Spine surgery method and inserter

Abstract

A surgical inserter for use in inserting an implant into a vertebral space may include: (a) a handle; (b) a gripper having one end attached to the handle and a second end having a pair of arms; and (c) a grip activator having an opening that threadingly receives the gripper. The grip activator can be rotated in a first direction with respect to the gripper to cause the arms to move toward each other to grip the inserter and in a second direction with respect to the gripper to cause the arms to move away from each other to release the inserter. In one embodiment a compression force activator is used to deploy the implant and in another embodiment a tension force activator is used to deploy the implant.

1 . A device comprising: a surgical inserter for use in inserting an implant into a vertebral space, the inserter comprising:
 a handle having first and second ends for use by a surgeon;   an implant gripping mechanism comprising: a gripper having a first end attached to the second end of the handle and a second end having a pair of arms; and, a grip activator having an opening that threadingly receives the gripper;   wherein the grip activator can be rotated in a first direction with respect to the gripper to cause the arms to move toward each other to grip the inserter; and,   wherein the grip activator can be rotated in a second direction with respect to the gripper to cause the arms to move away from each other to release the inserter.   
   
   
       2 . The device of  claim 1  wherein each arm has a hand having contact surface that is used to physically contact a surface of the implant. 
   
   
       3 . The device of  claim 2  wherein one hand has a gap between two hand portions and the other hand has a tang that is received within a groove in the implant. 
   
   
       4 . The device of  claim 1  wherein the surgical inserter further comprises:
 a connector having a first end attached to the second end of the handle and a second end attached to the first end of the gripper.   
   
   
       5 . The device of  claim 1  wherein:
 the gripper has an outer surface with a threaded region; and, the opening in grip activator is along the entire length of the grip activator and is at least partially defined by a threaded region that engages the threaded region of the gripper.   
   
   
       6 . The device of  claim 1  wherein the surgical inserter further comprises:
 an implant deployment mechanism for use in deploying the implant.   
   
   
       7 . The device of  claim 6  wherein:
 the gripper has an opening; and,   the implant deployment mechanism comprises:
 (1) a compression force member, wherein at least a portion of the compression force member is received within the opening in the gripper; and, 
 (2) a compression force activator that can apply a force to the compression force member to extend the compression force member out of the opening from the second end of the gripper and into contact with the implant. 
   
   
   
       8 . The device of  claim 7  wherein:
 the handle has an opening; and,   wherein at least a portion of the compression force member is received within the opening in the handle.   
   
   
       9 . The device of  claim 6  wherein:
 the gripper has an opening; and,   the implant deployment mechanism comprises:
 (1) a tension force member that is operatively connected to the implant, wherein at least a portion of the tension force member is received within the opening in the gripper; and, 
   (2) a tension force activator that can apply a tension force to the tension force member to deploy the implant.   
   
   
       10 . The device of  claim 9  wherein the tension force activator comprises:
 a screw having a first end and a second end that is operatively connected to the first end of the handle, the screw having a threaded region;   a tension knob having an opening that is at least partially defined by a threaded region that engages the threaded region of the screw;   wherein the handle, the screw, and the tension knob each have an opening that receives at least a portion of the tension force member; and,   wherein the tension knob is rotatable with respect to the screw to apply the tension force to the tension force member to deploy the implant.   
   
   
       11 . The device of  claim 6  wherein the surgical inserter further comprises:
 an implant anti-deployment mechanism for use in preventing the implant deployment mechanism from operating until the surgeon is ready to operate it.   
   
   
       12 . The device of  claim 11  wherein the implant anti-deployment mechanism comprises:
 a tube member that can contact the implant and that has an opening that receives the grip activator; and,   a securing device for use in securing the tube member in contact with the implant to prevent deployment of the implant.   
   
   
       13 . The device of  claim 12  wherein:
 the tube member has an outer surface with a threaded region;   the securing device comprises a nut having an opening that is at least partially defined by a threaded region that engages the threaded region of the gripper.   
   
   
       14 . The device of  claim 13  wherein the tube member comprises:
 a motion limiter that limits the movement of the nut toward the implant, the motion limiter defined by an extending surface that extends from the outer surface of the tube member.   
   
   
       15 . The device of  claim 13  wherein:
 the threaded region of the tube member is positioned at a first end of the tube member; and,   a clip for use in contacting the implant extends from a second end of the tube member.   
   
   
       16 . The devise of  claim 15  wherein:
 one hand has a gap between two hand portions; and,   the clip is received within the gap when contacting the implant.   
   
   
       17 . The device of  claim 7  wherein the compression force activator comprises:
 a screw having a first end with a contact surface that contacts the compression force member and a second end that is operatively connected to the first end of the handle, the screw having a threaded region;   a compression knob having an opening that is at least partially defined by a threaded region that engages the threaded region of the screw;   wherein the handle, the screw, and the compression knob each have an opening that receives at least a portion of the compression force member; and,   wherein the compression knob is rotatable with respect to the screw to apply the compression force to the compression force member to deploy the implant.   
   
   
       18 . The device of  claim 17  wherein the surgical inserter further comprises:
 a cap comprising: a first end that is attached to the compression knob; a second end that has an outer surface that is adapted to receive a direct force from a surgical mallet; and, an opening that receives at least a portion of the screw.   
   
   
       19 . The device of  claim 7  wherein the compression force activator comprises a compression trigger mechanism comprising:
 a body that is operatively connected to the first end of the handle;   a hold member;   a trigger that has a contact surface that contacts the compression force member and that is pivotally connected to the compression trigger mechanism; and,   wherein the trigger can be pivoted toward the hold member to apply the compression force to the compression force member to deploy the implant.   
   
   
       20 . The device of  claim 10  wherein the surgical inserter further comprises:
 a cap comprising: a first end that is attached to the tension knob; a second end that has an outer surface that is adapted to receive a direct force from a surgical mallet; and, an opening that receives at least a portion of the screw.   
   
   
       21 . The device of  claim 10  wherein the tension force activator further comprises:
 at least one set screw that tightens at least a portion of the tension force member to the inserter.   
   
   
       22 . The device of  claim 21  wherein the at least one set screw tightens the at least a portion of the tension force member to the screw. 
   
   
       23 . The device of  claim 10  wherein the tension force activator further comprises:
 at least one collar having an opening that receives at least a portion of the tension force member and that tightens the at least a portion of the tension force member to the inserter.   
   
   
       24 . The device of  claim 23  wherein the at least one collar tightens the at least a portion of the tension force member to the screw. 
   
   
       25 . The device of  claim 10  wherein the tension force activator further comprises:
 at least one reel device that receives at least a portion of the tension force member and that tightens the at least a portion of the tension force member to the inserter.   
   
   
       26 . The device of  claim 25  wherein the at least one reel device tightens the at least a portion of the tension force member to the screw. 
   
   
       27 . The device of  claim 9  wherein the tension force activator comprises:
 a shaft that receives at least a portion of the tension force member and that extends laterally from the inserter;   a tension knob operatively connected to the shaft; and,   wherein the tension knob is rotatable with respect to the handle to apply the tension force to the tension force member to deploy the implant.   
   
   
       28 . The device of  claim 9  wherein the tension force activator comprises a tension trigger mechanism comprising:
 a body that is operatively connected to the first end of the handle;   a hold member;   a trigger that has an attachment surface that attaches to the tension force member and that is pivotally connected to the tension trigger mechanism; and,   wherein the trigger can be pivoted toward the hold member to apply the tension force to the tension force member to deploy the implant.   
   
   
       29 . A surgical system comprising:
 an implant comprising:
 (a) a first portion having an opening; 
 (b) a second portion; and, 
 (c) wherein the implant may be deployed by moving the second portion with respect to the first portion; and, 
   a surgical inserter for use in inserting the implant into a vertebral space and deploying the implant within the vertebral space, the inserter comprising:
 (a) a handle having first and second ends for use by a surgeon; 
 (b) an implant gripping mechanism comprising: a gripper having a first end attached to the second end of the handle and a second end having a pair of arms that can grip and release the first portion of the inserter, the gripper also having an opening; and, 
 (c) an implant deployment mechanism comprises:
 (1) a compression force member, wherein at least a portion of the compression force member is received within the opening in the gripper; and, 
 (2) a compression force activator that applies a force to the compression force member to extend the compression force member through the gripper opening, through the opening in the first portion of the implant, and into contact with the second portion of the implant to deploy the implant. 
 
   
   
   
       30 . The surgical system of  claim 29  wherein the implant may be deployed by rotating the second portion with respect to the first portion. 
   
   
       31 . The surgical system of  claim 29  wherein the opening in the first portion of the implant is linear. 
   
   
       32 . The surgical system of  claim 29  wherein the opening in the first portion of the implant is curvilinear. 
   
   
       33 . The surgical system of  claim 29  wherein the second portion of the implant has a divot that receives an end of the compression force member during deployment of the implant. 
   
   
       34 . The surgical system of  claim 29  wherein the gripper opening is formed substantially in the radial center of the gripper. 
   
   
       35 . The surgical system of  claim 29  wherein:
 the handle has an opening formed substantially in the radial center of the handle; and,   the compression force activator applies a force to the compression force member to extend at least a portion of the compression force member through the handle opening.   
   
   
       36 . The surgical system of  claim 29  wherein the compression force activator comprises:
 a screw having a first end with a contact surface that contacts the compression force member and a second end that is operatively connected to the first end of the handle, the screw having a threaded region;   a compression knob having an opening that is at least partially defined by a threaded region that engages the threaded region of the screw;   wherein the handle, the screw, and the compression knob each have an opening that receives at least a portion of the compression force member; and,   wherein the compression knob is rotatable with respect to the screw to apply the compression force to the compression force member to deploy the implant.   
   
   
       37 . The surgical system of  claim 29  wherein the compression force activator comprises a compression trigger mechanism comprising:
 a body that is operatively connected to the first end of the handle;   a hold member;   a trigger that has a contact surface that contacts the compression force member and that is pivotally connected to the compression trigger mechanism; and,   wherein the trigger can be pivoted toward the hold member to apply the compression force to the compression force member to deploy the implant.   
   
   
       38 . A surgical system comprising:
 an implant comprising:
 (a) a first portion having a first opening; 
 (b) a second portion; and, 
 (c) wherein the implant may be deployed by moving the second portion with respect to the first portion; and, 
   a surgical inserter for use in inserting the implant into a vertebral space and deploying the implant within the vertebral space, the inserter comprising:
 (a) a handle having first and second ends for use by a surgeon; 
 (b) an implant gripping mechanism comprising: a gripper having a first end attached to the second end of the handle and a second end having a pair of arms that can grip and release the first portion of the inserter, the gripper also having an opening; and, 
 (c) an implant deployment mechanism comprises:
 (1) a tension force member that is operatively attached to the second portion of the implant, wherein at least a portion of the tension force member is received within the first opening in the first portion of the implant, and wherein at least a portion of the tension force member is received within the opening in the gripper; and, 
 (2) a tension force activator that applies a tension force to the tension force member to pull the tension force member through the first opening in the first portion of the implant, and through the gripper opening to deploy the implant. 
 
   
   
   
       39 . The surgical system of  claim 38  wherein the implant may be deployed by rotating the second portion with respect to the first portion. 
   
   
       40 . The surgical system of  claim 38  wherein:
 the first portion of the inserter has a second opening; and,   at least a portion of the tension force member is received within the second opening in the first portion of the implant.   
   
   
       41 . The surgical system of  claim 38  wherein:
 the second portion of the inserter has a first opening; and,   at least a portion of the tension force member is received within the first opening in the second portion of the implant.   
   
   
       42 . The surgical system of  claim 38  wherein:
 the first portion of the implant comprises first and second posts;   the first opening in the first portion is formed in the first post;   a second opening in the first portion is formed in the second post; and,   at least a portion of the tension force member is received within the second opening in the second post.   
   
   
       43 . The surgical system of  claim 38  wherein the gripper opening is formed substantially in the radial center of the gripper. 
   
   
       44 . The surgical system of  claim 38  wherein:
 the handle has an opening formed substantially in the radial center of the handle; and,   the tension force activator applies a force to the tension force member to extend at least a portion of the tension force member through the handle opening.   
   
   
       45 . The surgical system of  claim 38  wherein the tension force activator comprises:
 a screw having a first end and a second end that is operatively connected to the first end of the handle, the screw having a threaded region;   a tension knob having an opening that is at least partially defined by a threaded region that engages the threaded region of the screw;   wherein the handle, the screw, and the tension knob each have an opening that receives at least a portion of the tension force member; and,   wherein the tension knob is rotatable with respect to the screw to apply the tension force to the tension force member to deploy the implant.   
   
   
       46 . The surgical system of  claim 38  wherein the tension force activator comprises a tension trigger mechanism comprising:
 a body that is operatively connected to the first end of the handle;   a hold member;   a trigger that has an attachment surface that attaches to the tension force member and that is pivotally connected to the tension trigger mechanism; and,   wherein the trigger can be pivoted toward the hold member to apply the tension force to the tension force member to deploy the implant.   
   
   
       47 . A method comprising the steps of:
 (A) providing an implant made to be placed into a vertebral space;   (B) providing a surgical inserter comprising: a handle having first and second ends for use by a surgeon; a gripper having a first end attached to the second end of the handle and a second end having a pair of arms; and, a grip activator having an opening in that threadingly receives the gripper;   (C) preparing the vertebral space to receive the implant;   (D) rotating the grip activator with respect to the gripper to cause the arms to move toward each other to grip the inserter;   (E) moving the surgical inserter to insert the implant within the vertebral space;   (F) rotating the grip activator with respect to the gripper to cause the arms to move away from each other to release the inserter; and,   (G) moving the surgical inserter away from the vertebral space.   
   
   
       48 . The method of  claim 47  wherein:
 step (D) comprises the step of rotating the grip activator in a first direction; and,   step (F) comprises the step of rotating the grip activator in a second direction that is substantially opposite to the first direction.   
   
   
       49 . The method of  claim 47  wherein:
 step (D) comprises the step of moving the grip activator toward the implant; and,   step (F) comprises the step of moving the grip activator away from the implant.   
   
   
       50 . The method of  claim 49  wherein:
 the step of, moving the grip activator toward the implant, comprises the step of: contacting the outer surfaces of the arms with the grip activator; and,   the step of, moving the grip activator away from the implant, comprises the step of: moving the grip activator out of contact with the arms.   
   
   
       51 . The method of  claim 47  wherein:
 step (A) comprises the step of: providing the implant with a groove;   step (B) comprises the step of: providing one of the arms with a hand having a contact surface for use in contacting the implant, the hand having a tang extending from the contact surface; and,   step (D) comprises the step of: inserting the tang within the groove in the implant.   
   
   
       52 . The method of  claim 47  wherein:
 step (B) comprises the step of: providing the inserter with a cap having a first end with an outer surface and a second end that is attached the first end of the handle; and,   step (E) comprises the step of: applying a force to the outer surface of the first end of the cap.   
   
   
       53 . The method of  claim 47  wherein:
 step (A) comprises the step of: providing the implant to be deployable; and,   prior to step (G) the method further comprising the step of: (H) deploying the implant with the inserter.   
   
   
       54 . The method of  claim 53  wherein prior to step (H) the method further comprising the step of:
 (I) adjusting an anti-deployment mechanism to permit deployment of the implant.   
   
   
       55 . The method of  claim 54  wherein:
 step (B) comprises the step of: providing the surgical inserter with an anti-deployment mechanism comprising: a tube member having an opening that receives the grip activator; and,   step (I) comprises the steps of: moving the tube member out of contact with the implant.   
   
   
       56 . The method of  claim 55  wherein:
 step (B) comprises the step of: providing the anti-deployment mechanism with a nut that threadingly receives the tube member; and,   prior to the step of, moving the tube member out of contact with the implant, the method comprises the step of: rotating the nut with respect to the tube member to release the tube member.   
   
   
       57 . The method of  claim 54  wherein:
 step (B) comprises the step of: providing one of the arms with a hand having a gap between two hand portion; and,   step (I) comprises the step of: moving a portion of the tube member within the gap.   
   
   
       58 . The method of  claim 53  wherein
 step (B) comprises the steps of: (1) providing the gripper with an opening; and, (2) providing the inserter with an implant deployment mechanism comprising: a compression force member, wherein at least a portion of the compression force member is received within the opening in the gripper; and,   step (H) comprises the step of: applying a force to the compression force member to extend the compression force member out of the opening from the second end of the gripper and into contact with the implant.   
   
   
       59 . The method of  claim 58  wherein:
 step (B) comprises the step of: providing the surgical inserter with a compression force activator comprising: (1) a screw having a first end with a contact surface and a second end that is operatively connected to the first end of the handle, the screw having a threaded region; and, (2) a compression knob having an opening that is at least partially defined by a threaded region that engages the threaded region of the screw; and,   step (H) comprises the steps of:
 (1) rotating the compression knob with respect to the screw; 
 (2) contacting a first end of the compression force member with the contact surface of the screw; and, 
 (3) contacting the implant with a second end of the compression force member. 
   
   
   
       60 . The method of  claim 59  wherein:
 step (B) comprises the step of: providing the handle, the screw and the compression knob each with an opening; and,   step (H) comprises the steps of:
 (1) extending at least a portion of the compression force member through the opening in the compression knob; 
 (2) extending at least a portion of the compression force member through the opening in the screw; and, 
 (3) extending at least a portion of the compression force member through the opening in the handle. 
   
   
   
       61 . The method of  claim 58  wherein:
 step (B) comprises the step of: providing the surgical inserter with a compression force activator comprising: (1) a body that is operatively connected to the first end of the handle; (2) a hold member; and, (3) a trigger that has a contact surface and that is pivotally connected to the compression trigger mechanism; and,   step (H) comprises the steps of:
 (1) pivoting the trigger toward the hold member; 
 (2) contacting a first end of the compression force member with the contact surface of the trigger; and, 
 (3) contacting the implant with a second end of the compression force member. 
   
   
   
       62 . The method of  claim 47  wherein:
 step (B) comprises the steps of: (1) providing the gripper with an opening; and, (2) providing the inserter with an implant deployment mechanism comprising: a tension force member that is operatively connected to the implant, wherein at least a portion of the tension force member is received within the opening in the gripper; and,   step (H) comprises the step of: applying a tension force to the tension force member to deploy the implant.   
   
   
       63 . The method of  claim 62  wherein:
 step (B) comprises the step of: providing the surgical inserter with a tension force activator comprising: (1) a shaft that receives at least a portion of the tension force member and that extends laterally from the inserter; and, (2) a tension knob operatively connected to the shaft; and,   step (H) comprises the steps of:
 (1) rotating the tension knob; 
 (2) wrapping at least a portion of the tension force member about the shaft; and, 
 (3) applying a tension force to the implant. 
   
   
   
       64 . The method of  claim 62  wherein:
 step (B) comprises the steps of: providing the surgical inserter with a tension force activator comprising: (1) a screw having a first end and a second end that is operatively connected to the first end of the handle, the screw having a threaded region, the screw operatively connected to the tension force member; and, (2) a tension knob having an opening that is at least partially defined by a threaded region that engages the threaded region of the screw; and,   step (H) comprises the steps of:
 (1) rotating the tension knob; 
 (2) wrapping at least a portion of the tension force member about the shaft; and, 
 (3) applying a tension force to the implant. 
   
   
   
       65 . The method of  claim 64  wherein:
 step (B) comprises the step of: providing the handle, the screw and the tension knob each with an opening; and,   step (H) comprises the steps of:
 (1) extending at least a portion of the tension force member through the opening in the handle; 
 (2) extending at least a portion of the tension force member through the opening in the screw; and, 
 (3) extending at least a portion of the tension force member through the opening in the tension knob. 
   
   
   
       66 . The method of  claim 62  wherein:
 step (B) comprises the steps of: providing the surgical inserter with a tension force activator comprising: (1) a body that is operatively connected to the first end of the handle; (2) a hold member; and, (3) a trigger that has an attachment surface that is attached to the tension force member and that is pivotally connected to the tension trigger mechanism; and,   step (H) comprises the steps of:
 (1) pivoting the trigger toward the hold member; and, 
 (2) applying a tension force to the implant. 
   
   
   
       67 . The method of  claim 47  wherein:
 step (C) comprises the step of: removing a disc to create an intradiscal space between two adjacent vertebrae that defines the vertebral space.   
   
   
       68 . The method of  claim 47  wherein:
 step (C) comprises the step of: removing a vertebra and two adjacent discs to create a space between two remaining vertebrae that defines the vertebral space.