(12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY(PCT)
`(19) World Intellectual Property
`=
`
`Organization
`
`International Bureau
`
`(43) International Publication Date
`22 January 2015 (22.01.2015)
`
`(51)
`
`International Patent Classification:
`
`A61F 2/44 (2006.01)
`
`(21)
`
`International Application Number:
`
`=z
`Soe=\
`
`WIPOI|PCT
`
`AMCTATA UAAAAA
`
`(10) International Publication Number
`WO 2015/009793 Al
`
`(74) Agent: ALTMAN,Daniel, E.; Knobbe, Martens, Olson &
`Bear, LLP, 2040 Main Street, 14th Floor,
`Irvine, CA
`92614 (US).
`
`(22)
`
`International Filing Date:
`
`(25)
`
`Filing Language:
`
`Publication Language:
`
`PCT/US2014/046804
`
`(81)
`
`16 July 2014 (16.07.2014)
`
`English
`
`English
`
`Priority Data:
`61/847,506
`
`17 July 2013 (17.07.2013)
`
`US
`
`Applicant: SPINAL USA, INC. [US/US]; 5 Sylvan Way,
`Suite 220, Parsippany, NJ 07054 (US).
`
`Inventors: MOZELESKI,Scott, E.; 5 Sylvan Way, Suite
`220, Hoboken, NJ (US). CAMPBELL, Michael, N.; 5
`Sylvan Way, Suite 220, Elmwood Park, NJ (US).
`
`(84)
`
`(26)
`
`(30)
`
`(71)
`
`(72)
`
`Designated States (unless otherwise indicated, for every
`kind of national protection available): AE, AG, AL, AM,
`AO, AT, AU, AZ, BA, BB, BG, BH, BN, BR, BW, BY,
`BZ, CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM,
`DO, DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM,GT,
`HN, HR, HU,ID,IL,IN,IR, IS, JP, KE, KG, KN, KP, KR,
`KZ, LA, LC, LK, LR, LS, LT, LU, LY, MA, MD, ME,
`MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, NO, NZ,
`OM,PA,PE, PG, PH,PL, PT, QA, RO, RS, RU, RW, SA,
`SC, SD, SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, TM,
`TN, TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM,
`ZW.
`
`Designated States (unless otherwise indicated, for every
`kind of regional protection available): ARIPO (BW, GH,
`GM, KE, LR, LS, MW, MZ, NA, RW, SD, SL, SZ, TZ,
`UG, ZM, ZW), Eurasian (AM, AZ, BY, KG, KZ, RU,TJ,
`TM), European (AL, AT, BE, BG, CH, CY, CZ, DE, DK,
`
`[Continued on next page]
`
`(57) Abstract: Devices and methods are provided for spinal
`disc replacement. A plate can be configured to couple to an
`intervertebral cage disposed in an intervertebral space. The
`plate can be modular. For example, the plate can have a first
`receiving portion angled relative to a second receiving por-
`tion. Thefirst receiving portion receivesa first bone screw or
`bone blade to engage a first vertebra, and the second receiv -
`ing portion receives a second bone screw or bone blade to
`engage a second vertebra. A retention member can be
`coupled to the plate. The retention member is configured to
`block first and second bone screws or bone blades from
`backing out of the plate.
`
`(54) Title: MODULAR INTERVERTEBRAL CAGE SYSTEM
`
`700
`
`
`
`
`
`
`wo2015/009793A[INTIMAUMANITIETATATMATCAMAAAT
`
` we RN
`[SSSSeven
`OX SettetSS
`Vv =-200
`
`FIG. 1
`
`000001
`
`Exhibit 1006
`LIFE SPINE,INC.
`IPR2022-01602
`
`Exhibit 1006
`LIFE SPINE, INC.
`IPR2022-01602
`
`000001
`
`

`

`WO 2015/009793 AIIMNTIMITTAIINMA IANA TA AAUIANAT
`
`EE, ES, FI, FR, GB, GR, HR, HU,IE, IS, IT, LT, LU, Published:
`LV, MC, MK,MT,NL, NO,PL, PT, RO,RS, SE, SI, SK,
`SM, TR), OAPI (BF, BJ, CF, CG, CI, CM, GA, GN, GQ,
`GW, KM,ML, MR,NE, SN, TD, TG).
`Declarations under Rule 4.17:
`
`with international search report (Art. 21(3))
`
`before the expiration of the time limit for amending the
`claims and to be republished in the event of receipt of
`amendments (Rule 48.2(h))
`
`as to applicant's entitlement to apply for and be granted
`a patent (Rule 4.17(ii))
`
`as to the applicant's entitlement to claim the priority of
`the earlier application (Rule 4.17/(iii))
`
`000002
`
`000002
`
`

`

`WO2015/009793
`
`PCT/US2014/046804
`
`MODULAR INTERVERTEBRAL CAGE SYSTEM
`
`
`CROSS-REFERENCE TO RELATED APPLICATIONS
`
`[0001]
`
`This application claims priority benefit of U.S. Provisional Application
`
`No. 61/847,506, entitled “MODULAR INTERVERTEBRAL CAGE SYSTEM,”filed
`
`July 17, 2013, the entirety of which is hereby incorporated by reference.
`
`TECHNICAL FIELD
`
`[0002]
`
`The present application relates to systems, devices, and methods for
`
`spinal surgeries. In particular,
`
`the present application relates to systems, devices, and
`
`methodsfor disc replacement surgeries.
`
`DESCRIPTION OF THE RELATED TECHNOLOGY
`
`[0003]
`
`The spine relies on intervertebral spinal discs in between adjacent
`
`vertebrae to serve as mechanical cushions and transmit compressive loads. Spinal discs are
`
`composed of an outer annulus fibrosus that surrounds an inner nucleus pulposus. The
`
`annulus fibrosus is composed of laminae of fibrous tissue and fibrocartilage, while the
`
`nucleus pulposus is composed of water, chondrocytes, collagen fibrils and proteoglycan
`
`agerecans that have hyaluronic long chains. The nucleus pulposus functions to distribute
`
`hydraulic pressurein all directions within each disc under compressive loads.
`
`[0004]
`
`The nucleus pulposus, which beginsearly in life as eighty percent water,
`
`slowly dessicates with age. This causes the spinal disc to lose its cushioning ability and
`
`ability to bear loads, resulting in pain in the back and lower extremities. To resolve these
`
`problems, the degenerated nucleus may be removed and replaced.
`
`In some other cases,
`
`the nucleus may be removed and the vertebrae may be fused together in a spinal fusion
`
`procedure, which may include implanting an intervertebral cage and/or bone growth
`
`material to facilitate fusion of the vertebrae.
`
`[0005]
`
`During vertebral disc replacement surgery, it is commonplace to insert
`
`an intervertebral spacer between two adjacent vertebrae in the place of a ruptured or
`
`diseased disc. Such intervertebral spacers can include, but are not limited to, bone grafts,
`
`peek cages, titanium cages, stainless steel cages, bioresorbable cages, and the like.
`
`In
`
`some circumstances, bone screws are passed through the intervertebral cage and into the
`
`adjacent vertebrae in order to anchorthe cage in place.
`
`000003
`
`000003
`
`

`

`WO2015/009793
`
`PCT/US2014/046804
`
`SUMMARY
`
`[0006]
`
`The systems, methods and devices described herein have innovative
`
`aspects, no single one of which is indispensable or solely responsible for their desirable
`
`attributes. Without limiting the scope of the claims, some of the advantageousfeatures will
`
`now be summarized.
`
`[0007]
`
`One aspect of the present invention is the realization that the anatomy
`
`of some patients’ spines is prohibitive to utilizing existing intervertebral cage designs and
`
`fixation means. Thus, there exists a need for a modular cage system which doesnot suffer
`
`from the deficiencies of conventional intervertebral cages.
`
`[0008]
`
`One non-limiting embodiment of the present invention includes a plate
`
`configured to couple to an intervertebral cage,
`
`the intervertebral cage configured and
`
`arranged to be positioned in an intervertebral space betweenafirst vertebra and a second
`
`vertebra, wherein the plate comprises an upper surface configured to engage thefirst
`
`vertebra and a lower surface opposite the upper surface, the lower surface configured to
`
`engage the second vertebra, wherein the plate comprises a posterior face configured to
`
`face the intervertebral space and abut an anterior face of the intervertebral cage and an
`
`anterior face configured to face outward from the intervertebral space; wherein the plate
`
`comprises a first receiving portion and a second receiving portion,
`
`the first receiving
`
`portion angled relative to the second receiving portion,
`
`the first
`
`receiving portion
`
`configured to receive a first bone fixation member,
`
`the first bone fixation member
`
`comprising either a bone screw or a boneblade, the first bone fixation member configured
`
`to engage a first vertebra, the second receiving portion configured to receive a second
`
`bonefixation member, the second bonefixation member comprising either a bone screw or
`
`a bone blade, the second bone fixation member configured to engage a second vertebra,
`
`the first and second receiving portions each configured to optionally receive either a bone
`
`screw or a boneblade.
`
`[0009]
`
`In another embodiment, the first and second receiving portions each
`
`comprise at least one guidancerail configured to guide a bone blade into a vertebra.
`
`[0010]
`
`In another embodiment, the first and second receiving portions each
`
`comprise a through bore and a head engaging portion, each through bore configured to
`
`receive the bone engaging portion of the bone fixation member, each head engaging
`
`-2-
`
`000004
`
`000004
`
`

`

`WO2015/009793
`
`PCT/US2014/046804
`
`portion
`
`configured to block the head of the bone fixation member from passing
`
`completely through the receiving portion.
`
`[0011]
`
`In another embodiment
`
`the through bore of the first and second
`
`receiving portions each comprise at least one guidance rail, wherein each guidancerail
`
`comprises a recess formed therein a wall of each through bore, each guidancerail
`
`configured to accept a portion of the bone blade and guide the bone blade into a vertebra
`
`as it is passed through the receiving portion.
`
`[0012]
`
`In another embodiment, each receiving portion is configured to receive
`
`a bone blade, wherein the bone blade comprises a head and a bone engaging portion,
`
`wherein the bone engaging portion of the bone blade comprises a curve along its length,
`
`wherein the bone engaging portion of the bone blade comprises a major rib, wherein the
`
`bone blade is configured to engage a vertebra via translation without rotation of the bone
`
`blade, wherein the each guidance rail is configured to accept the major rib of the bone
`
`blade and guide the bone blade into a vertebra.
`
`[0013]
`
`In another embodiment, the bone engaging portion of the bone blade
`
`comprises a minorrib arranged perpendicular to the major mb.
`
`[0014]
`
`In another embodiment, each through bore of each receiving portion
`
`comprises a central axis, and wherein each of the guidancerails are arranged substantially
`
`parallel to a central axis of the through bore.
`
`[0015]
`
`In another embodiment, an intervertebral cage configured and arranged
`
`to be positioned in an intervertebral space betweenafirst vertebra and a second vertebra,
`
`the intervertebral cage comprising an upper surface and a lower surface opposite the upper
`
`surface, the intervertebral cage comprising a posterior face and an anterior face opposite
`
`said posterior face,
`
`the intervertebral cage comprising at
`
`least two sidewalls; a plate
`
`configured to couple to the intervertebral cage, the intervertebral cage configured and
`
`arranged to be positioned in the intervertebral space, wherein the plate comprises an upper
`
`surface configured to engage the first vertebra and a lower surface opposite the upper
`
`surface,
`
`the lower surface configured to engage a second vertebra, wherein the plate
`
`comprises a posterior face configured to face the intervertebral space and abut an anterior
`
`face of the intervertebral cage and an anterior face configured to face outward from the
`
`intervertebral space; at least two bone fixation members adapted for insertion through the
`
`receiving portions of the plate and configured for anchoring the plate in an intervertebral
`
`-3-
`
`000005
`
`000005
`
`

`

`WO2015/009793
`
`PCT/US2014/046804
`
`space between two vertebrae of a patient, the bone fixation members comprising at least a
`
`first bone fixation member and a second bone fixation member, the first bone fixation
`
`member comprising either a bone screw or a bone blade and the second bonefixation
`
`member comprising either a bone screw or a bone blade, the first bone fixation member
`
`configured to engage the first vertebra, the second bone fixation member configured to
`
`engage the second vertebra; wherein the intervertebral cage comprises a first cage bore
`
`formed therethrough the anterior face and the upper surface configured to receivethefirst
`
`bone fixation member and a second cage bore formed therethrough the anterior face and
`
`the lower surface configured to receive the second bone fixation member; wherein the
`
`plate comprises a first receiving portion and a second receiving portion, the first recerving
`
`portion angled relative to the second receiving portion,
`
`the first
`
`receiving portion
`
`configured to receive the first bone fixation member,
`
`the second receiving portion
`
`configured to receive a second bone fixation member,
`
`the first and second receiving
`
`portions each configured to optionally receive either a bone screw or a bone blade;
`
`wherein the plate comprises a plate coupling portion configured to couple the plate to the
`
`intervertebral cage; and wherein the intervertebral cage comprises a cage coupling portion
`
`configured to couple the cage to theplate.
`
`[0016]
`
`In another embodiment, the intervertebral cage is constructed of PEEK
`
`and the plate is constructed of titanium.
`
`[0017]
`
`In another embodiment,
`
`the system includes a retention member
`
`coupled to the plate, the retention member configured to block first and second bone
`
`fixation members from backing out of the plate; wherein the retention member comprises a
`
`shaft portion and a blocking portion, the shaft portion configured to engage and couple the
`
`retention member to the plate, the blocking portion configured to engage the first and
`
`second bone fixation members; wherein the retention member is configured to rotate
`
`between a locked position and an unlocked positions such that when in an unlocked
`
`position, the first and second bone fixation members can be installed through the first and
`
`second receiving portions of the plate, and in a locked position, the first and second bone
`
`fixation members are locked in place.
`
`[0018]
`
`In another embodiment, the blocking portion comprises at least a first
`
`clearance side andafirst interference side, and a second clearance side and a second
`
`interference side, wherein the first and second clearance sides each comprise a recess
`
`-4-
`
`000006
`
`000006
`
`

`

`WO2015/009793
`
`PCT/US2014/046804
`
`formed therein the blocking portion of the retention member, providing room for the first
`
`and second bonefixation members to enter the first and second receiving portions of the
`
`plate, wherein the first and second interference sides include first and second engaging
`
`portions respectively, the first engaging portion configured to engage the head ofthefirst
`
`bone fixation member and the second engaging portion configured to engage the head of
`
`the second bonefixation member when the retention memberis rotated from an unlocked
`
`position to a locked position.
`
`[0019]
`
`In another embodiment, the retention member is configured such that
`
`interference fit exists between the blocking portion of the retention member and the heads
`
`of the first and second bone fixation members when the retention memberis in a locked
`
`position.
`
`[0020]
`
`In another embodiment, the first and second receiving portions each
`
`comprise at least one guidancerail configured to guide a bonefixation member comprising
`
`a bone blade into a vertebra, the first and second receiving portions each comprise a
`
`through bore and a head engaging portion, each through bore configured to receive the
`
`bone engaging portion of the bone fixation member, each head engaging portion
`
`configured to block the head of the bonefixation member from passing completely through
`
`the receiving portion, wherein the through bore ofthe first and second receiving portions
`
`each comprise at least one guidance rail, wherein each guidance rail comprises a recess
`
`formed therein a wall of each through bor, each guidance rail configured to accept a
`
`portion of the bone blade and guide the bone blade into a vertebra asit is passed through
`
`the receiving portion, each receiving portion is configured to receive a bone blade, wherein
`
`the bone blade comprises a head and a bone engaging portion, wherein the bone engaging
`
`portion of the bone blade comprises a curve along its length, wherein the bone engaging
`
`portion of the bone blade comprises a major rib, wherein the boneblade is configured to
`
`engage a vertebra via translation without rotation of the bone blade, wherein the each
`
`guidancerail is configured to accept the major rib of the bone blade and guide the bone
`
`blade into a vertebra, and wherein each through bore of each receiving portion comprises a
`
`central axis, and wherein each of the guidancerails are arranged substantially parallel to
`
`the central axis of the through bore.
`
`[0021]
`
`In another embodiment, the cage coupling portion of the intervertebral
`
`cage comprises at least one channel configured to receive a portion of the plate, and
`
`-5-
`
`000007
`
`000007
`
`

`

`WO2015/009793
`
`PCT/US2014/046804
`
`wherein the plate coupling portion of the plate comprises at least one clasp extending
`
`outwards from the posterior face of the plate, the at least one clasp configured to enter the
`
`channel of the intervertebral cage and couple the plate to the intervertebral cage.
`
`[0022]
`
`In another embodiment, the intervertebral cage comprises at least one
`
`chamfer configured to deflect the at
`
`least one clasp, wherein the intervertebral cage
`
`comprises at least one recess formed in the at least one channel, the recess configured to
`
`receive a portion of the at least one clasp, wherein the at least one clasp comprises a
`
`protrusion configured to engage the recess of the intervertebral cage, and wherein the at
`
`least one clasp is configured to deflect when coupling the intervertebral cage and to return
`
`to toward the undeflected position when the protrusion engages the recess of the
`
`intervertebral cage and couples the plate to the intervertebralplate.
`
`[0023]
`
`In another embodiment, the plate comprises a plate height defined by
`
`the distance between the upper surface and the lower surface of the plate, wherein the
`
`intervertebral cage comprises an anterior cage height defined by the distance between the
`
`upper surface and the lower surface of the cage measured at an anterior face of the
`
`intervertebral cage, wherein the plate height is substantially the same as the anterior cage
`
`height.
`
`[0024]
`
`In another embodiment, A method for installing a spinal implant system
`
`includes positioning an intervertebral cage in an intervertebral space between a first
`
`vertebra and a second vertebra; positioning a plate at least partially in the intervertebral
`
`space and coupling the plate to the intervertebral cage; wherein coupling the plate to the
`
`intervertebral cage comprises
`
`forcing the plate agamst
`
`the anterior
`
`face of the
`
`intervertebral cage; installing a first bone fixation element througha first receiving portion
`
`of the plate and into a first vertebra, the first vertebra located above the intervertebral
`
`cage; installing a second bonefixation element througha first receiving portion of the plate
`
`and into a second vertebra, the second vertebra located below the intervertebral cage;
`
`wherein at least one of the first bone fixation element and second bonefixation element
`
`comprises a bone blade; rotating a retention member 90 degrees to lock the first and
`
`second bonefixation elements in place.
`
`[0025]
`
`In another embodiment,
`
`installation of the bone blade comprises
`
`aligning a major rib of the bone blade in a guidance rail located in the first or second
`
`-6-
`
`000008
`
`000008
`
`

`

`WO2015/009793
`
`PCT/US2014/046804
`
`receiving portion and exerting a force substantially parallel to a center axis of the bone
`
`blade in the posterior direction causing the bone bladeto enter thefirst or second vertebra.
`
`[0026]
`
`In another embodiment, the bone blade comprises a curve along a bone
`
`engaging portion of the boneblade.
`
`[0027]
`
`In another embodiment, rotating a retention member comprises creating
`
`an interference fit between the retention member and the first and second bonefixation
`
`elements, locking the first and second bonefixation elements in place.
`
`[0028]
`
`In another embodiment, a method of removing a bone blade whichis
`
`implanted into a intervertebral cage and a vertebra includes maneuvering a bone blade
`
`extraction tool towards the bone blade, rotating the bone blade extraction tool until at least
`
`one extraction lobe of the bone blade extraction tool aligns with at least one lobe recess of
`
`a tool receiving portion of the bone blade, inserting the bone blade extraction tool into the
`
`tool receiving portion of the bone blade until the at least one extraction lobe reaches an
`
`undercut channelof the tool receiving portion, rotating the bone blade extraction tool until
`
`the at least one extraction lobe locks the bone blade extraction tool to the bone blade, and
`
`pulling the bone blade extraction tool away from the intervertebral cage.
`
`[0029]
`
`In another embodiment, at least one extraction lobe locking the bone
`
`blade extraction tool to the bone blade includes the at least one extraction lobe achieving
`
`an interference fit between the at least one extraction lobe and the undercut channel.
`
`[0030]
`
`In another embodiment, the undercut channel comprises a decreasing
`
`diameter configured to achieve an interference fit with the at least one extraction lobe of
`
`the boneblade extraction tool.
`
`
`BRIEF DESCRIPTION OF THE DRAWINGS
`
`[0031]
`
`The above-mentioned aspects, as well as other features, aspects, and
`
`advantages of the present technology will now be described in connection with various
`
`embodiments, with reference to the accompanying drawings. Theillustrated embodiments,
`
`however, are merely examples and are not intendedto be limiting. Like reference numbers
`
`and designations in the various drawings indicate like elements.
`
`[0032]
`
`Figure | illustrates a perspective view of one embodiment of a modular
`
`cage system.
`
`-7-
`
`000009
`
`000009
`
`

`

`WO2015/009793
`
`PCT/US2014/046804
`
`[0033]
`
`Figure 2 illustrates a perspective view of one embodiment of an
`
`intervertebral cage.
`
`[0034]
`
`[0035]
`
`Figure 2.
`
`[0036]
`
`[0037]
`
`Figure 3 illustrates a perspective view of one embodimentofa plate.
`
`Figure 4 illustrates a top section view of the intervertebral cage of
`
`Figure 5 illustrates a top view ofthe plate of Figure 3.
`
`Figure 6Aillustrates a front view of the modular cage system of Figure
`
`1.
`
`1.
`
`blade.
`
`[0038]
`
`Figure 6B illustrates a side view of the modular cage system of Figure
`
`[0039]
`
`Figure 7A illustrates a perspective view of one embodiment of a bone
`
`[0040]
`
`[0041]
`
`Figure 2.
`
`Figure 7B illustrates a side view of the bone blade of Figure 7A.
`
`Figure 8 illustrates a perspective view of the intervertebral cage of
`
`[0042]
`
`Figure 9 illustrates a top section view of the plate of Figure 3 including
`
`one embodiment of a retention memberin a locked position.
`
`[0043]
`
`Figure 10A illustrates a perspective view of one embodiment of a
`
`retention member.
`
`[0044]
`
`Figure 10B illustrates a top view of the retention member of Figure
`
`10A.
`
`[0045]
`
`Figure 10C illustrates a perspective view of the retention member of
`
`Figure 10A.
`
`[0046]
`
`Figure 10D illustrates a side view of the retention member of Figure
`
`10A.
`
`TA.
`
`[0047]
`
`Figure 11 illustrates a partial section view of the bone blade of Figure
`
`[0048]
`
`Figure 12 illustrates a partial section view of one embodiment of a bone
`
`blade insertion tool engaged to the bone blade of Figure 7A.
`
`[0049]
`
`Figure 13 illustrates a partial section view of the bone blade insertion
`
`tool of Figure 12 engaged to the bone blade of Figure 7A and approaching the delivery
`
`site.
`
`000010
`
`000010
`
`

`

`WO2015/009793
`
`PCT/US2014/046804
`
`[0050]
`
`Figure 14 illustrates a partial section view of the bone blade of Figure
`
`7A fully installed in the plate and engaged by the bone bladeinsertion tool of Figure 12.
`
`[0051]
`
`Figure 15 illustrates a front view of the modular cage system of Figure
`
`1 including one embodimentof a bone blade extraction tool.
`
`[0052]
`
`Figure 16 illustrates a partial section view of the bone blade of Figure
`
`TA.
`
`[0053]
`
`Figure 17 illustrates a partial section view of the bone blade of Figure
`
`7A fully installed in the plate and engaged by the bone blade extraction tool of Figure 15.
`
`DETAILED DESCRIPTION
`
`[0054]
`
`In the following detailed description,
`
`reference is made to the
`
`accompanying drawings, which form a part of the present disclosure. The illustrative
`
`embodiments described in the detailed description, drawings, and claims are not meant to
`
`be limitng. Other embodiments may be utilized, and other changes may be made, without
`
`departing from the spirit or scope of the subject matter presented here.
`
`It will be readily
`
`understood that the aspects of the present disclosure, as generally described herein, and
`
`illustrated in the Figures, can be arranged, substituted, combined, and designed in a wide
`
`variety of different configurations, all of which are explicitly contemplated and form part
`
`of this disclosure. For example, a system or device may be implemented or a method may
`
`be practiced using any number of the aspects set forth herein.
`
`In addition, such a system
`
`or device may be implemented or such a method maybe practiced using other structure,
`
`functionality, or structure and functionality in addition to or other than one or more ofthe
`
`aspects set forth herein. Alterations and further modifications of the inventive features
`
`illustrated herein, and additional applications of the principles of the imventions as
`
`illustrated herein, which would occur to one skilled in the relevant art and having
`
`possession ofthis disclosure, are to be considered within the scope of the invention.
`
`[0055]
`
`Descriptions of unnecessary parts or elements may be omitted for
`
`clarity and conciseness, and like reference numerals refer to like elements throughout.
`
`In
`
`the drawings, the size and thickness of layers and regions may be exaggerated for clarity
`
`and convenience.
`
`[0056]
`
`Features of the present disclosure will become more fully apparent from
`
`the
`
`followmg description and appended claims,
`
`taken in conjunction with the
`
`accompanying drawings.
`
`It will be understood these drawings depict only certain
`
`-9-
`
`000011
`
`000011
`
`

`

`WO2015/009793
`
`PCT/US2014/046804
`
`embodiments in accordance with the disclosure and, therefore, are not to be considered
`
`limiting of its scope; the disclosure will be described with additional specificity and detail
`
`through use of the accompanying drawings. An apparatus, system or method according to
`
`some of the described embodiments can have several aspects, no single one of which
`
`necessarily is solely responsible for the desirable attributes of the apparatus, system or
`
`method. After considering this discussion, and particularly after reading the section
`
`entitled “Detailed Description” one will understand how illustrated features serve to
`
`explain certain principles of the present disclosure.
`
`[0057]
`
`Embodiments described herein generally relate to systems, devices, and
`
`methods for spinal surgeries. More specifically, some embodiments relate to systems,
`
`devices, and methodsfor spinal fusion surgeries.
`
`[0058]
`
`Figure | illustrates a perspective view of one embodiment of a modular
`
`cage system 100. In some embodiments, the modular cage system 100 can include an
`
`intervertebral cage 200 configured and arranged to be positioned in an intervertebral space
`
`between two vertebrae of a patient during spinal surgery. In some embodiments,
`
`the
`
`modular cage system 100 can include a plate 300 configured to couple to the intervertebral
`
`cage 200. In some embodiments, the plate 300 can be coupled to an intervertebral cage
`
`200 before implantation of the intervertebral cage 200. In some embodiments, the plate
`
`300 can be coupled to the intervertebral cage 200 after implantation of the intervertebral
`
`cage 200. In some embodiments, the intervertebral cage 200 and plate 300 can be formed
`
`integrally and comprise a single piece. One advantage to separate intervertebral cage 200
`
`and plate 300 components is the ability to mix and match different configurations of plate
`
`300 with different configurations of intervertebral cage 200. In addition,
`
`the modular
`
`construction of the modular cage system 100 can minimize inventory levels. In some
`
`embodiments,
`
`the intervertebral cage 200 and plate 300 can be made from different
`
`materials wherein the material for each component of the modular cage system 100 can be
`
`selected to optimally achieve the goal of each component. In some embodiments, the
`
`intervertebral cage 200 can be made from polyether ether ketone (PEEK).
`
`In some
`
`embodiments,
`
`the plate 300 can be constructed from a metal material.
`
`In some
`
`embodiments, the plate 300 can be constructed from titanium, which for example, offers
`
`advantages such as strength,
`
`robustness, and flexibility.
`
`In some embodiments,
`
`the
`
`intervertebral cage 200, plate 300, retention member 500, or additional portion of the
`
`-10-
`
`000012
`
`000012
`
`

`

`WO2015/009793
`
`PCT/US2014/046804
`
`modular cage system 100 can be made from biocompatible materials which mayinclude,
`
`for example, metal, titanium, stainless steel, Nitinol, pyrolitic carbon, polymers, polyether
`
`ether ketone, silicone methylmethacrylate, or other biocompatible materials known in the
`
`art.
`
`[0059]
`
`In some embodiments,
`
`the modular cage system 100 can include a
`
`plurality of bone fixation members 400 adapted to anchor the modular cage system 100 in
`
`an intervertebral space between two vertebrae of a patient. In some embodiments, the bone
`
`fixation members 400 can be configured to pass through the intervertebral cage 200. In
`
`some embodiments, the bone fixation members 400 can be configured to pass through the
`
`plate 300.
`
`In some embodiments, the bone fixation members 400 can be configured to
`
`engage the adjacent vertebrae.
`
`[0060]
`
`Figure 2 illustrates a perspective view of one embodiment of an
`
`intervertebral cage 200. In some embodiments, the intervertebral cage 200 can include an
`
`upper surface 202. The upper surface 202 can be configured to engage a vertebra above
`
`the intervertebral cage 200. The intervertebral cage 200 can include a lower surface 204
`
`opposite the upper surface 202. The lower surface 204 can be configured to engage a
`
`vertebra below the intervertebral cage 200. In some embodiments, the upper surface 202
`
`and lower surface 204 can include a surface texture configured to retain the intervertebral
`
`cage 200 in the intervertebral space between two vertebrae and minimize movement ofthe
`
`vertebrae relative to the intervertebral cage 200. In some embodiments, the surface texture
`
`can be configured to promote bone ingrowth and fusion. In some embodiments,
`
`the
`
`surface texture can include a pattern of peaks and valleys. In some embodiments, the
`
`surface texture can include a plurality of pyramid-shaped bumps. In some embodiments,
`
`the bumps can be created using a radius cut. In some embodiments, the bumps can be
`
`slanted to limit migration of the intervertebral cage 200 in a particular direction. In some
`
`embodiments,
`
`the bumps can be slanted towards the posterior
`
`face 208 of the
`
`intervertebral cage 200. In some embodiments, the bumps can be slanted towards the
`
`anterior face 206 of the intervertebral cage 200.
`
`[0061]
`
`In some embodiments, the intervertebral cage 200 can include a graft
`
`window 210. The graft window 210 can be formed through the upper surface 202 and
`
`lower surface 204 of the intervertebral cage 200. The graft window 210 can be configured
`
`to promote bone ingrowth and fusion. In some embodiments, the graft window 210 can be
`
`-ll-
`
`000013
`
`000013
`
`

`

`WO2015/009793
`
`PCT/US2014/046804
`
`filled or partially filled with bone graft material prior to, during, or after implantation.
`
`Bone graft material can include autologous, allograft, or synthetic materials which may
`
`include, for example, hydroxyapatite, tricalcium phosphate, bioglass, or calcium sulphate.
`
`In some embodiments, growth factors can be included in the graft window 210. In some
`
`embodiments,
`
`the intervertebral cage 200 can include at
`
`least one marker device
`
`configured to be viewed via fluoroscopy and aid in the positioning of the intervertebral
`
`cage 200.
`
`[0062]
`
`In some embodiments,
`
`the intervertebral cage 200 can include an
`
`anterior face 206 and a posterior face 208 (See Figure 4) opposite the anterior face 206.
`
`The intervertebral cage 200 can include sidewalls 207 on each side of the intervertebral
`
`cage 200. In some embodiments, the anterior face 206 can be configured to abut the
`
`posterior face 308 of the plate 300. In some embodiments, intervertebral cage 200 can
`
`include a cage coupling portion 220 configured to couple the cage to the plate 300. In
`
`some embodiments, the sidewalls 207 of the intervertebral cage 200 can include a cage
`
`coupling portion 220 configured to couple the intervertebral cage 200 to the plate 300. In
`
`some embodiments, the anterior face 206 of the intervertebral cage 200 can include a cage
`
`coupling portion 220 configured to couple the cage to the plate 300.
`
`In some
`
`embodiments, the cage coupling portion 220 can be part of a different portion of the
`
`intervertebral cage 200, which may include for example, the upper surface 202, the lower
`
`surface 204, the graft win