Post-Operative Bone Grown Stimulant Introduction Method

Abstract

A method of revising a patient having a fusion cage implanted within a spinal column, involving percutaneously delivering a first end of a tube to the spinal column, fluidly connecting the first end of the tube to the fusion cage, and delivering a bone growth agent into the fusion cage through the tube.

We claim: 
     
         1 . A method of revising a patient having a fusion device having a cavity implanted within a spinal column, comprising the steps of:
 a) making an incision in the patient,   b) delivering through the incision a distal end of a tube to the spinal column,   c) fluidly connecting the distal end of the tube to the cavity of the fusion device, and   d) delivering a bone growth agent into the cavity of the fusion device through the tube.   
     
     
         2 . The method of  claim 1  further comprising, betweens steps c) and d), the step of
 e) removing tissue from the cavity of the fusion device. 
 
     
     
         3 . The method of  claim 2  wherein tissue removal is accomplished with lavage. 
     
     
         4 . The method of  claim 1  wherein, in step c), the tube connects to a port on the fusion device. 
     
     
         5 . The method of  claim 4  wherein the port is associated with a radiographic marker. 
     
     
         6 . The method of  claim 1  further comprising, before step d), the step of:
 e) fluidly connecting a bone growth transfer apparatus containing a bone growth agent to a proximal end of the tube. 
 
     
     
         7 . The method of  claim 1  further comprising, before step a), the step of:
 e) radiographically locating the fusion device within the patient. 
 
     
     
         8 . The method of  claim 7  wherein step e) includes radiographically aligning a pair of radiopaque rings located in the fusion device. 
     
     
         9 . The method of  claim 1  further comprising the step of:
 e) altering a component of the fusion device. 
 
     
     
         10 . The method of  claim 9  wherein the alteration is carried out by a step selected from the group consisting of exchanging the component, manipulating the component, adjusting the component, adding a component, and removing a component. 
     
     
         11 . The method of  claim 1  further comprising the step of:
 e) delivering additional bone growth agent to a location outside of the fusion device. 
 
     
     
         12 . The method of  claim 11  wherein the additional bone growth agent is delivered adjacent a facet joint. 
     
     
         13 . The method of  claim 1  wherein the bone growth agent travels through the tube by fluid convection. 
     
     
         14 . The method of  claim 1  wherein the bone growth agent travels through the tube in a solid carrier. 
     
     
         15 . The method of  claim 14  wherein the solid carrier snaps into the fusion device. 
     
     
         16 . The method of  claim 14  wherein the solid carrier threads into the fusion device. 
     
     
         17 . The method of  claim 14  wherein the solid carrier is empty during its delivery to the implanted fusion device. 
     
     
         18 . The method of  claim 14  wherein the solid carrier is filled with a collagen sponge during delivery to the fusion device. 
     
     
         19 . The method of  claim 14  wherein the carrier is filled with a scaffold material during delivery to the fusion device. 
     
     
         20 . The method of  claim 1  wherein the bone growth agent is flowable. 
     
     
         21 . A method of revising a patient having a fusion device implanted within a disc space, comprising the steps of:
 a) making an incision in the patient,   b) percutaneously delivering through the incision a first end of a tube to the disc space,   c) fluidly connecting the first end of the tube to the fusion device,   d) passing an instrument down the tube, and   e) manipulating the instrument to alter a component of the fusion cage.   
     
     
         22 . The method of  claim 21  wherein the manipulation results in an alteration selected from the group consisting of exchanging the component, manipulating the component, adjusting the component, adding a component, and removing a component of the fusion device. 
     
     
         23 . The method of  claim 21  wherein the manipulations results in removing a pin or screw to allow motion in a previously-locked device, or to increase the motion in a constrained-motion device. 
     
     
         24 . An assembly comprising:
 a) an intervertebral fusion device having a cavity and a port;   b) a tube having a proximal end and a distal end;   c) a bone growth transfer apparatus containing a bone growth agent;   
       wherein the proximal end of the tube is fluidly connected to the bone growth transfer apparatus; and 
       wherein the distal end of the tube is fluidly connected to the port of the fusion device. 
     
     
         25 . The device of  claim 24  wherein the bone growth agent is a non-autologous bone growth agent. 
     
     
         26 . The device of  claim 24  wherein the bone growth agent is a synthetic bone growth agent. 
     
     
         27 . The device of  claim 24  wherein the port is surrounded by a radiographic ring. 
     
     
         28 . The device of  claim 24  wherein the bone growth transfer apparatus is a syringe. 
     
     
         29 . The device of  claim 24  wherein the tube is sized to extend from the skin of a patient to a disc space in the patient. 
     
     
         30 . An intervertebral fusion cage having an anterior wall and a posterior wall connected by a pair of side walls, and a vertical throughhole, the cage further comprising a pair of radiopaque rings respectively embedded in two of the different walls, wherein the rings align. 
     
     
         31 . An intervertebral fusion cage having an anterior wall and a posterior wall connected by a pair of side walls, a vertical throughhole, a docking port, and a radiopaque marker indicating the docking port. 
     
     
         32 . The cage of  claim 31  wherein the radiopaque marker is a ring that surrounds the docking port. 
     
     
         33 . The cage of  claim 31  wherein the docking port is in fluid communication with the vertical throughhole. 
     
     
         34 . An intervertebral fusion cage having an anterior wall and a posterior wall connected by a pair of side walls, a vertical throughhole, and a plurality of docking ports adapted to receive a tube. 
     
     
         35 . The cage of  claim 34  wherein each docking port is in fluid communication with the vertical throughhole. 
     
     
         36 . The cage of  claim 34  wherein at least one of the docking ports is located in a sidewall. 
     
     
         37 . The cage of  claim 34  having a distal end of a tube received in one of the docking ports. 
     
     
         38 . The cage of  claim 37  having a bone growth transfer apparatus containing a bone growth agent fluidly connected to a proximal end of the tube. 
     
     
         39 . An assembly comprising:
 a) an intervertebral fusion device having a cavity and a port;   b) a tube having a proximal end and a distal end;   c) a disc-manipulating instrument received in the tube,   
       wherein the distal end of the tube is fluidly connected to the port of the fusion device, 
       wherein the disc-manipulating instrument has a distal working end located in the cavity of the fusion device. 
     
     
         40 . The device of  claim 39  wherein the disc-manipulating instrument is adapted to remove non-bony tissue from the cavity of the fusion device. 
     
     
         41 . The device of  claim 39  wherein the disc-manipulating instrument is adapted to cut a vertebral endplate. 
     
     
         42 . The device of  claim 39  wherein the disc-manipulating instrument is a drill. 
     
     
         43 . The device of  claim 39  wherein the disc-manipulating instrument is a rasp. 
     
     
         44 . The device of  claim 39  wherein the disc-manipulating instrument is a loop cutter. 
     
     
         45 . An assembly comprising:
 a) an intervertebral fusion device having a cavity and a port, wherein the port is fluidly connected to the cavity;   b) a tube having a proximal end and a distal end;   c) a preformed solid bone growth agent located in the tube;   
       wherein the distal end of the tube is fluidly connected to the port of the fusion device. 
     
     
         46 . The assembly of  claim 45  wherein the preformed solid bone growth agent has a cylindrical shape. 
     
     
         47 . The assembly of  claim 45  wherein the preformed solid bone growth agent has a length substantially equal to a length of the cavity of the fusion device. 
     
     
         48 . An assembly comprising:
 a) an intervertebral fusion device having a cavity and a port, wherein the port is fluidly connected to the cavity;   b) a tube having a proximal end and a distal end;   c) a solid carrier having a bone growth agent therein;   
       wherein the distal end of the tube is fluidly connected to the port of the fusion device, and 
       wherein the solid carrier is located in the tube. 
     
     
         49 . The assembly of  claim 48  wherein the solid carrier snaps into the fusion cage. 
     
     
         50 . The assembly of  claim 48  wherein the solid carrier threads into the fusion cage. 
     
     
         51 . An assembly comprising:
 a) an intervertebral fusion device having a cavity and a port, wherein the port is fluidly connected to the cavity;   b) a solid carrier having a bone growth agent therein;   
       wherein the solid carrier is located in the cavity of the fusion device. 
     
     
         52 . The assembly of  claim 51  wherein the solid carrier snaps into the fusion cage. 
     
     
         53 . The assembly of  claim 51  wherein the solid carrier threads into the fusion cage. 
     
     
         54 . A method of revising a patient having a fusion device having a cavity implanted adjacent a bone, comprising the steps of:
 a) making an incision in the patient,   b) delivering through the incision a distal end of a tube to the bone,   c) fluidly connecting the distal end of the tube to the cavity of the fusion device, and   d) delivering a bone growth agent into the cavity of the fusion device through the tube.