Expandable intervertebral device and tool for inserting same
An expandable interbody device for implantation within an intervertebral space is provided, together with methods and tools for use therewith. The interbody devices include a leading first and trailing second bearing member configured to expand laterally via connecting portions disposed at the trailing end of the first being member and at least the leading end of the second bearing member. In some forms, the connecting portions have an arcuate configuration. The insertion tool is configured expand the interbody device by holding the first bearing member while shifting the second bearing member.
1. An expandable intervertebral device for implantation within an intervertebral space between adjacent vertebrae, the expandable intervertebral device comprising:
a first leading bearing member and a second trailing bearing member connected to the first leading bearing member each having a longitudinal axis and opposing bone-engaging outer surfaces extending between a distal leading end and a proximal trailing end; and
connecting portions of the first and second bearing members configured for allowing the first and second members to stay connected while shifting relative to each other;
wherein the first leading bearing member comprises an insertion tool engaging portion at the trailing end thereof configured to be fixed to an insertion tool and the second trailing bearing member is configured to allow the insertion tool to extend through at least a portion thereof to access the insertion tool engaging portion to allow the first leading bearing member to be fixed to the insertion tool at the insertion tool engaging portion and to allow the second trailing bearing member to be shifted relative to the first leading bearing member and the insertion tool while the first leading bearing member is fixed to the insertion tool.
2. The expandable intervertebral device of claim 1 , wherein the first and second bearing members are configured to shift relative to each other between:
(1) an unexpanded insertion configuration, wherein the trailing end of the first leading bearing member is engaged with the leading end of the second trailing bearing member and the longitudinal axes of the first and second bearing members are substantially aligned, and
(2) an expanded configuration, wherein the leading end of the second trailing bearing member is shifted away from the trailing end of the first leading bearing member so as to be spaced in a lateral direction from the trailing end of the first leading bearing member.
3. The expandable intervertebral device of claim 1 , wherein the connecting portions have an arcuate configuration.
4. The expandable intervertebral device of claim 1 , wherein the connecting portions comprise mating projecting and recess portions of the first and second bearing members that are configured to allow the projecting portion to slide in the recess portion as the second trailing bearing member is shifted relative to the first leading bearing member.
5. The expandable intervertebral device of claim 1 , further comprising a resilient retaining clip operably connected to one of the first and second bearing members for limiting the movement of the second trailing bearing member with respect to the first leading bearing member.
6. The expandable intervertebral device of claim 1 , wherein the first and second bearing members comprise an opening extending along the longitudinal axes thereof sized and configured to allow a guidewire to pass through the bearing members.
7. The expandable intervertebral device of claim 1 , wherein the opposing outer surfaces of the first leading bearing member comprise projections that are configured to resist migration in one direction, and the opposing outer surfaces of the second trailing bearing member comprise projections that are configured to resist migration in a different direction from the projections of the opposing outer surfaces of the first leading bearing member.
8. The expandable intervertebral device of claim 1 , wherein at least one of the first and second bearing members comprise a through-opening in each of the opposing bone-engaging outer surfaces to allow boney ingrowth therein.
9. The expandable intervertebral device of claim 1 , wherein the connecting portion of the second trailing bearing member extends from the leading end to the trailing end thereof.
10. The expandable intervertebral device of claim 1 , wherein the connecting portions of the first and second bearing members comprise upper and lower arcuate ridges of one of the first and second bearing members that are received in corresponding upper and lower arcuate channels of the other of the first and second bearing members.
11. The expandable intervertebral device of claim 1 , wherein the insertion tool engaging portion includes a threaded recess for engaging with a corresponding threaded rod of the insertion tool to fix the first leading bearing member thereto.
12. The expandable intervertebral device of claim 1 , wherein the second trailing bearing member includes a lateral opening on one side thereof to allow the insertion tool to be inserted through the lateral opening to hold the first leading bearing member while further allowing the second trailing bearing member to be shifted laterally while the first leading bearing member is held by the insertion tool.
13. An insertion tool for implanting a laterally expandable interbody device having interconnected first and second bearing members between adjacent upper and lower vertebrae, comprising:
a proximal handle;
a distal holding portion of the insertion tool configured for fixing the first bearing member of the interbody device to the insertion tool such that the first bearing member is kept from shifting with respect to the insertion tool; and
an actuator for engaging with the second bearing member for shifting the second bearing member laterally with respect to the first bearing member while the first bearing member is fixed to the insertion tool at the distal holding portion for expanding the interbody device laterally.
14. The insertion tool of claim 13 , wherein the distal holding portion further comprises a threaded rod configured to matingly engage with a threaded recess of the first bearing member to attach the expandable interbody device to the insertion tool.
15. The insertion tool of claim 13 , wherein the actuator is configured to shift proximally and distally along a longitudinal tool axis and abbutingly engage a proximal end of the second bearing member to shift the second bearing member from an unexpanded orientation to a laterally expanded orientation with respect to the first bearing member.
16. The insertion tool of claim 15 , wherein the actuator is a ram member operably connected to a rotatable knob that is operable to cause the ram member to shift along the longitudinal axis when the knob is rotated.
17. The insertion tool of claim 14 , further comprising a rotatable knob operably connected to the threaded rod for rotating the threaded rod to matingly engage or disengage with the threaded recess of the first bearing member.
18. The insertion tool of claim 13 , further comprising a stationary shaft connected to the proximal handle and to which the actuator is shiftably connected.
19. The insertion tool of claim 18 , wherein the stationary shaft comprises a distal alignment feature in the form of at least one prong for engaging with at least one corresponding mating slot of the first bearing member.
20. The insertion tool of claim 18 , further comprising a threaded rod rotatably disposed within the stationary shaft for matingly engaging with a threaded recess of the first bearing member to attach the expandable interbody device to the insertion tool.
21. An expandable intervertebral device for implantation within an intervertebral space between adjacent vertebrae, the expandable intervertebral device comprising:
a first leading bearing member and a second trailing bearing member connected to the first leading bearing member each having a longitudinal axis extending between a distal leading end and a proximal trailing end; and
a cam interface between the first and second bearing members configured for allowing the first and second members to stay connected while shifting relative to each other, the cam interface configured such that a longitudinally directed force aligned with the longitudinal axis of the first leading bearing member applied to the trailing end of the second trailing bearing member causes the second trailing bearing member to shift along a path transverse to the longitudinally directed force.
22. The expandable intervertebral device of claim 21 , wherein the cam interface comprises mating cam surfaces and cam follower surfaces of the first and second bearing members.
23. The expandable intervertebral device of claim 21 , wherein the cam interface includes an arcuate trailing end portion of the first leading bearing member and a corresponding arcuate connecting portion of the second trailing bearing member, such that the second trailing bearing member shifts along an arcuate path when the longitudinally directed force is applied to the trailing end of the second trailing bearing member.
24. The expandable intervertebral device of claim 23 , wherein the arcuate connecting portion of the second trailing bearing member extends from the distal leading end to the proximal trailing end thereof.
25. The expandable intervertebral device of claim 21 , wherein the first and second members are configured to shift relative to each other between:
(1) an unexpanded insertion configuration, wherein the trailing end of the first leading bearing member is engaged with the leading end of the second trailing bearing member and the longitudinal axes of the first and second bearing members are substantially aligned, and
(2) an expanded configuration, wherein the leading end of the second trailing bearing member is shifted away from the trailing end of the first leading bearing member so as to be spaced in a lateral direction from the trailing end of the first leading bearing member.
26. The expandable intervertebral device of claim 21 , wherein the first leading bearing member comprises an insertion tool engaging portion at the trailing end thereof and the second trailing bearing member is configured to allow an insertion tool to extend through at least a portion thereof to access the insertion tool engaging portion.
27. A method of expanding an expandable intervertebral device having interconnected first and second bearing members each having a longitudinal axis extending between leading and trailing ends thereof, comprising:
positioning the first and second bearing members in an aligned, unexpanded orientation with the longitudinal axes of the first and second bearing members in general alignment with one another; and
shifting the first and second bearing members to an unaligned, expanded orientation by applying a longitudinally directed force aligned with the longitudinal axis of the first bearing member to the trailing end of the second bearing member to cause the second bearing member to shift relative to the first bearing member along a path transverse to the longitudinally directed force.
28. The method of claim 27 , wherein the second bearing member is shifted along an arcuate path by the longitudinally directed force.
29. The method of claim 27 , further comprising holding the first bearing member with an insertion tool while applying the longitudinally directed force to the second bearing member.
30. The method of claim 27 , further comprising withdrawing application of the longitudinally directed force when the second bearing member is shifted to the expanded orientation with the leading end of the second bearing member spaced laterally from the trailing end of the first bearing member.
31. The method of claim 30 , wherein when the second bearing member is shifted to the expanded orientation, a retaining clip of the first bearing member engages with a mating recess in the second bearing member to keep the second bearing member from shifting relative to the first bearing member.
32. The method of claim 27 , further comprising applying the longitudinally directed force by shifting a moveable ram member along a longitudinal axis of an insertion tool.
33. The method of claim 27 , wherein shifting the first and second bearing members to an unaligned, expanded orientation is accomplished without changing the direction of the applied longitudinally directed force as the second bearing member shifts.