Interbody fusion device comprising textured surfaces
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 top surface, a bottom surface, a base at the proximal end extending between said top surface and said bottom surface, and a hollow interior accessible through a graft opening extending through said base, said cage having a length defining a length direction, a height defining a height direction and a width defining a width direction, said cage configured to be expandable in at least the height direction;
said cage comprising an upper arm and a lower arm, an upper hinge attaching said upper arm to said base, and a lower hinge attaching said lower arm to said base, said upper arm and said lower arm being free and not connected to each other at the distal end of said cage, each of said upper arm and said lower arm being deflectable outwardly at the distal end of said cage in the height direction about said respective upper and lower hinges each of said hinges including linear surfaces extending along the length direction and spaced in the height direction; and
said top surface of said cage, excluding a top surface portion of said upper hinge, comprising a top textured surface for contacting a superior vertebral body, said top textured surface comprising a three-dimensional geometric pattern having a plurality of projections and recesses formed in a laser ablation process by a pulsed laser in the nanosecond range, said bottom surface of said cage, excluding a bottom surface portion of said lower hinge, comprising a bottom textured surface for contacting an inferior vertebral body, said bottom textured surface comprising a three-dimensional geometric pattern having a plurality of projections and recesses formed in a laser ablation process by a pulsed laser in the nanosecond range.
2. The interbody fusion device of claim 1 , wherein said upper arm comprises an upper fixation portion along a portion of said top surface, said upper hinge being disposed between said upper fixation portion and said base, and wherein said lower arm comprises a lower fixation portion along a portion of said lower surface, said lower hinge being disposed between said lower fixation portion and said base.
3. The interbody fusion device of claim 2 , wherein said top textured surface comprises said upper fixation portion and said bottom textured surface comprises said lower fixation portion.
4. The interbody fusion device of claim 3 , wherein said top textured surface comprises a top surface portion of said base, and wherein said bottom textured surface comprises a bottom surface portion of said base.
5. The interbody fusion device of claim 1 , wherein said projections and recesses of said top and bottom textured surfaces have a depth of up to at least 100 μm.
6. The interbody fusion device of claim 1 , wherein said top textured surface and said bottom textured surface each further comprises nano-scale structures on said projections and within said recesses.
7. The interbody fusion device of claim 6 , wherein said nano-scale structures of said top textured surface and said bottom textured surface are formed in a laser ablation process by an ultrafast pulsed laser.
8. The interbody fusion device of claim 7 , wherein said nano-scale structures of said top textured surface and said bottom textured surface are formed in a laser ablation process by a pulsed laser in the femtosecond range.
9. The interbody fusion device of claim 1 , wherein said cage comprises a quadrangular shape that includes said top surface, said bottom surface and a pair of spaced opposing side surfaces that jointly define said hollow interior.
10. The interbody fusion device of claim 9 , wherein said top surface and said bottom surface each converge downwardly toward the distal end of said cage and said opposing side surfaces are generally parallel along a portion of said cage between said proximal end and said distal end.
11. The interbody fusion device of claim 1 , wherein said cage height and said cage width intersect to define four corners of said cage, said height and said width of said cage defining 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.
12. The interbody fusion device of claim 1 , 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.
13. The interbody fusion device of claim 1 , further including a wedge that is movable within said hollow interior of cage from said proximal end toward said distal end to deflect each of said upper arm and said lower arm outwardly at the distal end of said cage in the height direction.
14. The interbody fusion device of claim 1 , wherein said cage is formed of titanium or titanium alloys.
15. An interbody fusion device, comprising:
a monolithic cage having a distal end, a proximal end, a top surface, a bottom surface, a base at the proximal end extending between said top surface and said bottom surface, and a hollow interior accessible through a graft opening extending through said base, said cage having a length defining a length direction, a height defining a height direction, and a width defining a width direction, said cage being configured to be expandable in both the height and width directions,
said cage comprising four movable arms defined by two upper arms and two lower arms, each of said arms comprising an integral hinge, said arms being free and not connected to each other at the distal end of said cage, each of said arms being deflectable outwardly about said hinges in a cantilevered manner at the distal end of said cage in the height direction and width direction by a wedge that is movable within said hollow interior of said cage towards said distal end;
each of said upper arms comprising a first portion comprising fixation structures and a second portion comprising said hinges and attached to said base, said second portion being disposed between said first portion and said base, each of said hinges of said upper arms including first and second linear surfaces extending along the length direction and spaced in the height direction, a top surface of each said first portion comprising a top textured surface comprising nano-scale structures, said second portion of each upper arm having no fixation structures or a textured surface; and
each of said lower arms comprising a first portion comprising fixation structures and a second portion comprising said hinges and attached to said base, said second portion being disposed between said first portion and said base, each of said hinges of said lower arms including third and fourth linear surfaces extending along the length direction and spaced in the height direction, a bottom surface of each said first portion comprising a bottom textured surface comprising nano-scale structures, said second portion of each lower arm having no fixation structures or textured surface.
16. The interbody fusion device of claim 15 , wherein a top surface of said base comprises a fixation structure and a top textured surface comprising nano-scale structures, and wherein a bottom surface of said base comprises a fixation structure and a bottom textured surface comprising nano-scale structures.
17. The interbody fusion device of claim 15 , wherein said top textured surface comprises projections and recesses, said nano-scale structures of said top textured surface being formed on said projections and within said recesses, wherein said bottom textured surface comprises projections and recesses, said nano-scale structures of said bottom textured surface being formed on said projections and within said recesses, wherein said projections and recesses of said top textured surface and said bottom textured surface are formed in a laser ablation process by a pulsed laser in the nanosecond range, and wherein said nano-scale structures of said top textured surface and said bottom textured surface are formed in a laser ablation process by an ultrafast pulsed laser.
18. The interbody fusion device of claim 17 , wherein said ultrafast pulsed lased is a femtosecond pulsed laser.
19. The interbody fusion device of claim 15 , wherein said cage has a top opening between said upper arms, a bottom opening between said lower arms, and a pair of side openings, one side opening extending between one upper arm and one lower arm in the height direction, said second linear surface of said one upper arm and said fourth linear surface of said one lower arms being in communication with said one side opening, and the other side opening extending between the other upper arm and the other lower arm in the height direction, said second linear surface of said other upper arm and said fourth linear surface of said other lower arm being in communication with said other side opening, said top opening, said bottom opening and said pair of side openings all being in communication with said hollow interior of said cage.
20. The interbody fusion device of claim 15 , wherein said first linear surface and said second linear surface of each of said hinges of said upper arms are parallel, and wherein said third linear surface and said fourth linear surface of each of said hinges of said lower arms are parallel.