Expandable TLIF device and related insertion and grafting instrumentation
An expandable interbody fusion device and an associated instrument for inserting the device into an intervertebral disc space, expanding the device and for use in delivering graft material into the device once expanded in the disc space. The device is small enough to fit through Kambin's triangle yet is capable of expanding both in the vertical direction to accommodate spinal lordosis and in the lateral direction to provide sufficient structural support for opposing vertebral bodies laterally within the disc space. A process of forming textured top and bottom surfaces of the device by initially laser ablating each surface with a nano-second pulsed laser followed by laser ablating those surfaces with a femto-second pulsed laser.
1. An interbody fusion device, comprising:
a cage having a distal end, a proximal end, a base at the proximal end, and a hollow interior accessible through said base, said cage comprising an instrument attachment feature at said base including an outer wall at the proximal end of said cage and an inner wall spaced interiorly from said outer wall and defining therebetween a locking pocket, said inner wall having a first opening and said outer wall having a second opening, said first opening and said second opening being in communication with said hollow interior of said cage, said first opening being of lesser dimension than said second opening, said locking pocket having an extent extending behind a portion of said outer wall.
2. The interbody fusion device of claim 1 , wherein said cage has a height and a width that intersect and define four corners of said cage, opposing diagonal corners defining an axis that lies at an acute angle with respect to both said height and said width.
3. The interbody fusion device of claim 2 , wherein said second opening has a first extent that is longer along said axis and a second extent that is shorter in a direction transverse to said axis.
4. The interbody fusion device of claim 3 , wherein the second opening has a circular portion and a pair of arcuate lobes extending radially therefrom in opposite directions along said axis, said arcuate lobes defining said longer first extent along said axis and said circular portion defining said shorter extent.
5. The interbody fusion device of claim 4 , wherein said locking pocket has a circular portion aligned with said circular portion of said second opening and a pair of extended lobes extending radially therefrom in opposite directions along said axis, said extended lobes being in communication with said lobes of said second opening for an arcuate portion and extending for a further arcuate portion beyond said lobes of said second opening to a location behind said portion of said outer wall.
6. The interbody fusion device of claim 5 , wherein said first opening defines a graft opening having a circular configuration, and wherein said height and said width of said cage define a cross-sectional area of said cage, said graft opening having an area that is no less than 29% of the cross-sectional area of said cage.
7. The interbody fusion device of claim 2 , wherein said cage is configured to be expandable.
8. The interbody fusion device of claim 7 , wherein said cage is configured to be expandable in both the height and width directions.
9. The interbody fusion device of claim 8 , wherein said cage comprises four movable arms hingedly attached to said cage at said base.
10. The interbody fusion device of claim 9 , wherein said arms of said cage are deflected outwardly at the distal end of said cage in the height direction and width direction by a wedge that is movable within said cage towards said distal end.
11. The interbody fusion device of claim 10 , wherein said cage is dimensioned in an unexpanded condition to be introduced into an intravertebral disc space in a posterolateral approach through Kambin's triangle for a transforaminal lumbar interbody fusion (TLIF) procedure.
12. The interbody fusion device of claim 11 , wherein an unexpanded height of said cage for a TLIF procedure at the L1/L2 lumbar level is about 8.0 mm.
13. The interbody fusion device of claim 11 , wherein an unexpanded height of said cage for a TLIF procedure at the L4/L5 lumbar level is about 16.0 mm.
14. The interbody fusion device of claim 11 , wherein an unexpanded width of said cage for a TLIF procedure is about 8.5 mm.
15. The interbody fusion device of claim 1 , wherein said cage has a top surface and an opposite bottom surface, said top surface and said bottom surface comprising textured surfaces.
16. The interbody fusion device of claim 15 , wherein said cage is formed of titanium.
17. An interbody fusion device, comprising:
a cage having a distal end, a proximal end, a base at the proximal end, and a hollow interior accessible through said base, said cage comprising an instrument attachment feature at said base including an outer wall at the proximal end of said cage having an attachment opening therethrough in communication with said hollow interior of said cage, said cage having a height and a width that intersect to define four corners of said cage, opposing diagonal corners defining an axis that lies at an acute angle with respect to both said height and said width, said attachment opening having a first extent that is longer along said axis and a second extent that is shorter in a direction transverse to said axis.
18. The interbody fusion device of claim 17 , wherein the attachment opening has a circular portion and a pair of arcuate lobes extending radially therefrom in opposite directions along said axis, said arcuate lobes defining said longer first extent along said axis and said circular portion defining said shorter extent.
19. The interbody fusion device of claim 18 , wherein said cage is configured to be expandable.
20. The interbody fusion device of claim 19 , wherein said cage is configured to be expandable in both the height and width directions.
21. The interbody fusion device of claim 20 , wherein said cage comprises four movable arms hingedly attached to said cage at said base.
22. The interbody fusion device of claim 21 , wherein said arms of said cage are deflected outwardly at the distal end of said cage in the height direction and width direction by a wedge that is movable within said cage towards said distal end.
23. The interbody fusion device of claim 22 , wherein said cage is dimensioned in an unexpanded condition to be introduced into an intravertebral disc space in a posterolateral approach through Kambin's triangle for a transforaminal lumbar interbody fusion (TLIF) procedure.
24. The interbody fusion device of claim 17 , wherein said cage has a top surface and an opposite bottom surface, said top surface and said bottom surface comprising textured surfaces.
25. The interbody fusion device of claim 24 , wherein said cage is formed of titanium.
26. The interbody fusion device of claim 17 , wherein said instrument attachment feature at said base includes an inner wall spaced interiorly from said outer wall, said inner wall having a graft opening therethrough in communication with said attachment opening and said hollow interior of said cage, said inner wall defining with said outer wall a locking pocket therebetween that is configured for receipt of a portion of an instrument attachable to said cage.
27. The interbody fusion device of claim 26 , wherein said graft opening is of lesser dimension than said attachment opening.