System for distracting and measuring an intervertebral space
Systems and methods for distracting an intervertebral disc space are provided. The systems use an expandable trial with telescopic stabilizers. The systems and methods of distracting an intervertebral space are provided in a manner that addresses the problem of subsidence. The method includes inserting the trial into the intervertebral space in a collapsed state and, once inserted, the trial is then used for distracting the intervertebral space using an expansion that includes a first stage and a second stage. The first stage includes expanding the trial laterally toward the peripheral zones of the top vertebral plate and the bottom vertebral plate, and the second stage includes expanding the trial vertically to distract the intervertebral space.
1. A system for distracting and measuring the size of an intervertebral space for the selection and insertion of a fusion cage, the system comprising:
a barrel;
an expandable shell having a proximal region with an end, a mid-region, a distal region with an end, and a lumen; the proximal region having
a slider-guide flexibly attached to an expandable head in the distal region, the slider guide configured to (i) slide in the barrel and (ii) guide the expandable head into an intervertebral space;
the expandable head having a top subhead and a bottom subhead operably connected through a plurality of telescopic stabilizers, each telescopic stabilizer having
a linear member; and,
a counter-bore hole for the linear member in the top subhead and/or the bottom subhead;
wherein, the linear member slidably translates with it's respective counter-bore hole to stabilize and/or align the relationship between the top subhead and the bottom subhead when expanding the expandable shell from a collapsed state to an expanded state and collapsing the expandable shell from the expanded state to the collapsed state;
and,
a shim that induces a vertical expansion of the expandable head in the intervertebral space.
2. The system of claim 1 , further comprising an expansion gauge configured to provide a measure of intervertebral expansion and contraction.
3. The system of claim 1 , further comprising a retractable retention plunger configured for retaining the expandable head in the collapsed state and releasing the expandable head for expansion into the expanded state.
4. The system of claim 1 , further comprising an actuation component having a proximal end and a distal end that is operably connected to the shim, the actuation component configured to receive an axial proximal-to-distal force from an actuation screw that is operably attached to the proximal end of an actuation bar and transfers the force to the shim through the distal end of the actuation bar.
5. The system of claim 1 , further comprising an actuation means operably attached to the proximal end of an actuation bar to transfer an axial proximal-to-distal force to the shim through the distal end of the actuation bar.
6. The system of claim 1 , wherein
the expandable head has
a transverse cross-section in the collapsed state having a maximum dimension ranging from 5 mm to 18 mm for placing the frame in an intervertebral space through an annular opening for expansion in the intervertebral space; and,
a transverse cross-section in the expanded state having a maximum dimension ranging from 6.5 to 28 mm in the intervertebral space.
7. The system of claim 1 , wherein the shim includes a vertical wedge configured to vertically-expand the expandable head.
8. The system of claim 1 , wherein the shim includes a vertical-expansion wedge with angle θ V ranging from 30° to 50°.
9. The system of claim 1 , wherein the shim includes a vertical-expansion wedge with angle θ V ranging from 10° to 90°.
10. The system of claim 1 , wherein the linear member comprises a rod, and the guide is configured complementary to the rod.
11. The system of claim 1 , wherein the trial has at least 2 telescopic stabilizers.
12. The system of claim 1 , wherein the expandable shell is monolithically integral.
13. The system of claim 1 , wherein the shim has a tail configured to slide proximal to distal in the expandable shell through an opening in the slider guide.