AU2006235961A1 - Polyaxial bone screw with spline capture connection - Google Patents

Polyaxial bone screw with spline capture connection Download PDF

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Publication number
AU2006235961A1
AU2006235961A1 AU2006235961A AU2006235961A AU2006235961A1 AU 2006235961 A1 AU2006235961 A1 AU 2006235961A1 AU 2006235961 A AU2006235961 A AU 2006235961A AU 2006235961 A AU2006235961 A AU 2006235961A AU 2006235961 A1 AU2006235961 A1 AU 2006235961A1
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AU
Australia
Prior art keywords
shank
head
rod
channel
bone screw
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
AU2006235961A
Inventor
Roger P. Jackson
Original Assignee
Roger P. Jackson
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority to US10/464,633 priority Critical
Priority to AU2004254171A priority patent/AU2004254171B2/en
Application filed by Roger P. Jackson filed Critical Roger P. Jackson
Priority to AU2006235961A priority patent/AU2006235961A1/en
Publication of AU2006235961A1 publication Critical patent/AU2006235961A1/en
Application status is Abandoned legal-status Critical

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7035Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • A61B17/7037Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other wherein pivoting is blocked when the rod is clamped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7032Screws or hooks with U-shaped head or back through which longitudinal rods pass

Description

AUSTRALIA

Patents Act COMPLETE SPECIFICATION

(ORIGINAL)

Class Int. Class Application Number: Lodged: Complete Specification Lodged: Accepted: Published: Priority Related Art: Name of Applicant: Roger P. Jackson Actual Inventor(s): Roger P. Jackson Address for Service and Correspondence: PHILLIPS ORMONDE FITZPATRICK Patent and Trade Mark Attorneys 367 Collins Street Melbourne 3000 AUSTRALIA Invention Title: POLYAXIAL BONE SCREW WITH SPLINE CAPTURE CONNECTION Our Ref: 786645 POF Code: 451711/471129 The following statement is a full description of this invention, including the best method of performing it known to applicant(s): -1- POLYAXIAL BONE SCREW WITH SPLINE CAPTURE CONNECTION 0 z The present application is a divisional application from Australian patent application number 2004254171, the entire disclosure of which is incorporated herein by reference.

IND

Background of the Invention C The present invention is directed to a polyaxial bone screw for use in C)spinal surgery and the like and especially to such a screw adapted to receive a c 10 rod member and secure the rod member to a vertebra or the like.

A reference herein to a patent document or other matter which is given as prior art is not to be taken as an admission that that document or matter was, in Australia, known or that the information it contains was part of the common general knowledge as at the priority date of any of the claims.

Many spinal surgery procedures require securing various implants to bone and especially to vertebrae along the spine. For example, elongate rods are often required that extend along the spine to provide support to vertebrae that have been damaged or weakened due to injury, disease or the like. Such rods must be supported by certain vertebra and support other vertebra. One mechanism for providing such structure is to implant bone screws into certain bones which then in turn support the rod or are supported by the rod. Bone screws of this type may have a fixed head relative to a shank thereof. In the fixed bone screws, the head cannot be moved relative to the shank and the rod must be favorably positioned in order for it to be placed within the head. This is sometimes very difficult or impossible to do so polyaxial bone screws can be used. The polyaxial bone screws allow rotation of the head about the shank until a desired rotational position is achieved for the head relative to the shank after which the rod can be inserted and the position of the head eventually locked with respect to movement relative to the shank.

Because implants are for placement within the human body, it is desirable for the implant to have as little effect on the body as possible.

P:'USeAJU~eDDWI204254l71 DvlSonajo IDConsequently, it is quite desirable for the implants to have a relatively small profile both in height and width. It is also desirable that the implants be lightweight.

z Furthermore, it is desirable that swivel head implants be unlikely to unintentionally disassemble within the body. It is very undesirable for pieces of the implant to be free to move around within the body after surgery is completed IDand it also assures that the implant retains an ability to correct the structural n problem for which it was implanted. Furthermore, if the implant should slip or (Ni Sbecome loose for some reason, it is still desirable for all of the parts to remain together and not separate.

Consequently, it is desirable for there to be a lightweight, low profile polyaxial bone screw which assembles in such a manner that each subsequent piece locks proceeding pieces within the overall structure, so that there is less likelihood that the various pieces of the structure will undesirably disassemble.

Summary of the Invention The present invention relates to a swivel head type bone screw and, in particular, to a swivel head bone screw having an open head that allows placement of the rod member within the head and then subsequent closure by use of a closure top, plug or the like to capture the rod in the head of the screw.

The present invention provides a polyaxial bone screw including a head having a channel adapted to receive an elongate rod and having a lower aperture; a shank having a lower portion adapted to be implanted in a bone of a patient and an upper portion; said shank being sized and shaped to be uploaded into said head through said aperture; and said shank upper portion being sized and shaped so as to extend into said channel after said shank is received in said head.

The present invention also provides a polyaxial bone screw having a shank and a head with an upward opening rod receiving channel and a lower opening; including said shank being sized and shaped to be loaded upwardly through said head lower opening; said shank being sized and shaped to extend into said channel after being received in said head.

P:\UseJdieODDMV2042541 Dlvsiona.doc 2 IDThe present invention also provides a polyaxial bone screw and rod 0 0assembly including a head having a channel adapted to receive a rod and having a lower aperture; a shank having a threaded lower portion adapted to be 0 z implanted in a bone and an upper portion with a first capture structure; said shank upper portion being sized and shaped to be uploaded through said head lower aperture; a retaining structure having a second capture structure that _mates with and secures to said first capture structure inside said head; said IND retaining structure being non integral with said shank; said retaining structure Sbeing downloaded from a top of the said head; a rod adapted to be received in S 10 said channel; and said shank upper portion further including an upper convex surface sized, shaped and positioned such that when said bone screw is fully assembled and said rod is located in said channel, said convex surface engages said rod to urge said shank into a non moveable configuration relative to said head.

The present invention also provides a polyaxial bone screw having a shank and a head having a rod receiving channel; including sizing and shaping said shank to allow uploading of said shank into said head from below and retaining structure non integral with said head and said shank for capturing said shank in said head; said shank extending into said channel after assembly of said shank with said retaining structure.

The present invention also provides a polyaxial bone screw having a shank and a head wherein said head includes a rod receiving channel; further including said shank being sized and shaped to allow for said shank to be uploaded into said head; and said shank having an upper engagement region sized and shaped to project into said channel after said shank is loaded into said head.

The present invention also provides a polyaxial bone screw having a shank and a head with a rod receiving channel; including said head having a lower aperture and said shank being sized and shaped so as to allow uploading of an upper portion of said shank through said aperture into said head; and retaining structure that is non integral with said shank and loaded separately into said head; said retaining structure mating with and capturing said shank in P:%USeN luOI) Q2OO4254171 Dvlsil .adoc 3 IDsaid head and forming a combined assembly with said shank; and wherein a 0 0portion of said assembly extends into said channel.

The present invention also provides a polyaxial bone screw having a Z shank and a head; including said head having a lower aperture and said shank S 5 being sized and shaped so as to allow uploading of an upper portion of said shank through said aperture into said head; a retaining structure that is non integral with said shank and loaded separately into said head; said retaining structure mating with and capturing said shank in said head; and said retaining Sstructure being uploaded into said head prior to said shank.

IND

The present invention also provides a polyaxial bone screw having a Sshank and a head; including said head having an inner chamber and a lower aperture having a first radius; said shank having an upper portion with a second radius less than said first radius such that said shank upper portion is insertable through said aperture; a retaining structure independent of said head that is sized and shaped to mate with and be secured to said shank upper portion; said retaining structure and said shank upper portion being joined in said head to form an assembly; and a portion of said assembly extending into said channel.

The present invention also provides a polyaxial bone screw having a shank and a head having an inner chamber with a radiused surface and also having a lower aperture and a rod receiving channel; including said chamber surface having a larger radius than said aperture; said shank having an upper portion that has a smaller radius than said aperture to allow said shank to be uploaded through said aperture; a retaining device that loads separately from said shank into said chamber and captures said shank in said chamber so as to form an assembly within said chamber; said retaining device having a lower surface sized and shaped to slidingly mate and rotate with said chamber surface during positioning; and a portion of said assembly extending into said channel.

The present invention also provides a method of implanting a bone screw in a patient including the steps of providing a bone screw head having a lower aperture and an implant receiving channel; providing an elongate shank having a lower threaded portion and an upper portion with said upper portion having an implant engagement end; loading said shank upper portion into said head from P: Use ulieDD2OO( 24 171 DKLsonl.doc A IDbelow and through said aperture; implanting said shank into a bone of a patient; 0 0and placing said implant into said channel so that said shank engagement end abuts against said implant, so as to fix the position of said shank relative to said

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z head.

The present invention also provides a method of implanting a bone screw in a patient including the steps of providing a bone screw head having a lower IDaperture and a rod receiving channel; providing an elongate shank having a lower threaded portion and an upper portion with said upper portion having a rod engagement region; loading said shank upper portion into said head from C 10 below through said aperture; capturing said shank inside said head while C allowing pivoting of said shank relative to said head; implanting said shank into a bone of a patient; moving said head into a selected angular configuration with respect to said shank; placing said rod into said channel so that said rod engagement region abuts against said rod; installing a closure in said head that closes said channel and biases against said rod so as to bias said rod against said rod engagement region and lock said head in said selected angular configuration relative to said shank.

The present invention further provides a method of implanting a polyaxial bone screw in a patient wherein the bone screw has a shank and a head that has a channel adapted to receive a rod; the method including uploading said shank into said head so as to be captured therein; providing said shank with an upper engagement end; and positioning said shank upper engagement end in said channel so as to abut against a rod placed within said channel.

In a preferred embodiment, there is provided a polyaxial bone screw that includes a shank, a head and a retainer ring that operably cooperate with each other. The bone screw can be designed to allow the shank to be locked or secured in a selected angular configuration with respect to the head, while the head receives a rod member and while the shank is implanted in a bone, such as a vertebra or vertebral body.

The shank can have an implant body which includes an external helically wound thread that is in turn attached by a neck to a capture end with a capture or connector type structure. The capture structure can be positioned P:UsefJuUieODM2004254171 DwiSionl.dOC IDoutside the bone in use and can have a radiused and cylindrically shaped radially outer surface that has at least one radially outwardly extending non helically wound projection or spline thereon. The capture structure can also 0 z have an upper axially aligned and radiused dome that protrudes above the remainder of the shank and above the ring during use to manipulate the shank and to contact the rod. Further, in some embodiments the shank can include off axis apertures, grooves, side slots or the like for use by an installation tool with C a mating configured head for driving and rotating the shank into the bone.

SThe head preferably has a generally cylindrical shaped profile with an

IND

0 10 upwardly open U-shaped channel formed therein so as to effectively produce a c lower base with two upstanding and spaced arms. The inner surfaces of the arms can have a threadform thereon or another suitable guide and advancement structure such as a helically wound flangeform for use in closing the upper part of the channel. Located in the interior of the base and coaxially aligned with the head, there is preferably a chamber having an interiorly facing partial spherical shaped surface. The chamber can further open onto a bottom surface of the head through a head lower wall bore forming a constricted or restrictive neck which can be sized and shaped to allow passage of the capture structure therethrough.

The retainer ring can include an external partial spherical or hemispherical surface that is sized and shaped to be seated in and slidably engage the partial spherical surface within the head, both having approximately the same radius of generation. The ring can also have an internal, centrally located and axially extending ring bore sized and shaped to receive the capture structure of the shank therethrough. Further, the ring can have a series of axially extending channels positioned about and opening into the central bore that are sized and shaped to allow sliding passage of the shank splines entirely through the ring so that the shank can be inserted through the ring while the ring is positioned within the chamber in the head. The channels are not helically wound about the bore and preferably extend vertically or parallel to the axis of the ring. The ring can further include a set of recesses that are circumferentially spaced from the channels and that open onto the upper part of the ring and into the bore, but do not pass entirely through the ring and that can P:%LUse&PI eeDM~O04254171 Divison" dOc O be entered by the splines by drawing the shank with the splines thereon axially 0downwardly with respect to the ring. In this manner, the splines can be passed upwardly or uploaded through the ring by sliding through the channels in

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z conjunction with the remainder of the shank capture and after sliding completely through the bore, the shank can then be rotated a certain number of degrees relative to the head, and then drawn back downwardly or downloaded so that _the splines encounter and engage the recesses wherein the splines are NO captured by the ring. The splines preferably have a wedge-shaped surface Sthereon which pushes not only downwardly, but radially outward against the O 10 retainer or capture ring when force is applied to the top of the shank.

c During assembly, the ring can be placed through the U-shaped channel into the chamber having the partial spherical surface and then rotated so that the ring hemispherical surface mates with and slidably engages the head partial spherical surface. Subsequently, the shank capture structure can then be uploaded into and extended through the ring central bore, while the splines pass through the channels. The shank can then be rotated relative to the ring and then the shank can be moved in an axially reverse direction opposed to uploading while the splines are positioned over the recesses so as to be aligned with the recesses and not aligned with the channels and so that the splines then enter the recesses. The ring with connected shank can effectively thereafter form a ball and socket joint with the head and allow free rotation to a selected angular configuration until later locked in the selected configuration. The shank, head and ring can then be placed in a bone by screwing the shank body into the bone using the apertures on the top of the shank or alternative structure such as grooves or faceted surfaces on the outside of the portion of the shank extending above the ring.

Thereafter, a rod can be placed in the U-shaped channel and captured therein by closing the channel by use of a closure top or plug having a threadform or other external guide and advancement structure that mates with and advances along mating guide and advancement structure of the arms of the head, when the closure top is rotated. Preferably, the closure top also includes a break-off head that provides purchase for a tool for rotation and torquing of the closure top to a preselected torque and that such torque is transferred and P:UserUu MOkV00124254171 ODMIsoW.doc IDapplied as pressure against the rod received in the head. Once the preselected Ctorque is achieved, the break-off head breaks away from the closure top. Under pressure from the closure top, the rod can push against the dome of the shank 0 z that extends above the ring and thereby urges the splines downwardly.

Because of the wedge shaped structure of the splines, the splines can push both downwardly and outwardly upon the retainer or capture ring, when force is applied to the dome, so as to frictionally engage and positively seat the C \retaining ring in the cavity and prevent further rotation in conjunction with the t shank dome frictionally engaging the rod under pressure. In particular, the S 10 hemispherical surface of the ring can abuttingly and frictionally mate with the C)integral hemispherical interior facing surface of the head, while the dome can frictionally mate with the rod under pressure from the rod so as to lock the shank and ring in a selected angular configuration relative to the head. The shank, in this manner, can be locked in a configuration selected from an infinite number of angular configurations with respect to the head. Advantageously once fully assembled in this manner, unless a part breaks into pieces, the shank cannot disengage from the capture ring and the head without disassembly of the device by reversing the process or breaking the parts.

Advantageously, the present invention can provide a polyaxial bone screw having a bone implantable shank that can be locked in a fixed position relative to a head of the bone screw; can provide such a bone screw having a capture or retaining ring having a partial external hemispherical surface that seats within a partial internal spherical shaped chamber surface within and integrally formed with a head of the bone screw to form a ball and socket joint and wherein the shank is securable to the retaining ring; can provide such a bone screw wherein the shank has at least one spline that extends radially outward from a capture end thereof and wherein the retaining ring has a central bore that receives the capture end while a channel opening into the bore allows the spline to slide through the ring so as to pass above the ring, at which time the shank can be rotated a select number of degrees and further wherein the retaining ring has a capture recess that receives the spline on further downward or reverse movement along the axis of the shank relative to the retainer ring; can provide such a bone screw wherein the shank has an upwardly protruding radiused dome which has a radius that in one embodiment is substantially less P:\UsetubeDDM~004254171 DMshonal.doc 0 IDthan the radius of the external hemispherical surface on the retainer ring and Cthat extends upwardly within the head chamber so as to reduce height of the screw head and further, is operably positioned so as to engage a rod member

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Z received in the head so as to receive downward pressure from the rod during assembly; can provide such a bone screw wherein a closure top is used to close a channel in the bone screw head after receiving the rod and to apply pressure to the rod member that in turn, exerts pressure on the dome of the O'shank so as to urge each spline into an abutting and tight relationship with the Sretaining ring and to urge the retaining ring both downwardly and radially 'C 10 outwardly, so that the external hemispherical surface on the retaining ring more completely contacts and frictionally engages the internal spherical surface within the chamber of the head thereby providing improved mechanical fixation to prevent further rotation of the shank relative to the head; can provide such a bone screw which has a comparatively low profile and which is comparatively light in weight; can provide such a bone screw that resists disassembly thereof except by removal of the closure top; can provide such a bone screw wherein the closure top can be removed by the surgeon should disassembly be desired at which time the entire structure can be easily and quickly disassembled and removed from the bone, if necessary; can provide such a bone screw wherein the shank is locked in position relative to the head during usage in a locked or fixed configuration; can provide such a bone screw wherein the shank cannot disassemble from the head and the retaining ring once the screw is fully assembled except if the closure top is removed and the device is disassembled by the surgeon; can provide such a bone screw which is easy to use and extremely effective for the intended usage thereof.

Other objects and advantages of this invention will become apparent from the following description taken in conjunction with the accompanying drawings wherein are set forth, by way of illustration and example, certain embodiments of this invention.

The drawings constitute a part of this specification and include exemplary embodiments of the present invention and illustrate various objects and features thereof.

P:%UsefIJulDMa2O425417 D ionaS.Ooe INDBrief Description of the Drawings Fig. 1 is an exploded perspective view of three elements of a polyaxial

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z bone screw in accordance with the present invention, including a shank, a head, and a retaining ring.

Fig. 2 is an enlarged top plan view of the retaining ring.

Fig. 3 is an enlarged perspective view of the retaining ring.

DFig. 4 is an enlarged side elevational view of the retaining ring.

Fig. 4 is an enlarged bottomside elevational view of the retaining ring.

Cc, Fig. 5 is an enlarged bottom plan view of the retaining ring.

O 10 Fig. 6 is an enlarged cross-sectional view of the head, taken along line 6-6 of Fig. 1, illustrating the retaining ring being inserted into the head.

Fig. 7 is an enlarged cross-sectional view of the head similar to Fig. 6, showing the retaining ring seated in the head.

Fig. 8 is a cross-sectional view of a vertebra illustrating the shank implanted therein.

Fig. 9 is an enlarged and fragmentary perspective view of the shank, head and retainer ring during assembly and just prior to the retainer ring being placed over the shank.

Fig. 10 is an enlarged, fragmentary and perspective cross-sectional view of the head similar to Fig. 6, illustrating splines on a capture end of the shank that have been inserted through channels in the retainer ring and are positioned upwardly in the head above the retainer ring.

Fig. 11 is a cross-sectional view of the head, similar to Fig. 10, showing the upper capture end of the shank with the splines lowered into receiving recesses in the ring and positioned therein.

Fig. 12 is a cross sectional view of the head and a top plan view of the shank and ring corresponding to the positioning shown in Fig. Fig. 13 is a cross sectional view of the head and a top plan view of the shank and ring corresponding to the positioning shown in Fig. 11.

Fig. 14 is a side elevational view of the head, ring and shank, illustrating the shank swinging or rotating from one position shown in solid lines to a second position shown in phantom lines.

Fig. 15 is a fragmentary and partially exploded view of a complete polyaxial bone screw assembly, prior to final assembly and illustrating a rod P:\USedJeDM204254171 Dvislonal.doc IDreceived in the head and a closure top with a break-off head, prior to the closure Stop being rotatably inserted into the head.

Fig. 16 is a fragmentary and enlarged front elevational view of the bone

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Z screw assembly fully assembled and illustrating the head with the rod received therein and with the closure top fully inserted and biasing against the rod that in turn biases against the top of the shank.

Fig. 17 is an enlarged and fragmentary cross-sectional view of the bone screw assembly with rod inserted therein, taken along line 17-17 of Fig. 16.

SFig. 18 is an enlarged cross-sectional view of the vertebra, head, rod IN 10 and closure top, taken along line 18-18 of Fig. 17 showing the shank implanted in the vertebra and with the bone screw assembly in a completely assembled and operational configuration with the shank locked in an angled orientation with respect to the head.

Fig. 19 is a perspective view of a modified retainer ring of a first modified embodiment in accordance with the present invention.

Fig. 20 is a perspective view of a second modified embodiment of the present invention illustrating a cannulated shank having four splines and a hex tool engageable head for manipulating the shank.

Fig. 21 is a perspective view of a ring for use in accordance with the second modified embodiment of the invention and the shank of Fig. Detailed Description of the Invention As required, detailed embodiments of the present invention are disclosed herein; however, it is to be understood that the disclosed embodiments are merely exemplary of the invention, which may be embodied in various forms. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a basis for the claims and as a representative basis for teaching one skilled in the art to variously employ the present invention in virtually any appropriately detailed structure.

The reference number 1 generally represents a polyaxial bone screw apparatus or assembly in accordance with the present invention operably utilized by implantation into a vertebra 2 and in conjunction with a longitudinal P:%UseAJuh9irDMQ2425417I Divional.doc INO member or rod 3 so as to operably secure the rod 3 in a fixed position relative with respect to the vertebra 2.

The fully assembled bone screw assembly 1 includes a shank 6, a head

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7, a retainer ring 8 and a closure top 9. The shank 6 is perhaps best seen in 0 5 Figs. 1 and 8. The shank 6 is elongate and has a lower body 15 ending in a tip 16. The shank body 15 has a helically wound bone implantable thread 17 extending from near the tip 16 to near the top 18 of the body 15 and extending radially outward therefrom. During use, the body 15 utilizing the thread 17 is Cc implanted into the vertebra 2, as is seen in Fig. 18. The shank 6 has an ,0 10 elongated axis of rotation generally identified by the reference letter A. It is noted that the reference to the words top and bottom as used herein refers to the alignment shown in the various drawings, as well as the normal connotations applied to such devices, and is not intended to restrict positioning of the assembly 1 in actual use.

Axially extending outward and upward from the shank body 15 is a neck of reduced radius as compared to the adjacent top 18 of the body Further extending axially and outwardly from the neck 20 is a capture end or structure 21 operably providing a connective or capture structure free from the bone or vertebra 2 for joining with the head 7. The capture structure 21 has a radially outer cylindrical surface 22. The cylindrical surface 22 has at least one non-helically wound and radially outward extending projection or spline 24 that extends beyond the surface 22. In the embodiment shown in Figs. 1 through 18, the capture structure 21 has three such splines 24. The splines 24 are located near an upper end 25 of the shank 6 and are equally circumferentially centered and spaced thereabout so as to be centered at approximately 120 degree intervals relative to each other. Each of the splines 24 has a triangular shaped profile and a front wedge forming face 27 that slopes downwardly and radially inwardly from near the upper end 25 of the shank 6. Also located on the shank upper end 25 is a centrally located, axially extending and upwardly directed projection or dome 29 that is centrally radiused so as to have a first radius.

The shank upper end 25 still further includes at least one tool engagement aperture for engagement by a tool driving head (not shown) that is sized and shaped to fit into the apertures for both driving and rotating the shank P:sefuleADDM2O04254171 D onal dc ID6 into the vertebra 2. In the illustrated embodiment, a pair of apertures 31 0 0located in spaced relationship to each other, the dome 29 and the shank axis of rotation A are located on the shank upper end 25. The apertures 31 extend into

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Z the shank capture structure 21 parallel to the axis A. It is foreseen that various numbers of apertures, slots or the like may be utilized in accordance with the invention for engaging the driving tool of suitable and similar mating shape, or that the outer surface of the upper axial projection can be grooved or formed Owwith a faceted surface that can be driven by a mating tool that goes over the surface.

I 10 The head 7 has a generally cylindrical shaped profile, as is seen in Fig.

1, although the head 7 is not a solid cylinder. The head 7 has a base 33 with a pair of upstanding arms 34 and 35 forming a U-shaped channel 38 between the arms 34 and 35 with a lower seat 39 having substantially the same radius as the rod 3 for operably snugly receiving the rod 3. Each of the arms 34 and has an interior surface 41 that includes a partial helically wound guide and advancement structure 42. In the illustrated embodiment, the guide and advancement structure 42 is a partial helically wound flangeform which will mate under rotation with a similar structure on the closure top 9, as described below. However, it is foreseen that the guide and advancement structure 42 could alternatively be a V-shaped thread, a buttress thread, a reverse angle thread or other thread like or non-thread like helically wound advancement structures for operably guiding under rotation and advancing the closure top between the arms 34 and 35. Tool engaging apertures 44 are formed on the outsides of the arms 34 and 35 for holding the head 7 during assembly.

A chamber or cavity 47 is located within the head base 33 that opens upwardly into the U-shaped channel 38. The cavity 47 includes a partial spherical shaped surface 48, at least a portion of which forms a partial internal hemispherical seat 49 for the ring 8, as is described further below. A bore 52 further communicates between the cavity 47 and the bottom exterior of the base 33 and is coaxial with a rotational axis B of the head 7. The bore 52 at least partially defines a restrictive neck 54 that has a radius which is smaller than the radius of the ring 8, as will be discussed further below, so as to form a restrictive constriction at the location of the neck 54 relative to the retainer ring 8 to prevent the ring 8 from passing between the cavity 47 and the lower exterior P.W:sU L1UeMDDM2004254171 DMsonaldoC IDof the head 7. A bevel 55 extends between the neck 54 and the bottom exterior of the base 33. The hemispherical shaped surface 48 has a second radius associated therewith.

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Z The retainer ring 8 which is best seen in Figs. 2 through 5 has an operational central axis which is the same as the elongate axis A associated with the shank 6, but when the ring 8 is separated from the shank 2, the axis of rotation is identified as axis C, such as in Fig. 4. The retainer ring 8 has a central bore 57 that passes entirely through the retainer ring 8 from a top Ssurface 58 to a bottom surface 59 thereof. The bore 57 is sized and shaped to 'C 10 fit snugly but slidably over the shank capture structure cylindrical surface 22 in such a manner as to allow sliding axial movement therebetween under certain conditions, as described below. Three axially aligned channels 60 are spaced from the axis C and extend radially outward from the bore 57 and into the wall of the retainer ring 8 so as to form three top to bottom grooves or slots therein.

Backs 61 of the channels 60 are the same radial distance from the axis C as the distance the outermost portion of the splines 24 extend from the axis A of the shank 6. The channels 60 are also circumferentially angularly spaced equivalent to and have a width that corresponds with the splines 24. In this manner, the shank capture structure 21 can be uploaded into the ring 8 by axially sliding the capture structure 21 through the ring central bore 57 whenever the splines 24 are aligned with the channels 60 or are in an aligned configuration, as seen in Fig. 12.

The retainer ring 8 also has three capture partial slots, receivers or recesses 62 which extend radially outward from the upper part the bore 57 and that do not extend the entire length from top to bottom of the retainer ring 8, but rather only open on the top surface 59 and extend partly along the height of the ring 8 thereof. The recesses 62 are sized and positioned and shaped to receive the splines 24 from above when the splines 24 are in a non-aligned configuration relative to the channels 60. That is, each of the recesses 62 has a width that approximates the width of the splines 24 and has a mating wedge engaging surface 64 that is shaped similar to the spline wedge forming faces 27, so that the splines 24 can be slidably received into the recesses 62 from above by axially translating or moving the shank 6 downward relative to the ring P:VUJserJu8eDDMf 2O4254171 DIvlsona.doc IND 8 when the splines 24 are positioned above the recesses 62 in a recess aligned Cconfiguration.

In some embodiments, the wedge engaging faces 64 slope slightly z greater than the wedge forming faces 27 on the splines 24 so that there is additional outward wedging that takes place when the splines 24 are urged downwardly into the recesses 62, as further discussed below.

_In this manner the shank capture structure 21 can be uploaded or pushed upwardly through the retainer ring central bore 57 so as to clear the top Cc 58 of the retainer ring 8, rotated approximately 60 degrees and then S 10 downloaded or brought downwardly so that the splines 24 become located and Ccaptured in the recesses 62. Once the splines 24 are seated in the recesses 62 the shank 6 cannot move further axially downward relative to the ring 8.

Preferably, the retainer ring 8 is constructed of a metal or other material having sufficient resilience and elasticity as to allow the ring 8 to radially expand slightly outward by downward pressure of the splines 24 on the recesses 62 under pressure from structure above, as will be discussed further below. This produces a slight outward radial expansion in the ring 8 at the location of the recesses 62.

The ring 8 has a radially outer partial hemispherical shaped surface sized and shaped to mate with the partial spherical shaped surface 48 and having a third radius approximately equal to the second radius associated with the surface 48. The ring third radius is substantially larger than the first radius associated with the dome 29 and also substantially larger than the radius of the neck 54.

The longitudinal member or elongate rod 3 can be any of many different types of implants utilized in reconstructive spinal surgery and the like, but is normally a cylindrical elongate structure having a cylindrical surface 66 of uniform diameter. The rod 3 is preferably sized and shaped to snugly seat near the bottom of the U-shaped channel 38 and, during normal operation, will be positioned slightly above the bottom of the channel 38. In particular, the rod 3 normally engages the shank dome 29, as is seen in Fig. 16 and urges the dome 29 and, consequently, the shank 6 downwardly when the entire assembly 1 is fully assembled.

P: e uhJieDDM%00425171 DMslhonW.*dc NThe closure top 9 can be any of the variety of different types of closure tops for use in conjunction with the present invention with suitable mating structure on the upstanding arms 34 and 35. The illustrated closure top 9 has a 0 Z generally cylindrical shaped base 67 with an upwardly extending break-off head 68. The base 67 includes a helically wound guide and advancement structure 71 that is sized, shaped and positioned so as to engage the guide and advancement structure 42 on the arms 34 and 35 to allow the closure top 9 to be rotated into the head 7 and, in particular, to close the top of the U-shaped r channel 38 to capture the rod 3, see Fig. 16, preferably without splaying of the arms 34 and 35. The closure top 9 also operably biases against the rod 3 by 0advancement and applying pressure to the rod 7 under torquing, so that the rod 3 is urged downwardly against the shank dome 29. Downward biasing of the shank dome 29 operably produces a frictional engagement between the rod 3 and dome 29 and also urges the splines 24 downwardly to both bias downwardly and radially outwardly against the retainer ring 8, so as to snugly and frictionally seat the retainer ring external hemispherical surface 65 into and quite tightly against the partial internal spherical surface 48 of the head 7 and further so as to lock the shank 6 and retainer ring 8 in a fixed position relative to the head 7.

The closure top break-off head 68 is secured to the base 67 at a neck 73 that is sized and shaped so as to break away at a preselected torque that is designed to properly seat the retainer ring 8 in the head 7. The break-off head 68 includes an external faceted surface 75 that is sized and shaped to receive a conventional socket head of a driving tool (not shown) to rotate and torque the closure top 9. The break-off head 68 also includes a central bore 77 and grooves 78 for operably receiving the manipulating tools.

The closure top 9 also includes removal structure including a pair of off axis pass through apertures 81 that extend from top to bottom of the base 67.

The apertures 81 are located parallel to an axis of rotation axis D of the closure top 9, but are radially spaced away therefrom. The apertures 81 become accessible from the top of the base 67 after the break-off head 68 breaks away from the base 67, as is seen in Fig. 18. The apertures 81 are designed to receive a tool having a face that mates with and is insertable into the apertures P Us JDDUeMW 2O42S4l71 DivislonaI doc ID81 for rotating the closure top base 67 subsequent to installation so as to Sprovide for removal, if necessary.

While the embodiment illustrated in Figs. 1 through 18 includes three Z splines 3, it is foreseen that a shank 6 with a single spline would be operable within the scope of the invention. However, in some embodiments additional splines 3 may provide a more even distribution of force upon the ring 8 and reduce the likelihood of failure because of hoop strain or the like. Paired and \opposed splines in certain embodiments may provide a more even distribution t of forces. While any number of splines are foreseen as possible for use under S 10 the present invention, the requirement that the splines must get smaller as their Snumber gets larger, limits the maximum number at some point. However, the concept appears viable until that point is reached. It is also noted that additional channels and recesses allow the ring to be more elastic in certain embodiments.

When the polyaxial bone screw assembly 1 is placed in use in accordance with the invention the retainer ring 8 is normally first slid through the head U-shaped channel 38, as is shown in Fig. 6, and into and seated in the chamber 47, as is seen in Fig. 6. Thereafter, the retainer ring 8 is rotated degrees so as to be coaxial with the head 7 and so that the retainer ring outer surface 65 snugly but slidably mates with the head interior spherical shaped surface 48, as is seen in Fig. 7.

With reference to Figs. 9, 10, and 12 the ring 8 in the head 7 is slid over the shank capture structure 21 so that the splines 24 slide upwardly through and above respective channels 60 so that the splines 24 are then located, at least partially, in the U-shaped channel 38 and chamber 47 above the retainer ring 8, as is shown in Fig. 10. The shank 6 is then rotated 60 degrees relative to the head about the axis A and the translational direction of the shank 6 is reversed so that it goes downwardly or axially with respect to the head 7, as is seen in Figs. 11 and 13 and the splines 24 enter the recesses 62. At this point there is no substantial outward or downward pressure on the retainer ring 8 and so the retainer ring 8 is easily rotatable along with the shank 6 within the chamber 47 and such rotation is of a ball and socket type limited by engagement of the shank neck 20 with the ring restrictive neck 54. Rotation is shown in Fig. 14 where it is illustrated that the shank 6 can be rotated through a P:AUseubheDO2OO42541 7 1 DWOnaJl.doc IND substantial angular rotation relative to head 7, both from side to side and from 0 0front to rear so as to substantially provide a universal or ball joint wherein the angle of rotation is only restricted by engagement of the neck 20 with the neck Z 54 on the head 7.

The assembly 1 is then normally screwed into a bone, such as vertebra 2, by rotation of the shank 6 using a suitable driving tool (not shown) that operably drives and rotates the shank 6 by engagement thereof at the apertures 31. The relative position of the shank 6 is shown in Fig. 8 with a phantom Cc vertebra 2. Normally, the head 7 and ring 8 are assembled on the shank 6 ID 10 before placing the shank 6 in the vertebra 2, but in certain circumstances, the shank 6 can be first implanted with the capture structure 21 extending proud to allow assembly and then the shank 6 can be further driven into the vertebra 2.

A rod 3 is eventually positioned within the head U-shaped channel 38, as is seen in Fig. 15, and the closure top 9 is then inserted into and advanced between the arms 34 and 35 so as to bias or push against the rod 3. The break-off head 68 of the closure top 9 is torqued to a preselected torque, for example 90 inch pounds, to urge the rod 3 downwardly. The shank dome 29, because it is radiused and sized to extend upwardly into the U-shaped channel 38, is engaged by the rod 3 and pushed downwardly when the closure top 9 pushes downwardly on the rod 3, as is seen in Fig. 16. The downward pressure on the shank 6 in turn urges the splines 24 downwardly which exerts both a downward and outward thrust on the retainer ring 8, as is seen in the configuration shown in Fig. 17. The polyaxial bone screw assembly 1 including rod 3 and shown positioned in a vertebra 2 is illustrated in Fig. 18. The axis A of the bone screw shank 6 is illustrated as not being coaxial with the axis B of the head 7 and the shank 6 is locked in this angular locked configuration. Other angular configurations can be achieved, as required during installation surgery due to positioning of the rod 3 or the like.

If removal of the assembly 1 is necessary, the assembly 1 can be disassembled by using a driving tool mating with the closure top apertures 81 to rotate the base 67 and reverse the advancement thereof in the head 7 and then disassembly of the remainder of the assembly 1 in reverse mode in comparison to the procedure described above for assembly.

P:%Jse1u~elDM225471 DMonal.dC o Illustrated in Fig. 19 is a second embodiment of a retainer ring 88 in Saccordance with the present invention. The retainer ring 88 is quite similar to the retainer ring 8 of the previous embodiment except that it is noncontinuous Z and has a radially extending space or gap 90 from top to bottom along one side 0 5 thereof. The gap 90 allows for expansion without requiring stretching of the material of construction of the ring 88, as is the case with the previous embodiment. The ring 88 includes a central bore 92, spline channels 93 and spline receivers 94 which are all similar to the similar structures described for S the previous embodiment. The retainer ring 88 also has a partial hemispherical shaped surface 95 on the outer side thereof.

I Illustrated in figures 20 and 21 are elements of a third embodiment of the present invention including a shank 106 and a capture ring 107 which are used otherwise in the same manner as has been described in the first embodiment and, in particular, with a head such as head 7 which is not further described herein. The shank 106 is similar to the shank 6 in that it has a body 110 with a helically round thread 111 thereon and a capture structure 114 joined to the body 110 by a neck 115. The principle differences between the present embodiment and the first embodiment is that the capture structure 114 includes four splines 120 that are similar in shape to the splines 24 of the first embodiment, but the splines 120 are centered and located at 90 degrees from one another such that there is a pairing of opposed splines 120 and the dome of the prior embodiment is replaced with an axial extension 122. Each of the splines 120 includes a wedge face 121. The extension 122 has a faceted surface 123 that extends parallel to the axis of the shank 106 and that is sized and shaped to receive a hex head driving tool (not shown) for driving the shank 106 into bone. The extension 123 also has a radiused upper surface 124. The shank 106 also has an axial extending cannulation or bore 125 that extends entirely through the length of the shank 106.

The capture ring 107, shown in Fig. 21, is otherwise similar to the retainer ring 8 except that it includes a set of four channels 126 and four recesses 127 that are sized shaped and positioned so as with respect to the channels 126 to allow the splines 120 to slidingly pass upwardly through and with respect to the recesses 127 to capture and receive the splines 120, as they move axially downwardly. The ring 107 has a partial hemispherical outer P:W.erU"%DOM 142S4171 Dwusl.daDc N surface 129 that mates with the corresponding surface in the head 7 in the 0 manner described for the first embodiment.

It is to be understood that while certain forms of the present invention 0 Z have been illustrated and described herein, it is not to be limited to the specific forms or arrangement of parts described and shown.

P:\UaeubeelDDM2004254171 Dvisional.doc

Claims (26)

  1. 2. A bone screw according to Claim 1 including: a capture structure separate from said shank and received in said head; said capture structure mating with said shank upper portion so as to secure said shank to said head while allowing polyaxial movement of said shank relative to said head.
  2. 3. A bone screw according to Claim 2 wherein: said shank upper portion includes an engagement end positioned and shaped so as to be adapted to abut against a rod placed in said channel.
  3. 4. A bone screw according to Claim 3 wherein: said engagement end is convex.
  4. 5. A bone screw according to any one of Claims 1 to 4 including: a closure including mating structure for mating with said head and closing said channel so as to be adapted to capture the rod in said channel.
  5. 6. A bone screw according to Claim 5 wherein: said closure is threaded and said head includes mating threads to allow said closure to be threaded into and torqued in said head.
  6. 7. A bond screw according to Claim 6 including: a rod. P:UserJieDDMVO24254171 O si l .doc 1)4
  7. 8. A bone screw according to Claim 7 wherein: said shank upper portion is shaped and positioned such that upon assembly of said bone screw and said rod, said shank upper portion has an Z engagement region that directly and frictionally engages said rod so as to 0 5 secure said shank in a selected fixed angular configuration relative to said head. \O
  8. 9. A polyaxial bone screw having a shank and a head with an upward Cc opening rod receiving channel and a lower opening; including: O 10 said shank being sized and shaped to be loaded upwardly through said Shead lower opening; said shank being sized and shaped to extend into said channel after being received in said head. A bone screw according to Claim 9 wherein: said shank includes an upper portion that extends into said channel when said shank is loaded into said head.
  9. 11. A bone screw according to Claim 10 including: a retainer structure separate from said shank and being securable to said shank upper portion; said retainer structure being receivable into said head.
  10. 12. A bone screw according to Claim 11 wherein: said retainer structure is sized and shaped to be downloaded into said head through said channel from a side opposite said shank.
  11. 13. A bone screw according to Claim 11 or 12 wherein: said retainer structure has a radiused surface adapted to pivotally mate with radiused mating surface in a chamber in said head.
  12. 14. A polyaxial bone screw and rod assembly including: a head having a channel adapted to receive a rod and having a lower aperture; a shank having a threaded lower portion adapted to be implanted in a bone and an upper portion with a first capture structure; P VUJS eJLO DDM W M425 471 DM W W do M 2 2 IDsaid shank upper portion being sized and shaped to be uploaded through 0 0 said head lower aperture; a retaining structure having a second capture structure that mates with 0 z and secures to said first capture structure inside said head; said retaining structure being non integral with said shank; said retaining structure being downloaded from a top of the said head; a rod adapted to be received in said channel; and said shank upper portion further including an upper convex surface Ssized, shaped and positioned such that when said bone screw is fully S 10 assembled and said rod is located in said channel, said convex surface 0engages said rod to urge said shank into a non moveable configuration relative to said head. A bone screw according to Claim 14 wherein: said retaining structure is a continuous ring.
  13. 16. A bone screw according to Claim 14 wherein: said retaining structure is a discontinuous ring.
  14. 17. A polyaxial bone screw having a shank and a head having a rod receiving channel; including: sizing and shaping said shank to allow uploading of said shank into said head from below and a retaining structure non integral with said head and said shank for capturing said shank in said head; said shank extending into said channel after assembly of said shank with said retaining structure.
  15. 18. A polyaxial bone screw having a shank and a head wherein said head includes a rod receiving channel; further including: said shank being sized and shaped to allow for said shank to be uploaded into said head; and said shank having an upper engagement region sized and shaped to project into said channel after said shank is loaded into said head. P:%UsWJifleDDM\2O4254171 DMOol33 GO 23 I19. A polyaxial bone screw having a shank and a head with a rod receiving 0 0 channel; including: said head having a lower aperture and said shank being sized and O Z shaped so as to allow uploading of an upper portion of said shank through said S 5 aperture into said head; and a retaining structure that is non integral with said shank and loaded separately into said head; said retaining structure mating with and capturing said shank in said head and forming a combined assembly with said shank; and Swherein a portion of said assembly extends into said channel. A bone screw according to Claim 19 wherein: said retaining structure is sized and shaped to be loaded into said head opposite said shank.
  16. 21. A polyaxial bone screw having a shank and a head; including: said head having a lower aperture and said shank being sized and shaped so as to allow uploading of an upper portion of said shank through said aperture into said head; a retaining structure that is non integral with said shank and loaded separately into said head; said retaining structure mating with and capturing said shank in said head; and said retaining structure being uploaded into said head prior to said shank.
  17. 22. A polyaxial bone screw having a head with a rod receiving channel and a shank; including: said head having an inner chamber and a lower aperture having a first radius; said shank having an upper portion with a second radius less than said first radius such that said shank upper portion is insertable through said aperture; a retaining structure independent of said head that is sized and shaped to mate with and be secured to said shank upper portion; said retaining P:V'(Us..flDMWQe004254171 OMon2J.ODC IDstructure and said shank upper portion being joined in said head to form an 0 0 assembly; and a portion of said assembly extending into said channel. 0
  18. 23. A polyaxial bone screw having a shank and a head having an inner chamber with a radiused surface and also having a lower aperture and a rod receiving channel; including: said chamber surface having a larger radius than said aperture; Ssaid shank having an upper portion that has a smaller radius than said S 10 aperture to allow said shank to be uploaded through said aperture; Sa retaining device that loads separately from said shank into said chamber and captures said shank in said chamber so as to form an assembly within said chamber; said retaining device having a lower surface sized and shaped to slidingly mate and rotate with said chamber surface during positioning; and a portion of said assembly extending into said channel.
  19. 24. A method of implanting a bone screw in a patient including the steps of: providing a bone screw head having a lower aperture and an implant receiving channel; providing an elongate shank having a lower threaded portion and an upper portion with said upper portion having an implant engagement end; loading said shank upper portion into said head from below and through said aperture; implanting said shank into a bone of a patient; and placing said implant into said channel so that said shank engagement end abuts against said implant, so as to fix the position of said.shank relative to said head.
  20. 25. A method according to Claim 24 including the steps of: providing a separate capture structure for capturing said shank within said head; placing said capture structure in said head; and securing said shank upper portion to said capture structure. P:UsJefllDMQO42541?1 DMNOna.doc 0 Ib I 26. A method according to Claim 25 further including the step of: Ssecuring said capture structure to said shank upper portion prior to implanting said shank in said bone. 0 S 5 27. A method according to Claim 25 or 26 wherein: said capture structure is a continuous ring; and Sproviding structure on said ring to mate with said shank. S28. A method according to any one of Claims 25 to 27 including the step of: loading said capture structure from above at least partially through said Schannel.
  21. 29. A method according to any one of Claims 25 to 28 including the step of: providing a closure for closing said channel and installing said closure in said channel subsequent to said implant being placed in said channel. A method according to Claim 29 wherein: said implant is a rod; and including the step of positioning said rod in said channel so as to frictionally engage said shank upper portion engagement end.
  22. 31. A method according to Claim 30 including the step of: providing mating threads on said closure and said head and screwing said closure into said head until said closure engages said rod and thereafter applying torque to said closure to set said rod and bias said rod against said shank upper portion engagement region.
  23. 32. A method according to Claim 30 or 31 including the steps of: providing said shank with a pivot structure relative to said head and allowing adjustment of the angular position of said shank relative to said head prior to said shank engagement end frictionally engaging said rod; making said shank engagement end radiused, such that said shank engagement end engages said rod in a plurality of selectable angular configurations between said shank and said rod; such that PAUse&JLADDM200O42S417 DMSJnainoC 9 1 IDsaid rod frictionally engages and locks said shank in a selected angular Sconfiguration relative to said head when said rod is biased against said shank upper engagement end. 0
  24. 33. A method according to any one of Claims 25 to 32 including the step of: projecting said shank upper portion engagement end into said channel prior to placement of said implant into said channel. \O c 34. A method of implanting a bone screw in a patient including the steps of: IN 10 providing a bone screw head having a lower aperture and a rod receiving channel; providing an elongate shank having a lower threaded portion and an upper portion with said upper portion having a rod engagement region; loading said shank upper portion into said head from below through said aperture; capturing said shank inside said head while allowing pivoting of said shank relative to said head; implanting said shank into a bone of a patient; moving said head into a selected angular configuration with respect to said shank; placing said rod into said channel so that said rod engagement region abuts against said rod; installing a closure in said head that closes said channel and biases against said rod engagement region and locking said head in said selected angular configuration relative to said shank. A method of implanting a polyaxial bone screw in a patient wherein the bone screw has a shank and a head that has a channel adapted to receive a rod; the method including: uploading said shank into said head so as to be captured therein; providing said shank with an upper engagement end; and positioning said shank upper engagement end in said channel so as to abut against a rod placed within said channel. P:\UseJueDD ,2D004254171I DiviLona).dOC 9 O 36. A method according to Claim 35 including the step of: providing a capture structure to capture said shank. O Z 37. A method according to Claim 36 including the step of: downloading said capture structure into said head from an opposite side from said shank.
  25. 38. A polyaxial bone screw according to any one of the embodiments c substantially as herein described and illustrated. NO
  26. 39. A polyaxial bone screw and rod assembly according to any one of the embodiments substantially as herein described and illustrated. A method according to any one of the embodiments substantially as herein described. P:\UseJui\DDOM\2004254171 Divisona oc
AU2006235961A 2003-06-18 2006-11-10 Polyaxial bone screw with spline capture connection Abandoned AU2006235961A1 (en)

Priority Applications (3)

Application Number Priority Date Filing Date Title
US10/464,633 2003-06-18
AU2004254171A AU2004254171B2 (en) 2003-06-18 2004-04-05 Polyaxial bone screw with spline capture connection
AU2006235961A AU2006235961A1 (en) 2003-06-18 2006-11-10 Polyaxial bone screw with spline capture connection

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
AU2006235961A AU2006235961A1 (en) 2003-06-18 2006-11-10 Polyaxial bone screw with spline capture connection
AU2008240340A AU2008240340B2 (en) 2003-06-18 2008-10-31 Polyaxial bone screw with spline capture connection
AU2010200319A AU2010200319A1 (en) 2003-06-18 2010-01-28 Polyaxial bone screw with spline capture connection

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AU2004254171A Division AU2004254171B2 (en) 2003-06-18 2004-04-05 Polyaxial bone screw with spline capture connection

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AU2008240340A Division AU2008240340B2 (en) 2003-06-18 2008-10-31 Polyaxial bone screw with spline capture connection
AU2010200319A Division AU2010200319A1 (en) 2003-06-18 2010-01-28 Polyaxial bone screw with spline capture connection

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AU2006235961A1 true AU2006235961A1 (en) 2006-11-30

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AU2006235961A Abandoned AU2006235961A1 (en) 2003-06-18 2006-11-10 Polyaxial bone screw with spline capture connection
AU2008240340A Active AU2008240340B2 (en) 2003-06-18 2008-10-31 Polyaxial bone screw with spline capture connection
AU2010200319A Abandoned AU2010200319A1 (en) 2003-06-18 2010-01-28 Polyaxial bone screw with spline capture connection

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AU2010200319A Abandoned AU2010200319A1 (en) 2003-06-18 2010-01-28 Polyaxial bone screw with spline capture connection

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* Cited by examiner, † Cited by third party
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US5891145A (en) * 1997-07-14 1999-04-06 Sdgi Holdings, Inc. Multi-axial screw
DE10115014A1 (en) * 2001-03-27 2002-10-24 Biedermann Motech Gmbh anchoring element

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AU2008240340B2 (en) 2011-11-03
AU2010200319A1 (en) 2010-02-18

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