Bi-directional fixating/locking transvertebral body screw/intervertebral cage stand-alone constructs
A bi-directional fixating transvertebral (BDFT) screw/cage apparatus is provided. The BDFT apparatus includes an intervertebral cage including a plurality of internal angled screw guides, a plurality of screw members, and a novel screw locking mechanism which consists of leaf springs which mechanically interact with BDFT screws which have ratcheted screw heads. The small leaf springs allow the ratchet teeth of the screw heads to rotate only in the penetrating direction. Due to the geometric orientation of the ratchet teeth vis-a-vis the adjacent spring leaf, rotation of the screw head in the opposite direction is prevented by the insertion of the string leaf in the space between the ratchet teeth (trough) of its final rotation. The uni-rotational interaction between the screw head-ratchet teeth/troughs and adjacent leaf spring is the mechanical basis for this novel locking mechanism. The internal angled screw guides orient a first screw member superiorly and a second screw member inferiorly in some embodiments, and orient a second screw member and a third screw member superiorly, and a first screw member and fourth screw member inferiorly in other embodiments. The intervertebral cage is adapted for posterior lumbar intervertebral placement, anterior lumbar intervertebral placement, anterio-lateral thoracic intervertebral placement, or anterior cervical intervertebral placement.
1. An intervertebral combination internal screw guide and fixation apparatus configured to be inserted into a disc space between a first vertebral body and a second vertebral body and to provide fusion of the first vertebral body to the second vertebral body via biological bone fusion and screw fusion, the apparatus comprising:
an intervertebral spacing implant including a top wall, a bottom wall, and first and second sidewalls, wherein the intervertebral spacing implant defines:
an open space between the top, bottom, first, and second sidewalls capable of receiving bone filling for biological bone fusion,
a first internal screw guide having a first entry opening and a first exit opening, the first entry opening of the first internal screw guide formed at least partially in a top surface of the top wall and the first exit opening formed at least partially in a bottom surface of the top wall and at least partially in a first side surface of the top wall,
a second internal screw guide having a second entry opening and a second exit opening, the second entry opening of the second internal screw guide formed at least partially in the top surface of the top wall and the second exit opening formed at least partially in the bottom surface of the top wall and at least partially in a second side surface of the top wall so as to extend in a direction different than that of the first internal screw guide,
a first screw having a first screw head and a first threaded body that is sized and configured to be inserted into the first internal screw guide;
a second screw having a second screw head and a second threaded body that is sized and configured to be inserted into the second internal screw guide;
a first locking spring, wherein the first locking spring comprises titanium, wherein the first locking spring is positioned at least partially in the first internal screw guide between the first screw and the intervertebral spacing implant when the first screw is in a first final resting position in the first internal screw guide, wherein the first locking spring is configured to bend and spring back when the first screw is screwed into the first internal screw guide, and wherein the first locking spring is sized and configured to resist back out by the first screw when the first screw is in the first final resting position in the first internal screw guide; and
a second locking spring, wherein the second locking spring comprises titanium, wherein the second locking spring is positioned at least partially in the second internal screw guide between the second screw and the intervertebral spacing implant when the second screw is in a second final resting position in the second internal screw guide, wherein the second locking spring is configured to bend and spring back when the second screw is screwed into the second internal screw guide, wherein the second locking spring is sized and configured to resist back out by the second screw when the second screw is in the second final resting position in the second internal screw guide.
2. The apparatus of claim 1 , wherein the first and second locking springs nest in first and second indentations in the first and second internal screw guides to hold the first and second locking springs in place.
3. The apparatus of claim 1 , wherein the intervertebral spacing implant defines first and second vertebral body facing surfaces which each define ridges.
4. The apparatus of claim 1 , wherein the intervertebral spacing implant defines superior and inferior vertebral body facing surfaces which each define means to facilitate integration and fusion with superior and inferior vertebral bodies.
5. The apparatus of claim 1 , wherein the intervertebral spacing implant defines a first tool engagement indentation on the first sidewall and a second tool engagement indentation on the second sidewall, wherein the first and second tool engagement indentations are positioned nearer to the top surface of the top wall than to a bottom surface of the bottom wall.
6. A system comprising:
the apparatus of claim 5 ; and
a tool comprising:
an elongate shaft;
first and second gripper prongs that are sized and positioned such that the first gripper prong engages the first tool engagement indentation and the second gripper prong engages the second tool engagement indentation when the tool engages the intervertebral spacing implant; and
a screwdriver sized and configured for driving the first and second screws through the first and second internal screw guide.
7. The system of claim 6 , wherein the tool further comprises a tool screw guide defining first and second screw trajectory guides that align with the first and second internal screw guides and control direction of the first and second screws when the tool is engaged with the intervertebral spacing implant and the first and second screws are inserted into the first and second internal screw guides of the intervertebral spacing implant, wherein the first and second gripper prongs extend distally past the tool screw guide on opposite sides of the tool screw guide, and wherein the screwdriver is sized and configured for driving the first and second screws through the first and second internal screw guide while the tool is holding the intervertebral spacing implant between the first and second vertebral bodies.
8. The apparatus of claim 1 , wherein the first and second screw heads define first and second tool receiving portions each having a hexagonal shape that is configured for receiving a tool having a substantially similar hexagonal shape.
9. The apparatus of claim 1 , wherein the first and second locking springs are first and second leaf springs.
10. The apparatus of claim 1 , wherein the first and second locking springs are press-fit into indentations in the intervertebral spacing implant.
11. The apparatus of claim 1 , wherein removal of the first and second screws requires destroying or disrupting the first and second locking springs.
12. The apparatus of claim 1 , wherein the top wall is continuous with the first and second sidewalls.
13. The apparatus of claim 1 , wherein the open space extends from an inner surface of the first sidewall to an inner surface of the second sidewall and extends from the bottom surface of the top wall to a top surface of the bottom wall.
14. A system comprising:
the apparatus of claim 1 ; and
means for inserting the apparatus.
15. The system of claim 14 , and further comprising bone fusion material positioned in the open space of the intervertebral spacing implant.
16. The apparatus of claim 1 , wherein the first entry opening of the first internal screw guide is formed at least partially at a first intersection between the top surface of the top wall and the first side surface of the top wall, wherein the second entry opening of the second internal screw guide is formed at least partially at a second intersection between the top surface of the top wall and the second side surface of the top wall, wherein the first entry opening of the first internal screw guide is spaced from the second intersection between the top surface of the top wall and the second side surface of the top wall by a first portion of the top surface, and wherein the second entry opening of the second internal screw guide is spaced from the first intersection between the top surface of the top wall and the first side surface of the top wall by a second portion of the top surface.
17. The apparatus of claim 1 , wherein each of the first and second locking springs are positioned at least partially between portions of the first and second screws.
18. The apparatus of claim 1 , wherein the first locking spring is positioned at least partially between a portion of the first screw and the first side surface of the top wall and wherein the second locking spring is positioned at least partially between a portion of the second screw and the second side surface of the top wall.
19. The apparatus of claim 1 , wherein the first locking spring is sized, shaped, and positioned such that rotation of the first screw causes the first locking spring to bend to a deformed shape and further rotation of the first screw causes the first locking spring to spring back so as to resist back out of the first screw, and wherein the second locking spring is sized, shaped, and positioned such that rotation of the second screw causes the second locking spring to bend to the deformed shape and further rotation of the second screw causes the second locking spring to spring back so as to resist back out of the second screw.
20. The apparatus of claim 1 , wherein the first and second locking springs are sized, shaped, and positioned to engage first and second troughs of the first and second screws when the first and second locking springs lock the first and second screws in the first and second internal screw guides.