Patent Application
20140257232
The present disclosure relates to a bone graft delivery apparatus.
This section provides background information related to the present disclosure which is not necessarily prior art.
The human musculoskeletal system is composed of a variety of tissues including bone, ligaments, cartilage, muscle, and tendons. Tissue damage or deformity stemming from trauma, pathological degeneration, or congenital conditions often necessitates surgical intervention to restore function. Surgical intervention can include any surgical procedure that can restore function to the damaged tissue or correct the deformity, which can require the use of one or more implants such as bone grafts.
In one example, in order to restore function to or correct a deformity of the spinal column, posterior lumbar interbody fusion (PLIF) surgery can be performed through the posterior part of the spine. This technique can also be used through other lumbar approaches, such as anterior, posterolateral, as well as through various approaches in the thoracic and cervical spinal regions. During such surgery, hardware such as pedicle screws and rods can be attached to the back of the vertebra to stabilize the spine and to enhance the fusion rate. One or more intervertebral implants or spacers can also be used to further stabilize the spine. Bone grafts are inserted into the disc space from one side of the spine. Delivering and positioning the bone grafts into and within the disc space can be problematic.
This section provides a general summary of the disclosure, and is not a comprehensive disclosure of its full scope or all of its features.
In accordance with one particular aspect, the present teachings provide a bone graft delivery apparatus. The apparatus includes a housing including a barrel and a handle. A magazine is coupled to the housing and has a plurality of chambers. Each of the chambers is configured to support a bone graft. A plunger is supported by the housing and is configured to selectively pass through one of the chambers and along the barrel. A selector knob is operably coupled to a plurality of stops that are coupled to the plunger. The selector knob is movable into a plurality of positions, wherein each position employs one of the stops. A trigger mechanism is supported by the housing and is operably coupled to the plunger to advance the plunger along the barrel. A first of the stops prevents the plunger from being moved forward past a first predetermined plunger position when the selector knob is in a first of the positions. A second of the stops prevents the plunger from being moved forward past a second predetermined plunger position when the selector knob is in a second of the positions.
In accordance with another particular aspect, the present teachings provide a bone graft delivery apparatus. The apparatus includes a housing including a barrel and a handle. A magazine is rotatably coupled to the housing and has a plurality of chambers. Each of the chambers is configured to support a bone graft. A plunger is supported by the housing and is configured to selectively pass through one of the chambers and along the barrel. A selector knob is operably coupled to a plurality of stops that are coupled to the plunger. The selector knob is movable into a plurality of positions, wherein each position employs one of the stops. A trigger mechanism is supported by the housing and is operably coupled to the plunger to advance the plunger along the barrel. A first of the stops prevents a distal end of the plunger from moving beyond a first predetermined plunger distal end position that is short of a distal end of the barrel when the selector knob is in a first of the positions. A second of the stops prevents the distal end of the plunger from moving beyond a second predetermined plunger distal end position that is beyond the distal end of the barrel when the selector knob is in a second of the positions.
In accordance with still yet another particular aspect, the present teachings include a method of providing a bone graft delivery apparatus. The method includes configuring a longitudinal passageway and a plunger movable along the passageway to push a bone graft along the passageway. A stop mechanism is configured to selectively prevent the plunger from moving past a predetermined ready position with the bone graft being held by the passageway adjacent a distal end of the passageway. The stop mechanism is also configured to selectively prevent the plunger from moving past a predetermined dispensing position with a distal end of the plunger substantially aligned with the distal end of the passageway. The stop mechanism is additionally configured to selectively permit the plunger to move past the predetermined dispensing position to extend the plunger beyond the distal end of the passageway.
Further areas of applicability will become apparent from the description provided herein. The description and specific examples in this summary are intended for purposes of illustration only and are not intended to limit the scope of the present disclosure.
The drawings described herein are for illustrative purposes only of selected embodiments and not all possible implementations, and are not intended to limit the scope of the present disclosure.
Corresponding reference numerals indicate corresponding parts throughout the several views of the drawings.
Example embodiments will now be described more fully with reference to the accompanying drawings.
Referring to
A trigger mechanism 20 comprises trigger 22 coupled to housing 12 via pivot pin 24. Trigger mechanism 20 also comprises a plunger release plate 26 and a driving plate 28, each biased by a corresponding spring 30 and 32, respectively. Trigger mechanism 20 operates to drive plunger 16 down barrel 14 upon manual actuation of trigger 22. A plunger release plate 26 to be manually moved into an unlocked position against the biasing force of spring 30 until it engages stop 33, permitting plunger 16 to be manually withdrawn back along barrel 14.
A magazine 34 comprises a plurality of chambers 36, and each chamber 36 is configured to support a bone graft 18. In this case, four chambers 36 are provided in magazine 34. A spring loaded ball member 38 is centrally positioned to extend from each opposing side of magazine 34. Spring loaded ball members 38 cooperate with a detent 40 at the end of recess 42 of housing 12 to releasably couple magazine 34 to housing 12. A detent 44 on the outer circumferential surface of magazine 34 is associated with each chamber 36 to cooperate with a protrusion 46 of housing 12 when the chamber 36 is in an angular position such that it is aligned with plunger 16 and barrel 14.
An elongate member 48 is provided at the proximal end of plunger 16. Elongate member 48 includes an enlarged knurled knob 49 to facilitate a surgeon rotating the elongate member 48 into one of a plurality of selected angular positions. Thus, in this case, selector knob 49 is an integral part of elongate member 48. Each selected angular position corresponds to one of a plurality of stops 50, 52, 54 of elongate member 48. When selected, each stop 50, 52, 54 of the elongate member 48 engages a cooperating stop 55 of housing 12 to prevent plunger 16 from moving beyond a predetermined position corresponding to the selected stop 50, 52, or 54.
With additional reference to
To operate the bone graft dispensing device 10, plunger 16 is withdrawn from barrel 14 so that magazine 34 can be coupled to housing 12. Spring loaded ball members 38 are aligned with and manipulated down recess 42 until spring loaded ball members 38 engage with cooperating detents 40; thereby removably coupling magazine 34 to housing 12. If necessary, magazine 34 is rotated until housing protrusion 46 engages one of positioning detents 44 that corresponds to a chamber 36 supporting a bone graft 18.
A surgeon can rotate the elongate member into the first position. Elongate member 48 can include indicia 60 to identify the correct angular positioning to the surgeon. In this case, indicia 60 is positioned on the outer periphery of elongate member 48 adjacent each stop 50, 52, 54. Thus, indicia 60 is directly in the surgeon's line of sight as bone graft dispensing device 10 is held in his or her hand. Alternatively, indicia 60 can be provided on the outer end surface of elongate member 48. In either case, indicia 60 can be aligned with a known position relative to housing 12, which can include corresponding indicia (e.g., arrow) 62.
A surgeon can position the distal end 64 of the barrel 14 adjacent a spinal disc space (not shown). Prior to or after such positioning, the surgeon can actuate trigger mechanism 20 which advances the distal end 66 of plunger 16 along barrel 14; thereby advancing bone graft 18 along barrel 14. Barrel 14 includes slots 68 allowing the surgeon to visually verify the position of bone graft 18 along substantially the entire length of barrel 14.
With repeated actuation of trigger mechanism 20, the surgeon can advance plunger 16 and bone graft 18 along barrel 14 until the selected stop 50, 52, or 54 engages corresponding stop 55 of housing 12. As illustrated in
The size of bone graft 18 can affect the specific distance that distal end 66 of plunger 16 is short of distal end 64 of barrel 14 (or passageway 15) in the ready position. In some cases, distal end 66 of plunger 16 can be less than about 30 mm short of distal end 64 of barrel 14 when plunger 16 is in the predetermined ready position with cooperating stops 50 and 55 engaged against each other. In some cases, distal end 66 of plunger 16 can be from about 5 mm to about 30 mm short of distal end 64 of barrel 14 when plunger 16 is in the ready position. In some cases, distal end 66 of plunger 16 can be about 8 mm short of distal end 64 of barrel 14 when plunger 16 is in the ready position.
When the surgeon is ready to dispense bone graft from the delivery apparatus 10, the surgeon can rotate elongate member 48 into the second position. As illustrated in
As noted above, different situations may call for different dimensions, but in some cases, distal end 66 of plunger 16 can be from about 2 mm short of distal end 64 of barrel 14 to about 2 mm beyond distal end 64 of barrel 14 when plunger 16 is in the dispensing position. In some cases, distal end 66 of plunger 16 can be substantially aligned with distal end 64 of barrel 14 when plunger 16 is in the dispensing position.
When the surgeon desires to reposition a dispensed bone graft 18, the surgeon can rotate elongate member 48 into the third position. As illustrated in
As noted above, different situations may call for different dimensions, but in some cases, distal end 66 of plunger 16 can extend less than about 30 mm beyond distal end 64 of barrel 14 when plunger 16 is in the predetermined manipulating position. In some cases, distal end 66 of plunger 16 can extend from about 10 mm to about 25 mm beyond distal end 64 of barrel 14 when plunger 16 is in the predetermined manipulating position. In some cases, distal end 66 of plunger 16 can extend about 20 mm beyond distal end 64 of barrel 14 when plunger 16 is in the predetermined manipulating position.
Surgeon can press plunger release plate 26 against stop 33 causing plunger release plate 26 to rotate and allowing the surgeon to withdraw plunger 16 back to its starting position. The surgeon can rotate magazine 34 to the next chamber 36 holding a bone graft 18. The surgeon can also rotate selector knob 49 into the first stop position and repeat the process for multiple bone grafts 18, without having to completely reposition the bone graft delivery apparatus 10 within, or to completely remove and reinsert the bone graft delivery apparatus 10 into a body cavity opening.
Methods for providing a bone graft delivery apparatus 10 should also be apparent from the above. For example, methods can include configuring a longitudinal passageway 15 and a plunger 16 movable along the passageway to push a bone graft 18 along passageway 15.
A stop mechanism 48, 55 is provided and configured to selectively prevent plunger 16 from moving past a predetermined ready position with bone graft 18 being held by passageway 15 adjacent a distal end 64 of passageway 15. Stop mechanism 48, 55 can also be configured to selectively prevent plunger 16 from moving past a predetermined dispensing position with a distal end 66 of the plunger 16 substantially aligned with the distal end 64 of the passageway 15. Stop mechanism 48, 55 can additionally be configured to selectively permit plunger 16 to move past the predetermined dispensing position to extend distal end 66 of plunger 16 beyond distal end 64 of the passageway 15.
Stop mechanism 48, 55 can further be configured to selectively prevent plunger 16 from moving past a predetermined manipulating position with distal end 66 of plunger 16 extending a predetermined distance beyond distal end 64 of passageway 15. Distal end of plunger 16 can be configured to reposition bone graft 18 in a spinal disc space after bone graft 18 has been dispensed from passageway 15.
A trigger mechanism 20 can be provided and configured to advance plunger 16 along passageway 15. A magazine 34 can be provided and configured to support bone grafts 18 in chambers 36 configured to be selectively aligned with passageway 15 and plunger 16. Magazine 34 can additionally be configured to be retained in the various alignment positions (e.g., via detent 44 and cooperating protrusion 46 of housing 12).
The terminology used herein is for the purpose of describing a particular example embodiment only and is not intended to be limiting. For example, the terms first, second, third are used herein to differentiate the various stops from each other, such terms do not imply a sequence or order unless clearly indicated by the context. Thus, a first stop could be termed a second stop elsewhere in this disclosure and claims, and without departing from the teachings of the example embodiments.
The foregoing description of the embodiments has been provided for purposes of illustration and description. It is not intended to be exhaustive or to limit the disclosure. Individual elements or features of a particular embodiment are generally not limited to that particular embodiment, but, where applicable, are interchangeable and can be used in a selected embodiment, even if not specifically shown or described. The same may also be varied in many ways. Such variations are not to be regarded as a departure from the disclosure, and all such modifications are intended to be included within the scope of the disclosure.
