot the first and third segments with respect to the second segment after insertion of the implantable member into a body of a patient.
3. The method of claim 2 , further comprising removing the insertion instrument from the implantable member when the implantable member is in the wide profile.
4. The method of claim 1 , wherein the implantable member is inserted into the intervertebral space from an opening in a spinal disc annulus posteriorly.
5. The method of claim 1 , wherein the sequential pivoting of the first and third segments is limited by first and second stops which limit the pivoting of the first and third segments.
6. The method of claim 1 , wherein the first, second and third segments are retained in the narrow profile by an insertion instrument while the implantable member is inserted into the intervertebral space.
7. The method of claim 1 , wherein the implantable member is a posterior artificial intervertebral disc introduced into the intervertebral space from a posterior lateral approach.
8. The method of claim 1 , wherein the first pivot joint has a first pivot axis extending through the first segment and the second segment and the second pivot joint has a second pivot axis extending through the second segment and the third segment.
9. The method of claim 8 , wherein the first pivot joint comprises a first aperture, the first pivot axis extending through the first aperture and wherein the second pivot joint comprises a second aperture, the second pivot axis extending through the second aperture.
10. The method of claim 8 , wherein each of the segments has a first surface shaped to contact a first vertebra and a second surface shaped to contact a second vertebra and wherein the first and second pivot axes extend through the first and second vertebrae when the first surface contacts the first vertebra and the second surface contacts the second vertebra.
11. The method of claim 10 , wherein the first segment has first pyramidal anchors and the second segment has second pyramidal anchors and the third segment has third pyramidal anchors and wherein the first pivot axis extends between the first pyramidal anchors and the second pyramidal anchors and the second pivot axis extends between the second pyramidal anchors and the third pyramidal anchors.
12. A method of treating a patient having upper and lower vertebrae and an intervertebral space between the upper and lower vertebrae, the method comprising:
providing an implantable assembly comprising a first segment, a second segment and a third segment, the first segment pivotally connected to the second segment with a first pivot joint, the second segment connected to the third segment with a second pivot joint;
introducing the first segment into intervertebral space when the first segment, the second segment and the third segment are arranged in an elongate configuration;
pivoting the first segment about the first pivot joint when the first segment is introduced into the intervertebral space; and
pivoting the third segment about the second pivot joint when the third segment is introduced into the intervertebral space, such that each of the first, second, and third segments is not parallel with each of the other segments so as to form a non-parallel arrangement, wherein the first, second, and third segments form the three sides of a triangle so that the non-parallel arrangement is a triangular arrangement, and such that the implantable assembly supports the upper and lower vertebrae when placed in the intervertebral space.
13. The method of claim 12 wherein the first pivot joint has a first pivot axis and the second pivot joint has a second pivot axis and wherein the first pivot axis extends through the first segment and the second segment and wherein the second pivot axis extends through the second segment and the third segment.
14. The method of claim 13 wherein the first pivot axis and the second pivot axis extend along an inferior/superior orientation with respect to the upper and lower vertebrae of the patient.
15. The method of claim 14 wherein the first pivot axis and the second pivot axis extend through the upper and lower vertebrae when the first segment, the second segment and the third segment are placed in the intervertebral space.