US20210121203A1 - Sublaminar band clamp - Google Patents
Sublaminar band clamp Download PDFInfo
- Publication number
- US20210121203A1 US20210121203A1 US16/667,330 US201916667330A US2021121203A1 US 20210121203 A1 US20210121203 A1 US 20210121203A1 US 201916667330 A US201916667330 A US 201916667330A US 2021121203 A1 US2021121203 A1 US 2021121203A1
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- Prior art keywords
- sublaminar
- band
- clamp system
- passage
- clamp
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Images
Classifications
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- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
- A61B17/7032—Screws or hooks with U-shaped head or back through which longitudinal rods pass
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- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
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- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
- A61B17/7002—Longitudinal elements, e.g. rods
- A61B17/7004—Longitudinal elements, e.g. rods with a cross-section which varies along its length
- A61B17/7008—Longitudinal elements, e.g. rods with a cross-section which varies along its length with parts of, or attached to, the longitudinal elements, bearing against an outside of the screw or hook heads, e.g. nuts on threaded rods
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- A61B17/7019—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other
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- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
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- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
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- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
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- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7071—Implants for expanding or repairing the vertebral arch or wedged between laminae or pedicles; Tools therefor
Definitions
- spinal irregularities cause pain, limit range of motion, or injure the nervous system within the spinal column. These irregularities can result from trauma, tumor, disc degeneration, or disease. Typically, these irregularities are treated by immobilizing a portion of the spine. This treatment typically involves affixing a plurality of components, such as, for example, screws, hooks, and/or clamps, to one or more vertebrae, and attaching the components to an elongated rod that stabilizes the vertebrae.
- components such as, for example, screws, hooks, and/or clamps
- the present disclosure provides a sublaminar band clamp system that may include a first locking mechanism, a second locking mechanism, and a body.
- the body may include a first portion comprising a first passage, wherein the first locking mechanism is disposed within the first passage.
- the body may further include a second portion comprising a second passage, wherein the second locking mechanism is disposed within the second passage.
- a third passage may extend across the body and may be in fluid communication with the second passage.
- An opening may be positioned between the first and second portions, and the opening may be in fluid communication with the first passage.
- the present disclosure provides a sublaminar band clamp system that may include a tulip comprising a passage and a chamber fluidly coupled to the passage.
- a protrusion may extend inward from an inner surface of the chamber.
- a locking mechanism may be movably disposed within the chamber.
- the locking mechanism may include a saddle comprising a groove and a clamp. The saddle may be coupled to the clamp.
- the present disclosure provides a sublaminar band clamp system that may include a spinal rod comprising an elongated portion, and a clamp positioned at a first end of the spinal rod.
- the clamp may include a passage that extends in a direction from the first end to a second end of the spinal rod.
- the sublaminar band system may also include a locking mechanism extending toward the passage.
- FIG. 1 illustrates a sublaminar band clamp (“clamp”) in accordance with embodiments of the present disclosure
- FIG. 2 is a cross-section of FIG. 1 ;
- FIG. 3 illustrates the clamp of FIG. 1 with a spinal rod and a sublaminar band, in accordance with embodiments of the present disclosure
- FIG. 4 is a cross-section of FIG. 3 ;
- FIG. 5 illustrates a clamp in accordance with embodiments of the present disclosure
- FIG. 6 is a cross-section of FIG. 5 ;
- FIG. 7 illustrates a clamp system in accordance with embodiments of the present disclosure
- FIG. 8 illustrates a locking mechanism of the clamp system of FIG. 7 , in accordance with embodiments of the present disclosure
- FIG. 9 is a cross-section of FIG. 8 ;
- FIG. 10 is a cross-section of the clamp system of FIG. 7 in an assembled configuration in accordance with embodiments of the present disclosure
- FIG. 11 is a bottom view of a tulip and a clamp of the clamp system of FIG. 7 , in accordance with embodiments of the present disclosure
- FIG. 12 is a cross-section of a locking mechanism in a locked position in accordance with embodiments of the present disclosure
- FIG. 13A is a cross-section of a clamp system with a sublaminar band in an unlocked position, in accordance with embodiments of the present disclosure
- FIG. 13B is a cross-section of the clamp system of FIG. 13A in a locked position, in accordance with embodiments of the present disclosure
- FIG. 14A is a cross-section of a clamp system with a sublaminar band in an unlocked position, in accordance with embodiments of the present disclosure
- FIG. 14B is a cross-section of the clamp system of FIG. 14A in a locked position, in accordance with embodiments of the present disclosure
- FIG. 15A is a cross-section of a clamp system with a sublaminar band in an unlocked position, in accordance with embodiments of the present disclosure
- FIG. 15B is a cross-section of the clamp system of FIG. 15A in a locked position, in accordance with embodiments of the present disclosure
- FIG. 16 illustrates a clamp in accordance with embodiments of the present disclosure
- FIG. 17A is a cross-section of FIG. 16 ;
- FIG. 17B is a cross-section of the clamp of FIG. 16 with a sublaminar band in a locked position, in accordance with embodiments of the present disclosure
- FIG. 18 illustrates a clamp in accordance with embodiments of the present disclosure
- FIG. 19A is a cross-section of FIG. 18 ;
- FIG. 19B is a cross-section of the clamp of FIG. 18 with a sublaminar band in a locked position, in accordance with embodiments of the present disclosure
- FIG. 20 illustrates a spinal rod integrated with a clamp, in accordance with embodiments of the present disclosure
- FIG. 21 illustrates a sublaminar band secured to the clamp of FIG. 20 , in accordance with embodiments of the present disclosure
- FIG. 22 illustrates a clamp in accordance with embodiments of the present disclosure
- FIG. 23 illustrates the clamp of FIG. 22 secured to a spinal rod in accordance with embodiments of the present disclosure
- FIG. 24 illustrates the clamp of FIG. 22 positioned between pedicle screw assemblies, in accordance with embodiments of the present disclosure
- FIG. 25A illustrates separate components of a clamp system in accordance with embodiments of the present disclosure
- FIG. 25B illustrates the clamp system of FIG. 25A in an assembled configuration, in accordance with embodiments of the present disclosure
- FIG. 26A is a cross-section of a first portion of the clamp system, as shown on FIG. 25B , in an unlocked position, in accordance with embodiments of the present disclosure
- FIG. 26B is a cross-section of a first portion of the clamp system, as shown on FIG. 25B , in a locked position, in accordance with embodiments of the present disclosure
- FIG. 27A is a cross-section of a second portion of the clamp system, as shown on FIG. 25B , in an unlocked position, in accordance with embodiments of the present disclosure
- FIG. 27B is a cross-section of a second portion of the clamp system, as shown on FIG. 25B , in a locked position, in accordance with embodiments of the present disclosure
- FIG. 28 illustrates a perspective view of the clamp system of FIG. 25A with a pedicle screw and a sublaminar band, in accordance with embodiments of the present disclosure
- FIG. 29 illustrates the clamp system of FIG. 25A further including pedicle screw assemblies and a spinal rod, in accordance with embodiments of the present disclosure
- FIG. 30 illustrates a clamp system including a bridge, in accordance with embodiments of the present disclosure
- FIG. 31A illustrates a clamp system including a hook, in accordance with embodiments of the present disclosure
- FIG. 31B illustrates the clamp system of FIG. 31A with a sublaminar band secured therein, in accordance with embodiments of the present disclosure
- FIG. 32 illustrates the clamp system of FIG. 31A attached to a spinal rod with pedicle screw assemblies, in accordance with embodiments of the present disclosure
- FIG. 33 illustrates a first portion of the clamp system of FIG. 30 further including a hook, in accordance with embodiments of the present disclosure.
- FIG. 34 illustrates a second portion of the clamp system of FIG. 30 further including a hook and a sublaminar band, in accordance with embodiments of the present disclosure.
- Embodiments generally relate to spinal surgery. More particularly, embodiments relate to systems, methods, and devices for fixating spinal anatomy with a sublaminar band.
- Sublaminar bands should be understood by one having skill in the art.
- the sublaminar bands may be utilized to provide posterior fixation of the spine as an alternative to pedicle screw instrumentation. They may be used in patients with poor bone quality or difficult anatomy where an interface between a bone and an implant is compromised. Patients with pediatric deformity often times have dysmorphic vertebrae, which restrict the use of pedicle screws. Additionally, the risk of screw pullout is increased in patients with osteoporosis due to weak connection between the bone and the implant. Also, the sublaminar bands may be used in cases where patients have fractured pedicles.
- sublaminar bands offer an advantage of contacting the cortical bone of the lamina instead of relying on the cancellous bone within the pedicle and vertebral body.
- sublaminar bands may be wrapped around the lamina and transverse process to create a figure eight pattern.
- FIG. 1 illustrates a sublaminar band clamp (“clamp”) 100 in accordance with particular embodiments of the present disclosure.
- the clamp 100 may be a rigid member including a body 101 .
- the body 101 may include a nose portion 102 .
- the nose portion 102 may include a planar wall or surface.
- the body 101 may also include portions 104 a and 104 b that may extend from the nose portion 102 , thereby forming an opening 106 between distal ends 108 a and 108 b of the portions 104 a and 104 b .
- the opening 106 may extend from between the distal ends 108 a and 108 b to (or at least partially through) a central portion 110 of the clamp 100 , as shown.
- the opening 106 may be bound by inner surfaces 112 a , 112 b , and 110 a of the portions 104 a , 104 b , and the central portion 110 , respectively.
- the clamp 100 may generally be C-shaped or U-shaped and/or the opening 106 may generally be of or include a cylindrical shape or a portion thereof.
- An outer portion 114 a of the portion 104 a may include a first clamping mechanism 116 a (e.g., a set screw) which may extend through a passage 118 which extends through and from outer surface portion 114 a to and through the inner surface 112 a , as shown. That is, the passage 118 is in fluid communication with the opening 106 .
- Pins 120 extend through the passage 118 to prevent the first clamping mechanism 116 a from being removed from the passage 118 .
- the pins 120 may extend orthogonally, relative to a longitudinal axis of the passage 118 , to prevent the first clamping mechanism 116 a (e.g., the set screw) from being backed out or completely rotated out of the passage 118 .
- the first clamping mechanism 116 a may secure a spinal rod (e.g., spinal rod 128 shown on FIG. 3 ) within the opening 106 .
- FIG. 2 is a cross-section, of the clamp 100 of FIG. 1 , taken along the dashed line extending between A and A′ (as shown on FIG. 1 ).
- an outer portion 114 b of the portion 104 b may include a second clamping mechanism 116 b (e.g., a set screw) which may extend through a passage 122 .
- the passage 122 extends from the outer surface portion 114 b to an internal conduit (“conduit”) 124 .
- the passage 122 may be in fluid communication with the conduit 124 .
- the passage 122 may extend orthogonally from the conduit 124 , as shown.
- the inner conduit 124 extends internally between the portion 104 b and a portion of the nose portion 102 and may include an opening 125 a at the nose portion 102 and may also include an opening 125 b on outer portion 114 b .
- the passage 124 extends between the openings 125 a and 125 b .
- the second clamping mechanism 116 b may secure a portion of the sublaminar band (e.g., sublaminar band 130 as shown on FIG. 3 ) within the inner conduit 124 .
- Both the clamping mechanisms 116 a and 116 b may be movable in a forward direction (e.g., toward a center of the clamp 100 ) and a reverse direction.
- the passages 118 and 122 may be threaded. Also, as previously noted, the pins 120 may extend through the passage 118 . As shown, a lip 126 at a distal end of the first clamping mechanism 116 a is positioned adjacent to the pins 120 . The lip 126 is positioned between the pins 120 and the opening 106 , thereby preventing the first clamping mechanism 116 a from being completely removed from the passage 118 .
- FIG. 3 illustrates the clamp 100 with a spinal rod 128 and a sublaminar band 130 in accordance with particular embodiments of the present disclosure.
- the spinal rod 128 may extend through the opening 106 of the clamp 100 .
- the first clamping mechanism 116 a may be tightened or moved forward to press the spinal rod 128 against the inner surface 112 b thereby securing the spinal rod 128 within the opening 106 .
- the sublaminar band 130 may extend through the passage 124 .
- the sublaminar band 130 may be folded or curved and may include portions 132 a and 132 b which are stacked upon each other, as shown.
- FIG. 4 illustrates a cross-section, of the clamp 100 of FIG. 3 , taken along the dashed line extending between B and B′ (as shown on FIG. 3 ).
- the first clamping mechanism 116 a may be tightened or moved forward away from the pins 120 and toward the spinal rod 128 .
- a distal end 133 of the first clamping mechanism 116 a may include a protrusion 133 a that contacts the spinal rod 128 .
- the spinal rod 128 is secured within the opening 106 . That is, the spinal rod 128 is compressed between the tapered distal end 133 and the inner surface 112 b , upon tightening.
- the inner surface 112 b may include teeth or grooves 113 to assist with gripping and stabilizing the spinal rod 128 within the opening 106 , as shown.
- the second clamping mechanism 116 b may be tightened or moved forward to compress the portions 132 a and 132 b of the sublaminar band 130 within the passage 124 , thereby securing the portions 132 a and 132 b between an inner surface 134 of the passage 124 and a distal end 136 of the second clamping mechanism 116 b , as shown.
- FIG. 5 illustrates a clamp 500 in accordance with particular embodiments of the present disclosure.
- the clamp 500 may be similar to the clamp 100 (e.g., shown on FIGS. 1-4 ). However, instead of the opening 106 , the clamp 500 includes an aperture 502 that is completely surrounded by a body 504 of the clamp 500 , as shown. The aperture 502 is in fluid communication with the passage 118 .
- FIG. 6 illustrates a cross-section of the clamp 500 of FIG. 5 taken along the dashed line extending between C and C′ (as shown on FIG. 5 ).
- the first clamping mechanism 116 a may be tightened or moved forward away from the pins 120 and toward the spinal rod 128 .
- a distal end 133 of the first clamping mechanism 116 a may include a protrusion 133 a that contacts the spinal rod 128 thereby securing the spinal rod 128 within the opening 106 , upon tightening. That is, upon tightening, the spinal rod 128 is compressed between the distal end 133 and an inner surface 506 of the aperture 502 .
- the second clamping mechanism 116 b may be tightened or moved forward to compress the portions 132 a and 132 b of the sublaminar band 130 within the passage 124 , thereby securing the portions 132 a and 132 b between an inner surface 134 of the passage 124 and a distal end 136 of the second clamping mechanism 116 b , as shown.
- FIG. 7 illustrates a clamp system 700 in accordance with particular embodiments of the present disclosure.
- the clamp system 700 may include a tulip 702 .
- the tulip 702 may resemble a bullet with a hollow interior.
- the tulip 702 may include a portion 708 that may be hollow and extends from a nose portion 710 , as shown.
- the portion 708 may include openings 712 on opposing sides of the tulip 702 , as shown.
- the openings 712 may resemble arches to correspond with a curvature of a spinal rod that may be positioned within the openings 712 .
- the openings 712 may extend from a distal end 714 to (or at least partially through) a central portion 716 of the tulip 702 , as shown.
- the portion 708 may include slots 718 positioned on an end of the tulip 702 that is opposite to the nose portion 710 .
- a passage 720 may extend centrally and longitudinally from and through the nose portion 710 through the tulip 702 .
- the passage 720 may be in fluid communication with the openings 712 and the slots 718 , as shown.
- the clamp system 700 may further include a saddle 724 and a clamp 726 that are disposed within the tulip 702 .
- the saddle 724 and the clamp 726 may be coupled together to form a locking mechanism 727 , as shown on FIG. 8 .
- FIG. 8 is a perspective view of the locking mechanism 727 in accordance with particular embodiments of the present disclosure.
- the saddle 724 may be of a cylindrical shape and may include a groove 728 extending along a circumference of the saddle 724 , as shown.
- the groove 728 may be positioned between ridges 730 a and 730 b which also extend circumferentially about the saddle 724 , as shown.
- a passage 729 may be disposed at the center of the locking mechanism 727 , as shown.
- FIG. 9 is a cross-section of FIG. 8 taken along the dashed line extending between D and D′ (as shown on FIG. 8 ).
- the clamp 726 may include a first portion 732 a and a second portion 732 b which may be placed adjacent to each other to form a ring 734 , as best shown on FIG. 7 .
- the passage 729 may extend through the saddle 724 and the ring 734 .
- the ring 734 may be positioned within a groove 736 that extends internally along an internal circumference of the saddle 724 .
- the saddle 724 may also include ramps 738 extending along an outer edge of the saddle 724 to facilitate installation or coupling of the clamp 726 to the saddle 724 .
- the clamp 726 may also include ridges 740 positioned along an internal surface of an opening 742 formed by the portions 732 a and 732 b.
- FIG. 10 illustrates a cross-section of the clamp system 700 including the locking mechanism 727 positioned within the tulip 702 in a first configuration or unlocked position, in accordance with particular embodiments of the present disclosure. That is, the position of the locking mechanism 727 may be adjustable. In some embodiments, the locking mechanism 727 may be move axially in a direction of a longitudinal axis L. As shown, the passage 720 may be threaded and may include protrusion 744 that extends into the groove 728 of the saddle 724 to secure the locking mechanism within the tulip 702 . As shown, the protrusion 744 is between and adjacent to the ridges 730 a and 730 b .
- a space 713 is formed between the distal ends 745 and distal ends 715 of the portions 732 a and 732 b , as shown.
- the space 713 may be in fluid communication with the opening 742 and the slots 718 of the tulip 702 .
- the space 713 can allow placement or installation of a sublaminar band (e.g., sublaminar band 130 as shown on FIGS. 13 and 14 ) within the clamp system 700 .
- the opening 742 may include a profile that aligns with and corresponds to the shape the opening 712 shown on FIG. 7 to allow reception and securing of a spinal rod (e.g., spinal rod 128 as shown on FIGS. 13 and 14 ).
- FIG. 11 is a bottom view of the portions 732 a and 732 b positioned within the tulip 702 in accordance with particular embodiments of the present disclosure.
- the inner surfaces of distal ends 745 of the tulip 702 may include recesses 746 to complement, mate, or correspond with ridges 748 that protrude outward from the portions 732 a and 732 b that may be positioned between the distal ends 745 and the portions 732 a and 732 b .
- the distal ends 745 may include tapered regions 745 a to force the distal ends 715 inward thereby securing the sublaminar band, upon depression of the locking mechanism 727 .
- the tapered regions 745 a may retain the locking mechanism 727 within the tulip 702 .
- FIG. 12 illustrates a cross-section of the locking mechanism 727 positioned within the tulip 702 in a second configuration or locked position, in accordance with particular embodiments of the present disclosure.
- the passage 720 includes a first portion 750 (e.g., a threaded portion) and a second portion 752 (e.g., a chamber).
- the second portion 752 does not include threads and may have an inner diameter that is larger than an inner diameter of the first portion 750 .
- the saddle 724 may have an outer diameter that is larger than an inner diameter of the first portion 750 .
- the protrusion 744 may be positioned within the second portion 752 .
- the second portion 752 In the second position, the second portion 752 is not completely occupied resulting in a gap 754 positioned between the ridge 730 a and the first portion 750 . In comparison, with reference back to FIG. 10 , in the first position, the second portion 752 is completely occupied with no gap 754 . As shown in the locked position, the space 713 is reduced thereby holding or locking a sublaminar band in place between the distal ends 715 and the distal ends 745 .
- FIG. 13A illustrates a cross-section of the clamp system 700 , with the sublaminar band 130 , in the unlocked position, in accordance with particular embodiments of the present disclosure.
- the portions 132 a and 132 b of the sublaminar band 130 may be positioned through the space 713 and the slots 718 , as shown.
- the spinal rod 128 may be disposed between the portions 732 a and 732 b , as shown.
- the spinal rod 128 may extend in a lateral direction relative to a longitudinal axis L of the clamp system 700 , as shown.
- the protrusion 744 may be aligned and positioned within with the groove 728 .
- FIG. 13B illustrates a cross-section of the clamp system 700 , with the sublaminar band 130 , in the locked position, in accordance with particular embodiments of the present disclosure.
- the space 713 is reduced thereby holding or locking a sublaminar band in place between the distal ends 715 and the distal ends 745 .
- the tapered regions 745 a cause the distal ends 715 to move inward as the locking mechanism 727 is moved or translated toward the sublaminar band 130 . This inward movement secures or locks the sublaminar band 130 in place, as shown.
- the protrusion 744 is not aligned with the groove 728 and is positioned outside (e.g., above the groove 728 ) of and adjacent to the groove 728 , as shown.
- the clamp system 700 may further include a threaded locking cap 756 .
- the locking mechanism 727 may be moved, translated, or locked into place with the threaded locking cap 756 that may be removably disposed (e.g., a separate piece) within the passage 720 , as shown.
- the threaded locking cap 756 may be rotated thereby moving or shifting the locking mechanism 727 toward the spinal rod 128 , thereby securing the spinal rod 128 and the sublaminar band 130 , as shown.
- the threaded locking cap 756 may be rotated to translate the locking mechanism 727 from the unlocked position to the locked position, as described herein.
- FIG. 14A illustrates a cross-section of a clamp system 1400 in an unlocked position in accordance with particular embodiments of the present disclosure.
- the clamp system 1400 is similar to the clamp system 700 (e.g., shown on FIGS. 7 to 13B ). However, placement of the sublaminar band 130 differs from previously described configurations. As shown, the sublaminar band 130 may be positioned to extend through a passage or central cannulation 1402 of the threaded locking cap 756 and through the passage 729 of the locking mechanism 727 .
- FIG. 14B illustrates a cross-section of the clamp system 1400 in a locked position in accordance with particular embodiments of the present disclosure.
- the locking mechanism 727 is translated (e.g., moved toward the spinal rod 128 ) into a locked position with the threaded locking cap 756 , the sublaminar band 130 may be squeezed and secured between the spinal rod 128 and the locking mechanism 727 , as shown.
- FIG. 15A illustrates a cross-section of a clamp system 1500 in an unlocked position in accordance with particular embodiments of the present disclosure.
- the clamp system 1500 is similar to the clamp system 1400 (e.g., shown on FIGS. 14A and 14B ).
- placement of the sublaminar band 130 differs from previously described configurations.
- the portions 132 a and 32 b of the sublaminar band 130 are stacked and positioned to extend through a passage 1502 that extends between the first portion 750 and the second portion 752 of the passage 720 .
- FIG. 15B illustrates a cross-section of the clamp system 1500 in a locked position in accordance with particular embodiments of the present disclosure.
- the locking mechanism 727 is translated (e.g., moved toward the spinal rod 128 ) into a locked position with the threaded locking cap 756 , the sublaminar band 130 may be squeezed and secured between the locking mechanism 727 and the threaded locking cap 756 , as shown.
- the spinal rod 128 may be locked into place due to the tapered regions 745 a as described herein.
- FIG. 16 illustrates a clamp 1600 that is similar to the clamp 100 (e.g., shown on FIG. 1 ). However, placement of the sublaminar band differs from previously described configurations.
- the clamp 1600 includes a passage 1602 extending through the portion 104 b .
- the clamp 1600 also includes a sliding or moveable member (“member”) 1604 to secure the sublaminar band within the passage 1602 .
- the member 1604 may be elongated and rigid, and may be disposed between the opening 106 and the passage 1602 , as shown.
- FIG. 17A illustrates a cross-section of the clamp 1600 taken along the dashed line extending between E and E′ (as shown on FIG. 16 ).
- the passage 1602 is in fluid communication with the passage 1606 that contains the member 1604 .
- the passage 1606 may intersect the passage 1602 orthogonally.
- the passage 1604 extends through the inner surface 112 b.
- FIG. 17B illustrates another cross-section of the clamp 1600 including the sublaminar band 130 and the spinal rod 128 , in accordance with particular embodiments of the present disclosure.
- the sublaminar band 130 may extend through the passage 1602 .
- the sublaminar band 130 may be folded or curved and may include portions 132 a and 132 b which are stacked upon each other, as shown.
- the locking mechanism 116 a may be tightened to move the spinal rod 128 toward the member 1604 . This causes the member 1604 to move toward the passage 1602 thereby compressing and securing the sublaminar band 130 , as shown.
- the spinal rod 128 may be secured between a portion of the member 1604 and the locking mechanism 116 a , as shown.
- FIG. 18 illustrates a clamp 1800 that is similar to the clamp 1600 (e.g., shown on FIG. 16 ), in accordance with particular embodiments of the present disclosure. However, placement of the sublaminar band differs from previously described configurations.
- the clamp 1800 includes a groove 1802 positioned on the inner surface 112 b .
- the clamp 1800 also includes a passage 1804 extending from the nose portion 102 to the opening 106 , as shown.
- FIG. 19A illustrates a cross-section of the clamp 1800 taken along the dashed line extending between F and F′ (as shown on FIG. 18 ).
- the groove 1802 may extend along the passage 1804 , as shown.
- the passage 1804 may include a curve 1806 that corresponds with the shape of the spinal rod 128 , as shown on FIG. 19B .
- FIG. 19B illustrates another cross-section of the clamp 1800 including the sublaminar band 130 and the spinal rod 128 , in accordance with particular embodiments of the present disclosure.
- the groove 1802 can stabilize the sublaminar band 130 within the passage 1804 and against the curve 1806 .
- the locking mechanism 116 a may be tightened to move the spinal rod 128 toward the sublaminar band 130 .
- the spinal rod 128 may be secured between the locking mechanism 116 a and the sublaminar band 130 , as shown.
- the sublaminar band 130 may be secured between the spinal rod 128 and the curve 1806 of the passage 1804 , as shown.
- FIG. 20 illustrates a spinal rod 2000 in accordance with embodiments of the present disclosure.
- the spinal rod 2000 may be similar to the spinal rod 128 (e.g., shown on FIGS. 3, 4, 6, 13A, 13B, 14B, 15B, 17B ) as described herein.
- the spinal rod 2000 may include an elongated portion 2002 that is integrated with a clamp 2003 that may be similar to previously described clamps.
- the clamp 2003 may include a body 2004 and may include the locking mechanism 116 a (and the passage 118 as shown on FIG. 1 , for example).
- the clamp 2003 may be disposed on an end of the elongated portion 2002 , as shown.
- the clamp 2003 may include a passage 2006 that extends through the body 2004 in a direction toward an end 2007 of the elongated portion 2002 that is opposite to the clamp 2003 .
- the passage 2006 may be in fluid communication with the passage 118 .
- FIG. 21 illustrates the spinal rod 2000 with the sublaminar band 130 , in accordance with particular embodiments of the present disclosure.
- the sublaminar band 130 may extend through the passage 2006 .
- the passage 2006 may include an opening 2010 at a distal end of the spinal rod 2000 , as shown.
- the passage 2006 may include an opening 2012 at a section of the clamp 2003 that is adjacent to the elongated portion 2002 , as shown.
- the portions 132 a and 132 b of the sublaminar band 130 may extend adjacent to the elongated portion 2002 , as shown.
- the locking mechanism 116 a may be tightened thereby securing the sublaminar band 130 within the passage 2006 .
- FIG. 22 illustrates a clamp 2200 in accordance with particular embodiments of the present disclosure.
- the clamp 2200 may include an opening 2202 situated between portions 2204 a and 2204 b .
- a curved portion 2205 may be disposed between the portions 2204 a and 2204 b , as shown.
- the opening 2202 may extend from the curved portion 2205 to distal ends 2204 b and 2204 c of the portions 2204 a and 2204 b , as shown.
- Inner surfaces 2206 a and 2206 b of the portions 2204 a and 2204 b may be threaded.
- the portions 2204 a and 2204 b may include apertures 2207 a and 2207 b .
- the apertures 2207 a and 2207 b may be in fluid communication with the opening 2202 , as shown.
- the sublaminar band 130 may extend through the apertures 2207 a , 2207 b , and the opening 2202 , as shown.
- FIG. 23 illustrates the clamp 2200 secured to the spinal rod 128 in accordance with particular embodiments of the present disclosure.
- the rod 128 may extend through the opening 2202 .
- the spinal rod 128 may be disposed between the sublaminar band 130 and a set screw or locking cap 2208 that may be inserted between the portions 2204 a and 2204 b , as shown.
- the locking cap 2208 may be threaded and may be tightened to secure the spinal rod 128 and the sublaminar band within the opening 2202 , as shown.
- the sublaminar band 130 may be secured between the curved portion 2205 and the spinal rod 128 .
- the spinal rod 128 may be secured between the locking cap 2208 and the sublaminar band 130 , as shown.
- the spinal rod 128 may be positioned orthogonal to the sublaminar band 130 .
- FIG. 24 illustrates the clamp 2200 positioned between pedicle screw assemblies 2402 a and 2402 b , in accordance with particular embodiments of the present disclosure.
- the pedicle screw assemblies 2402 a and 2402 b may include similar components to that of the clamp 2200 .
- the pedicle screw assemblies 2402 a and 2402 b may include clamps 2402 a and 2402 b that are similar to the clamp 2200 , as described herein.
- the clamps 2402 a and 2402 b may include portions 2404 a , 2404 b , and 2406 a , 2406 b , respectively, that are similar to the portions 2204 a and 2204 b .
- locking caps 2408 a and 2408 b may be disposed between the portions 2404 a , 2404 b , and 2406 a , 2406 b , respectively.
- the locking caps 2408 a and 2408 b may be similar to the locking cap 2208 .
- FIG. 25A illustrates a clamp system 2500 in accordance with particular embodiments of the present disclosure.
- the clamp system 2500 may include first portion 2500 a including a clamp 2501 that is similar to the clamp 2200 as shown on FIG. 22 , for example.
- the clamp 2501 may include a passage 2502 that is in fluid communication with the opening 2202 .
- the passage 2502 may be positioned within a base 2503 , as shown.
- Portions 2505 and 2507 may extend from the base 2503 .
- the base 2503 may be opposite to distal ends 2505 a and 2505 b of the portions 2505 and 2507 , as shown.
- the first portion 2500 a may extend in a direction of a longitudinal axis L 1 .
- the clamp system 2500 may further include the saddle 724 and the clamp 726 to form the locking mechanism 727 , as previously described.
- the clamp 726 may be made of separate overlapping or interlocking portions 726 a and 726 b .
- the locking mechanism 727 may be secured within the passage 2502 .
- the clamp system 2500 may further include a second portion 2500 b that may be coupled to the first portion 2500 a .
- the second portion 2500 b may include a body 2511 that may extend in a direction of a longitudinal axis L 2 . In some embodiments, L 2 may be parallel to L 1 .
- the second portion 2500 b may include an aperture 2504 in fluid communication with an opening 2506 , as shown.
- a screw 2508 may include a flange 2508 a disposed adjacent to a threaded portion 2508 b .
- the flange 2508 a may be inserted through the opening 2506 and press-fitted into an aperture 2510 of a carriage 2512 thereby coupling the carriage 2512 to the screw 2508 .
- a carriage assembly 2509 may include the carriage 2512 and the screw 2508 .
- the carriage assembly 2509 may be retained in the second portion 2500 b.
- FIG. 25B illustrates the carriage assembly 2509 installed into the second portion 2500 b , and also shows the locking mechanism 727 installed into the first portion 2500 a , in accordance with particular embodiments of the present disclosure.
- the components of FIG. 25A are shown assembled in FIG. 25B , to form the clamp system 2500 .
- FIG. 26A is a partial cross-section of the clamp system 2500 taken along the dashed line extending between G and G′ (as shown on FIG. 25B ).
- FIG. 26A illustrates the locking mechanism 727 in an unlocked position.
- the partial cross-section illustrates an inside of the first portion 2500 a with the locking mechanism 727 disposed therein.
- the locking mechanism 727 is disposed within passage 2502 .
- the clamp 726 may include an inner surface 2600 that is threaded to correspond with a head of a screw such as the pedicle screws 2410 a and 2410 b , shown on FIG. 24 for example.
- the passage 2502 may extend through the base 2503 .
- Protrusion 2602 of an inner surface 2604 of the passage 2502 may extend into the groove 728 .
- the protrusion 2602 may be similar to the protrusion 744 , shown on FIG. 10 for example.
- the locking mechanism 727 may be disposed within the passage 2502 and may move axially therein, in a direction of a longitudinal axis L.
- FIG. 26B is a partial cross-section of the clamp system 2500 taken along the dashed line extending between G and G′ (as shown on FIG. 25B ).
- FIG. 26B illustrates the locking mechanism 727 in a locked position.
- the inner surface 2604 includes tapered portions 2606 that are similar to the tapered regions 745 a (shown on FIG. 12 for example).
- the tapered portions 2606 cause the portions 726 a and 726 b to move inward to squeeze and secure a pedicle screw, for example.
- a head of the pedicle screw may be inserted into a distal portion 2607 of the passage 2502 and may be retained by the clamp 726 .
- the locking mechanism 727 may be moved into a locked position by the threaded locking cap 756 shown on FIG. 15B for example.
- FIG. 27A is a cross-section of the second portion 2500 b taken along the dashed line extending between G and G′ (as shown on FIG. 25B ).
- FIG. 27A illustrates the carriage assembly 2509 in an unlocked position. As shown on FIG. 27A , the sublaminar band 130 extends through the aperture 2504 . The portions 132 a and 132 b may be in a stacked configuration. In the unlocked position, the carriage assembly 2509 does not contact the sublaminar band 130 , as shown.
- FIG. 27B is a cross-section of the second portion 2500 b taken along the dashed line extending between G and G′ (as shown on FIG. 25B ).
- FIG. 27A illustrates the carriage assembly 2509 in an unlocked position. As shown, the carriage assembly 2509 may be tightened thereby closing the aperture 2504 . Specifically, the screw 2508 may be moved toward the sublaminar band 130 thereby causing the carriage 2512 to squeeze and secure the sublaminar band 130 within the aperture 2504 , as shown on FIG. 28 . That is, the sublaminar band 130 may be secured between an inner surface 2504 a of the aperture 2504 and a distal end 2512 a of the carriage 2512 , for example.
- FIG. 29 illustrates the clamp system 2500 further including pedicle screw assemblies 2900 a and 2900 b and the spinal rod 128 in accordance with particular embodiments of the present disclosure.
- the pedicle screw assemblies 2900 a and 2900 b may include tulips 2902 a and 2902 b , as shown, that may be similar to the first portion 2500 a .
- Threaded locking caps 2904 a , 2904 b , and 2904 c may be disposed within pedicle the screw assemblies 2900 a and 2900 b and the first portion 2500 a , as shown.
- the threaded locking caps 2904 a , 2904 b , and 2904 c may be similar to the threaded locking cap 756 , shown FIG. 13B for example.
- FIG. 30 illustrates the first portion 2500 a coupled to the second portion 2500 b by a bridge 3000 , in accordance with particular embodiments of the present disclosure.
- the bridge 3000 may be collapsible. That is, the bridge 3000 can be adjusted to shorten a distance D between the first portion 2500 a and the second portion 2500 b by moving the first portion 2500 a and/or the second portion 2500 b toward each other.
- the bridge 3000 may also be extendable. That is, the bridge 3000 may be adjusted to lengthen the distance D by moving the first portion 2500 a and/or the second portion 2500 b away from each other.
- the adjustability of D should allow the clamp system 2500 to adjust to specific patient anatomy.
- the bridge 3000 may include a first portion 3002 a extending from an outer surface 3004 of the first portion 2500 a .
- the first portion 3002 a may include a recess 3006 comprising at least one slot 3008 a .
- another slot may be positioned on an opposite side (opposite from the first slot 3008 a ) of the recess 3006 .
- the position of the second slot is indicated by reference 3008 b , as shown.
- the bridge 3000 may also include a second portion 3002 b that may be an elongated member including at least one rail 3010 a that is aligned with and extends into the slot 3008 a , as shown.
- FIG. 31A illustrates the clamp system 2500 further including a hook 3100 , in accordance with particular embodiments of the present disclosure.
- the hook 3100 may extend from a portion 3102 of the clamp system 2500 that may be positioned between and/or adjacent to the first portion 2500 a and the second portion 2500 b , as shown.
- the hook 3100 may include a flat surface that may taper in a direction away from the portion 3102 .
- FIG. 31B illustrates the clamp system 2500 with the sublaminar band 130 secured therein, in accordance with particular embodiments of the present disclosure.
- the sublaminar band 130 may extend through the second portion 2500 b .
- the sublaminar band 130 may be positioned adjacent to the hook 3100 .
- the hook 3100 may be engaged with a lamina, pedicle or transverse process of a patient before the spinal rod 128 is inserted through the first portion 2500 a and secured therein.
- FIG. 32 illustrates the clamp system 2500 and the hook 3100 attached to the spinal rod 128 along with the pedicle screw assemblies 2900 a and 2900 b , in accordance with particular embodiments of the present disclosure.
- the configuration shown in FIG. 32 may be similar to the configuration shown in FIG. 29 .
- the first portion 2500 a and the second portion 2500 b may be disposed between the pedicle screw assemblies 2900 a and 2900 b .
- the spinal rod 128 may be retained in the clamp system 2500 via the threaded locking caps 2904 a , 2904 b , and 2904 c .
- the sublaminar band 130 may be secured to the second portion 2500 b .
- the configuration shown in FIG. 32 may allow a surgeon to create a claw construct by placing the hook 3100 on a lamina of one vertebral level and placing the sublaminar band 130 around a lamina of an adjacent vertebral level. When the sublaminar band 130 is tensioned, the two vertebral levels may be compressed together to offer an increased fixation to the claw construct.
- FIG. 33 illustrates the first portion 2500 a (as shown on FIG. 30 ) further including the hook 3100 (as shown on FIG. 31A , for example).
- This configuration allows a distance IA between the hook 3100 and the second portion 2500 b to be adjusted due to the adjustability of the first portion 2500 a relative to the second portion 2500 b via the bridge 3000 , as described herein.
- the first portion 2500 a (including the hook 3100 ) may be initially separate from the second portion 2500 b and may subsequently be connected to each other to form the clamp system 2500 or a portion thereof.
- FIG. 34 illustrates an embodiment in which the sublaminar band 130 is secured to the second portion 2500 b that includes the hook 3100 , in accordance with particular embodiments of the present disclosure.
- the hook 3100 may extend from the second portion 2500 b
- the sublaminar band 130 may extend through the second portion 2500 b such that the sublaminar band 130 is adjacent to the hook 3100 .
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Abstract
Description
- The present application is a continuation of U.S. patent application Ser. No. 16/666,988, filed Oct. 29, 2019, the entire disclosure of which is incorporated herein by reference.
- Many types of spinal irregularities cause pain, limit range of motion, or injure the nervous system within the spinal column. These irregularities can result from trauma, tumor, disc degeneration, or disease. Typically, these irregularities are treated by immobilizing a portion of the spine. This treatment typically involves affixing a plurality of components, such as, for example, screws, hooks, and/or clamps, to one or more vertebrae, and attaching the components to an elongated rod that stabilizes the vertebrae.
- In an exemplary embodiment, the present disclosure provides a sublaminar band clamp system that may include a first locking mechanism, a second locking mechanism, and a body. The body may include a first portion comprising a first passage, wherein the first locking mechanism is disposed within the first passage. The body may further include a second portion comprising a second passage, wherein the second locking mechanism is disposed within the second passage. A third passage may extend across the body and may be in fluid communication with the second passage. An opening may be positioned between the first and second portions, and the opening may be in fluid communication with the first passage.
- In another exemplary embodiment, the present disclosure provides a sublaminar band clamp system that may include a tulip comprising a passage and a chamber fluidly coupled to the passage. A protrusion may extend inward from an inner surface of the chamber. A locking mechanism may be movably disposed within the chamber. The locking mechanism may include a saddle comprising a groove and a clamp. The saddle may be coupled to the clamp.
- In another exemplary embodiment, the present disclosure provides a sublaminar band clamp system that may include a spinal rod comprising an elongated portion, and a clamp positioned at a first end of the spinal rod. The clamp may include a passage that extends in a direction from the first end to a second end of the spinal rod. The sublaminar band system may also include a locking mechanism extending toward the passage.
- It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory in nature and are intended to provide an understanding of the present disclosure without limiting the scope of the present disclosure. In that regard, additional aspects, features, and advantages of the present disclosure will be apparent to one skilled in the art from the following detailed description.
- These drawings illustrate certain aspects of some of the embodiments of the present disclosure and should not be used to limit or define the disclosure.
-
FIG. 1 illustrates a sublaminar band clamp (“clamp”) in accordance with embodiments of the present disclosure; -
FIG. 2 is a cross-section ofFIG. 1 ; -
FIG. 3 illustrates the clamp ofFIG. 1 with a spinal rod and a sublaminar band, in accordance with embodiments of the present disclosure; -
FIG. 4 is a cross-section ofFIG. 3 ; -
FIG. 5 illustrates a clamp in accordance with embodiments of the present disclosure; -
FIG. 6 is a cross-section ofFIG. 5 ; -
FIG. 7 illustrates a clamp system in accordance with embodiments of the present disclosure; -
FIG. 8 illustrates a locking mechanism of the clamp system ofFIG. 7 , in accordance with embodiments of the present disclosure; -
FIG. 9 is a cross-section ofFIG. 8 ; -
FIG. 10 is a cross-section of the clamp system ofFIG. 7 in an assembled configuration in accordance with embodiments of the present disclosure; -
FIG. 11 is a bottom view of a tulip and a clamp of the clamp system ofFIG. 7 , in accordance with embodiments of the present disclosure; -
FIG. 12 is a cross-section of a locking mechanism in a locked position in accordance with embodiments of the present disclosure; -
FIG. 13A is a cross-section of a clamp system with a sublaminar band in an unlocked position, in accordance with embodiments of the present disclosure; -
FIG. 13B is a cross-section of the clamp system ofFIG. 13A in a locked position, in accordance with embodiments of the present disclosure; -
FIG. 14A is a cross-section of a clamp system with a sublaminar band in an unlocked position, in accordance with embodiments of the present disclosure; -
FIG. 14B is a cross-section of the clamp system ofFIG. 14A in a locked position, in accordance with embodiments of the present disclosure; -
FIG. 15A is a cross-section of a clamp system with a sublaminar band in an unlocked position, in accordance with embodiments of the present disclosure; -
FIG. 15B is a cross-section of the clamp system ofFIG. 15A in a locked position, in accordance with embodiments of the present disclosure; -
FIG. 16 illustrates a clamp in accordance with embodiments of the present disclosure; -
FIG. 17A is a cross-section ofFIG. 16 ; -
FIG. 17B is a cross-section of the clamp ofFIG. 16 with a sublaminar band in a locked position, in accordance with embodiments of the present disclosure; -
FIG. 18 illustrates a clamp in accordance with embodiments of the present disclosure; -
FIG. 19A is a cross-section ofFIG. 18 ; -
FIG. 19B is a cross-section of the clamp ofFIG. 18 with a sublaminar band in a locked position, in accordance with embodiments of the present disclosure; -
FIG. 20 illustrates a spinal rod integrated with a clamp, in accordance with embodiments of the present disclosure; -
FIG. 21 illustrates a sublaminar band secured to the clamp ofFIG. 20 , in accordance with embodiments of the present disclosure; -
FIG. 22 illustrates a clamp in accordance with embodiments of the present disclosure; -
FIG. 23 illustrates the clamp ofFIG. 22 secured to a spinal rod in accordance with embodiments of the present disclosure; -
FIG. 24 illustrates the clamp ofFIG. 22 positioned between pedicle screw assemblies, in accordance with embodiments of the present disclosure; -
FIG. 25A illustrates separate components of a clamp system in accordance with embodiments of the present disclosure; -
FIG. 25B illustrates the clamp system ofFIG. 25A in an assembled configuration, in accordance with embodiments of the present disclosure; -
FIG. 26A is a cross-section of a first portion of the clamp system, as shown onFIG. 25B , in an unlocked position, in accordance with embodiments of the present disclosure; -
FIG. 26B is a cross-section of a first portion of the clamp system, as shown onFIG. 25B , in a locked position, in accordance with embodiments of the present disclosure; -
FIG. 27A is a cross-section of a second portion of the clamp system, as shown onFIG. 25B , in an unlocked position, in accordance with embodiments of the present disclosure; -
FIG. 27B is a cross-section of a second portion of the clamp system, as shown onFIG. 25B , in a locked position, in accordance with embodiments of the present disclosure; -
FIG. 28 illustrates a perspective view of the clamp system ofFIG. 25A with a pedicle screw and a sublaminar band, in accordance with embodiments of the present disclosure; -
FIG. 29 illustrates the clamp system ofFIG. 25A further including pedicle screw assemblies and a spinal rod, in accordance with embodiments of the present disclosure; -
FIG. 30 illustrates a clamp system including a bridge, in accordance with embodiments of the present disclosure; -
FIG. 31A illustrates a clamp system including a hook, in accordance with embodiments of the present disclosure; -
FIG. 31B illustrates the clamp system ofFIG. 31A with a sublaminar band secured therein, in accordance with embodiments of the present disclosure; -
FIG. 32 illustrates the clamp system ofFIG. 31A attached to a spinal rod with pedicle screw assemblies, in accordance with embodiments of the present disclosure; -
FIG. 33 illustrates a first portion of the clamp system ofFIG. 30 further including a hook, in accordance with embodiments of the present disclosure; and -
FIG. 34 illustrates a second portion of the clamp system ofFIG. 30 further including a hook and a sublaminar band, in accordance with embodiments of the present disclosure. - For the purposes of promoting an understanding of the principles of the present disclosure, reference will now be made to the implementations illustrated in the drawings and specific language will be used to describe them. It will nevertheless be understood that no limitation of the scope of the disclosure may be intended. Any alterations and further modifications to the described devices, instruments, methods, and any further application of the principles of the present disclosure are fully contemplated as would normally occur to one skilled in the art to which the disclosure relates. In particular, it may be fully contemplated that the features, components, and/or steps described with reference to one or more implementations may be combined with the features, components, and/or steps described with reference to other implementations of the present disclosure. For simplicity, in some instances the same reference numbers are used throughout the drawings to refer to the same or like parts.
- Embodiments generally relate to spinal surgery. More particularly, embodiments relate to systems, methods, and devices for fixating spinal anatomy with a sublaminar band.
- Sublaminar bands should be understood by one having skill in the art. The sublaminar bands may be utilized to provide posterior fixation of the spine as an alternative to pedicle screw instrumentation. They may be used in patients with poor bone quality or difficult anatomy where an interface between a bone and an implant is compromised. Patients with pediatric deformity often times have dysmorphic vertebrae, which restrict the use of pedicle screws. Additionally, the risk of screw pullout is increased in patients with osteoporosis due to weak connection between the bone and the implant. Also, the sublaminar bands may be used in cases where patients have fractured pedicles. In these clinical scenarios, the sublaminar bands offer an advantage of contacting the cortical bone of the lamina instead of relying on the cancellous bone within the pedicle and vertebral body. Alternatively, sublaminar bands may be wrapped around the lamina and transverse process to create a figure eight pattern.
-
FIG. 1 illustrates a sublaminar band clamp (“clamp”) 100 in accordance with particular embodiments of the present disclosure. Theclamp 100 may be a rigid member including abody 101. Thebody 101 may include anose portion 102. Thenose portion 102 may include a planar wall or surface. Thebody 101 may also includeportions nose portion 102, thereby forming anopening 106 betweendistal ends portions opening 106 may extend from between the distal ends 108 a and 108 b to (or at least partially through) acentral portion 110 of theclamp 100, as shown. Theopening 106 may be bound byinner surfaces portions central portion 110, respectively. In certain embodiments, theclamp 100 may generally be C-shaped or U-shaped and/or theopening 106 may generally be of or include a cylindrical shape or a portion thereof. - An
outer portion 114 a of theportion 104 a may include afirst clamping mechanism 116 a (e.g., a set screw) which may extend through apassage 118 which extends through and fromouter surface portion 114 a to and through theinner surface 112 a, as shown. That is, thepassage 118 is in fluid communication with theopening 106.Pins 120 extend through thepassage 118 to prevent thefirst clamping mechanism 116 a from being removed from thepassage 118. For example, thepins 120 may extend orthogonally, relative to a longitudinal axis of thepassage 118, to prevent thefirst clamping mechanism 116 a (e.g., the set screw) from being backed out or completely rotated out of thepassage 118. Thefirst clamping mechanism 116 a may secure a spinal rod (e.g.,spinal rod 128 shown onFIG. 3 ) within theopening 106. -
FIG. 2 is a cross-section, of theclamp 100 ofFIG. 1 , taken along the dashed line extending between A and A′ (as shown onFIG. 1 ). As shown onFIG. 2 , anouter portion 114 b of theportion 104 b may include asecond clamping mechanism 116 b (e.g., a set screw) which may extend through apassage 122. Thepassage 122 extends from theouter surface portion 114 b to an internal conduit (“conduit”) 124. Thepassage 122 may be in fluid communication with theconduit 124. In certain embodiments, thepassage 122 may extend orthogonally from theconduit 124, as shown. Theinner conduit 124 extends internally between theportion 104 b and a portion of thenose portion 102 and may include anopening 125 a at thenose portion 102 and may also include anopening 125 b onouter portion 114 b. Thepassage 124 extends between theopenings second clamping mechanism 116 b may secure a portion of the sublaminar band (e.g.,sublaminar band 130 as shown onFIG. 3 ) within theinner conduit 124. Both the clampingmechanisms - The
passages pins 120 may extend through thepassage 118. As shown, alip 126 at a distal end of thefirst clamping mechanism 116 a is positioned adjacent to thepins 120. Thelip 126 is positioned between thepins 120 and theopening 106, thereby preventing thefirst clamping mechanism 116 a from being completely removed from thepassage 118. -
FIG. 3 illustrates theclamp 100 with aspinal rod 128 and asublaminar band 130 in accordance with particular embodiments of the present disclosure. As shown, thespinal rod 128 may extend through theopening 106 of theclamp 100. Thefirst clamping mechanism 116 a may be tightened or moved forward to press thespinal rod 128 against theinner surface 112 b thereby securing thespinal rod 128 within theopening 106. - The
sublaminar band 130 may extend through thepassage 124. Thesublaminar band 130 may be folded or curved and may includeportions -
FIG. 4 illustrates a cross-section, of theclamp 100 ofFIG. 3 , taken along the dashed line extending between B and B′ (as shown onFIG. 3 ). As shown onFIG. 4 , thefirst clamping mechanism 116 a may be tightened or moved forward away from thepins 120 and toward thespinal rod 128. Adistal end 133 of thefirst clamping mechanism 116 a may include aprotrusion 133 a that contacts thespinal rod 128. Upon tightening, thespinal rod 128 is secured within theopening 106. That is, thespinal rod 128 is compressed between the tapereddistal end 133 and theinner surface 112 b, upon tightening. Theinner surface 112 b may include teeth orgrooves 113 to assist with gripping and stabilizing thespinal rod 128 within theopening 106, as shown. Thesecond clamping mechanism 116 b may be tightened or moved forward to compress theportions sublaminar band 130 within thepassage 124, thereby securing theportions inner surface 134 of thepassage 124 and adistal end 136 of thesecond clamping mechanism 116 b, as shown. -
FIG. 5 illustrates aclamp 500 in accordance with particular embodiments of the present disclosure. Theclamp 500 may be similar to the clamp 100 (e.g., shown onFIGS. 1-4 ). However, instead of theopening 106, theclamp 500 includes anaperture 502 that is completely surrounded by abody 504 of theclamp 500, as shown. Theaperture 502 is in fluid communication with thepassage 118. -
FIG. 6 illustrates a cross-section of theclamp 500 ofFIG. 5 taken along the dashed line extending between C and C′ (as shown onFIG. 5 ). As shown onFIG. 6 , thefirst clamping mechanism 116 a may be tightened or moved forward away from thepins 120 and toward thespinal rod 128. Adistal end 133 of thefirst clamping mechanism 116 a may include aprotrusion 133 a that contacts thespinal rod 128 thereby securing thespinal rod 128 within theopening 106, upon tightening. That is, upon tightening, thespinal rod 128 is compressed between thedistal end 133 and aninner surface 506 of theaperture 502. Thesecond clamping mechanism 116 b may be tightened or moved forward to compress theportions sublaminar band 130 within thepassage 124, thereby securing theportions inner surface 134 of thepassage 124 and adistal end 136 of thesecond clamping mechanism 116 b, as shown. -
FIG. 7 illustrates aclamp system 700 in accordance with particular embodiments of the present disclosure. Theclamp system 700 may include atulip 702. Thetulip 702 may resemble a bullet with a hollow interior. Thetulip 702 may include aportion 708 that may be hollow and extends from anose portion 710, as shown. Theportion 708 may includeopenings 712 on opposing sides of thetulip 702, as shown. In certain embodiments, theopenings 712 may resemble arches to correspond with a curvature of a spinal rod that may be positioned within theopenings 712. Theopenings 712 may extend from adistal end 714 to (or at least partially through) acentral portion 716 of thetulip 702, as shown. Theportion 708 may includeslots 718 positioned on an end of thetulip 702 that is opposite to thenose portion 710. - A
passage 720 may extend centrally and longitudinally from and through thenose portion 710 through thetulip 702. Thepassage 720 may be in fluid communication with theopenings 712 and theslots 718, as shown. - The
clamp system 700 may further include asaddle 724 and aclamp 726 that are disposed within thetulip 702. Thesaddle 724 and theclamp 726 may be coupled together to form alocking mechanism 727, as shown onFIG. 8 . -
FIG. 8 is a perspective view of thelocking mechanism 727 in accordance with particular embodiments of the present disclosure. As shown, thesaddle 724 may be of a cylindrical shape and may include agroove 728 extending along a circumference of thesaddle 724, as shown. Thegroove 728 may be positioned betweenridges saddle 724, as shown. Apassage 729 may be disposed at the center of thelocking mechanism 727, as shown. -
FIG. 9 is a cross-section ofFIG. 8 taken along the dashed line extending between D and D′ (as shown onFIG. 8 ). As shown onFIG. 9 , theclamp 726 may include afirst portion 732 a and asecond portion 732 b which may be placed adjacent to each other to form aring 734, as best shown onFIG. 7 . Thepassage 729 may extend through thesaddle 724 and thering 734. Thering 734 may be positioned within agroove 736 that extends internally along an internal circumference of thesaddle 724. Thesaddle 724 may also includeramps 738 extending along an outer edge of thesaddle 724 to facilitate installation or coupling of theclamp 726 to thesaddle 724. Theclamp 726 may also includeridges 740 positioned along an internal surface of anopening 742 formed by theportions -
FIG. 10 illustrates a cross-section of theclamp system 700 including thelocking mechanism 727 positioned within thetulip 702 in a first configuration or unlocked position, in accordance with particular embodiments of the present disclosure. That is, the position of thelocking mechanism 727 may be adjustable. In some embodiments, thelocking mechanism 727 may be move axially in a direction of a longitudinal axis L. As shown, thepassage 720 may be threaded and may includeprotrusion 744 that extends into thegroove 728 of thesaddle 724 to secure the locking mechanism within thetulip 702. As shown, theprotrusion 744 is between and adjacent to theridges space 713 is formed between the distal ends 745 anddistal ends 715 of theportions space 713 may be in fluid communication with theopening 742 and theslots 718 of thetulip 702. Thespace 713 can allow placement or installation of a sublaminar band (e.g.,sublaminar band 130 as shown onFIGS. 13 and 14 ) within theclamp system 700. Theopening 742 may include a profile that aligns with and corresponds to the shape theopening 712 shown onFIG. 7 to allow reception and securing of a spinal rod (e.g.,spinal rod 128 as shown onFIGS. 13 and 14 ). -
FIG. 11 is a bottom view of theportions tulip 702 in accordance with particular embodiments of the present disclosure. As shown, the inner surfaces ofdistal ends 745 of thetulip 702 may includerecesses 746 to complement, mate, or correspond withridges 748 that protrude outward from theportions portions regions 745 a to force the distal ends 715 inward thereby securing the sublaminar band, upon depression of thelocking mechanism 727. Also, the taperedregions 745 a may retain thelocking mechanism 727 within thetulip 702. -
FIG. 12 illustrates a cross-section of thelocking mechanism 727 positioned within thetulip 702 in a second configuration or locked position, in accordance with particular embodiments of the present disclosure. As shown, thepassage 720 includes a first portion 750 (e.g., a threaded portion) and a second portion 752 (e.g., a chamber). In certain embodiments, thesecond portion 752 does not include threads and may have an inner diameter that is larger than an inner diameter of thefirst portion 750. Thesaddle 724 may have an outer diameter that is larger than an inner diameter of thefirst portion 750. Theprotrusion 744 may be positioned within thesecond portion 752. In the second position, thesecond portion 752 is not completely occupied resulting in agap 754 positioned between theridge 730 a and thefirst portion 750. In comparison, with reference back toFIG. 10 , in the first position, thesecond portion 752 is completely occupied with nogap 754. As shown in the locked position, thespace 713 is reduced thereby holding or locking a sublaminar band in place between the distal ends 715 and the distal ends 745. -
FIG. 13A illustrates a cross-section of theclamp system 700, with thesublaminar band 130, in the unlocked position, in accordance with particular embodiments of the present disclosure. As shown, theportions sublaminar band 130 may be positioned through thespace 713 and theslots 718, as shown. Thespinal rod 128 may be disposed between theportions spinal rod 128 may extend in a lateral direction relative to a longitudinal axis L of theclamp system 700, as shown. In the unlocked position, theprotrusion 744 may be aligned and positioned within with thegroove 728. -
FIG. 13B illustrates a cross-section of theclamp system 700, with thesublaminar band 130, in the locked position, in accordance with particular embodiments of the present disclosure. As shown, thespace 713 is reduced thereby holding or locking a sublaminar band in place between the distal ends 715 and the distal ends 745. As previously noted, the taperedregions 745 a cause the distal ends 715 to move inward as thelocking mechanism 727 is moved or translated toward thesublaminar band 130. This inward movement secures or locks thesublaminar band 130 in place, as shown. In the locked position, theprotrusion 744 is not aligned with thegroove 728 and is positioned outside (e.g., above the groove 728) of and adjacent to thegroove 728, as shown. - In certain embodiments, the
clamp system 700 may further include a threadedlocking cap 756. Thelocking mechanism 727 may be moved, translated, or locked into place with the threadedlocking cap 756 that may be removably disposed (e.g., a separate piece) within thepassage 720, as shown. The threadedlocking cap 756 may be rotated thereby moving or shifting thelocking mechanism 727 toward thespinal rod 128, thereby securing thespinal rod 128 and thesublaminar band 130, as shown. In other words, the threadedlocking cap 756 may be rotated to translate thelocking mechanism 727 from the unlocked position to the locked position, as described herein. -
FIG. 14A illustrates a cross-section of aclamp system 1400 in an unlocked position in accordance with particular embodiments of the present disclosure. Theclamp system 1400 is similar to the clamp system 700 (e.g., shown onFIGS. 7 to 13B ). However, placement of thesublaminar band 130 differs from previously described configurations. As shown, thesublaminar band 130 may be positioned to extend through a passage orcentral cannulation 1402 of the threadedlocking cap 756 and through thepassage 729 of thelocking mechanism 727. -
FIG. 14B illustrates a cross-section of theclamp system 1400 in a locked position in accordance with particular embodiments of the present disclosure. As shown, as thelocking mechanism 727 is translated (e.g., moved toward the spinal rod 128) into a locked position with the threadedlocking cap 756, thesublaminar band 130 may be squeezed and secured between thespinal rod 128 and thelocking mechanism 727, as shown. -
FIG. 15A illustrates a cross-section of aclamp system 1500 in an unlocked position in accordance with particular embodiments of the present disclosure. Theclamp system 1500 is similar to the clamp system 1400 (e.g., shown onFIGS. 14A and 14B ). However, placement of thesublaminar band 130 differs from previously described configurations. As shown, theportions 132 a and 32 b of thesublaminar band 130 are stacked and positioned to extend through apassage 1502 that extends between thefirst portion 750 and thesecond portion 752 of thepassage 720. -
FIG. 15B illustrates a cross-section of theclamp system 1500 in a locked position in accordance with particular embodiments of the present disclosure. As shown, as thelocking mechanism 727 is translated (e.g., moved toward the spinal rod 128) into a locked position with the threadedlocking cap 756, thesublaminar band 130 may be squeezed and secured between thelocking mechanism 727 and the threadedlocking cap 756, as shown. Also, thespinal rod 128 may be locked into place due to the taperedregions 745 a as described herein. -
FIG. 16 illustrates aclamp 1600 that is similar to the clamp 100 (e.g., shown onFIG. 1 ). However, placement of the sublaminar band differs from previously described configurations. As shown, theclamp 1600 includes apassage 1602 extending through theportion 104 b. Theclamp 1600 also includes a sliding or moveable member (“member”) 1604 to secure the sublaminar band within thepassage 1602. Themember 1604 may be elongated and rigid, and may be disposed between theopening 106 and thepassage 1602, as shown. -
FIG. 17A illustrates a cross-section of theclamp 1600 taken along the dashed line extending between E and E′ (as shown onFIG. 16 ). As shown onFIG. 17A , thepassage 1602 is in fluid communication with thepassage 1606 that contains themember 1604. Thepassage 1606 may intersect thepassage 1602 orthogonally. As shown, thepassage 1604 extends through theinner surface 112 b. -
FIG. 17B illustrates another cross-section of theclamp 1600 including thesublaminar band 130 and thespinal rod 128, in accordance with particular embodiments of the present disclosure. As shown, thesublaminar band 130 may extend through thepassage 1602. Thesublaminar band 130 may be folded or curved and may includeportions locking mechanism 116 a may be tightened to move thespinal rod 128 toward themember 1604. This causes themember 1604 to move toward thepassage 1602 thereby compressing and securing thesublaminar band 130, as shown. Additionally, thespinal rod 128 may be secured between a portion of themember 1604 and thelocking mechanism 116 a, as shown. -
FIG. 18 illustrates aclamp 1800 that is similar to the clamp 1600 (e.g., shown onFIG. 16 ), in accordance with particular embodiments of the present disclosure. However, placement of the sublaminar band differs from previously described configurations. As shown, theclamp 1800 includes agroove 1802 positioned on theinner surface 112 b. Theclamp 1800 also includes apassage 1804 extending from thenose portion 102 to theopening 106, as shown. -
FIG. 19A illustrates a cross-section of theclamp 1800 taken along the dashed line extending between F and F′ (as shown onFIG. 18 ). As shown onFIG. 19A , thegroove 1802 may extend along thepassage 1804, as shown. Thepassage 1804 may include acurve 1806 that corresponds with the shape of thespinal rod 128, as shown onFIG. 19B . -
FIG. 19B illustrates another cross-section of theclamp 1800 including thesublaminar band 130 and thespinal rod 128, in accordance with particular embodiments of the present disclosure. Thegroove 1802 can stabilize thesublaminar band 130 within thepassage 1804 and against thecurve 1806. As shown, thelocking mechanism 116 a may be tightened to move thespinal rod 128 toward thesublaminar band 130. Thespinal rod 128 may be secured between thelocking mechanism 116 a and thesublaminar band 130, as shown. Thesublaminar band 130 may be secured between thespinal rod 128 and thecurve 1806 of thepassage 1804, as shown. -
FIG. 20 illustrates aspinal rod 2000 in accordance with embodiments of the present disclosure. Thespinal rod 2000 may be similar to the spinal rod 128 (e.g., shown onFIGS. 3, 4, 6, 13A, 13B, 14B, 15B, 17B ) as described herein. Thespinal rod 2000 may include anelongated portion 2002 that is integrated with aclamp 2003 that may be similar to previously described clamps. - The
clamp 2003 may include abody 2004 and may include thelocking mechanism 116 a (and thepassage 118 as shown onFIG. 1 , for example). Theclamp 2003 may be disposed on an end of theelongated portion 2002, as shown. Theclamp 2003 may include apassage 2006 that extends through thebody 2004 in a direction toward anend 2007 of theelongated portion 2002 that is opposite to theclamp 2003. Thepassage 2006 may be in fluid communication with thepassage 118. -
FIG. 21 illustrates thespinal rod 2000 with thesublaminar band 130, in accordance with particular embodiments of the present disclosure. As shown, thesublaminar band 130 may extend through thepassage 2006. Thepassage 2006 may include anopening 2010 at a distal end of thespinal rod 2000, as shown. Additionally, thepassage 2006 may include anopening 2012 at a section of theclamp 2003 that is adjacent to theelongated portion 2002, as shown. Theportions sublaminar band 130 may extend adjacent to theelongated portion 2002, as shown. Thelocking mechanism 116 a may be tightened thereby securing thesublaminar band 130 within thepassage 2006. -
FIG. 22 illustrates aclamp 2200 in accordance with particular embodiments of the present disclosure. As shown, theclamp 2200 may include anopening 2202 situated betweenportions curved portion 2205 may be disposed between theportions opening 2202 may extend from thecurved portion 2205 todistal ends portions Inner surfaces portions portions apertures apertures opening 2202, as shown. Thesublaminar band 130 may extend through theapertures opening 2202, as shown. -
FIG. 23 illustrates theclamp 2200 secured to thespinal rod 128 in accordance with particular embodiments of the present disclosure. As shown, therod 128 may extend through theopening 2202. Thespinal rod 128 may be disposed between thesublaminar band 130 and a set screw or lockingcap 2208 that may be inserted between theportions locking cap 2208 may be threaded and may be tightened to secure thespinal rod 128 and the sublaminar band within theopening 2202, as shown. Thesublaminar band 130 may be secured between thecurved portion 2205 and thespinal rod 128. And thespinal rod 128 may be secured between the lockingcap 2208 and thesublaminar band 130, as shown. In certain embodiments, thespinal rod 128 may be positioned orthogonal to thesublaminar band 130. -
FIG. 24 illustrates theclamp 2200 positioned betweenpedicle screw assemblies pedicle screw assemblies clamp 2200. For example, thepedicle screw assemblies clamps clamp 2200, as described herein. Theclamps portions portions caps portions locking cap 2208. -
Pedicle screws curved portions curved portions curved portion 2205. -
FIG. 25A illustrates aclamp system 2500 in accordance with particular embodiments of the present disclosure. Theclamp system 2500 may includefirst portion 2500 a including aclamp 2501 that is similar to theclamp 2200 as shown onFIG. 22 , for example. However, theclamp 2501 may include apassage 2502 that is in fluid communication with theopening 2202. Thepassage 2502 may be positioned within abase 2503, as shown.Portions base 2503. Thebase 2503 may be opposite todistal ends portions first portion 2500 a may extend in a direction of a longitudinal axis L1. - The
clamp system 2500 may further include thesaddle 724 and theclamp 726 to form thelocking mechanism 727, as previously described. In certain embodiments, theclamp 726 may be made of separate overlapping or interlockingportions locking mechanism 727 may be secured within thepassage 2502. - The
clamp system 2500 may further include asecond portion 2500 b that may be coupled to thefirst portion 2500 a. Thesecond portion 2500 b may include abody 2511 that may extend in a direction of a longitudinal axis L2. In some embodiments, L2 may be parallel to L1. Thesecond portion 2500 b may include anaperture 2504 in fluid communication with anopening 2506, as shown. Ascrew 2508 may include aflange 2508 a disposed adjacent to a threadedportion 2508 b. Theflange 2508 a may be inserted through theopening 2506 and press-fitted into anaperture 2510 of acarriage 2512 thereby coupling thecarriage 2512 to thescrew 2508. In certain embodiments, acarriage assembly 2509 may include thecarriage 2512 and thescrew 2508. Thecarriage assembly 2509 may be retained in thesecond portion 2500 b. -
FIG. 25B illustrates thecarriage assembly 2509 installed into thesecond portion 2500 b, and also shows thelocking mechanism 727 installed into thefirst portion 2500 a, in accordance with particular embodiments of the present disclosure. In other words, the components ofFIG. 25A are shown assembled inFIG. 25B , to form theclamp system 2500. -
FIG. 26A is a partial cross-section of theclamp system 2500 taken along the dashed line extending between G and G′ (as shown onFIG. 25B ).FIG. 26A illustrates thelocking mechanism 727 in an unlocked position. The partial cross-section illustrates an inside of thefirst portion 2500 a with thelocking mechanism 727 disposed therein. As shown, thelocking mechanism 727 is disposed withinpassage 2502. In certain embodiments, theclamp 726 may include aninner surface 2600 that is threaded to correspond with a head of a screw such as the pedicle screws 2410 a and 2410 b, shown onFIG. 24 for example. Thepassage 2502 may extend through thebase 2503. -
Protrusion 2602 of aninner surface 2604 of thepassage 2502 may extend into thegroove 728. Theprotrusion 2602 may be similar to theprotrusion 744, shown onFIG. 10 for example. As shown, thelocking mechanism 727 may be disposed within thepassage 2502 and may move axially therein, in a direction of a longitudinal axis L. -
FIG. 26B is a partial cross-section of theclamp system 2500 taken along the dashed line extending between G and G′ (as shown onFIG. 25B ).FIG. 26B illustrates thelocking mechanism 727 in a locked position. As shown, theinner surface 2604 includes taperedportions 2606 that are similar to the taperedregions 745 a (shown onFIG. 12 for example). As thelocking mechanism 727 moves toward adistal end 2607 of thepassage 2502, thetapered portions 2606 cause theportions distal portion 2607 of thepassage 2502 and may be retained by theclamp 726. Thelocking mechanism 727 may be moved into a locked position by the threadedlocking cap 756 shown onFIG. 15B for example. -
FIG. 27A is a cross-section of thesecond portion 2500 b taken along the dashed line extending between G and G′ (as shown onFIG. 25B ).FIG. 27A illustrates thecarriage assembly 2509 in an unlocked position. As shown onFIG. 27A , thesublaminar band 130 extends through theaperture 2504. Theportions carriage assembly 2509 does not contact thesublaminar band 130, as shown. -
FIG. 27B is a cross-section of thesecond portion 2500 b taken along the dashed line extending between G and G′ (as shown onFIG. 25B ).FIG. 27A illustrates thecarriage assembly 2509 in an unlocked position. As shown, thecarriage assembly 2509 may be tightened thereby closing theaperture 2504. Specifically, thescrew 2508 may be moved toward thesublaminar band 130 thereby causing thecarriage 2512 to squeeze and secure thesublaminar band 130 within theaperture 2504, as shown onFIG. 28 . That is, thesublaminar band 130 may be secured between aninner surface 2504 a of theaperture 2504 and adistal end 2512 a of thecarriage 2512, for example. -
FIG. 28 illustrates a perspective view of theclamp system 2500 with apedicle screw 2800 and thesublaminar band 130 in accordance with particular embodiments of the present disclosure. As shown, the first andsecond portions pedicle screw 2800 to thelocking mechanism 727 and securing thesublaminar band 130 to thecarriage assembly 2509, as described herein. The spinal rod 128 (shown onFIG. 23 for example) may be positioned to extend through theopening 2202 such that thespinal rod 128 is perpendicular to L1. Then, the threaded locking cap 756 (shown onFIG. 13B ) may be disposed and tightened within theopening 2202 to secure thespinal rod 128 therein. -
FIG. 29 illustrates theclamp system 2500 further includingpedicle screw assemblies spinal rod 128 in accordance with particular embodiments of the present disclosure. Thepedicle screw assemblies tulips first portion 2500 a. Threaded locking caps 2904 a, 2904 b, and 2904 c may be disposed within pedicle thescrew assemblies first portion 2500 a, as shown. The threadedlocking caps locking cap 756, shownFIG. 13B for example. - As shown, locking
mechanisms spinal rod 128 may be positioned to extend through thepedicle screw assemblies first portion 2500 a, as illustrated. The threadedlocking caps spinal rod 128 thereby securing thespinal rod 128 to theclamp system 2500. Thesublaminar band 130 may extend through thesecond portion 2500 b and may be secured therein, as previously described. The configuration of theclamp system 2500 should reduce operating time for a spinal procedure by allowing simultaneous fixations or installations of thesublaminar band 130 and the pedicle screws 2800, 2800 a, and 2800 b, as described herein. -
FIG. 30 illustrates thefirst portion 2500 a coupled to thesecond portion 2500 b by abridge 3000, in accordance with particular embodiments of the present disclosure. Thebridge 3000 may be collapsible. That is, thebridge 3000 can be adjusted to shorten a distance D between thefirst portion 2500 a and thesecond portion 2500 b by moving thefirst portion 2500 a and/or thesecond portion 2500 b toward each other. Thebridge 3000 may also be extendable. That is, thebridge 3000 may be adjusted to lengthen the distance D by moving thefirst portion 2500 a and/or thesecond portion 2500 b away from each other. The adjustability of D should allow theclamp system 2500 to adjust to specific patient anatomy. - The
bridge 3000 may include afirst portion 3002 a extending from anouter surface 3004 of thefirst portion 2500 a. Thefirst portion 3002 a may include arecess 3006 comprising at least one slot 3008 a. In certain embodiments, another slot may be positioned on an opposite side (opposite from the first slot 3008 a) of therecess 3006. The position of the second slot is indicated byreference 3008 b, as shown. Thebridge 3000 may also include asecond portion 3002 b that may be an elongated member including at least onerail 3010 a that is aligned with and extends into the slot 3008 a, as shown. Thesecond portion 3002 b may also include a second rail (not shown) opposite to the first rail that extends into the second slot that indicated by thereference 3008 b. In certain embodiments, thefirst portion 2500 a may be initially separate from thesecond portion 2500 b and may be assembled to form theclamp system 2500. That is, theclamp system 2500 may be assembled by at least inserting therail 3010 a into the slot 3008. -
FIG. 31A illustrates theclamp system 2500 further including ahook 3100, in accordance with particular embodiments of the present disclosure. Thehook 3100 may extend from aportion 3102 of theclamp system 2500 that may be positioned between and/or adjacent to thefirst portion 2500 a and thesecond portion 2500 b, as shown. Thehook 3100 may include a flat surface that may taper in a direction away from theportion 3102. -
FIG. 31B illustrates theclamp system 2500 with thesublaminar band 130 secured therein, in accordance with particular embodiments of the present disclosure. As shown, thesublaminar band 130 may extend through thesecond portion 2500 b. Thesublaminar band 130 may be positioned adjacent to thehook 3100. Thehook 3100 may be engaged with a lamina, pedicle or transverse process of a patient before thespinal rod 128 is inserted through thefirst portion 2500 a and secured therein. -
FIG. 32 illustrates theclamp system 2500 and thehook 3100 attached to thespinal rod 128 along with thepedicle screw assemblies FIG. 32 may be similar to the configuration shown inFIG. 29 . - As shown in a locked position, the
first portion 2500 a and thesecond portion 2500 b may be disposed between thepedicle screw assemblies spinal rod 128 may be retained in theclamp system 2500 via the threadedlocking caps sublaminar band 130 may be secured to thesecond portion 2500 b. The configuration shown inFIG. 32 may allow a surgeon to create a claw construct by placing thehook 3100 on a lamina of one vertebral level and placing thesublaminar band 130 around a lamina of an adjacent vertebral level. When thesublaminar band 130 is tensioned, the two vertebral levels may be compressed together to offer an increased fixation to the claw construct. -
FIG. 33 illustrates thefirst portion 2500 a (as shown onFIG. 30 ) further including the hook 3100 (as shown onFIG. 31A , for example). This configuration allows a distance IA between thehook 3100 and thesecond portion 2500 b to be adjusted due to the adjustability of thefirst portion 2500 a relative to thesecond portion 2500 b via thebridge 3000, as described herein. As noted previously, thefirst portion 2500 a (including the hook 3100) may be initially separate from thesecond portion 2500 b and may subsequently be connected to each other to form theclamp system 2500 or a portion thereof. -
FIG. 34 illustrates an embodiment in which thesublaminar band 130 is secured to thesecond portion 2500 b that includes thehook 3100, in accordance with particular embodiments of the present disclosure. As shown, thehook 3100 may extend from thesecond portion 2500 b, and thesublaminar band 130 may extend through thesecond portion 2500 b such that thesublaminar band 130 is adjacent to thehook 3100. - The described embodiments allow surgeons to fixate the spine by securing a sublaminar band to a spinal rod construct or by securing two vertebral levels to each other. Sublaminar bands are useful when traditional pedicle screw fixation is compromised or not possible, for example in the case of patients with dysmorphic vertebrae, osteoporosis, or fractured pedicles. The embodiments described above provide a means to fixate the spine using a sublaminar band in these clinical scenarios.
- It is believed that the operation and construction of the present disclosure will be apparent from the foregoing description. While the apparatus and methods shown or described above have been characterized as being preferred, various changes and modifications may be made therein without departing from the spirit and scope of the disclosure as defined in the following claims.
Claims (20)
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US16/667,330 US20210121203A1 (en) | 2019-10-29 | 2019-10-29 | Sublaminar band clamp |
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US16/667,330 US20210121203A1 (en) | 2019-10-29 | 2019-10-29 | Sublaminar band clamp |
US16/666,988 US11771472B2 (en) | 2019-10-29 | 2019-10-29 | Sublaminar band clamp |
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US17/548,663 Pending US20220096129A1 (en) | 2019-10-29 | 2021-12-13 | Sublaminar band clamp |
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US11974785B2 (en) | 2020-10-16 | 2024-05-07 | Globus Medical, Inc | Band clamp implants |
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Also Published As
Publication number | Publication date |
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US20220096129A1 (en) | 2022-03-31 |
EP3815637A1 (en) | 2021-05-05 |
US20210121204A1 (en) | 2021-04-29 |
JP2021069944A (en) | 2021-05-06 |
US11771472B2 (en) | 2023-10-03 |
JP7082170B2 (en) | 2022-06-07 |
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