Methods and instrumentation for intervertebral cage expansion
An instrument may be coupled to a multi-axis expandable intervertebral cage so that the cage may be inserted into an intervertebral space, expanded along multiple different directions, filled with bone graft, and locked with a fastener. The instrument may be part of an instrument set that includes auxiliary instruments to determine implant size, insert bone graft into the cage, and deliver the fastener.
1. An instrument comprising:
a handle comprising a distal end comprising a distal thumb wheel and a proximal end comprising a proximal thumb wheel;
a first instrument part that is removably connectable to a first implant part of a distal end of an implant via actuation of the proximal thumb wheel; and
a second instrument part that is removably connectable to a second implant part of a proximal end of the implant via actuation of the distal thumb wheel;
wherein, when the first instrument part is connected to the first implant part, the second instrument part is connected to the second implant part, and the instrument is actuated, the first instrument part and the first implant part translate relative to the second instrument part and the second implant part along a central longitudinal axis of the instrument without rotating about the central longitudinal axis during instrument actuation.
2. The instrument of claim 1 , wherein the first instrument part comprises a draw bar that is removably connectable to the first implant part by rotation of the draw bar about the central longitudinal axis;
wherein the instrument further comprises an actuator and a rotation lock;
wherein instrument actuation comprises movement of the actuator in engagement with the draw bar to translate the draw bar relative to the second instrument part and the second implant part along the central longitudinal axis;
wherein when the rotation lock is engaged, the draw bar cannot rotate about the central longitudinal axis, wherein when the rotation lock is disengaged, the draw bar is free to rotate about the central longitudinal axis;
wherein the instrument comprises a first state in which the actuator is disengaged from the draw bar, the rotation lock is disengaged, and the draw bar is free to translate along and rotate about the central longitudinal axis;
wherein the instrument comprises a second state in which the actuator is engaged with the draw bar, the rotation lock is engaged, and the draw bar is prevented from rotating about the central longitudinal axis.
3. The instrument of claim 2 , wherein the rotation lock comprises a rotation lock ring and a spline insert, wherein the rotation lock ring and the draw bar are fixed together for rotation about the central longitudinal axis, wherein the spline insert is fixed in translation along and rotation about the central longitudinal axis, wherein the spline insert is removably connectable to the rotation lock ring;
wherein when the rotation lock is engaged, the spline insert is connected to the rotation lock ring so that the rotation lock ring cannot rotate about the central longitudinal axis, wherein when the rotation lock is disengaged, the spline insert is disconnected from the rotation lock ring so that the rotation lock ring is free to rotate about the central longitudinal axis;
wherein the actuator and the rotation lock are coupled together so that the actuator engages the draw bar when the rotation lock is engaged and the actuator disengages from the draw bar when the rotation lock is disengaged.
4. The instrument of claim 3 , wherein the draw bar comprises threads;
wherein the actuator comprises a threaded slider, wherein the threaded slider comprises threads that engage the threads of the draw bar, wherein instrument actuation comprises rotation of the threaded slider threads in engagement with the draw bar threads to translate the draw bar relative to the second instrument part and the second implant part along the central longitudinal axis.
5. The instrument of claim 1 , wherein:
the handle further comprises a distal portion and a proximal portion rotatable with respect to the distal portion; and
rotation of the proximal portion actuates the instrument.