Methods and devices for interbody spinal stabilization

Abstract

Methods and instruments for preparing a disc space and for forming interbody devices therein are provided. The instruments include distractors having enlargeable portions positionable in the disc space for distracting the disc space. The enlargeable portions can also provide form about or against which an interbody device of a first material is placed. A second material may be placed in the disc space in the space previously occupied by the distractors.

1 - 47 . (canceled)  
   
   
       48 . A spinal surgical system, comprising: 
 a distraction instrument including an enlargeable portion with a reduced size configuration for insertion into a disc space between adjacent vertebrae and an enlarged configuration adapted to occupy a first portion of the disc space and distract the adjacent vertebrae, wherein in said enlarged configuration said enlargeable portion includes opposite vertebral endplate contacting surfaces for contacting vertebral endplates adjacent the disc space;    a material having a first condition for placement in a second portion of the disc space formed exteriorly of the enlarged enlargeable portion, said material being changeable to a second condition after placement in the second portion; and    a stabilization system attachable to the adjacent vertebrae exteriorly of the disc space.    
   
   
       49 . The system of  claim 48 , wherein said opposite vertebral endplate contacting surfaces each include a vertebral endplate contact area in the range of 0.1 square inches to 0.5 square inches with said enlargeable portion in said enlarged configuration.  
   
   
       50 . The system of  claim 48 , wherein said enlargeable portion is removable from the disc space in said reduced size configuration.  
   
   
       51 . The system of  claim 48 , wherein said material substantially surrounds said enlargeable portion.  
   
   
       52 . The system of  claim 48 , wherein said material includes a curable cement.  
   
   
       53 . The system of  claim 48 , wherein said enlargeable portion is inflatable.  
   
   
       54 . The system of  claim 48 , wherein said distraction instrument includes a shaft defining a lumen in communication with said enlargeable portion.  
   
   
       55 . The system of  claim 48 , further comprising a second enlargeable portion including a reduced size configuration for insertion into the disc space between the adjacent vertebrae and an enlarged configuration adapted to occupy a third portion of the disc space and distract the adjacent vertebrae, wherein in said enlarged configuration said enlargeable portion includes opposite vertebral endplate contacting surfaces.  
   
   
       56 . The system of  claim 55 , wherein said second enlargeable portion defines a distraction height in said enlarged configuration that differs from a distraction height defined by the enlargeable portion of the distraction instrument in its enlarged configuration.  
   
   
       57 . The system of  claim 56 , wherein said second enlargeable portion comprises a distal portion of a second distraction instrument.  
   
   
       58 . The system of  claim 56 , wherein said enlargeable portions each include a banana shape and are positionable along opposite lateral sides of the disc space.  
   
   
       59 . The system of  claim 48 , wherein said enlargeable portion is removable from said material when in said second condition and further comprising a second material positionable in the first portion of the disc space.  
   
   
       60 . The system of  claim 59 , wherein said material comprises a bone cement and said second material comprises bone graft.  
   
   
       61 . The system of  claim 48 , wherein said enlargeable portion is configured to establish lordosis of the disc space.  
   
   
       62 . The system of  claim 48 , wherein each of said vertebral endplate contacting surfaces has an oval shape.  
   
   
       63 . The system of  claim 48 , wherein each of said vertebral endplate contacting surfaces has a circular shape.  
   
   
       64 . The system of  claim 48 , wherein each of said vertebral endplate contacting surfaces has a generally rectangular shape.  
   
   
       65 . The system of  claim 48 , wherein each of said vertebral endplate contacting surfaces has a first contacting node and a second contacting node and said enlargeable portion includes a concave surface extending between said first and second contacting nodes.  
   
   
       66 . The system of  claim 48 , wherein when in said enlarged configuration said enlargeable portion is sized to contact vertebral endplates adjacent the disc space and restore the disc space to a desired disc space height, said enlargeable portion being further sized and shaped in the anterior, posterior and lateral directions to occupy the disc space and form said second portion of the disc space between the enlargeable portion and an inner wall of an annulus surrounding the disc space.  
   
   
       67 . The system of  claim 48 , wherein said stabilization system includes first and second screws engageable to respective ones of the adjacent vertebrae and a rod extending between the first and second screws.  
   
   
       68 . A spinal surgical system, comprising: 
 a first distraction instrument including a first enlargeable portion with a reduced size configuration for insertion into a disc space between adjacent vertebrae and an enlarged configuration adapted to occupy a first portion of the disc space and distract the adjacent vertebrae, wherein in said enlarged configuration said first enlargeable portion includes opposite vertebral endplate contacting surfaces; and    a second distraction instrument including a second enlargeable portion with a reduced size configuration for insertion into the disc space between the adjacent vertebrae and an enlarged configuration adapted to occupy a second portion of the disc space and distract the adjacent vertebrae, wherein in said enlarged configuration said second enlargeable portion includes opposite vertebral endplate contacting surfaces.    
   
   
       69 . The system of  claim 68 , wherein said second enlargeable portion defines a distraction height in its enlarged configuration that differs from a distraction height defined by said first enlargeable portion in its enlarged configuration.  
   
   
       70 . The system of  claim 69 , wherein said enlargeable portions each include a banana shape and are positionable along opposite lateral sides of the disc space with concave portions of the banana shapes oriented toward one another.  
   
   
       71 . The system of  claim 70 , wherein said concave portions form a central cavity in the disc space when said enlargeable portions are enlarged.  
   
   
       72 . The system of  claim 68 , further comprising a material having a first condition for placement in a third portion of the disc space formed exteriorly of the enlarged enlargeable portion, said material being changeable to a second condition after placement in the third portion of the disc space.  
   
   
       73 . The system of  claim 72 , wherein said material includes a curable cement.  
   
   
       74 . The system of  claim 68 , wherein said first and second enlargeable portions are inflatable.  
   
   
       75 . The system of  claim 74 , wherein said first and second distraction instruments each include a shaft defining a lumen in communication with said enlargeable portion thereof.  
   
   
       76 . The system of  claim 68 , further comprising a stabilization system attachable to the adjacent vertebrae exteriorly of the disc space.