Spinal fusion implants and devices and methods for deploying such implants

Abstract

Methods and apparatus are disclosed for distracting tissue. The devices and methods may include insertion of first and second elongated members into the space between two tissue layers, with an augmenting elongated member inserted therebetween to form a distraction device between the tissues to be distracted. The distraction device defines a generally annular configuration, with a locking member secured to one of the elongated members at a plurality of locations to maintain the distraction device in the generally annular configuration. The augmenting elongated member may be shorter than the first and second elongated members such that a window is defined between the proximal and distal ends of the augmenting elongated member when the distraction device and the first and second elongated members are in the generally annular configuration. Bone graft material or bone filler may be introduced into the interior of the distraction device through the window.

The invention claimed is: 
     
       1. A tissue distraction device comprising:
 first and second elongated members, each elongated member defining a closed loop in a separate plane in a deployed configuration, wherein the first elongated member comprises a first elongated member proximal end and a first elongated member distal end; and 
 an augmenting elongated member fully comprising an augmenting elongated member proximal end and an augmenting elongated member distal end, wherein the augmenting elongated member is configured to be moved toward the first elongated member distal end to be fully received between the first and second elongated members in the deployed configuration and having a length that is less than the length of each of the first and second elongated members wherein the augmenting elongated ember distal end stops short of the first elongated member distal end in the deployed configuration. 
 
     
     
       2. The tissue distraction device of  claim 1 , wherein the augmenting, first, and second elongated members cooperate to define a window into an interior of the tissue distraction device. 
     
     
       3. The tissue distraction device of  claim 2 , wherein the window is configured to allow for the introduction of a bone filler material into the interior of the tissue distraction device through the window. 
     
     
       4. The tissue distraction device of  claim 2 , further comprising a locking member secured to the augmenting elongated member at a plurality of locations to lock the augmenting elongated member in a generally arcuate configuration, wherein a portion of the locking member extends across the window. 
     
     
       5. The tissue distraction device of  claim 4 , further comprising a fastener, wherein
 the locking member extends between a fixed end and a free end,   the fixed end of the locking member is secured at or adjacent to a proximal end of the augmenting elongated member, and   the fastener secures the free end of the locking member to the augmenting elongated member at or adjacent to the proximal end of the augmenting elongated member.   
     
     
       6. The tissue distraction device of  claim 1 , wherein the first, second, and augmenting elongated members combine to define a structure having a non-uniform thickness configured to adjust the lordotic angle of the a spine. 
     
     
       7. The tissue distraction device of  claim 1 , wherein
 each of the first and second elongated members extends between proximal and distal ends and includes a lateral side, and 
 one of the ends end of the first elongated member contacts the approaches a lateral side of the first elongated member adjacent to the other end of the first elongated member, and 
 one of the ends end of the second elongated member contacts the approaches a lateral side of the second elongated member adjacent to the other end of the second elongated member. 
 
     
     
       8. The tissue distraction device of  claim 1 , wherein each elongated member is generally rectangular in cross-sectional shape and defined by elongated upper and lower surfaces, proximal and distal ends, and elongated lateral side surfaces. 
     
     
       9. The tissue distraction device of claim  8  1, wherein each of the elongated members includes
 a longitudinally extending wall, 
 a plurality of similarly shaped first teeth extending laterally from the longitudinally extending wall in one direction, and 
 a plurality of similarly shaped second teeth extending laterally from the longitudinally extending wall in an opposite direction and differently configured from said first teeth. 
 
     
     
       10. A tissue distraction device comprising:
 first and second elongated members insertable between tissue layers and adapted to define a structure in situ having a dimensional aspect dimension in a direction extending between the tissue layers; and 
 an augmenting elongated member insertable between and in contact with said first and second elongated members to spread the first and second elongated members apart to increase the dimension of at least a portion of the structure in situ, wherein 
 each elongated member is generally rectangular in cross-sectional shape and defined by elongated upper and lower surfaces, proximal and distal ends, and elongated lateral side surfaces, 
 each elongated member is the first and second elongated members are sufficiently flexible to change between a generally linear first configuration and a second configuration that is less linear than the first configuration, wherein the first elongated member comprises a first elongated member proximal end and a first elongated member distal end, and wherein  
 the augmenting elongated member has a length that is less than the length of each of the first and second elongated members comprises an augmenting elongated member proximal end and an augmenting elongated member distal end, wherein the augmenting elongated member is configured to be moved toward the first elongated member distal end to be received between the first and second elongated members in the deployed configuration and the augmenting elongated member distal end stops short of the first elongated member distal end in the deployed configuration. 
 
     
     
       11. The tissue distraction device of  claim 10 , wherein each of the elongated members includes
 a longitudinally extending wall, 
 a plurality of similarly shaped first teeth extending laterally from the longitudinally extending wall in one direction, and 
 a plurality of similarly shaped second teeth extending laterally from the longitudinally extending wall in an opposite direction and differently configured from said first teeth. 
 
     
     
       12. The tissue distraction device of  claim 10 , wherein
 the proximal end of each of the first and second elongated members is ramped, and 
 the distal end of the augmenting elongated member augmenting elongated member distal end is tapered to engage and separate the first and second elongated members when the augmenting elongated member is inserted therebetween. 
 
     
     
       13. The tissue distraction device of  claim 10 , wherein the augmenting elongated member is configured to cooperate with said first and second elongated members to define a window into an interior of the tissue distraction device when the augmenting elongated member is inserted between and in contact with said first and second elongated members and the elongated members are in the second configuration. 
     
     
       14. The tissue distraction device of  claim 13 , further comprising a locking member configured to be secured to the augmenting elongated member at a plurality of locations to lock the augmenting elongated member in the second configuration in which a portion of the locking member extends across the window. 
     
     
       15. The tissue distraction device of  claim 14 , further comprising a fastener, wherein
 the locking member extends between a fixed end and a free end,   the fixed end of the locking member is secured at or adjacent to a proximal end of the augmenting elongated member, and   the fastener is configured to secure the free end of the locking member to the augmenting elongated member at or adjacent to the proximal end of the augmenting elongated member when the augmenting elongated member is in the second configuration.   
     
     
       16. The tissue distraction device of  claim 10 , wherein the first, second, and augmenting elongated members are configured to combine to define a structure having a non-uniform thickness configured to adjust the lordotic angle of the a spine. 
     
     
       17. The tissue distraction device of  claim 10 , wherein
 one of the ends end of the first elongated member is configured to contact one of the lateral sides approach a lateral side of the first elongated member adjacent to the other end of the first elongated member when the first elongated member is in the second configuration, and 
 one of the ends end of the second elongated member is configured to contact one of the lateral sides approach a lateral side of the second elongated member adjacent to the other end of the second elongated member when the second elongated member is in the second configuration. 
 
     
     
       18. The tissue distraction device of  claim 10 , wherein each of the first and second elongated members is configured to define a closed loop an annular shape in the second configuration. 
     
     
       19. The tissue distraction device of  claim 18 , wherein the augmenting elongated member is configured to define a generally arcuate configuration in the second configuration. 
     
     
       20. The tissue distraction device of  claim 10 , wherein
 each of the first and second elongated members is configured to define a closed loop an annular shape in the second configuration, 
 the augmenting elongated member is configured to cooperate with said first and second elongated members to define a window into an interior of the tissue distraction device in the second configuration, and 
 the window is configured to allow for the introduction of a bone filler material into the interior of the tissue distraction device in the second configuration through the window. 
 
     
     
       21. A tissue distraction device comprising:
 first and second elongated members insertable between tissue layers and adapted to define a structure in situ having a dimension in a direction extending between the tissue layers, wherein the first elongated member comprises a first elongated member proximal end and a first elongated member distal end; and   an augmenting elongated member comprising an augmenting elongated member proximal end and an augmenting elongated member distal end, wherein the augmenting elongated member is insertable between and in contact with said first and second elongated members to spread the first and second elongated members apart to increase the dimension of at least a portion of the structure in situ in a deployed configuration, wherein the augmenting elongated member is configured to be moved toward the first elongated member distal end to be received between the first and second elongated members in the deployed configuration and the augmenting elongated member distal end stops short of the first elongated member distal end in the deployed configuration.    
     
     
       22. The tissue distraction device of claim 21, wherein the augmenting, first, and second elongated members cooperate to define a window.  
     
     
       23. The tissue distraction device of claim 22, wherein the window is configured to allow for the introduction of a bone filler material through the window.  
     
     
       24. The tissue distraction device of claim 21, wherein the first, second, and augmenting elongated members combine to define a structure having a non-uniform thickness configured to adjust the lordotic angle of a spine.  
     
     
       25. The tissue distraction device of claim 21, wherein
 one end of the first elongated member approaches a lateral side of the first elongated member adjacent to the other end of the first elongated member, and   one end of the second elongated member approaches a lateral side of the second elongated member adjacent to the other end of the second elongated member.    
     
     
       26. The tissue distraction device of claim 21, wherein each elongated member is generally rectangular in cross-sectional shape.  
     
     
       27. The tissue distraction device of claim 21, wherein each of the elongated members includes
 a longitudinally extending wall,   a plurality of first teeth extending laterally from the longitudinally extending wall in one direction, and   a plurality of second teeth extending laterally from the longitudinally extending wall in an opposite direction.    
     
     
       28. The tissue distraction device of claim 1, wherein the augmenting, first, and second elongated members cooperate to define a window which is adjacent to the augmenting elongated member distal end.  
     
     
       29. The tissue distraction device of claim 10, wherein the augmenting, first, and second elongated members cooperate to define a window which is adjacent to the augmenting elongated member distal end.  
     
     
       30. The tissue distraction device of claim 21, wherein the augmenting, first, and second elongated members cooperate to define a window which is adjacent to the augmenting elongated member distal end.  
     
     
       31. The tissue distraction device of claim 1, wherein the augmenting, first, and second elongated members cooperate to define a window, wherein the augmenting elongated member distal end defines a lateral side of the window.  
     
     
       32. The tissue distraction device of claim 10, wherein the augmenting, first, and second elongated members cooperate to define a window, wherein the augmenting elongated member distal end defines a lateral side of the window.  
     
     
       33. The tissue distraction device of claim 21, wherein the augmenting, first, and second elongated members cooperate to define a window, wherein the augmenting elongated member distal end defines a lateral side of the window.  
     
     
       34. The tissue distraction device of claim 1, wherein the augmenting, first, and second elongated members cooperate to define a window, wherein the first and second elongated members define lower and upper sides of the window.  
     
     
       35. The tissue distraction device of claim 10, wherein the augmenting, first, and second elongated members cooperate to define a window, wherein the first and second elongated members define lower and upper sides of the window.  
     
     
       36. The tissue distraction device of claim 21, wherein the augmenting, first, and second elongated members cooperate to define a window, wherein the first and second elongated members define lower and upper sides of the window.  
     
     
       37. The tissue distraction device of claim 1, wherein a window is defined between the augmenting elongated member proximal end and the augmenting elongated member distal end, which define lateral sides of the window, and the first elongated member distal end and the second elongated member distal end, which define lower and upper sides of the window.  
     
     
       38. The tissue distraction device of claim 10, wherein a window is defined between the augmenting elongated member proximal end and the augmenting elongated member distal end, which define lateral sides of the window, and the first elongated member distal end and the second elongated member distal end, which define lower and upper sides of the window.  
     
     
       39. The tissue distraction device of claim 21, wherein a window is defined between the augmenting elongated member proximal end and the augmenting elongated member distal end, which define lateral sides of the window, and the first elongated member distal end and the second elongated member distal end, which define lower and upper sides of the window.