Lateral approach expandable spinal implant and method
View Patent ↗An expandable interbody fusion device configured for placement into the intradiscal space between vertebral bodies in a lumbar spine from a lateral approach. The device is expanded by the insertion of a plurality of wafers into the device in situ. The length of the device is configured to extend on the vertebral body endplate from pedicle to pedicle and to reside interiorly of the ring apophysis with at least a portion of the device resting on the area of increased bone density at the posterior portion of the endplate between the pedicles.
1. A method of inserting an expandable interbody fusion device from the lateral approach into the intradiscal space of the lumbar spine, the intradiscal space being divided by a transverse centerline extending across the lateral width of said intradiscal space that defines an anterior portion and a posterior portion, comprising the steps of:
providing an access corridor to the spine from the lateral approach;
providing an elongate expandable device having a length and a width, said length being less than the lateral width of the vertebral endplate interiorly between the peripheral ring apophysis and not less than the pedicle-to pedicle spacing of the vertebral body;
inserting said device into the intradiscal space between opposing vertebral bodies entirely within the interior of said ring apophysis of said endplate with at least a portion of the width of said device being disposed in the anterior portion of said intradiscal space and a greater portion of the width of said device being disposed in the posterior portion of said intradiscal space and residing on the area of endplate increased bone density at the posterior portion of the endplates between the pedicles; and then
expanding the expandable device in situ to increase the height of the intradiscal space and stabilize the spine.
2. The method of claim 1 , wherein said elongate expandable device comprises a superior endplate, an inferior endplate and an expansion structure therebetween, and wherein said expansion structure is expanded to increase the height of said device.
3. The method of claim 2 , wherein said expansion structure comprises a plurality of elements that are introduced into said device individually consecutively to form a stack of elements between said superior endplate and said inferior endplate.
4. The method of claim 2 , wherein the height of said device is increased from an unexpanded height to an expanded height, said expanded height being at least 50% greater than said unexpanded height.
5. The method of claim 1 , further including the step of nerve monitoring during the creation of said access corridor.
6. The method of claim 5 , further including the step of dilating said access corridor.
7. The method of claim 6 , further including the step of enlarging the access corridor, and wherein said device is inserted through said enlarged access corridor.
8. The method of claim 1 , wherein a bone filler is inserted into said intradiscal space adjacent said expanded device.
9. The method of claim 8 , wherein said bone filler is a bone graft and is injected under pressure to stress load the bone graft against the vertebral endplates of opposing vertebral bodies communicating with said intradiscal space.
10. The method of claim 9 , wherein said bone graft is placed prior to insertion of device.
11. The method of claim 9 , wherein after insertion of said device said bone graft is placed adjacent the device only in said anterior portion of said intradiscal space.