Spinal joint implant delivery device and system
Provided herein are devices, systems, apparatus and methods for accessing the cervical spine via an anterior approach and implanting a spinal fixation member between two vertebrae of the cervical spine in the disc or intervertebral joint space, such as in an ACDF procedure. The delivery device includes a distal end that can be anchored to the spinal fixation member. Once anchored to the spinal fixation member, the delivery device is operable to both advance and attach the spinal fixation member within a cervical disc joint space.
1. An apparatus for guiding a fixation member to a cervical disc joint space in a spine in an ACDF procedure, the apparatus comprising:
a delivery device comprising:
an anchor shaft comprising a central lumen defining a longitudinal axis, a distal portion and a proximal portion extending from the distal portion;
a guide member operably associated with the anchor shaft, the guide member defining a first lumen coaxial with the central lumen, two angled lumen offset from the first lumen and at least one fixation member engagement feature; and
a fixation member comprising a main body having top and bottom surfaces, each with a cavity defined in the respective surface, at least one threaded opening and at least one guide member engagement feature such that when the guide member engagement feature receives the fixation member engagement feature, the engagement hinders rotation of the fixation member relative to the guide member,
wherein the fixation member further comprises two angled threaded apertures defined in the main body and offset from the at least one threaded opening, one of the two angled threaded apertures extending toward the top or bottom surface to guide a fastener through the cavity defined in the respective surface.
2. The apparatus of claim 1 , further comprising a rod member having at least one threaded end extending at least partially through the central lumen of the anchor shaft to releasably engage the threaded opening of the fixation member.
3. The apparatus of claim 2 , further comprising a handle, the handle operably coupled to the proximal portion of the anchor shaft and rotatably coupled to the rod, wherein rotation of the rod releasably engages the rod with the fixation member.
4. The apparatus of claim 1 , wherein the at least one fixation member engagement feature includes at least one slot.
5. The apparatus of claim 1 , wherein the two angled lumen comprise a first angled lumen defining a first trajectory that is angled relative to the longitudinal axis and a second angled lumen defining a second trajectory that is angled relative to the longitudinal axis.
6. The apparatus of claim 5 , wherein the first trajectory is different from the second trajectory.
7. The apparatus of claim 5 , wherein the first trajectory guides a first fastener to a superior vertebral surface and the second trajectory guides a second fastener to an inferior vertebral surface.
8. The apparatus of claim 1 , wherein the two angled threaded apertures are coextensive or coaxial with a respective angled lumen of the guide member when the guide member and the fixation member are engaged and the other of the two angled threaded apertures extending toward the other of the top or bottom surface to guide a second fastener through the cavity defined in the respective surface.
9. The apparatus of claim 1 , wherein when the guide member and the fixation member are engaged, the opening of the fixation member is coextensive or coaxial with the central lumen of the anchor shaft.
10. The apparatus of claim 1 , wherein a surface of the guide member and a surface of the fixation member abut each other.
11. The apparatus of claim 1 , wherein the guide member is slidably coupled with the anchor shaft.
12. A system for guiding and securing a fixation member to a cervical disc joint space in a spine in an ACDF procedure, the system comprising:
a fixation member delivery device comprising:
an anchor shaft comprising a central lumen defining a longitudinal axis, a distal portion and a proximal portion extending from the distal portion; and
a guide member operably associated with the anchor shaft, the guide member defining a first lumen coaxial with the central lumen, two angled lumen offset from the first lumen and at least one fixation member engagement feature; and
a fixation member comprising a main body having top and bottom surfaces, each with a cavity defined in the respective surface, at least one threaded opening and at least one guide member engagement feature such that when the guide member engagement feature receives the fixation member engagement feature, the engagement hinders rotation of the fixation member relative to the guide member; and
a drive member having a first end operably associated with the guide member adjacent the anchor shaft,
wherein the fixation member further comprises two angled threaded apertures defined in the main body and offset from the at least one threaded opening, one of two angled threaded apertures extending toward the top or bottom surface to guide a fastener through the cavity defined in the respective surface.
13. The system of claim 12 wherein the fixation member delivery device further comprises a rod having at least one threaded end extending at least partially through the central lumen of the anchor shaft to releasably engage the threaded opening of the fixation member.
14. The system of claim 13 wherein the fixation member delivery device further comprises a handle, the handle operably coupled to the proximal portion of the anchor shaft and rotatably coupled to the rod, wherein rotation of the rod releasably engages the rod with the fixation member.
15. The system of claim 12 , wherein the two angled threaded apertures are coextensive or coaxial with a respective angled lumen of the guide member when the guide member and the fixation member are engaged and the other of the two angled threaded apertures extending toward the other of the top or bottom surface to guide a second fastener through the cavity defined in the respective surface.
16. The system of claim 15 , further comprising at least one fastener, the at least one fastener received in one of the two angled threaded apertures of the fixation member to secure the fixation member to a vertebral surface.
17. The system of claim 16 , wherein the at least one fastener is an anti-backout screw or a self-locking screw, with an interference thread at the head of the screw.
18. The system of claim 12 , wherein the first end of the drive member includes a coupling that permits the drive member to rotate and/or articulate with a fastener at a desired angle to deploy the fastener at a desired angle with minimal tissue retraction.
19. The system of claim 18 , wherein the coupling is selected from a group consisting of a universal joint, a coil spring, or a relief cut tube portion.
20. A method of implanting a spinal fixation implant, the method comprising:
advancing a delivery apparatus into a disc joint space between two adjacent vertebrae in an ACDF procedure, the delivery apparatus comprising:
an anchor shaft comprising a central lumen defining a longitudinal axis, a distal portion and a proximal portion extending from the distal portion;
a guide member operably associated with the anchor shaft, the guide member defining a first lumen coaxial with the central lumen, two angled lumen offset from the first lumen and at least one fixation member engagement feature; and
a fixation member comprising:
a main body having top and bottom surfaces, each with a cavity defined in a respective surface,
at least one threaded opening;
two angled threaded apertures defined in the main body and offset from the at least one threaded opening, one of the two angled threaded apertures extending toward the top or bottom surface to guide a fastener through the cavity defined in the respective surface; and
at least one guide member engagement feature such that when the guide member engagement feature receives the fixation member engagement feature, the engagement hinders rotation of the fixation member relative to the guide member;
advancing a drill/drive member adjacent the delivery apparatus, the drill/drive member having the fastener releasably attached to a first end of the drill/drive member; and
advancing the fastener through the one of the two angled lumen of the guide member to attach the fixation member to at least one of the two adjacent vertebrae.