Anterior intervertebral fusion with fixation system, device and method

Abstract

A system, device, and method are disclosed for anterior intervertebral fusion with fixation. An intervertebral fusion with fixation device includes a spacer configured to fit into a disc space between plural vertebrae, the spacer including through holes between and through plural sidewalls. A first fixating element is rigidly preloaded in a first portion of the spacer along a first linear trajectory. A second fixating element is rigidly preloaded in a second portion of the spacer along a second linear trajectory. An integrated drill and screwdriver instrument is adapted to extend through a cannula of the first fixating element and second fixating element and penetrate the vertebra. The instrument is further adapted to drive the head of the first fixating element and second fixating element into the vertebra and lock the first fixating element and second fixating element with respect to the spacer to prevent extrusion from the spacer.

1 . An intervertebral fusion with fixation device configured to be implanted between plural vertebrae, the device comprising:
 a spacer with an insertion wall, a trailing wall opposite to the insertion wall, a first lateral wall, a second lateral wall opposite to the first lateral wall, a top surface, and a bottom surface opposite to the top surface;   a first fixating element rigidly preloaded in a first portion of the spacer along a first linear trajectory, the first fixating element configured to penetrate and secure to a first vertebra by advancing along the first linear trajectory; and   a second fixating element rigidly preloaded in a second portion of the spacer along a second linear trajectory that is different from the first linear trajectory, the second fixating element configured to penetrate and secure to a second vertebra by advancing along the second trajectory.   
     
     
         2 . The intervertebral fusion with fixation device of  claim 1 , wherein the spacer includes a through opening having an entrance proximate the top surface and an exit proximate the bottom surface to facilitate contact and in-growth of bone fusion material with the first vertebra and second vertebra. 
     
     
         3 . The intervertebral fusion with fixation device of  claim 1 , wherein the spacer is made of polyetheretherketone (PEEK), other polymers, metal, ceramics, or composites. 
     
     
         4 . The intervertebral fusion with fixation device of  claim 1 , wherein at least one of the first fixating element and the second fixating element is a cannulated bone screw. 
     
     
         5 . The intervertebral fusion with fixation device of  claim 4 , wherein the cannulated bone screw includes a head that is configured to integrate with a driving instrument. 
     
     
         6 . The intervertebral fusion with fixation device of  claim 4 , wherein the cannulated bone screw includes a head that has a locking mechanism configured to penetrate and lock into spacer to prevent screw toggling and extrusion. 
     
     
         7 . An integrated drill and screwdriver instrument, the instrument comprising:
 a handle;   a driving element configured to engage a head of a bone screw and to rotate the bone screw into a vertebra,   a drilling element extending from the driving element, the drilling element configured to extend through a cannula of the bone screw and to penetrate the vertebra, the driving element engaging the head of the bone screw as the drilling element penetrates through a vertebral endplate.   
     
     
         8 . An intervertebral fusion with fixation system, the system compromising:
 an intervertebral fusion with fixation device configured to be implanted between plural vertebrae, the device comprising:
 a spacer with an insertion wall, a trailing wall opposite to the insertion wall, a first lateral wall, a second lateral wall opposite to the first lateral wall, a top surface, and a bottom surface opposite to the top surface; 
 a first fixating element rigidly preloaded in a first portion of the spacer along a first linear trajectory, the first fixating element configured to penetrate and secure to a first vertebra by advancing along the first linear trajectory; and 
 a second fixating element rigidly preloaded in a second portion of the spacer along a second linear trajectory that is different from the first linear trajectory, the second fixating element configured to penetrate and secure to a second vertebra by advancing along the second trajectory; and 
   an integrated drill and screwdriver instrument, the instrument comprising:
 a handle; 
 a driving element configured to engage a head of a bone screw and to rotate the bone screw into a vertebra; and 
 a drilling element extending from the driving element, the drilling element configured to extend through a cannula of the bone screw and to penetrate the vertebra, the driving element engaging the head of the bone screw as the drilling element penetrates through a vertebral endplate. 
   
     
     
         9 . A method to secure plural vertebrae, the method comprising:
 implanting an intervertebral fusion with fixation device between plural vertebrae, the device comprising:
 a spacer with an insertion wall, a trailing wall opposite to the insertion wall, a first lateral wall, a second lateral wall opposite to the first lateral wall, a top surface, and a bottom surface opposite to the top surface; 
 a first fixating element rigidly preloaded in a first portion of the spacer along a first linear trajectory; and 
 a second fixating element rigidly preloaded in a second portion of the spacer along a second linear trajectory that is different from the first linear trajectory, the second fixating element configured to penetrate and secure to a second vertebra by advancing along the second trajectory; 
   driving the first fixating element along the first linear trajectory to penetrate the first vertebra and to secure the spacer to the first vertebra; and   driving the second fixating element along the second linear trajectory to penetrate the second vertebra and to secure the spacer to the second vertebra.   
     
     
         10 . The method of  claim 9 , the method comprising:
 introducing an integrated drill and screwdriver instrument to the first fixating element of the intervertebral fusion with fixation device, the instrument comprising:
 a handle; 
 a driving element configured to engage a head of the first fixating element; and 
 a drilling element extending from the driving element, the drilling element configured to extend through a cannula of the first fixating element; and 
   drilling the first vertebra with the drilling element;   engaging the first fixating element with the driving element as the drilling element penetrates through a vertebral endplate of the first vertebra; and   rotating the first fixating element via the driving element to penetrate the first vertebra and to secure the spacer to the first vertebra.   
     
     
         11 . The method of  claim 10 , the method comprising:
 locking the first fixating element with respect to the spacer to prevent the first fixating element from extruding from the spacer.   
     
     
         12 . The method of  claim 9 , the method comprising:
 introducing the instrument to the second fixating element of the intervertebral fusion with fixation device;   drilling the second vertebra with the drilling element;   engaging the second fixating element with the driving element as the drilling element penetrates through a vertebral endplate of the second vertebra; and   rotating the second fixating element via the driving element to penetrate the second vertebra and to secure the spacer to the second vertebra.   
     
     
         13 . The method of  claim 12 , the method comprising:
 locking the second fixating element with respect to the spacer to prevent the second fixating element from extruding from the spacer.   
     
     
         14 . A method to assemble an intervertebral fusion with fixation device, the method comprising:
 providing a spacer that includes an insertion wall, a trailing wall opposite to the insertion wall, a first lateral wall, a second lateral wall opposite to the first lateral wall, a top surface, and a bottom surface opposite to the top surface;   preloading a first fixating element rigidly in a first portion of the spacer along a first linear trajectory, the first fixating element configured to penetrate and secure to a first vertebra by advancing along the first linear trajectory; and   preloading a second fixating element rigidly in a second portion of the spacer along a second linear trajectory that is different from the first linear trajectory, the second fixating element configured to penetrate and secure to a second vertebra by advancing along the second trajectory.