Systems and techniques for restoring and maintaining intervertebral anatomy

Abstract

Techniques and systems for distracting a spinal disc space and supporting adjacent vertebrae are provided. Trial instruments are insertable into the disc space to determine a desired disc space height and to select a corresponding implant. Implants can be also be self-distracting and the implant providing the desired disc space height can be implanted in the spinal disc space.

1 - 35 . (canceled)  
   
   
       36 . An implant insertion assembly, comprising: 
 an intervertebral implant having upper and lower surface and opposite lateral surfaces extending between said upper and lower surfaces, each of said lateral surfaces having a notch formed therein opening at a proximal end of said implant; and    an insertion instrument including a shaft with a distal coupling portion engageable in said notches of each of said opposite lateral surfaces of said implant, said coupling portion including a pair of distally extending and spaced apart fingers each positionable in a respective one of said notches, said fingers including a first position relative to one another for receiving said implant therebetween and a second position wherein said fingers in said notches grip said implant therebetween, wherein in said second position each of said fingers are received in said respective notch without protruding outwardly from said lateral surface adjacent said respective notch.    
   
   
       37 . The assembly of  claim 36 , wherein said lateral surfaces comprise outwardly facing surfaces of opposite sidewalls of said implant.  
   
   
       38 . The assembly of  claim 36 , wherein said shaft of said insertion instrument includes an outer shaft with said coupling portion at a distal end of said outer shaft, and an inner shaft extending through said outer shaft, said inner shaft including a distal end extending between said fingers and a proximal end extending proximally from said outer shaft.  
   
   
       39 . The assembly of  claim 38 , further comprising a handle adjacent said proximal end of said outer shaft, said inner shaft extending proximally of said handle, and said handle being obliquely oriented to said outer shaft.  
   
   
       40 . The assembly of  claim 38 , wherein said inner shaft includes an adjustment member at a proximal end thereof, said adjustment member being operable to rotate said inner shaft in said outer shaft.  
   
   
       41 . The assembly of  claim 40 , wherein said distal end of said inner shaft is threaded for engagement with a threaded hole in a trailing end wall of said implant.  
   
   
       42 . The assembly of  claim 40 , wherein said outer shaft includes a housing portion at said proximal end of said outer shaft, said adjustment member being positioned in said housing portion.  
   
   
       43 . The assembly of  claim 36 , wherein said coupling portion includes a body member and said pair of fingers extends distally from said body member on opposite sides thereof.  
   
   
       44 . The assembly of  claim 43 , wherein said shaft of said insertion instrument includes an outer shaft with said body member at a distal end of said outer shaft, and an inner shaft extending through said outer shaft and through a passage of said body member, said inner shaft including a distal end extending between said fingers.  
   
   
       45 . The assembly of  claim 43 , wherein said shaft of said insertion instrument includes an outer shaft and an inner shaft with said body member at a distal end of said inner shaft, said inner shaft extending through said outer shaft with said body member positioned distally of a distal end of said outer shaft.  
   
   
       46 . The assembly of  claim 45 , wherein said body member includes a pair of biasing members spaced from one another with a slot therebetween, said pair of fingers extending distally from respective ones of said biasing members.  
   
   
       47 . The assembly of  claim 46 , wherein said pair of biasing members extend distally from a base portion of said body member, said base portion including a proximally tapered outer surface profile, wherein said outer shaft is distally advanceable along said outer surface of said base portion to move said pair of biasing members and said pair of fingers toward one another to grip said implant therebetween.  
   
   
       48 . The assembly of  claim 46 , wherein in said first position each of said fingers are disengaged from said implant and received in said respective notch without protruding outwardly from said lateral surface adjacent said respective notch.  
   
   
       49 . A spinal implant, comprising: 
 an elongated body sized for positioning in a spinal disc space and extending along a longitudinal axis between a distal leading end portion and an opposite trailing end portion, said body further comprising: 
 opposite first and second sidewalls extending along said longitudinal axis between said leading end portion and said trailing end portion, said first and second sidewalls extending parallel to one another at least adjacent said leading end portion of said body;  
 an upper surface and an opposite lower surface extending along said body between said first and second sidewalls and between said leading end portion and said trailing end portion, wherein said upper and lower surfaces are each convexly curved along said longitudinal axis;  
 a cavity extending between and opening through said upper and lower surfaces;  
 a number of engaging members extending from said upper and lower surfaces around said cavity for engaging an adjacent vertebral endplate;  
 at least one hole in each of said first and second sidewalls in communication with said cavity; and  
 wherein said leading end portion includes convexly curved and smooth upper and lower surface portions extending along said longitudinal axis from said engaging members toward a leading end of said body.  
   
   
   
       50 . The implant of  claim 49 , wherein said upper and lower surfaces are smooth adjacent said trailing end portion of said implant.  
   
   
       51 . The implant of  claim 49 , wherein said first and second sidewalls are parallel to one another along an entire length of said body.  
   
   
       52 . The implant of  claim 49 , wherein said leading end is convexly curved between said upper and lower surface portions.  
   
   
       53 . The implant of  claim 49 , wherein said body includes: 
 a first notch in said first sidewall of said body; and    a second notch in said second sidewall of said body, said first and second notches opening at a proximal end wall of said body.    
   
   
       54 . The implant of  claim 53 , wherein said proximal end wall is planar and extends between said first and second sidewalls and said upper and lower surfaces.  
   
   
       55 . The implant of  claim 49 , wherein said cavity includes an oval shape elongated along said longitudinal axis and defined by inner surfaces of said first and second sidewalls of said body, said inner surfaces extending parallel to one another along said cavity.  
   
   
       56 . The implant of  claim 55 , wherein said inner surfaces of said first and second sidewalls are connected at one end thereof with a curved inner surface adjacent said leading end portion and at an opposite end thereof with a curved inner surface adjacent said trailing end portion.  
   
   
       57 . The implant of  claim 55 , wherein said cavity extends along more than half a length of said body between said leading end portion and said trailing end portion.  
   
   
       58 . A spinal implant, comprising: 
 an elongated body sized for positioning in a spinal disc space and extending along a longitudinal axis between a leading end and an opposite trailing end, said body further comprising: 
 opposite first and second sidewalls extending along said longitudinal axis between said leading end and said trailing end;  
 an upper surface and an opposite lower surface extending along said body between said first and second sidewalls and between said leading end and said trailing end, wherein said upper and lower surfaces are each convexly curved along said longitudinal axis,  
 a cavity extending between and opening through said upper and lower surfaces; and  
 a number of engaging members extending from said upper and lower surfaces around said cavity, said engaging members being configured for engaging an adjacent vertebral endplate, wherein said upper and lower surfaces each include a convexly curved smooth surface portion adjacent said leading end extending from said cavity toward said leading end.  
   
   
   
       59 . The implant of  claim 58 , wherein said first and second sidewalls extending parallel to one another at least adjacent said leading end of said body.  
   
   
       60 . The implant of  claim 58 , further comprising at least one hole in each of said first and second sidewalls in communication with said cavity.  
   
   
       61 . The implant of  claim 58 , wherein said upper and lower surfaces are smooth adjacent said trailing end of said implant.  
   
   
       62 . The implant of  claim 58 , wherein said leading end is convexly curved between said upper surface and said lower surface.  
   
   
       63 . The implant of  claim 58 , wherein said cavity includes an elongated oval shape extending along more than half of a length of said body along said longitudinal axis, said cavity being defined by inner surfaces of said first and second sidewalls of said body, said inner surfaces extending parallel to one another along said cavity.  
   
   
       64 . The implant of  claim 58 , wherein said smooth surface portions further extend between said first and second sidewalls.