Drilling/milling guide and keel cut preparation system
View Patent ↗An instrument system, associated milling or drilling guide and method include use of a trial implant of a size corresponding to an actual implant for the intervertebral space, with a milling guide mounted on the trial implant. The system also includes a cutting tool which is used to form a cutout in an adjacent vertebra.
1. A milling guide for use with an instrument system for preparing an intervertebral space defined by two adjacent vertebrae, the instrument system including a trial head sized to be received in the intervertebral space, the milling guide comprising:
a milling guide body defining a proximal end and a distal end that is spaced from the proximal end along a first direction, the milling guide configured to be supported relative to the trial head;
a chamber coupled to the milling guide body, the chamber being elongate along the first direction; and
a pivot element coupled to the milling guide body and defining a channel that extends through the pivot element such that the channel is configured to at least partially receive a tool for preparing at least one of the two adjacent vertebrae, the pivot element configured to pivot relative to the milling guide body about a pivot axis that extends through both the milling guide body and the channel in a second direction that is substantially transverse to the first direction,
wherein the pivot element is configured to pivot about the pivot axis when 1) the milling guide is supported relative to the trial head, and 2) when the trial head is received in the intervertebral space.
2. The milling guide as in claim 1 , further comprising a pin that extends from the milling guide body to the pivot element in the second direction so as to pivotally couple the pivot element to the milling guide body.
3. The milling guide as in claim 2 , wherein the pivot element comprises an elongate member, wherein the elongate member is coupled to the pin.
4. The milling guide as in claim 1 , wherein the proximal end of the milling guide body comprises a bearing mechanism coupling the milling guide body to the pivot element, where the bearing mechanism defines the pivot axis when the tool is at least partially received in the pivot element.
5. The milling guide as in claim 4 , wherein the bearing mechanism is a movable bearing mounted in the proximal end of the milling guide body.
6. The milling guide as in claim 1 , wherein the chamber defines an inner shape that is at least partially tapered.
7. The milling guide as in claim 1 , wherein the chamber defines an inner shape that is generally cylindrical.
8. The milling guide as in claim 1 , wherein the milling guide body defines a first end and a second end that is spaced from the first end along a third direction that is substantially perpendicular to the first direction and the second direction, wherein the pivot element is disposed on either the first end or second end of the milling guide body, and wherein the chamber is disposed on the other of the first end or the second end of the milling guide body.
9. The milling guide of claim 1 , further comprising:
a second pivot element pivotally coupled to the milling guide body and configured to at least partially receive the tool or another tool, the second pivot element configured to pivot relative to the first pivot element about a second pivot axis that extends in the second direction,
wherein the second pivot element is configured to pivot about the second pivot axis when 1) the milling guide is supported relative to the trial head, and 2) when the trial head is received in the intervertebral space.
10. The milling guide as in claim 9 , further comprising a pin pivotally coupling the pivot element to the milling guide body.
11. The milling guide as in claim 10 , further comprising a second pin pivotally coupling the second pivot element to the milling guide body.
12. The milling guide as in claim 10 , wherein the pivot element comprises an elongate member, wherein the elongate member is coupled to the pin.
13. The milling guide as in claim 11 , wherein the second pivot element comprises a second elongate member, wherein the second elongate member is coupled to the second pin.
14. The milling guide as in claim 9 , further comprising a second chamber coupled to the milling guide body, the second chamber being elongate along the first direction.
15. The milling guide as in claim 14 , wherein the second chamber defines an inner shape that is at least partially tapered.
16. The milling guide as in claim 14 , wherein the second chamber defines an inner shape that is generally cylindrical.
17. The milling guide as in claim 9 , wherein the milling guide defines a first end and a second end that is spaced from the first end along a third direction that is substantially perpendicular to the first direction and the second direction, wherein the first pivot element is disposed on either the first end or second end of the milling guide body, and wherein the second pivot element is disposed on the other of the first end or the second end of the milling guide body.
18. The milling guide as in claim 9 , wherein the proximal end of the milling guide body comprises a bearing mechanism coupling the milling guide body to the pivot element, where the bearing mechanism defines the pivot axis when the tool is at least partially received in the pivot element.
19. A milling guide for use with an instrument system for preparing an intervertebral space defined by two adjacent vertebrae, the instrument system including a trial head sized to be received in the intervertebral space, the milling guide comprising:
a milling guide body defining a proximal end and a distal end that is spaced from the proximal end along a first direction, the milling guide configured to be supported relative to the trial head;
a chamber coupled to the milling guide body, the chamber being elongate along the first direction; and
a pivot element coupled to the milling guide body and configured to at least partially receive a tool for preparing at least one of the two adjacent vertebrae, the pivot element configured to pivot relative to the chamber about a pivot axis that extends in a second direction that is substantially transverse to the first direction,
wherein the milling guide body defines a first end and a second end that is spaced from the first end along a third direction that is substantially perpendicular to the first direction and the second direction, the pivot element is disposed on either the first end or second end of the milling guide body, and the chamber is disposed on the other of the first end or the second end of the milling guide body, and wherein the pivot element is configured to pivot about the pivot axis when 1) the milling guide is supported relative to the trial head, and 2) the trial head is received in the intervertebral space.
20. The milling guide as in claim 19 , further comprising a pin pivotally coupling the pivot element to the milling guide body.
21. The milling guide as in claim 20 , wherein the pivot element comprises an elongate member, wherein the elongate member is coupled to the pin.
22. The milling guide as in claim 19 , wherein the proximal end of the milling guide body comprises a bearing mechanism coupling the milling guide body to the pivot element, where the bearing mechanism defines the pivot axis when the tool is at least partially received in the pivot element.
23. The milling guide as in claim 22 , wherein the bearing mechanism is a movable bearing mounted in the proximal end of the milling guide body.
24. The milling guide as in claim 19 , wherein the chamber defines an inner shape that is at least partially tapered.
25. The milling guide as in claim 19 , wherein the chamber defines an inner shape that is generally cylindrical.
26. The milling guide of claim 19 , further comprising:
a second pivot element pivotally coupled to the milling guide body and configured to at least partially receive the tool or another tool, the second pivot element configured to pivot relative to the first pivot element about a second pivot axis that extends in the second direction,
wherein the second pivot element is configured to pivot about the second pivot axis when 1) the milling guide is supported relative to the trial head, and 2) when the trial head is received in the intervertebral space.