Bone anchoring systems

Abstract

Embodiments relate generally to tissue anchors and methods of deliveπng same to the intervertebral disc or other sites within the body. In some embodiments, the anchors provide increased pull-out resistance, stability and/or contact with tissue involving a reduced amount of penetration. In some embodiments, delivery methods are minimally invasive and can include linear, lateral, and off-angle implantation or driving of anchors along, against or within tissue surfaces. Several embodiments disclose anchors and anchoπng systems that effectively reconstruct or augment vertebral endplate surfaces.

1 - 24 . (canceled) 
     
     
         25 . A graft containment system, comprising:
 a support member for containing a bone graft implanted in a disc space between two vertebral bodies; and   a bone anchor for insertion into an outer surface and an endplate of a first vertebral body,   wherein the bone anchor comprises a neck having a length defined by a sharpened leading edge and a trailing end,   wherein said neck comprises an attachment site along at least a portion of its length,   wherein said support member is coupled to the neck via the attachment site,   wherein said neck comprises a bottom portion terminating in two or more keels,   wherein said keels are configured for pull-out resistance and stability by presenting a larger surface area below the endplate and embedded in the outer surface,   wherein said keels form an angle of about 10 to about 180 degrees relative to each other;   wherein each of said keels comprises sharpened leading edges,   wherein the attachment site is offset relative to both the anchor's angle of insertion and said neck to present said attachment site along the first endplate, while said keels are inserted into the outer surface,   wherein the sharpened leading edges of said keels are adapted to be driven into the outer surface while the support member is simultaneously advanced along and across the endplate, and   wherein the support member is configured to block the bone graft from extruding from the disc space.   
     
     
         26 . The graft containment system of  claim 25 , wherein the support member comprises a polymer and the anchor comprises titanium. 
     
     
         27 . The graft containment system of  claim 25 , wherein the neck comprises two keels that form an angle of about 180 degrees relative to each other. 
     
     
         28 . The graft containment system of  claim 25 , wherein the neck comprises two keels that form an angle of about 180 degrees relative to each other, and wherein the neck is perpendicular to said keels to form a “T” shape. 
     
     
         29 . The graft containment system of  claim 25 , wherein the support member comprises an anulus augmentation device. 
     
     
         30 . The graft containment system of  claim 25 , wherein the support member comprises a nucleus augmentation device. 
     
     
         31 . The graft containment system of  claim 25 , wherein the support member comprises a biologically active or therapeutic agent. 
     
     
         32 . The graft containment system of  claim 25 , wherein the support member comprises a polymer. 
     
     
         33 . The graft containment system of  claim 25 , wherein the bone anchor further comprises an engagement portion. 
     
     
         34 . The graft containment system of  claim 33 , wherein said engagement portion comprises at least one barb, hook, or angled projection. 
     
     
         35 . The graft containment system of  claim 33 , wherein said engagement portion comprises one or more teeth, spikes or barbs. 
     
     
         36 . The graft containment system of  claim 33 , wherein said engagement portion comprises one or more protrusions. 
     
     
         37 . The graft containment system of  claim 33 , wherein said engagement portion comprises one or more friction plates. 
     
     
         38 . The graft containment system of  claim 25 , wherein the bone anchor comprises a biologically active or therapeutic agent. 
     
     
         39 . The graft containment system of  claim 25 , wherein the anchor is at least partially constructed from a material selected from the group consisting of one or more of the following: nickel titanium alloy, titanium, cobalt chrome alloy, and steel. 
     
     
         40 . The graft containment system of  claim 25 , wherein said support member and said anchor are integral. 
     
     
         41 . A method of reconstructing or augmenting a vertebral endplate to retain a graft, comprising:
 identifying a first vertebral body and a second vertebral body, wherein said first vertebral body comprises a first outer surface and a first endplate;   identifying a disc space bordered by the first vertebral body and the second vertebral body,   providing a bone graft containment system comprising a bone graft, a support member for containing the bone graft, and a bone anchor,   wherein the bone anchor is configured for insertion into the first outer surface and for presenting an attachment site along the first endplate,   wherein the first outer surface is offset at an angle substantially perpendicular from the first endplate,   wherein the support member is coupled to the bone anchor;   wherein the bone anchor comprises a neck,   wherein said neck has a length defined by a sharpened leading edge and a trailing end,   wherein said neck comprises an attachment site along at least a portion of its length,   wherein said attachment site is attachable to the support member,   wherein the attachment site is configured to extend above the first endplate,   wherein said neck comprises a bottom portion terminating in two or more keels,   wherein said keels are configured for pull-out resistance and stability by presenting a larger surface area below the first endplate and embedded in the first outer surface,   wherein said keels form an angle of about 10 to about 180 degrees relative to each other;   wherein each of said keels comprises sharpened leading edges,   wherein the attachment site is offset relative to both the anchor's angle of insertion and said neck to present said attachment site along the first endplate, while said keels are inserted into the first outer surface;   inserting the bone graft into the disc space;   driving the sharpened leading edges of the keels into the first outer surface while simultaneously advancing the support member along and across the first endplate until said anchor is countersunk within said outer surface; and   positioning the support member to contain the bone graft, thereby reconstructing or augmenting the endplate of the first vertebral body to minimize extrusion of the bone graft from the disc space.   
     
     
         42 . The method of  claim 41 , wherein the neck comprises two keels that form an angle of about 180 degrees relative to each other. 
     
     
         43 . The method of  claim 41 , wherein the neck comprises two keels that form an angle of about 180 degrees relative to each other, and wherein the neck is perpendicular to said keels to form a “T” shape. 
     
     
         44 . A method of reconstructing or augmenting a vertebral endplate to retain a graft, comprising:
 identifying a first vertebral body and a second vertebral body, wherein said first vertebral body comprises a first outer surface and a first endplate;   identifying a disc space bordered by the first vertebral body and the second vertebral body,   providing a bone graft containment system comprising a support member for containing a bone graft and a bone anchor,   wherein the bone anchor is configured for insertion into the first outer surface and for presenting an attachment site along the first endplate,   wherein the first outer surface is offset at an angle substantially perpendicular from the first endplate,   wherein the support member is coupled to the bone anchor,   wherein the bone anchor comprises a neck,   wherein said neck has a length defined by a sharpened leading edge and a trailing end,   wherein said neck comprises an attachment site along at least a portion of its length,   wherein said attachment site is attachable to the support member,   wherein the attachment site is configured to extend above the first endplate,   wherein said neck comprises a bottom portion terminating in at least one keel,   wherein said keel is configured for pull-out resistance and stability by presenting a larger surface area below the first endplate and embedded in the first outer surface,   wherein said keel is substantially perpendicular to said neck to form a T-shape,   wherein said keel comprises a sharpened leading edge,   wherein the attachment site is offset relative to both the anchor's angle of insertion and said neck to present said attachment site along the first endplate, while said keel is inserted into the first outer surface;   inserting the bone graft into the disc space;   advancing the sharpened leading edge of the keel against the first outer surface while simultaneously advancing the support member along and across the first endplate; and   positioning the support member to contain the bone graft, thereby reconstructing or augmenting the endplate of the first vertebral body to minimize extrusion of the bone graft from the disc space.   
     
     
         45 . The method of  claim 44 , wherein the support member comprises a polymer and the anchor comprises titanium.