DRIVE INSTRUMENTS WITH RETENTION MECHANISMS, MEDICAL IMPLANTS, AND RELATED TECHNOLOGIES

A system for treating a subject's spine can include an intervertebral spacer. The intervertebral spacer can be movable between unexpanded and expanded configurations. A locking member can have a threaded distal region configured to threadably engage the intervertebral spacer, and a proximal drive. A drive instrument assembly can include a retention mechanism detachably couplable to the locking member. The retention mechanism can include a socket configured to receive the drive head to rotationally fix the drive instrument to the locking member, and a spring element biased outwardly to releasably hold the drive head in the socket when the spring element extends into the drive head. The drive instrument assembly can be configured to rotate the locking member to move the intervertebral spacer from the unexpanded configuration to the expanded configuration.

TECHNICAL FIELD

The present technology relates generally to drive instruments with retention mechanisms and, more particularly, to systems, devices, and methods for implanting medical devices.

BACKGROUND

Implants are often positioned at implantation sites within patients to treat various medical conditions, such as nerve compression and/or damaged or displaced spinal discs and/or vertebral bodies due to trauma, disease, degenerative defects, or wear over an extended period of time. One result of nerve compression and/or displacement or damage to a spinal disc or vertebral body may be chronic back pain. One procedure for treating the spine may involve partial or complete removal of tissue (e.g., an intervertebral disc, tissue contributing to stenosis, etc.) from a target implantation site, and implanting an implantable device along the spine to, for example, replace biological structures or support organs and tissues, reduce nerve compression, help maintain height of the spine, and/or restore stability to the spine. Such implantable device can include spinal fusion devices (e.g., pedicle screw and rods), which can fuse together one or more segments of the spine; interspinous spacers, which can hold apart adjacent vertebrae to help eliminate or reduce nerve compression; and/or intervertebral spacers, which may provide a lordotic correction to the curvature of the spine. However, it may be difficult to position these and other devices at the target implantation site and/or manipulate these devices while they are positioned at the target implantation site.

DETAILED DESCRIPTION

The present technology generally relates to drive instruments with retention mechanisms and, more particularly, to systems, devices, and methods for implanting medical devices. Certain details are set forth in the following description and inFIGS.1-19to provide a thorough understanding of such embodiments of the present technology. Other details describing well-known structures and systems often associated with, for example, surgical procedures are not set forth in the following description to avoid unnecessarily obscuring the description of various embodiments of the present technology.

In some embodiments, a drive instrument for use with implantable devices includes a retention mechanism having or more grippers or springs (e.g., a split leaf spring, cantilever spring, multi-prong spring) inside of a screwdriver or screwdriving body. The screwdriving body has a female socket for receiving a male driving head of a screw. The retention mechanism can be inserted at least partially into a screw pocket of the male driving head. The retention mechanism can couple/attach to the male driving head of the screw via a retention feature (e.g., an undercut pocket, a groove/channel, etc.) to captively hold the screw relative to the drive instrument for transport, insertion through access instruments, tightening, etc. The screw can be insertable at least partially within an implantable device, such as an intervertebral device for treating a patient's spine. In at least some embodiments, for example, the intervertebral device can be implanted in an intervertebral space to at least partially support the patient's spine. The drive instrument can detachably attach to screws or other drive elements before, during, or after insertion into patient. The retention mechanism can release the screw after transport, insertion, achieving desired tightening, and/or positioning of the implantable device at a target implant location.

In some embodiments, a system can include an implantable device and a drive instrument. The drive instrument can include a retention mechanism configured to selectively hold and release (e.g., detachably couple, releasably couple, etc.) the device.

The retention mechanism can include a socket configured to receive a drive portion of the implantable device to rotationally fix the drive instrument to the implantable device. The retention mechanism can include a spring element biased outwardly to releasably hold the drive portion in the socket when the spring element extends into the drive portion. The drive portion can be a head of a screw or other drive feature. The implantable device can be an expandable device (e.g., intervertebral cage, expandable spacer, etc.), a non-expandable device, a screw (e.g., pedicle screw, bone screw, etc.), a fixation device, or the like.

In several of the embodiments described below, a system for treating a spine of a subject can include an intervertebral spacer configured to be implanted between a first vertebra and a second vertebra of the subject's spine. The intervertebral spacer can be movable between a first (e.g., unexpanded) configuration and a second (e.g., expanded) configuration. The system can further include a locking member having a (i) threaded distal region configured to threadably engage the intervertebral spacer and (ii) a proximal drive head opposite the threaded distal region, and a drive instrument assembly configured to rotate the locking member to move the intervertebral spacer from the first (unexpanded) configuration to the second (expanded) configuration. The drive instrument assembly can include a retention mechanism detachably couplable to the locking member. The retention mechanism can include a socket configured to receive the locking member's drive head to rotationally fix the drive instrument relative to the locking member, and a spring element biased outwardly to releasably hold the drive head in the socket when the spring element is received within the drive head.

In some embodiments, a system can include a drive instrument assembly configured to detachably couple to a rotatable element, such as a screw (e.g., a drive screw, a locking screw, etc.). The screw can be integrated into or part of another device, such as an expandable implant. In some procedures, the screw can be inserted within or coupled to another component while the screw is inside the patient. The drive instrument assembly can include a screwdriver configured to apply a desired force (e.g., torque, axial force, etc.) to the screw, for example, to cause the implant to expand or otherwise transition between configurations. To remove the drive instrument assembly from the patient, the user can pull the screwdriver proximally to overcome a biasing retention force coupling the screw to the screwdriver. Before, during, and/or after the drive instrument assembly is removed from the patient, the implant can engage the patient's tissue (e.g., spinal tissue, such as one or more of the patient's vertebra) to keep the implant positioned at the implantation site.

In some embodiments, the screwdriver can include a retention mechanism having a female feature that receives a male feature of the screw. For example, a head of the screw can be inserted into a female socket. The retention mechanism can include one or more grippers that automatically grip the head when the head is inserted into the socket. The grippers can correspond to and/or be insertable at least partially within a corresponding recess or chamber of the male feature of the screw, such that the grippers can provide a desired retention force to releasably couple the screw to the screwdriver. This can allow a user to use the drive instrument to carry and manipulate the retained screw. In some procedures, the drive instrument assembly holds the screw through an access port, an access instrument (e.g., a cannula, a trocar, etc.), or the like, configured to provide access to a target implant location within a patient. The drive instrument assembly can then be used to rotate the screw inside the patient to, for example, manipulate or adjust an implantable device. In some procedures, the drive instrument assembly can be coupled to the head of a screw already positioned in the patient.

In some embodiments, a screwdriver includes a drive shaft and a retention mechanism connected to the drive shaft. The retention mechanism can include a socket head and a gripper extending at least partially through a passageway of the socket head. The gripper can be inserted into a passageway of a drive head. In some embodiments, the drive head can be inserted into the socket such that the gripper is positioned within the passageway. The gripper can include one or more biasing elements which can apply sufficient force to hold the drive head in the socket. In some embodiments, the gripper can be inserted within the socket regardless of the relative angular/radial orientations of the gripper and the drive head, respectively. This can allow the drive head to be inserted into the socket at any suitable angular position. The gripper can include one or more cantilevered springs, prongs, compression springs, or combinations thereof. The configuration of the gripper can be selected based on the desired retention forces and/or the forces needed to separate the screwdriver from the drive head. The gripper can help keep at least a portion of the drive head positioned within the socket during use. In some embodiments, the gripper can keep the drive head translationally fixed with respect to the socket when the socket rotates the drive head.

FIG.1is a side view of a spinal surgical system100(“system100”) positioned along a human subject's spine in accordance with embodiments of the present technology. The system100can include an instrument110and a cannula120. A series of tools and/or other devices, including the instrument110, can be delivered through the cannula120to perform a surgical procedure. In some procedures, the instrument110can be used to prepare an implantation site by, for example, moving organs or tissue (e.g., moving nerve tissue), removing tissue (e.g., removing the intervertebral disc171, removing tissue contributing to stenosis, etc.), preparing vertebral bodies (e.g., roughening or shaping vertebral endplates), or the like. In some embodiments, the instrument110can be removed and a distraction instrument (not shown) can be delivered through the cannula120. The distraction instrument can distract adjacent vertebrae170,172, thereby enlarging the intervertebral space. In some embodiments, an intervertebral spacer can be delivered through the cannula120and into the enlarged intervertebral space. In some embodiments, the instrument110can be configured to deliver the intervertebral spacer through the cannula120. In some embodiments, the intervertebral spacer can be expanded to contact one or more adjacent vertebral endplates (e.g., a lower endplate of the upper vertebra170and/or an upper endplate of the lower vertebra172). The instrument110can be further configured to drive the expansion of the expandable intervertebral spacer. In at least some embodiments, for example, the instrument110can be or include one or more of the instruments, drive instrument assemblies, and/or other devices described in detail below with reference toFIGS.2A-18.

FIGS.2A and2Bare side views of an intervertebral spacer260positioned in an intervertebral space in accordance with embodiments of the present technology. InFIG.2Athe intervertebral spacer260is in a first (e.g., unexpanded configuration) and releasably coupled to an instrument210, which can include at least some aspects that are generally similar or identical in structure and/or function to the instrument110ofFIG.1. The intervertebral spacer260and instrument210can be delivered through a port222, with or without the use of a cannula220, which can include at least some aspects that are generally similar or identical in structure and/or function to the cannula120ofFIG.1.

The instrument210can include a handle assembly212, an elongated body214, and a drive assembly216. The handle assembly212can include a grip250and one or more control elements240operable to control operation of the intervertebral spacer260and control decoupling from the intervertebral spacer260. For example, the grip250and/or one or more control elements240can apply a proximal force to decouple the intervertebral spacer260from the drive assembly216. In some embodiments, the control elements240can include one or more dials, levers, triggers, or other movable elements. The drive assembly216can be connected to the grip250by the elongated body214. The elongated body214and/or the grip250can include one or more rods, shafts, or other elements used to manipulate the drive assembly216to operate the intervertebral spacer260. In some embodiments, a locking member (e.g., locking member500ofFIG.4) is coupled to a proximal end of the drive assembly216and operably engaged with the intervertebral spacer260. In some embodiments, the locking member can be rotated to gradually and controllably transition the intervertebral spacer260between the first and second configurations. In other embodiments, the drive assembly216can both couple the intervertebral spacer260to the instrument210and drive (e.g., reconfigure, operate, expand, collapse, etc.) the intervertebral spacer260between the first and second configurations. The features, configuration, and/or functionality of the drive assembly216can be selected based on and/or to correspond with the configuration of the intervertebral spacer260.

InFIG.2Bthe intervertebral spacer260is in an expanded configuration and the delivery instrument210has been separated from a connection feature or connection interface262(“connection feature262”) of the intervertebral spacer260. The connection feature262can be releasably coupled to the drive assembly216, and can be operable to expand the intervertebral spacer260from an unexpanded to an expanded configuration. In some embodiments, the connection feature262can include a locking member releasably coupled to a proximal end of the drive assembly216and insertable into the intervertebral spacer260. The locking member and/or the connection feature262can maintain the intervertebral spacer260in the expanded configuration. To reposition the intervertebral spacer260, the instrument210can be reconnected to the intervertebral spacer260and operated to unlock and collapse the intervertebral spacer260. The delivery instrument210can be used to move the collapsed intervertebral spacer260.

The delivery instrument210can include one or more distal connection elements or features for detachably coupling the delivery instrument210to the intervertebral spacer260and/or the connection feature262. These connection elements can include a polygonal connection (e.g., a hexagonal protrusion) received by a complementary polygonal recess or feature of the intervertebral spacer260. In some embodiments, the connection feature262can be insertable into the intervertebral spacer260, releasably attached to the delivery instrument210, and can be released from the delivery instrument210when inserted into the intervertebral spacer260. The delivery instrument210can be configured to expand one or more spacers (e.g., intervertebral spacers, interspinous spacers, etc.) at different levels along the spine. Example delivery instruments and locking elements for intervertebral spacers are discussed in detail below with reference toFIGS.3A-19. Example intervertebral spacers are discussed in detail below with reference toFIGS.3A-3D, as well as in U.S. Pat. Nos. 10,105,238 and 10,201,431, which are hereby incorporated by reference in their entireties.

FIGS.3A-3Dare isometric views of an embodiment of an intervertebral spacer300(“spacer300”) at various stages of horizontal and/or vertical expansion, in accordance with embodiments of the present technology. The spacer300may also be referred to as a device, cage, insert, implant, or the like.FIG.3Aillustrates the spacer300in an unexpanded (e.g., compact, compressed, collapsed, delivery, etc.) configuration. The spacer300includes a lengthwise spacer axis302, and may be expandable in a first direction along a first axis304, which may be a horizontal or lateral expansion axis, to a horizontally expanded configuration, as shown inFIG.3B. The spacer300may be further expanded in a second direction along a second axis306, which may be a vertical expansion axis, to a horizontally and vertically expanded configuration, as shown inFIGS.3C and3D. Axes304,306may be perpendicular to each other and/or to the spacer axis302.

Referring toFIGS.3A-3C, when implanted between two vertebral bodies in a portion of a spine (e.g., as illustrated inFIGS.2A and2B), the spacer300is expandable horizontally, or substantially anterior-posteriorly, along the first axis304, and vertically, or cephalad-caudally, along the second axis306. A single axial force acting along the spacer axis302may provide the expansion force for both the horizontal and vertical expansion. The spacer300may be bilaterally symmetrical with respect to a vertical plane extending along spacer axis302, and may be bilaterally symmetrical with respect to a horizontal plane extending along spacer axis302. In an alternate embodiment, the spacer may be expandable medial-laterally. In other embodiments, the spacer may be asymmetrically expandable anterior-posteriorly, cephalad-caudally, and/or medial-laterally. It is understood that any one of the spacers disclosed within may also be implanted non-parallel to the sagittal plane of the vertebral bodies, in which instance horizontal spacer expansion may not be strictly anterior-posterior or medial-lateral.

Referring toFIG.3A, the spacer300includes an upper surface310and a lower surface312separated by a first side314and a second side316. The spacer300can further include a first end body318and a second end body320separated by the upper and lower surface310,312and first and second sides314,316. The second end320can include a port322via which the space300can be releasably coupled to a drive instrument assembly400(which can also be referred to as a delivery instrument, a delivery instrument assembly, an instrument, an insertion tool, and the like). The drive instrument assembly400can include at least some aspects that are generally similar or identical in structure and/or function to the instrument110ofFIG.1, the instrument210ofFIGS.2A and2B, and/or the drive assembly216ofFIGS.2A and2B. The drive instrument assembly400can be configured to drive the horizontal and/or vertical expansion of the spacer300such that the drive instrument assembly400can be used to deliver, position, and/or expand the spacer300, for example, when the spacer300is positioned within an intervertebral space. The drive instrument assembly400can be configured to detachably hold the spacer300.

Referring toFIG.3B, the intervertebral spacer300comprises a set of bodies pivotably linked together, allowing the bodies to articulate relative to one another. A first support member330includes a first upper body332and a first lower body334. A second support member340includes a second upper body342and a second lower body344. The first end body318is pivotably linked to the first and second support members330,340toward a first end350of the spacer300, and the second end body320is pivotably linked to the first and second support members330,340toward a second end352of the spacer300. The upper and lower bodies may be mirror images of one another, as may the first and second support members. In an alternate embodiment, the first and second support members330and340may be of differing proportions and/or configuration in order to provide asymmetric expansion.

After or during insertion between the vertebral bodies, the drive instrument assembly400may be manipulated to urge horizontal expansion of the spacer300. For example, drive instrument assembly400can be detachably coupled to a locking member (such as locking member500ofFIG.4), and the locking member may be rotated or ratcheted to provide an axial force along axis302to urge first end body318and second end body320toward one another, decreasing the distance between them. The axial force can push the first and second support members330,340outward and away from one another along axis304, from the unexpanded configuration seen inFIG.3Ainto the horizontally expanded configuration seen inFIG.3B. During this horizontal expansion, links360,362,364,366pivot outward, or laterally relative to axis302.

Referring toFIGS.3B-3C, further axial force along axis302, which may be attained by further rotation of the drive instrument assembly400and/or the locking member500, can push the upper332,342and lower334,344bodies away from one another along axis306, from the vertically unexpanded configuration seen inFIGS.2A and3Binto the vertically expanded configuration seen inFIGS.2B,3C, and3D.

Referring toFIG.3D, after attaining the desired expansion of the spacer300, the drive instrument assembly400(not shown) can be decoupled from the locking member500. The locking member500can remain in the spacer300and can be configured to lock the spacer300in a horizontally and/or vertically expanded configuration.

In some embodiments of the present technology, the spacer could be expanded on only one side; for example, support member330could be horizontally and/or vertically expanded while support member340remains in its collapsed position, or vice versa. In another embodiment, a non-expanding support member such as340could be solid. This type of asymmetrical expansion could provide a lordotic or kyphotic correction.

In a method of use, a patient may be prepared by performance of a discectomy between two target vertebral bodies at a target implant location. A lateral or anterior approach may be used. The vertebral bodies may be distracted, and the spacer300may be mounted on and/or otherwise coupled to a suitable insertion instrument, such as the delivery instrument400or any other suitable delivery instrument, and inserted into the prepared space between the two target vertebral bodies. In one example, the spacer300is releasably coupled to the drive instrument assembly400. The spacer300may be inserted within a patient with first end350leading. If necessary, force may be applied to the instrument400and the spacer300to facilitate insertion; the second end body320can be configured to withstand and/or transmit such insertion forces. Before and/or during insertion, the spacer300can be in the collapsed/unexpanded configuration, such as shown inFIGS.2A and3A. The expansion of the spacer300can begin when the spacer300is partially or fully positioned within the intervertebral space.

FIGS.4and4Aare isometric views of a drive instrument assembly400releasably coupled to a locking member500in accordance with an embodiment of the present technology. Referring toFIG.4, The drive instrument assembly400can include an elongate drive shaft410having a distal retention mechanism420and a proximal connecting region430. The retention mechanism420is configured to selectively (e.g., releasably, detachably, etc.) hold the locking member500. After rotating the locking member500to deploy the implant, a gripping force of the retention mechanism420can be overcome (e.g., by pulling the drive instrument assembly400away from the locking member500) to separate the retention mechanism420from the locking member500and the deployed implant.

FIG.4Ashows the locking member500can include a distal threaded region510configured to threadably engage an intervertebral spacer. For example, the threaded region510can threadably engage the first and/or second end body318,320of the spacer300ofFIGS.3A-Dto move the spacer300from the unexpanded configuration ofFIG.3Ato the horizontally expanded configuration ofFIG.3Band/or to the vertically expanded configuration ofFIG.3C. With continued reference toFIG.4A, the locking member500further includes a drive head520that can be at least partially received by the retention mechanism420.

FIGS.5and6are exploded isometric views of the drive instrument assembly400in accordance with embodiments of the present technology. Referring first toFIG.5, the drive instrument assembly400can include a proximal grip or handle440. The handle440can be configured for a user's hand and can be used to manipulate the drive instrument assembly400and/or the locking member500. In some embodiments, the handle440can include a port442configured to detachably couple to the connecting region430. In other embodiments, the handle440and the drive shaft410can be a one-piece component.

Referring toFIG.6, the locking member can include a drive head520configured to be releasably received by the retention mechanism420of the drive instrument assembly400. In the illustrated embodiment, for example, the retention mechanism420includes a socket422having a plurality of interior grooves424, and the drive head520includes a plurality of exterior grooves522configured to slidably and/or matingly receive the interior grooves424of the retention mechanism420. The interior grooves424(e.g., of socket422) can correspond to the exterior grooves522(e.g., of drive head520) so that the locking member500can be rotationally fixed to the drive shaft410when the drive head520is inserted into the socket422. This can allow the drive shaft410and/or drive instrument assembly400to rotate the locking member500to expand, collapse, and/or otherwise adjust the configuration of an intervertebral spacer, such as the spacer300described in detail previously with reference toFIGS.3A-3D.

The drive instrument assembly400can further include a connecting member600carried by the socket422. The connecting member600can be configured to couple the locking member500to the drive instrument assembly400. In some embodiments, the connecting member600can be part of the retention mechanism420of the drive instrument assembly400, and can include a biasing or spring element610configured to releasably couple the locking member500to the drive instrument assembly400, for example, when the drive head520is inserted within the socket422. Additionally, or alternatively, the connecting member600can include a threaded region620configured to be threadably received within the socket422.

FIG.7is a side view of the drive instrument assembly400(handle not shown) and locking member500.FIG.8Ais a cross-sectional view of the drive instrument assembly400, locking member500, and connecting member600taken along line8A-8A ofFIG.7.FIG.8Bis an exploded view of the side cross-sectional view ofFIG.8A. A description of the drive instrument assembly400and locking member500discussed in connection withFIGS.3A-6applies equally toFIGS.7-8Bunless indicated otherwise.

Referring toFIG.8B, the drive head520can include a pocket530(which can also be referred to as a chamber, a recessed area, or the like). The spring element610can be at least partially insertable into the pocket530of the drive head520. The pocket530can additionally include an undercut532(e.g., an inner flange, an inner rim, a flared end, a narrowed portion, etc.) configured to releasably receive at least part of the spring element610. When inserted within the pocket530and biased outwardly, at least part of the spring element610can contact or abut the undercut532to releasably couple the locking member500to the connecting member600.

The spring element610can be released from the drive head520and/or the pocket530by applying a proximal force to the drive instrument assembly400. The proximal force can cause the spring element610to compress such that the spring element610can be removed from the pocket530and uncouple/release the drive head520of the locking member500. Applying a proximal force to the drive instrument assembly400can uncouple the locking member500while the locking member is threadably engaged with an intervertebral spacer (e.g., the spacer300ofFIGS.3C-3D).

The connecting member600can be releasably received by the drive shaft410. For example, the connecting member600can include a threaded region620, and the socket422can include a corresponding threaded region426configured to threadably hold/mate with the threaded region620to couple the connecting member to the delivery instrument400when the connecting member600is inserted within the socket422. The connecting member600can further include an end portion630positioned distally from the threaded region620. The end portion630can correspond to an end chamber428of the socket422, and can include an end taper632. The end taper632and end portion630can have a width less than the threaded region620so that the connecting member600can be insertable into the socket422. In some embodiments, the threaded region426can be modular such that one or more other connecting members can be coupled to the delivery instrument, each of which can be configured to couple to other drive screws, locking members, and the like. Accordingly, the delivery instrument400can to be used with a wide range of different locking member, drive screws, and/or implants.

In some embodiments, the connecting member can be included in an implant kit, for example, along with a corresponding implant and/or locking screw(s) (each of which can provide for a different amount of expansion of the implant). The drive shaft410and/or the connecting member600can be disposable or reusable and may be included in the kit or in a separate delivery instrument kit.

In an alternate embodiment, the connecting member600can be an integral component of the drive shaft410. For example, the retention mechanism420can be a one-piece component that includes the socket422, the interior grooves424, and the spring element610. The retention mechanism420can be configured to releasably receive at least a portion of the drive head520, and the spring element610can be at least partially insertable within the pocket530of the drive head520to releasably hold the locking member500to the drive instrument assembly400.

In some embodiments, the drive shaft410can include an assembly of multiple shafts. For example, the drive shaft410can include an outer shaft and an inner shaft slidably disposed within the outer shaft. The outer shaft can define the socket422and can at least partially contain the drive head520of the locking member500. The inner shaft can include the threaded region426, the end chamber428, and be threadably coupled to the connecting member600. The inner shaft can be moved axially (e.g., proximally and/or distally) to translate the connecting member600relative to the outer shaft. This can allow the spring element610of the connecting member600to be selectively inserted into and/or decoupled from the drive head520while the drive head520remains stationary with respect to the socket422(e.g., drive head520can be decoupled from the inner shaft while remaining at least partially contained by outer shaft). In another embodiment, the inner shaft and the connecting member600can be a one-piece component. The number and configuration of components of the drive shaft410can be selected based on the desired engagement and disengagement with the drive head520.

FIGS.9-12illustrate various views of the locking member500.FIG.9is an isometric view of the locking member500.FIG.10is a side view of the locking member500.FIG.11is a front view of the locking member500.FIG.12is an end view of the locking member500. A description of the locking member500discussed in connection withFIGS.3A-8Bapplies equally to the locking member500ofFIGS.9-12unless indicated otherwise. Similarly, features of the locking member500discussed in connection withFIGS.9-12can apply equally to the locking member500ofFIGS.3A-8B.

Referring toFIGS.9-12, the drive head520of the locking member500can further include an outer annular flange524. The flange524and the threaded region510can be configured to lock an intervertebral spacer (e.g., intervertebral spacer300ofFIGS.3A-3D) in a horizontally expanded configuration (e.g.,FIG.3B) and/or a vertically expanded configuration (e.g.,FIG.3C). For example, the flange524can abut the second end body320ofFIGS.3A-3Dand the threaded region510can threadably engage the first end body318ofFIGS.3A-3D. Rotating the drive head520can threadably engage the threaded region510with the first end body318and cause the flange524to move the second end body320toward the first end body318, for example, to horizontally and/or vertically expand the intervertebral spacer300, as described in detail with reference toFIGS.3A-3D. The locking member500can further include a head540positioned distally from the threaded region510. The head540can be at least partially rounded to allow for easier insertion into an intervertebral spacer (e.g., the intervertebral spacer300ofFIGS.3A-3D, or any other suitable intervertebral spacer).

FIGS.13-15illustrate various views of the connecting member.FIG.13is an isometric view of the connecting member600.FIG.14is a side view of the connecting member600.FIG.15is a front view of the connecting member600. A description of the connecting member600discussed in connection withFIGS.5-8Bapplies equally to the connecting member600unless indicated otherwise. Similarly, features of the connecting member600discussed in connection withFIGS.13-15can apply equally to the connecting member600ofFIGS.5-8B.

Referring toFIGS.13-15, the spring element610can be a cantilever spring having a plurality of outwardly biased arms612a-b, and each of the arms612a-bcan include a corresponding end prong614a-b. Referring toFIGS.13and14, the arms612a-band the corresponding prongs614a-bcan be insertable into a female feature (e.g., pocket530of the drive head520ofFIG.8B) to releasably hold a male feature, such as a drive head (e.g., drive head520in the socket422ofFIG.8B). Additionally, the prongs614a-band/or the arms612a-bcan correspond to an undercut (such as the undercut532ofFIG.8B) to releasably couple the spring element to a drive head, as discussed in connection with the pocket530of the drive head520ofFIG.8B.

Referring again toFIGS.13-15, the connecting member600can further include a plurality of ridges or flanges616a-b. Each of the ridges616a-bcan be positioned proximally from and/or at least partially aligned with one of the arms612a-bof the spring element610. Referring additionally toFIG.8B, the ridges616a-bcan have a width greater than the width of the threaded region620and/or the threaded region426of the socket422to limit the extent to which the connecting member600can be inserted into socket422.

FIGS.16A-18illustrate various views of the drive instrument assembly400.FIG.16Ais an isometric view of the drive instrument assembly400.FIG.16Bis a detailed isometric view of the socket422of the drive instrument assembly400.FIG.16Cis a detailed isometric view of the connecting region430of the drive instrument assembly400.FIG.17is a front view of the socket422.FIG.18is an end view of the connecting region430. Referring toFIGS.16A-18together, in some embodiments, the drive instrument assembly400can include at least some aspects that are generally similar or identical in structure and/or function to the instrument110ofFIG.1and/or the instrument210ofFIGS.2A and2B. In other embodiments, the drive instrument assembly400can be coupled to the instrument110ofFIG.1, the instrument210ofFIGS.2A and2B, and/or the drive assembly216ofFIGS.2A and2B.

Referring toFIGS.16A,16C, and18the connecting region430can be connected by a handle (e.g., the handle440ofFIG.5) and used to manipulate the drive instrument assembly400and/or a locking member, such as the locking member500ofFIGS.4A-12. The connecting region430can include an axial or radial groove432extending at least partially about/around a longitudinal axis of the delivery instrument400, a longitudinal groove434extending in a direction at least generally parallel to the longitudinal axis of the delivery instrument, and a locking surface436. The axial groove432can be releasably received by a handle or another instrument (e.g., the instrument110ofFIG.1, the instrument210ofFIG.210, etc.) to couple the drive instrument assembly400to the instrument. Additionally, the locking surface436and/or the longitudinal groove434can rotationally fix the drive instrument assembly400relative to another instrument so that said instrument can be used to rotate the drive instrument assembly400. In some embodiments the connecting region430can be directly coupled to the handle assembly212ofFIG.2Aor the elongated body214ofFIGS.2A.

Referring toFIGS.16A-16B, in the illustrated embodiment, the drive shaft410has a circular cross-sectional shape. In other embodiments, the drive shaft410can have a triangular, square, pentagonal, hexagonal, or any other suitable cross-sectional shape. Referring additionally toFIG.17, while the socket422is shown to have interior grooves424in a hexagonal configuration, in other embodiments the interior grooves424can be in a triangular, square, pentagonal, heptagonal, octagonal, or any other suitable configuration.

FIG.19is flow diagram of a method700of implanting a device, for example, between first and second vertebral bodies of a spine of a subject. The method can be used with any embodiments of the present technology described herein and/or with one or more components thereof (e.g., system100ofFIG.1, instrument210ofFIGS.2A and2B, intervertebral spacer300ofFIGS.3A-3D, drive instrument assembly400, locking member500, connecting member600, etc.).

At block710, the method includes positioning the intervertebral spacer in the patient by, for example, aligning the locking member with an opening or port of an intervertebral spacer within the patient or outside the patient and coupling the locking member to the drive instrument. The drive instrument can be used to insert the locking member into the patient when the locking member is coupled to the intervertebral spacer. The drive instrument assembly can include a socket configured to receive at least a portion of a drive head of the locking member. The socket can be further configured to rotationally fix the locking member with respect to the drive instrument assembly. The drive instrument assembly can further include a spring element biased outwardly to releasably hold the drive head in the socket when the spring element extends into the drive head.

At block720, the method includes moving the intervertebral spacer from an unexpanded configuration and an expanded configuration. The intervertebral spacer can be expandable in a horizontal direction (e.g., into a horizontally expanded configuration) and/or a vertical direction (e.g., into a vertically expanded configuration). The intervertebral spacer can be expanded by using the drive instrument assembly to drive the locking member. For example, rotating the drive instrument assembly can cause corresponding rotation of the locking member, which can cause the intervertebral spacer to expand horizontally and/or vertically. Expanding the intervertebral spacer can bring one or more surfaces (e.g., upper surface310, lower surface312, first side114, and/or second side116ofFIG.3A) of the intervertebral spacer into contact with at least one vertebral endplate of the spine of the subject.

At block730, the method includes decoupling the drive instrument assembly and the locking member. Decoupling the drive instrument assembly and the locking member can lock the intervertebral spacer in a horizontally and/or vertically expanded configuration. A proximal force can be applied to the drive instrument assembly to decouple the locking member. The proximal force can cause the spring element of the drive instrument assembly to compress such that the spring element exits the pocket, thereby uncoupling the drive head of the locking member. The drive instrument assembly can further include a connecting member, the connecting member can include the spring element, and the proximal force can uncouple the connecting member from the locking member. In some embodiments, the drive instrument assembly can include an inner shaft having the spring element, the inner shaft being disposed within an outer shaft having the socket. The proximal force can be applied to the inner shaft to move the inner shaft proximally relative to the outer shaft and decouple the spring element from the locking member.

Any methods disclosed herein comprise one or more steps or actions for performing the described method. The method steps and/or actions may be interchanged with one another. In other words, unless a specific order of steps or actions is required for proper operation of the embodiment, the order and/or use of specific steps and/or actions may be modified. For example, the actions of method700can be interchanged with one another or interchanged with other actions disclosed herein.

EXAMPLES

Several aspects of the present technology are set forth in the following examples:

1. A system for treating a spine of a subject, the system comprising:an intervertebral spacer configured to be implanted between a first and a second vertebra of the spine of the subject, wherein the intervertebral spacer is movable between an unexpanded configuration and an expanded configuration;a locking member including:a threaded distal region configured to threadably engage the intervertebral spacer, anda proximal drive head; anda drive instrument assembly configured to rotate the locking member to move the intervertebral spacer from the unexpanded configuration to the expanded configuration, the drive instrument assembly including a retention mechanism detachably couplable to the locking member, the retention mechanism including:a socket configured to receive the drive head to rotationally fix the drive instrument assembly to the locking member, anda spring element biased outwardly to releasably hold the drive head in the socket when the spring element extends into the drive head.

2. The system of example 1 wherein the spring element is a multi-pronged-pronged cantilever spring.

3. The system of example 1 or example 2 wherein the drive head includes a pocket having an undercut opening, and wherein the pocket and the undercut are configured to releasably receive the spring element.

4. The system of example 3 wherein the spring element includes prongs that are biased outwardly to releasably hold the locking member when the prongs are positioned within the pocket of the drive head.

5. The system of any of examples 1-4 wherein the drive head is configured to compress the spring element when the spring element is pulled proximally relative to the drive head.

6. The system of any of examples 1-5 wherein the drive head is configured to compress the spring element when the spring element is moved distally into an opening of the drive head to releasably couple the spring element to the drive head.

7. The system of any of examples 1-6 wherein the drive instrument assembly further includes a drive shaft having the socket, wherein at least a portion of the socket is threadably coupled to a connecting member including the spring element.

8. The system of example 7 wherein the connecting member is configured to retain the drive head such that the drive head is seated in the socket.

9. An instrument assembly operable to move an implantable spacer between a collapsed configuration and an expanded configuration, the instrument assembly comprising:a drive instrument including a socket having a threaded portion;a connecting member having an elongate body positionable within the socket, wherein the connecting member includes—a proximal region threadably coupled to the threaded portion of the drive instrument, anda distal region having a multi-pronged cantilever spring; anda locking member including—a proximal drive head configured to be positioned at least partially within the socket, wherein the proximal drive head includes an end pocket configured to releasably receive at least a portion of the multi-pronged cantilever spring of the connecting member, anda distal threaded portion insertable into the intervertebral spacer;wherein the locking member is configured to keep the intervertebral spacer in the expanded configuration.

10. The instrument assembly of example 9 wherein the proximal drive head includes a pocket having an undercut opening, and wherein the pocket and the undercut are configured to releasably receive at least part of the multi-pronged cantilever spring of the connecting member.

11. The instrument assembly of example 9 or example 10 wherein the multi-pronged cantilever spring includes one or more arms that are biased outwardly to releasably couple the locking member to the drive head.

12. The instrument assembly of any of examples 9-11 wherein the proximal drive head is configured to inwardly deflect the multi-pronged cantilever spring when the multi-pronged cantilever spring is pulled away from the drive head to decouple the locking member from the connecting member.

13. The instrument assembly of any of examples 9-12 wherein the proximal drive head is configured to inwardly deflect the multi-pronged cantilever spring when the multi- pronged cantilever spring is moved into contact with the end pocket of the proximal drive head to releasably couple the multi-pronged cantilever spring to the drive head.

14. A method of implanting a device by locking a configuration of an intervertebral spacer implanted between first and second vertebral bodies of a spine of a subject, the method comprising:coupling a locking member to a drive instrument, wherein the drive instrument includes:a socket configured to receive at least a portion of a drive head of the locking member to rotationally fix the drive instrument to the locking member, anda spring element biased outwardly to releasably hold the drive head in the socket when the spring element extends into the drive head;coupling the locking member to the intervertebral spacer;positioning the intervertebral spacer proximate a target implant location within the subject;transitioning the intervertebral spacer from an unexpanded configuration to an expanded configuration; andapplying a proximal force to the drive instrument to decouple the drive instrument and the locking member.

15. The method of example 14 wherein coupling the locking member to the intervertebral spacer includes rotating the locking member relative to the intervertebral spacer such that a threaded coupling region of the locking member is threadably received by a correspondingly threaded coupling region of the intervertebral spacer.

16. The method of example 14 or example 15 wherein coupling the locking member to the intervertebral spacer includes positioning at least part of the locking member within the intervertebral spacer via a port of the intervertebral spacer configured to releasably receive the locking member.

17. The method of any of examples 14-16 wherein coupling the locking member to the intervertebral spacer includes coupling the locking member to the intervertebral spacer after the intervertebral spacer is positioned proximate the target implant location.

18. The method of any of examples 14-17 wherein transitioning the intervertebral spacer from the unexpanded configuration to the expanded configuration includes rotating the locking member relative to the intervertebral spacer to cause the intervertebral spacer to transition from the unexpanded configuration to the expanded configuration.

19. The method of example 18 wherein rotating the locking member includes rotating the drive instrument to cause the locking member to rotate relative to the intervertebral spacer.

20. The method of any of examples 14-19 wherein transitioning the intervertebral spacer from the unexpanded configured to the expanded configuration includes transitioning the intervertebral spacer to a horizontally expanded configuration.

21. The method of any of examples 14-20 wherein transitioning the intervertebral spacer from the unexpanded configuration to the expanded configuration includes transitioning the intervertebral spacer to a vertically expanded configuration.

22. The method of any of examples 14-21 wherein transitioning the intervertebral spacer from the unexpanded configuration to the expanded configuration includes transitioning the intervertebral spacer to a horizontally and vertically expanded configuration.

23. The method of any of examples 14-22 wherein coupling the locking member to the drive instrument includes positioning at least part of the drive head of the locking member within the socket of the drive instrument to cause at least part of the spring element to be inserted within a chamber defined by the drive head.

24. The method of any of examples 14-23, further comprising coupling a connecting member to the drive instrument, wherein the connecting member includes the spring element and a coupling region opposite the spring element, and wherein the coupling region is configured to be received within the socket to couple the connecting member to the drive instrument, such that coupling the connecting member to the drive instrument includes inserting the coupling region into the socket.

25. A system comprising:a screwdriver including a drive shaft and a retention mechanism, the retention mechanism having a socket and a gripper extending through a passage of the socket; anda screw including a body and a head, wherein the head includes a receiving pocket configured to receive at least a portion of the gripper such that the retention mechanism detachably holds the head, which is rotationally fixed to the screwdriver.

26. The system of example 25, wherein the gripper clips into an undercut along the receiving pocket to retain the head.

27. The system of example 25 or example 26, wherein the gripper and socket hold the head translationally fixed.

28. The system of any of examples 25-27, wherein the exterior of the head is geometrically congruent to an interior of the socket.

29. The system of any of examples 25-28, wherein the socket is a polygonal socket.

30. The system of any of examples 25-29, wherein the gripper is biased radially outward from a long axis of the drive shaft to press against a sidewall of the head when the gripper is within the receiving pocket.

31. The system of any of examples 25-30, wherein the gripper includes one or more springs.

32. An intervertebral device delivery assembly, comprising:an intervertebral device configured to be positioned in a target intervertebral implant location within a patient's spine, wherein the intervertebral device is expandable from a first configuration toward a second configuration;a locking member, wherein the locking member includes a threaded region configured to be threadably received by the intervertebral device and a drive head opposite the threaded locking region;a connecting member, wherein the connecting member includes (i) a spring element configured to be releasably couplable to the drive head of the locking member and (ii) a threaded coupling region opposite the spring element; anda drive instrument, wherein the drive instrument includes a socket configured to threadably receive the threaded coupling region of the connecting member to hold the connecting member at least partially within the socket.

33. The intervertebral device delivery assembly of example 32 wherein the socket is configured to rotationally fix the locking member relative to the drive instrument such that rotation of the drive instrument produces corresponding rotation of the locking member.

34. The intervertebral device delivery assembly of example 32 or example 33 wherein the intervertebral device is configured to transition between the first configuration and the second configuration in response to rotation of the locking member.

35. The intervertebral device delivery assembly of any of examples 32-34 wherein, when the intervertebral device is in the second configuration, the locking member is configured to at least partially prevent the intervertebral device from transitioning toward the first configuration.

36. The intervertebral device delivery assembly of any of examples 32-35 wherein the intervertebral device includes a first end body and a second end body opposite the first end body, wherein the first end body is configured to threadably receive the threaded region of the locking member, wherein the locking member further includes an outer flange configured to abut the second end body when the threaded region is threadably received by the first end body, and wherein rotation of the locking member drives the outer flange and the second end body toward the first end body to transition the intervertebral device from the first configuration toward the second configuration.

37. A method of implanting an intervertebral device, the method comprising:rotating a delivery instrument coupled to a locking member to cause a corresponding rotation of the locking member, wherein the locking member is coupled to an intervertebral device, and wherein rotating the locking member includes changing a configuration of the intervertebral device; andmoving the delivery instrument away from the intervertebral device to decouple the delivery instrument from the locking member.

38. A system for treating a spine of a subject, the system comprising:an intervertebral device configuration locking member; andan intervertebral device delivery instrument configured to be releasably coupled to the intervertebral device configuration locking member.

39. A system for treating a spine of a subject, the system comprising:a locking member including a drive head defining a chamber; anda delivery instrument including—an outer shaft defining a lumen therethrough, wherein the outer shaft includes a distal end portion defining a keyed socket configured to releasably receive at least part of the drive head; andan inner shaft slidably disposed within the outer shaft, wherein the inner shaft includes a coupling element configured to be at least partially insertable within the chamber of the drive head;wherein the delivery instrument is transitionable between (i) a first configuration, in which the delivery instrument is coupled to the locking member, and (i) a second configuration, in which the locking member is released from the delivery instrument in response to movement of the inner shaft relative to the outer shaft.

40. The system of example 39 wherein the coupling element includes a cantilevered spring arm.

The drive instrument assemblies disclosed herein can be used with non-expandable devices (e.g., screws, cages, etc.), expandable devices (e.g., expandable implants), or other devices. For example, the drive instrument assemblies can be used with devices for reducing nerve compression, maintaining height of the spine or spine segment, and/or restoring stability to the spine. The drive instrument assemblies can also be used in non-medical applications. For example, the drive instrument assemblies can be used to rotate bolts, screws (e.g., locking screws, bone fixation screws, etc.), or other rotatable elements configured to engage the retention mechanism.

Furthermore, the skilled artisan will recognize the interchangeability of various features from different embodiments disclosed herein and disclosed in U.S. Provisional Patent Application No. 63/159,327; U.S. application Ser. No. 16/687,520; App. No. PCT/US20/49982; U.S. Pat. Nos. 10,105,238; 10,201,431; and U.S. Provisional App. No. 63/126,253. For example, the systems, instruments, devices, etc., of U.S. application Ser. No. 16/687,520; App. No. PCT/US20/49982; U.S. Pat. No. 10,105,238; and U.S. Provisional App. No. 63/126,253 can be incorporated into or used with the technology disclosed herein. For example, the locking screws disclosed in U.S. Provisional Application No. 63/126,253 can be configured for use with the drive instrument assemblies disclosed herein. In some examples, components or features of the drive instrument assemblies can be similar to or the same as the inserter instrument and driver as described by U.S. Pat. No. 10,201,431. All of these applications are incorporated herein by reference in their entireties. Similarly, the various features and acts discussed above, as well as other known equivalents for each such feature or act, can be mixed and matched by one of ordinary skill in this art to perform methods in accordance with principles described herein. All of the above cited applications and patents are herein incorporated by reference in their entireties.