Adjustable spinal implants, associated instruments and methods
The present disclosure provides adjustable spinal devices, instruments for implanting the spinal devices, methods for adjusting the height and lordosis angles of the spinal devices and methods for implanting such devices. An adjustable spinal fusion device includes an upper plate component having an outer surface for placement against an endplate of a vertebral body and a lower plate component having an outer surface for placement against an endplate of a vertebral body. The device further includes a first translation member configured to move longitudinally relative to the upper and lower plates to adjust a distance between the upper and lower plates and a second translation member configured to move longitudinally relative to the upper and lower plates to adjust an angle between the upper and lower plates.
1. An adjustable spinal fusion device, comprising:
an upper plate having an outer surface for placement against a first vertebral body, proximal and distal ends, and first and second sides extending from the proximal end to the distal end;
a lower plate having an outer surface for placement against a second vertebral body, proximal and distal ends, and first and second sides extending from the proximal end to the distal end;
a first translation member configured to move longitudinally relative to the upper and lower plates to adjust a distance between the upper and lower plates; and
a second translation member configured to move longitudinally relative to the upper and lower plates to adjust an angle between the upper and lower plates;
wherein the second translation member includes a movable wedge with at least one angled surface, and the first translation member includes at least one angle surface positioned to cooperate with the movable wedge of the second translation member, and
wherein the movable wedge and the at least one angled surface are positioned on the first side of the upper and lower plates such that longitudinal movement of the second translation member causes the first side of the upper plate to move towards and away from the first side of the lower plate.
2. The adjustable spinal fusion device of claim 1 , wherein the second translation member is configured to adjust the angle between the first and second sides.
3. The adjustable spinal fusion device of claim 2 , further comprising a hinge on one of the first and second sides for rotatably coupling the upper plate to the lower plate.
4. The adjustable spinal fusion device of claim 3 , wherein the upper plate comprises one or more knuckles and further comprising a rod coupled to the lower plate and extending through the one or more knuckles.
5. The adjustable spinal fusion device of claim 1 , wherein longitudinal movement of the first translation member causes longitudinal movement of the second translation member to adjust the distance between the upper and lower plates and longitudinal movement of the second translation member relative to the first translation member adjusts the angle between the upper and lower plates.
6. The adjustable spinal fusion device of claim 1 , wherein the first translation member comprises a first bore with a mating feature for cooperating with a first actuator shaft of a surgical instrument to move the first translation member in the longitudinal direction.
7. The adjustable spinal fusion device of claim 6 , wherein the second translation member comprises a second bore with a mating feature for cooperating with a second actuator shaft of a surgical instrument to move the second translation member in the longitudinal direction.
8. The adjustable spinal fusion device of claim 1 , wherein the first translation member includes a movable wedge having at least one angled surface and wherein the upper plate comprises first and second proximal ramps and first and second distal ramps extending towards the lower plate each in the proximal direction, wherein the first translation member comprises first and second upper proximal angled surfaces for cooperating with the first and second proximal ramps of the upper plate and first and second distal angled surfaces for cooperating with the first and second distal ramps of the upper plate.
9. The adjustable spinal fusion device of claim 1 , further comprising an endplate coupled to a proximal surface of at least one of the upper and lower plates, and a fastener extending through a through-hole of the endplate such that the fastener extends along the outer surface of one of the upper and lower plates, wherein the fastener is configured for advancement into one of the first and second vertebral bodies.
10. The adjustable spinal fusion device of claim 9 , further comprising a locking element coupled to the through-hole of the endplate, wherein the locking element is movable from an unlocked position, wherein the fastener may be passed through the through-hole, and a locked position, wherein the fastener is secured within the through-hole.
11. The adjustable spinal fusion device of claim 10 , wherein the locking element comprises a rotatable element and a spring, wherein rotation of the rotatable element moves the spring into engagement with the through-hole into the locking position.
12. A spinal fusion system, comprising:
an adjustable spinal fusion device comprising:
an upper plate having an outer surface for placement against a first vertebral body;
a lower plate having an outer surface for placement against a second vertebral body; and
a first movable wedge configured to move longitudinally relative to the upper and lower plates to adjust a distance and an angle between the upper and lower plates;
a second movable wedge, wherein longitudinal movement of the first movable wedge causes longitudinal movement of the second movable wedge to adjust the distance between the upper and lower plates, and wherein longitudinal movement of the second movable wedge relative to the first movable wedge adjusts the angle between the upper and lower plates; and
an instrument having a proximal handle, an elongate shaft and an actuator within the elongate shaft coupled to the proximal handle and the first movable wedge for translating the movable wedge longitudinally relative to the upper and lower plates, wherein the actuator comprises a first rotatable shaft coupled to the first movable wedge and a second rotatable shaft coupled to the second movable wedge.
13. The system of claim 12 , further comprising a hinge on one of first and second sides of the upper and lower plates for rotatably coupling the upper plate to the lower plate, wherein the upper plate comprises one or more knuckles and further comprising a rod coupled to the lower plate and extending through the one or more knuckles.
14. An adjustable spinal fusion device, comprising:
an upper plate having an outer surface for placement against a first vertebral body, proximal and distal ends and first and second sides extending from the proximal end to the distal end;
a lower plate having an outer surface for placement against a second vertebral body, proximal and distal ends and first and second sides extending from the proximal end to the distal end;
a hinge on the second sides of the upper and lower plates for rotatably coupling the upper plate to the lower plate, the hinge comprising a rod extending in a longitudinal direction along the second sides of the upper and lower plates;
a first translation member configured to move longitudinally relative to the upper and lower plates to rotate the upper plate relative to the lower plate and adjust a distance between the first side of the upper plate and the first side of the lower plate; and
a second translation member configured to move longitudinally relative to the upper and lower plates to adjust a height between the upper and lower plates, wherein the second translation member comprises a knuckle for receiving the rod and at least one angled surface positioned to cooperate with a ramp of the first translation member, wherein the ramp and the at least one angled surface are positioned on the first side of the plates such that longitudinal movement of the first translation member causes the first side of the upper plate to move towards and away from the first side of the lower plate.
15. The spinal fusion device of claim 14 , wherein the upper plate comprises one or more knuckles rotatably coupled to the rod.
16. The spinal fusion device of claim 15 , wherein the one or more knuckles have a hollow interior with a height larger than an outer diameter of the rod to allow the second side of the upper plate to move relative to the second side of the lower plate.
17. An adjustable spinal fusion device, comprising:
an upper plate having an outer surface for placement against a first vertebral body;
a lower plate having an outer surface for placement against a second vertebral body;
a first translation member configured to move longitudinally relative to the upper and lower plates to adjust a distance between the upper and lower plates; and
a second translation member configured to move longitudinally relative to the upper and lower plates to adjust an angle between the upper and lower plates;
wherein longitudinal movement of the first translation member causes longitudinal movement of the second translation member to adjust the distance between the upper and lower plates, and longitudinal movement of the second translation member relative to the first translation member adjusts the angle between the upper and lower plates.
18. The adjustable spinal fusion device of claim 17 , wherein the upper and lower plates each have proximal and distal ends and first and second sides extending from the proximal end to the distal end, and wherein the second translation member is configured to adjust the angle between the first and second sides.
19. The adjustable spinal fusion device of claim 18 , further comprising a hinge on one of the first and second sides for rotatably coupling the upper plate to the lower plate.
20. The adjustable spinal fusion device of claim 18 , wherein the upper plate comprises one or more knuckles, and further comprising a rod coupled to the lower plate and extending through the one or more knuckles.
21. The adjustable spinal fusion device of claim 17 , wherein the first translation member comprises a first bore with a mating feature for cooperating with a first actuator shaft of a surgical instrument to move the first translation member in the longitudinal direction.
22. The adjustable spinal fusion device of claim 21 , wherein the second translation member comprises a second bore with a mating feature for cooperating with a second actuator shaft of a surgical instrument to move the second translation member in the longitudinal direction.
23. The adjustable spinal fusion device of claim 22 , wherein the first translation member includes a movable wedge having at least one angled surface and wherein the upper plate comprises first and second proximal ramps and first and second distal ramps extending towards the lower plate each in the proximal direction, and
wherein the first translation member comprises first and second upper proximal angled surfaces for cooperating with the first and second proximal ramps of the upper plate and first and second distal angled surfaces for cooperating with the first and second distal ramps of the upper plate.
24. The adjustable spinal fusion device of claim 23 , wherein the second translation member includes a second movable wedge with at least one angled surface and the first translation member includes at least one angle surface positioned to cooperate with the second movable wedge of the second translation member, and
wherein the second movable wedge and the at least one angled surface are positioned on a first side of the upper plate such that longitudinal movement of the second translation member causes the first side of the upper plate to move towards and away from the first side of the lower plate.
25. The adjustable spinal fusion device of claim 17 , wherein the device is configured for advancement in a direct lateral approach to the first and second vertebral bodies.
26. The adjustable spinal fusion device of claim 17 , wherein the device is configured for a transforaminal lumbar interbody fusion (TLIF) approach to the first and second vertebral bodies.