Bone graft delivery system
The present invention relates to an apparatus and method for near-simultaneous and integrated delivery of bone graft material during the placement of surgical cages or other medical implants in a patient's spine. The integrated fusion cage and graft delivery device according to various embodiments delivers and disperses biologic material through a fusion cage to a disc space and, without withdrawal from the surgical site, may selectably detach the fusion cage for deposit to the same disc space. The integrated fusion cage and graft delivery device is formed such that a hollow tube and plunger selectively and controllably place bone graft material and a fusion cage in or adjacent to the bone graft receiving area.
1. A bone graft insertion apparatus comprising:
a hollow tube constructed to receive bone graft, said hollow tube having an extended axis and a proximal end and a distal end, said hollow tube having a rectangular interior cross-section from said proximal end to said distal end, said distal end having a substantially tapered distal tip interior surface and a distal end interior surface of rectangular cross-section, said hollow tube of single-piece construction;
a plunger adapted for inserting into said proximal end of said hollow tube, said plunger having a distal end exterior surface of rectangular cross-section contoured to said distal end interior surface of said hollow tube, said plunger of single-piece construction, said plunger distal end exterior surface of rectangular cross-section forming a substantially congruent fit with said hollow tube rectangular interior cross-section, said plunger having a substantially tapered distal tip contoured to said substantially tapered distal tip interior surface of said hollow tube to form a substantially congruent fit, wherein said hollow tube and said plunger are configured to deliver bone graft material to a graft receiving area through one or more lateral openings near said distal end of said hollow tube, said plunger having an axial length at least sufficient wherein at a least a portion of said plunger distal end is positioned adjacent to said one or more lateral openings when fully inserted into said hollow tube, said one or more lateral openings substantially precluding the delivery of bone graft material directly along said axis of said hollow tube, said plunger precluded from rotating when inserted into said hollow tube.
2. The apparatus according to claim 1 , wherein said hollow tube comprises a ramp located near its distal end.
3. The apparatus according to claim 1 , wherein said distal end of said hollow tube has a curved surface located opposite said at least one opening.
4. The apparatus according to claim 1 , further comprising:
a footing at said distal end of said hollow tube.
5. The apparatus according to claim 1 , further comprising:
a detachable funnel connected to said proximal end of said hollow tube, wherein said detachable funnel facilitates insertion of said bone graft into said hollow tube.
6. The apparatus of claim 1 , wherein said hollow tube has a length and said one or more lateral openings are solely located on a lower half of said length.
7. The apparatus of claim 1 , wherein at least one of said one or more lateral openings is at least one of substantially oval and substantially rectangular.
8. The apparatus of claim 1 , wherein said distal end of at least one of said plunger and said hollow tube are constructed of material more flexible than material comprising said proximal end of said hollow tube.
9. The apparatus of claim 1 , wherein said hollow tube is preloaded with one of bone graft and bone morphogenic protein.
10. The apparatus of claim 1 , wherein said distal end of said hollow tube has at least one opening permitting bone graft material to pass therethrough, said bone graft material passing through said opening along a path having an axis that is at an angle to said axis of said hollow tube, said angle between 2 degrees and 120 degrees.
11. The apparatus of claim 1 , wherein said hollow tube has an angle at its distal end, said angle being between 5 degrees and 35 degrees from the axis of the hollow tube.
12. The apparatus of claim 1 , wherein the hollow tube has at least one telescoping portion.
13. A bone graft insertion apparatus comprising:
a hollow tube having a length, a proximal end and a distal end, said hollow tube having a rectangular interior cross-section from said proximal end to said distal end, said distal end having a tapered tip interior surface and at least one opening, said hollow tube of single-piece construction;
a plunger adapted for insertion within said hollow tube at said proximal end of said hollow tube, said plunger of single-piece construction, said plunger having a distal end exterior surface of rectangular cross-section forming a substantially congruent fit with said hollow tube rectangular interior cross-section, said plunger having a distal tip contoured to conform to the distal end of said hollow tube, said plunger having an axial length at least sufficient wherein at a least a portion of said plunger distal end is positioned adjacent to said one or more lateral openings when fully inserted into said hollow tube, wherein said hollow tube and said plunger are configured to deliver bone graft material to a graft receiving area through one or more lateral openings near said distal end of said hollow tube.
14. The apparatus according to claim 13 , wherein said hollow tube has at least one ramp located near its distal end.
15. The apparatus according to claim 13 , wherein at least one opening is substantially oval.
16. The apparatus according to claim 13 , wherein said at least opening is located on a lateral side of said hollow tube.
17. The apparatus according to claim 13 , further comprising:
a funnel located at said proximal end of said hollow tube.
18. The apparatus of claim 13 , wherein said hollow tube has a curved surface located opposite to said at least one opening.
19. A bone graft insertion apparatus comprising:
a hollow tube constructed to receive bone graft having an extended axis, a length, a proximal end and a distal end, said hollow tube having a rectangular interior cross-section from said proximal end to said distal end, said distal end having a tapered tip interior surface with a terminus and two oval-shaped openings having an upper and a lower end located on opposite lateral sides of said distal end, said tapered tip extending into said hollow tube and said terminus positioned adjacent to said oval-shaped openings, said hollow tube of single-piece construction;
a plunger adapted for insertion within said hollow tube at said proximal end of said hollow tube, said plunger having a distal lower surface, said plunger of single-piece construction, said plunger having a distal end exterior surface of rectangular cross-section forming a substantially congruent fit with said hollow tube rectangular interior cross-section, said plunger having a length sufficient such that when fully inserted into said hollow tube, said plunger distal lower surface contacts said hollow tube terminus at a position adjacent to said oval-shaped openings, said plunger rectangular cross-section end portion forming a continuous surface adjacent each of the oval-shaped openings from a position opposite said terminus to a point extending beyond said upper end of each oval-shaped opening;
wherein said hollow tube and said plunger are configured to deliver bone graft material to a graft receiving area through said two oval-shaped openings near said distal end of said hollow tube, said oval-shaped openings precluding the delivery of bone graft material directly along said axis of said hollow tube, said plunger precluded from rotating when inserted into said hollow tube;
wherein said oval-shaped openings near the distal end of said hollow tube are positioned within a 25% length from said distal end relative to a total length of said hollow tube.