Expandable scaffolding with a rigid, central beam
An intervertebral scaffolding system is provided having a rigid central beam and a laterovertically-expanding frame operable for a reversible collapse from an expanded state into a collapsed state.
1. An intervertebral scaffolding system for use in a subject, comprising;
a central beam having a proximal portion and a distal portion, wherein the central beam is sized to have a transverse cross-section having a maximum dimension ranging from 5 mm to 15 mm for placing the central beam into an intervertebral space through an annular opening having a maximum lateral dimension ranging from 5 mm to 15 mm; and,
an expanding frame having a collapsed state and an expanded state, the frame configured for operably contacting the central beam to create an intervertebral scaffolding system in vivo, the frame having
a proximal end and a distal end; and,
a lumen formed by the expanding frame, the lumen of the frame configured for slidably engaging with the central beam in vivo following placement of the central beam in the intervertebral space through the annular opening, the slidably engaging including translating the central beam into the frame from the proximal end of the frame toward the distal end of the frame in vivo.
2. The scaffolding system of claim 1 , wherein the scaffolding has a localized loading range from about 1.0× to about 2.0× the vertebral body compression strength of the subject.
3. The scaffolding system of claim 1 , wherein the scaffolding has a top surface that supports a top vertebral endplate, a bottom surface that supports a bottom vertebral endplate, and the top surface and the bottom surface remain at least substantially constant in length regardless of the amount of expansion.
4. The scaffolding system of claim 1 , the central beam comprising an I-beam.
5. The scaffolding system of claim 1 , the central beam further comprising a grafting port.
6. The scaffolding system of claim 1 , wherein the scaffolding comprises a plurality of beams interconnected by a plurality of struts configured in an at least substantially parallel alignment in the collapsed state.
7. The scaffolding system of claim 1 , wherein the struts are configured monolithically integral to the top beam and the bottom beam.
8. A method of fusing an intervertebral space using the scaffolding system of claim 1 , the method comprising:
creating a point of entry into an intervertebral disc, the intervertebral disc having a nucleus pulposus surrounded by an annulus fibrosis;
removing the nucleus pulposus from within the intervertebral disc through the point of entry, leaving the intervertebral space for expansion of the scaffolding system of claim 1 within the annulus fibrosis, the intervertebral space having a top vertebral plate and a bottom vertebral plate;
inserting the expanding frame in the collapsed state through the point of entry into the intervertebral space;
inserting the central beam into the frame to form the scaffolding system;
and,
adding a grafting material to the intervertebral space.
9. The method of claim 8 , wherein the connector elements are struts are adapted to stack in the collapsed state to minimize void space for a low profile entry of the frame into the intervertebral space.
10. The method of claim 8 , wherein the expanding includes
expanding the expanding frame laterally to a width that exceeds the width of the point of entry; and,
inserting the central beam to expand the expanding frame vertically to support the frame in the expanded state.
11. A kit, comprising:
the scaffolding system of claim 1 ;
a cannula for inserting the scaffolding system into the intervertebral space;
a guidewire adapted for guiding the central beam into the expanding frame; and,
an expansion handle for inserting the central beam into the expanding frame to form the scaffolding system.
12. The kit of claim 11 , the distal end of the frame having a slidably translational connection with a guide that restricts the expandable frame to movement relative to the guide when converting the frame from the collapsed state to the expanded state in vivo.
13. The kit of claim 11 ; wherein, the expandable frame has a plurality of beams interconnected by struts, and the struts are configured monolithically integral to the plurality of beams.
14. An intervertebral scaffolding system, comprising:
a plurality of beams that define an expandable frame comprising a collapsed state and an expanded state, the plurality of beams configured at least substantially parallel in the collapsed state and define a proximal-distal axis, and a plurality of connector elements that operably connect the plurality of beams and maintain a high structural stiffness and strength in the direction perpendicular to the proximal-distal axis so that a transverse cross section perpendicular to the proximal-distal axis maintains shape during and after insertion of the frame into the intervertebral disc space,
a lumen surrounded by the plurality of beams;
a central beam configured for translatably inserting into the lumen to expand the expandable frame.
15. The scaffolding system of claim 14 , wherein the plurality of connector elements are configured monolithically integral to the plurality of beams.
16. The scaffolding system of claim 14 , wherein, the connector elements are struts configured monolithically integral to the plurality of beams.
17. The scaffolding system of claim 14 , the distal end of the frame having a guide that restricts the movement of the plurality of beams when converting the frame from the collapsed state to the expanded state in vivo.
18. The scaffolding system of claim 14 , the central beam further comprising a graft port.
19. The scaffolding system of claim 14 , wherein
the plurality of beams include a first top beam, a first bottom beam, a second top beam, and a second bottom beam; wherein, the first top beam and the first bottom beam form an angle ⊖ FS , the second top beam and the second bottom beam form an angle ⊖ SS , and each of ⊖ FS and ⊖ SS are independently selected as something other than 0°, such that (i) the first top beam and the first bottom beam or (ii) the second top beam and the second bottom beam, are not substantially parallel in the expanded state; ⊖ FS and ⊖ SS are each independently selected to range from about 0.5° to 31.5°.
20. The scaffolding system of claim 19 , wherein ⊖ FS and ⊖ SS are each independently selected to be about 1°, 2°, 3°, 4°, 5°, 6°, 7°, 8°, 9°, 10°, 11°, 12°, 13°, 14°, 15°, 16°, 17°, 18°, 19°, 20°, 21°, 22°, 23°, 24°, 25°, 26°, 27°, 28°, 29°, 30°, 31°, 32°, 33°, 34°, 35°, or any angle therein in increments of 0.1°.