AU2020201231A1 - Surgical guidance device and system for insertion thereof - Google Patents

Abstract

Briefly, the invention relates to a surgical tool and method for forming a pilot bore by inserting a guide wire into bone. More particularly, the device includes a cannulated hand grip and driving tool used for the rotation of a pedicle screw into bone. The rear portion of the hand grip includes a slide assembly that is suited to grip a guide wire. The slide assembly includes a user adjustable stop to control the sliding movement of the guide wire. The rear surface of the slide assembly is constructed to be impacted with a hammer or similar device, whereby the stop prevents the guide wire from penetrating the bone further than desired. Should it be desired that the guide wire be retracted, a screw jack is included to allow the guide wire to be precisely retracted. 28 "bo -S

Description

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Australian Patents Act 1990

ORIGINAL COMPLETE SPECIFICATION STANDARDPATENT

Invention Title Surgical guidance device and system for insertion thereof

The following statement is a full description of this invention, including the best method of performing it known to me/us:

RELATED APPLICATIONS CROSS-REFERENCE

[0001] In accordance with 37 C.F.R. 1.76, a claim of priority

is included in an Application Data Sheet filed concurrently

herewith. Accordingly, the present invention claims priority to

U.S. Provisional Patent Application No. 62/783,054, entitled

"SURGICAL GUIDANCE DEVICE AND SYSTEM FOR INSERTION THEREOF",

filed on December 20, 2018. The contents of the above

application are incorporated herein by reference.

FIELD OF THE INVENTION

[0002] The invention relates to a guidance instrument and a

device for insertion of the guidance instrument for surgical

spinal procedures. In particular, the device includes a driving

tool for inserting and positioning a guide wire into bone in

addition to a tool for inserting a pedicle screw into a

vertebra.

BACKGROUND

[0003] Medical procedures involving the vertebrae are

normally complicated because of the preciseness and accuracy

required to avoid both neural damage and injury to major blood

vessels. Precision depth guided instruments are required to

perform percutaneous spinal surgery. These surgeries sometimes

require penetration of the hard cortical bone of the vertebra

la and traversal of the softer cancellous bone lying thereunder. A large force is normally required by the surgeon to penetrate the cortical bone. Once the cortical bone is penetrated, extreme care must then be taken to avoid rapidly penetrating through all of the cancellous bone. There is also the danger of rapidly passing through the cancellous bone and then through the cortical bone on the other side of the vertebra. This can result in injury or damage to the spinal cord and/or other organs or blood vessels located adjacent the spine. In some instances, the force required to penetrate the cortical bone is greater than a surgeon can apply by hand. In these instances, a hammer or other similar instrument is required to force the instrument through the cortical bone. When a hammer or similar instrument is used, there is a greater danger of the instrument passing rapidly through the cancellous bone and out the other side of the vertebra.

[0004] Thus, what is needed is a device and method for

inserting a small diameter guide wire that is capable of

precisely controlling the depth that the guide wire can

penetrate. The device and method should also be constructed to

allow the user to precisely retract the guide wire through bone

as needed.

SUMMARY

[0005] Briefly, the invention relates to a surgical tool and

method for forming a pilot bore by inserting a guide wire into

bone. The surgical tool is constructed and arranged for use in

conjunction with X-ray or ultrasound machines. More

particularly, the device includes a cannulated hand grip and

driving tool used for the rotation of a pedicle screw into bone.

The rear portion of the hand grip includes a slide assembly that

is suited to grip a guide wire. The slide assembly includes a

user adjustable stop to control the sliding movement of the

guide wire. The rear surface of the slide is constructed to be

impacted with a hammer or similar device, whereby the stop

prevents the guide wire from penetrating the bone further than

desired. Should it be desired that the wire be retracted, a

screw thread is included to allow the wire to be precisely

retracted. The hand grip is securable to various surgical

driving tools for the purpose of providing the ability to

cooperate with various brands of pedicle screws and other

surgical implants for spinal procedures. Thus, more than one

driving tool may be secured to the same surgical tool, and the

driving tool is rotatable about the longitudinal axis of the

surgical tool. This construction saves the surgeon time by

forming the pilot bore which may retain the guide wire. Since

the pedicle screw is already positioned on the guide wire, the

surgeon need only rotate the tool to insert the screw along the guide wire to its desired position. Once the screw is placed, the screw jack can be utilized to retract the guide wire.

[0006] Accordingly, it is an objective of the present

invention to provide a surgical tool which can be utilized to

provide a precise trajectory and insertion depth for a guide

wire.

[0007] It is another objective of the present invention to

provide a surgical tool for insertion of guide wires which can

be secured to various drive tools for the insertion of a pedicle

screw into a patient.

[0008] It is yet another objective of the present invention

to provide a surgical tool for the insertion of a guide wire

that includes a screw jack for retracting or removing a guide

wire.

[0009] Still yet another objective of the present invention

is to provide a surgical tool for formation of a pilot bore by

insertion of a guide wire that includes a driving surface for a

striking instrument and a stop for controlling the driving

depth.

[0010] Still yet a further objective of the present invention

is to provide a surgical tool that can be used to ensure a

desired trajectory and/or depth of a pilot hole by advancing a

guide wire or biopsy needle in any number of surgical

procedures, such as bone marrow biopsies, placement of spinal implants, spinal surgery, including ensuring proper placement of pedicle screws during pedicle fixation procedures and ensuring proper trajectory during the establishment of an operative corridor to a target site.

[0011] Other objects and advantages of this invention will

become apparent from the following description taken in

conjunction with any accompanying drawings wherein are set

forth, by way of illustration and example, certain embodiments

of this invention. Any drawings contained herein constitute a

part of this specification, include exemplary embodiments of the

present invention, and illustrate various objects and features

thereof.

BRIEF DESCRIPTION OF THE DRAWINGS

[0012] Many advantages of the present invention will be

apparent to those skilled in the art with a reading of this

specification in conjunction with the attached drawings, wherein

like reference numerals are applied to like elements and

wherein:

[0013] FIG. 1 is a side view of one embodiment of the

surgical tool, illustrated with a guide wire and a driving tool

for a pedicle screw;

[0014] FIG. 2 is a perspective top view of one embodiment of

the surgical tool;

[0015] FIG. 3 is a top perspective view of the embodiment

shown in FIG. 2, illustrated with a driving tool and pedicle

screw;

[0016] FIG. 4 is an exploded view of one embodiment of the

surgical tool;

[0017] FIG. 5 is a perspective view of one embodiment of the

guide wire chuck and anvil in cooperation with a guide wire;

[0018] FIG. 6 is a perspective view of one embodiment of the

guide wire chuck and anvil in cooperation with the wire lock;

[0019] FIG. 7 is an exploded perspective view of the wire

chuck assembly;

[0020] FIG. 8 is a partial view partially in section of the

surgical tool, illustrating the cooperation between the slide

and the screw jack;

[0021] FIG. 9 is a side view of one embodiment of the

surgical tool;

[0022] FIG. 10 is a section view taken along the longitudinal

centerline of FIG. 8; and

[0023] FIG. 11 is an exploded view of the surgical tool

illustrated in FIG. 8.

DETAILED DESCRIPTION

[0024] While the present invention is susceptible of

embodiment in various forms, there is shown in the drawings and

will hereinafter be described a presently preferred, albeit not

limiting, embodiment with the understanding that the present

disclosure is to be considered an exemplification of the present

invention and is not intended to limit the invention to the

specific embodiments illustrated.

[0025] Various embodiments and surgical uses of devices are

described for enhancing the safety and efficiency of surgical

procedures. In one example, set forth by way of example only,

the present invention may facilitate safe and reproducible

pedicle screw guidance and placement by controlling the axial

trajectory of a guide wire for pilot hole formation and/or screw

insertion. In another example, set forth by way of example

only, intraoperative imaging performance may be improved and

radiation exposure minimized by providing precise control to the

surgeon during guide wire depth placement. In yet another

example, controlling the trajectory and depth of surgical access

instruments can aid in both the insertion and positioning of the

access instruments themselves, as well as aiding in the later

insertion of instruments and/or implants through or with the

surgical access instruments. It is expressly noted that these

examples are set forth by way of example, and that the present

invention may be suitable for use in any number of additional surgical actions where the angular orientation, trajectory or depth (linear distance traveled) of instrumentation and/or implants is important. By way of example only, the present invention may be useful in directing, among other things, the formation of tunnels for ligament or tendon repair and the placement of facet screws. Another example would include bone biopsies and the like. Other uses may include orientation of drills, saws, cutters or other hand operated tools used in the performance of surgery where specific fiducial markers may be useful.

[0026] FIGS. 1-8, which are now referenced, illustrate one

embodiment of the present invention and one manner in which it

may be assembled. Like reference numerals refer to like

components in the various figures. FIGS. 1 and 3 illustrate a

surgical tool 100 for operation of a driving tool 10, a guide

wire 12 and a bone screw 14. By way of example only, while

placing bone screws through a pedicle (which is a small

generally tubular structure connecting posterior elements of a

vertebra to the vertebral body), it is critical to ensure the

bone screw is contained within the pedicle and does not breach

the outer pedicle wall. Since the pedicle is surrounded by

delicate nervous tissue, a breach can have serious consequences

for the patient, ranging from mild pain to paralysis. One way

to mitigate the risk of a pedicle breach during screw placement

(including preparation for screw placement, such as pilot hole

formation and tapping) is to determine the angular orientation

of the pedicle, and thereafter advance the necessary

instruments, guide wires and screws along the determined

trajectory. By orienting the surgical access components along

the pedicle trajectory with a guide wire, the surgical

instruments and pedicle screws may be simply and efficiently

advanced along the same trajectory, and thus avoid a breach.

[0027] Thus, in spinal surgery, before the pilot hole is

formed with the guide wire 12, the desired angular trajectory

must first be determined. Preoperative superior view utilizing

AP fluoroscopy, MRI or CAT scan imaging device(s) are used to

determine the trajectory once the surgical tool 100, in

combination with the driving tool 10, pedicle screw 14 and guide

wire 12, has been placed at the anatomical site for which the

surgery is to be conducted. C-arm fluoroscopes are used

extensively during many surgical procedures. During spinal

surgery, for example, the C-arm is used frequently to help

locate specific structures of the spine, to direct the

positioning of surgical instruments and/or instrumentation, and

to verify the proper alignment and height of vertebra, among

other uses. Imaging devices, such as the C-arm, are typically

provided with a scale (not shown) indicating the orientation of

the radiography beam with respect to the patient and thus, in this example, the surgical tool 100, in combination with the driving tool 10, pedicle screw 14 and guide wire 12.

[0028] FIGS. 1-8, which are now referenced, illustrate one

embodiment of the present invention and the manner in which it

is constructed. In general, the figures illustrate a surgical

tool 100 for creating a precise pilot bore using a guide wire 12

in a bone structure. The surgical tool 100 can further insert

a bone screw 14 into the pilot bore without removal of the tool

from the surgical site. The surgical tool 100 comprises a

substantially rigid cannulated hand grip 16 including a first

end 18 and a second end 20, the first end 18 including a quick

release chuck 22 for securing to a driving tool 10, the second

end 20 including a barrel 26 for housing a slide assembly 24.

The hand grip 16 is secured to the barrel 26 in a manner that

prevents rotation between the two. The hand grip 16 may be

fixed to the barrel 26 by various means, which include

overmolding, or can be detachably removable. In embodiments

where the hand grip 16 is detachably removable, the hand grip 16

may include adhesive, keyways, press fits, serrations or the

like which allow the hand grip 16 to adhere to the barrel 26 to

prevent rotation between the hand grip 16 and the barrel 26

during operation. The quick release chuck 22 is operated by

pressing the face plate 28 into the hand grip depressing spring

member 30 to allow the locking balls 32 to sufficiently retract to allow a driving tool 10 to be inserted or removed. Release of the face plate 28 allows the spring to force the face plate

28 outwardly, causing the locking balls 32 to retract inwardly

to engage a ring or other indentions in the driving tool 10,

preventing it from pulling out of the surgical tool 100. The

quick release chuck 22 includes an inner sleeve 40 which

includes the ramp surfaces for the locking balls 32. The inner

sleeve 40 is also constructed to contain the spring member 30

while guiding the face plate 28. The inner surface 34 of the

quick release chuck 22 and the driving tool 10 are provided with

intermeshing, preferably conjugate shapes, which allow the

surgical tool 100 to rotate the driving tool 10 in either

direction. The distal end 36 of the driving tool 10 includes a

shaped driver 38 which is constructed to cooperate with a female

cavity in a bone screw 14 to allow the screw 14 to be rotated

into a bone. The driving tool 10 includes a bore extending

along the longitudinal axis of the driving tool 10 for passage

of a guide wire 12, biopsy needle (not shown) or the like.

[0029] Referring to FIG. 4, barrel 26 is generally a tubular

member having an enlarged head 42. The enlarged head 42

includes a slide lock bore 44 extending transversely across the

barrel 26. The slide lock bore 44 is shaped to receive a slide

lock 46. The slide lock 46 is spring loaded by slide lock

spring 54, and includes a bore 48 sized to accept and engage a side wall 50 of the slide assembly 24 to removably retain and position the slide assembly 24 within the bore 52 of the barrel

26. The slide lock 46 applies a predetermined pressure to the

side wall 50, which allows the slide assembly to move in a

controllable manner within the barrel 26. Depression of the

slide lock 46 allows the slide assembly 24 to be removed from

and inserted into the barrel 26. Adjustment of the screw jack

56 provides a means to adjust and control the amount of travel

provided to the slide assembly 24, which allows the guide wire

12 to travel through the hand grip 16, barrel 26, and driving

tool 10. The barrel 26 is also provided with tangent pin

apertures 58, which cooperate with tangent pins 60 to prevent

rotation of the slide assembly 24 during traversal of the slide

assembly 24 within the barrel 26. The tangent pins 60 cooperate

with tangent surface 62 to prevent the rotation.

[0030] Still referring to FIG. 4, the slide assembly 24 is

generally constructed and arranged to control the travel of the

guide wire 12 within the surgical tool assembly 100. The slide

assembly 24 includes a slide head 64, threaded portion 66, side

wall 50, wire guide portion 68 and tangent surface 62. The

slide head 64 includes a transverse bore 70 sized and shaped to

cooperate with a wire lock 72 having a bore 74 sized to

cooperate with the outer surface of the wire chuck 76 to

position and retain the wire chuck 76 within the slide assembly

24. Thus, a side surface of the wire lock bore 74 engages the

lock surface 78, which includes a shoulder 80 to provide a

positive stop. The slide assembly 24 is sized to fit within the

barrel 26 for sliding movement between the two. The threaded

portion 66 cooperates with the screw jack 56, which allows the

amount of travel to be adjusted. The screw jack 56 also

provides the ability to the surgeon to withdraw the guide wire

12 from bone and from a bone screw 14.

[0031] Still referring to the FIGS. and particularly to FIGS.

4 and 5, the wire chuck 76 is generally constructed and arranged

to engage a side surface 82 of the guide wire 12 to position the

wire as desired by the surgeon. The wire chuck 76 includes the

sleeve 84, collet 86 and collet closer 88. The sleeve 84

includes an internal taper 90 adapted to cooperate with the

collet 86 when pushed into the sleeve 84 by the collet closer

88. In this manner, the movement of the collet closer 88 causes

the internal taper 90 and the collet taper 92 to close the

collet 86 on the outer surface of the guide wire 12 to position

the guide wire. Threads 94 are provided on the outer surface of

the sleeve 84, and an inner surface of the collet closer 88 to

allow the user to precisely close the collet 86 to provide grip

on the guide wire 12. An anvil 96 is provided and placed in

bore 98 within the slide assembly 24. The anvil 98 provides a

surface upon which the wire chuck 76 can impact without damage to the surgical tool assembly 100. It should be noted that while the collet 86 is illustrated as positioning the guide wire

12, the guide wire 12 may be provided with a head (not shown)

that interlocks within the wire chuck 76 to position the guide

wire 12. The guide wire 12 may be solid or cannulated, and may

include any number of tips desirable for penetrating bone. It

should also be noted that indicia may be included on the barrel

26, slide assembly 24, or screw jack 56 to assist the surgeon in

controlling the movement of the guide wire 12. In some

embodiments, the indicia may be embossed, printed, embedded or

otherwise imprinted on a sticker or the like. In other

embodiments, the indicia are etched or electro-plated into the

hand grip 16. In some embodiments, the hand grip 16 may include

a cutout region for accommodating indicia for depth.

[0032] One method of operation includes placing a bone screw

14 on the distal end 36 of driving tool 10. The guide wire 12

is secured in the wire chuck 76, having the approximate amount

of guide wire extending outwardly therefrom. The guide wire 12

is slid through the slide assembly 24, depressing wire lock 72,

allowing the wire chuck 76 to be locked into the slide assembly

24. The slide assembly 24 can then be inserted into the barrel

26 and locked in place by depressing the slide lock 46, the

guide wire 12 extending through the driving tool 10 and bone

screw 14. Travel of the guide wire 12, and thus the amount that the guide wire 12 is allowed to extend through the bone screw

14, is adjusted by rotation of the screw jack 56. The guide

wire 12 can then be retracted to not extend through the bone

screw 14. The bone screw 14 can be positioned as desired on the

bone, and the slide assembly 24 impacted with a hammer or the

like to drive the guide wire 12 into position. The guide wire

12 may be retracted for insertion of the bone screw 14, or left

in place while the screw is inserted into the bone. The screw

jack 56 can be utilized to retract the guide wire 12 in either

scenario.

[0033] Referring to FIGS. 9-11, an alternative embodiment of

the surgical tool 200 is illustrated. The surgical tool 200

comprises a substantially rigid cannulated hand grip 16

including a first end 18 and a second end 20, the first end 18

including a quick release chuck 22 for securing to a driving

tool 10, the second end 20 including a barrel 26 for housing a

slide assembly 124. The hand grip 16 is secured to the barrel

26 in a manner that prevents rotation between the two. The hand

grip 16 may be fixed to the barrel 26 by various means, which

include overmolding, or can be detachably removable. In

embodiments where the hand grip 16 is detachably removable, the

hand grip 16 may include adhesive, keyways, press fits,

serrations, or the like, which allow the hand grip 16 to adhere

to the barrel 26 to prevent rotation between the hand grip 16 and the barrel 26 during operation. The quick release chuck 22 is operated by pressing the face plate 28 into the hand grip 16, depressing spring member 30 to allow the locking balls 32 to sufficiently retract to allow a driving tool 10 to be inserted or removed. Release of the face plate 28 allows the spring member 30 to force the face plate 28 outwardly, causing the locking balls 32 (FIG. 4) to retract inwardly to engage a ring or other indentions in the driving tool 10, preventing it from pulling out of the surgical tool 200. The quick release chuck

22 includes an inner sleeve 40 (FIG. 4) which includes the ramp

surfaces for the locking balls 32. The inner sleeve 40 is also

constructed to contain the spring member 30 while guiding the

face plate 28. The inner surface 34 of the quick release chuck

22 and the driving tool 10 are provided with intermeshing,

preferably conjugate shapes, which allow the surgical tool 200

to rotate the driving tool 10 in either direction without

slippage. The distal end 36 (FIG. 1) of the driving tool 10

includes a shaped driver 38 which is constructed to cooperate

with a female cavity in a bone screw 14 to allow the screw 14 to

be rotated into a bone. The driving tool 10 includes a bore 11

extending along the longitudinal axis of the driving tool 10 for

passage of a guide wire 12, biopsy needle (not shown) or the

like.

[0034] Referring to FIGS. 4 and 9-11, barrel 26 is generally

a tubular member having an enlarged head 42. The enlarged head

42 includes a slide lock bore 44 extending transversely across

the barrel 126. The slide lock bore 44 is shaped to receive a

slide lock 46. The slide lock 46 is spring loaded by slide lock

spring 54 (FIG. 4), and includes a bore 48 sized to accept and

engage a side wall 150 of the slide assembly 124 to removably

retain and position the slide assembly 124 within the bore 152

of the barrel 126. The slide lock 46 applies a predetermined

pressure to the side wall 150, which allows the slide assembly

124 to move in a controllable manner within the barrel 126.

Annular groove 127 allows the slide assembly 124 to have a home

position as illustrated in FIG. 9, from which mallet of the like

can be used to advance the slide assembly 124 forward.

Depression of the slide lock 46 allows the slide assembly 124 to

be removed from and inserted into the barrel 126. Adjustment of

the screw jack 56 provides a means to adjust and control the

amount of travel provided to the slide assembly 124, which

allows the guide wire 12 to travel through the hand grip 16,

barrel 126, and driving tool 10. In this manner, the surgeon

can control how far the guide wire 12 is allowed to travel into

a bone, even when using a mallet or the like to advance the wire

12. The barrel 126 is devoid of pins, threads, or the like to

allow rotation of the slide assembly 124 during traversal of the slide assembly 124 within the barrel 126. In this manner, the slide assembly 124 can be rotated or pulled in and out as desired. Alternatively, the annular groove 127 and the slide lock 46 can be used to retain the slide assembly 124 in a fixed position until it is desired to advance the guide wire 12 by hand or mallet.

[0035] Still referring to FIGS. 9-11, the slide assembly 124

is generally constructed and arranged to control the travel of

the guide wire 12 within the surgical tool assembly 200. The

slide assembly 124 includes a slide head 64, threaded portion

66, side wall 150 and wire guide portion 68. The slide head 64

includes a transverse bore 70 sized and shaped to cooperate with

a wire lock 172 having a bore 74 sized to cooperate with the

outer surface 176 of the wire lock 172 to position and retain

the wire lock 172 within the slide assembly 124. Thus, a side

surface of the wire lock bore 74 engages the lock surface 176,

which includes shoulder 80 to provide a positive stop. The

slide assembly 124 is sized to fit within the barrel 126 for

sliding and rotational movement between the two. The threaded

portion 66 cooperates with the screw jack 56, which allows the

amount of travel to be adjusted. The screw jack 56 also

provides the ability to the surgeon to withdraw the guide wire

12 from bone and from a bone screw 14.

[0036] Still referring to FIGS. 9-11, the wire lock 177 is

generally constructed and arranged to engage a side surface 82

of the guide wire 12 to position the wire 12 as desired by the

surgeon. The wire lock 176 includes an inner bore 184, and a

plurality of set screws 185 for engaging the side surface 82 to

position the guide wire 12. It should be noted that while the

bore and set screw(s) are illustrated as positioning the guide

wire 12, the guide wire 12 may be provided with a head (not

shown) that interlocks within the wire lock 176 to position the

guide wire 12. The guide wire 12 may be solid or cannulated,

and may include any number of tips desirable for penetrating

bone which may include split points such as those provided on

drill bits. It should also be noted that indicia may be

included on the barrel 126, slide assembly 124, or screw jack 56

to assist the surgeon in controlling the movement of the guide

wire 12. In some embodiments, the indicia may be embossed,

printed, embedded or otherwise imprinted on a sticker or the

like. In other embodiments, the indicia are etched or electro

plated into the hand grip 16. In some embodiments, the hand

grip 16 may include a cutout region for accommodating indicia

for depth.

[0037] One method of operation includes placing a bone screw

14 on the distal end 36 of driving tool 10. The guide wire 12

is secured in the wire lock 176, having the approximate amount of guide wire 12 extending outwardly therefrom. The guide wire

12 is slid through the slide assembly 124, depressing wire lock

72, allowing the wire lock 176 to be locked into the slide

assembly 124. The slide assembly 124 can then be inserted into

the barrel 126 and locked in place by depressing the slide lock

46, the guide wire 12 extending through the driving tool 10 and

bone screw 14. Travel of the guide wire 12, and thus the amount

that the guide wire 12 is allowed to extend through the bone

screw 14, is adjusted by rotation of the screw jack 56. The

guide wire 12 can then be retracted to not extend through the

bone screw 14. The bone screw 14 can be positioned as desired

on the bone, and the slide assembly 124 impacted with a hammer,

rotated with a drill, or the like, to drive the guide wire 12

into position. The guide wire 12 may be retracted for insertion

of the bone screw 14, or left in place while the screw 12 is

inserted into the bone. The screw jack 56 can be utilized to

retract the guide wire 12 in either scenario.

[0038] It should be noted that, while not illustrated, the

present device may be utilized for numerous orthopedic

procedures that require precision and guidance. While not

limited to the following list, such procedures may include other

instruments such as drills, bone pins, hip, knee and shoulder

replacements, as well as other surgical implantations where the

surgeon desires to control the depth the tool is allowed to penetrate the bone. The device may also be applicable for biopsies of tissue, particularly for small tumors and the like where depth of the biopsy needle must be closely controlled.

The present device may be used in parallel with devices, such as

a drill, to control trajectory and depth of the drill.

[0039] All patents and publications mentioned in this

specification are indicative of the levels of those skilled in

the art to which the invention pertains. All patents and

publications are herein incorporated by reference to the same

extent as if each individual publication was specifically and

individually indicated to be incorporated by reference.

[0040] It is to be understood that while a certain form of

the invention is illustrated, it is not to be limited to the

specific form or arrangement herein described and shown. It

will be apparent to those skilled in the art that various

changes may be made without departing from the scope of the

invention, and the invention is not to be considered limited to

what is shown and described in the specification and any

drawings/figures included herein.

[0041] One skilled in the art will readily appreciate that

the present invention is well adapted to carry out the

objectives and obtain the ends and advantages mentioned, as well

as those inherent therein. The embodiments, methods, procedures

and techniques described herein are presently representative of the preferred embodiments, are intended to be exemplary, and are not intended as limitations on the scope. Changes therein and other uses will occur to those skilled in the art which are encompassed within the spirit of the invention and are defined by the scope of the appended claims. Although the invention has been described in connection with specific preferred embodiments, it should be understood that the invention as claimed should not be unduly limited to such specific embodiments. Indeed, various modifications of the described modes for carrying out the invention which are obvious to those skilled in the art are intended to be within the scope of the following claims.

[0042] Throughout this specification and the claims which

follow, unless the context requires otherwise, the word

"comprise", and variations such as "comprises" and "comprising",

will be understood to imply the inclusion of a stated integer or

step or group of integers or steps but not the exclusion of any

other integer or step or group of integers or steps.

[0043] The reference in this specification to any prior

publication (or information derived from it), or to any matter

which is known, is not, and should not be taken as an

acknowledgment or admission or any form of suggestion that that

prior publication (or information derived from it) or known matter forms part of the common general knowledge in the field of endeavor to which this specification relates.

Claims (15)

1. THE CLAIMS DEFINING THE INVENTION ARE AS FOLLOWS:

   Claim 1. The surgical guidance device for inserting a guide

   wire and bone screw into a bone structure comprising:

   a surgical tool having a cannulated hand grip including a

   first end and a second end, said first end including a quick

   release chuck for securing said hand grip to a driving tool,

   said second end including a barrel for housing a slide assembly,

   said driving tool includes a bore extending along a longitudinal

   axis of said driving tool for passage of a guide wire, a distal

   end of said driving tool includes a shaped driver which is

   constructed to cooperate with a conjugately shaped portion of a

   bone screw to allow controlled rotation thereof, a tubular

   barrel positioned within said cannulated hand grip, said

   tubular barrel having a bore sized to slidably accept said slide

   assembly, said slide assembly constructed and arranged for

   securement and positioning of said guide wire, a front surface

   of said slide assembly constructed to contact a rear surface of

   said barrel for limiting forward travel of said slide assembly

   and said guide wire.
2. Claim 2. The surgical device of Claim 1 wherein said slide

   assembly includes a screw jack for limiting forward movement of said slide assembly with respect to said tubular barrel, said screw jack contacting a portion of said tubular barrel to limit said movement.
3. Claim 3. The surgical device of Claim 1 wherein said

   tubular barrel includes a screw jack for limiting forward

   movement of said slide assembly with respect to said tubular

   barrel, said screw jack contacting a portion of said slide

   assembly to limit said movement.
4. Claim 4. The surgical device of Claim 1 wherein said slide

   assembly includes a slide lock, said slide lock extending

   transversely across said tubular barrel, said slide lock

   including a bore sized and shaped to receive said slide

   assembly, said slide lock including a slide lock spring to cause

   said slide lock to engage a side wall of said slide assembly to

   restrict forward and rearward movement thereof.
5. Claim 5. The surgical device of Claim 1 wherein said slide

   assembly includes one or more annular groove(s) that provide

   said slide assembly with one or more fixed position(s).
6. Claim 6. The surgical device of Claim 5 wherein at least

   one of said annular grooves includes a ramping surface from which a mallet can be used to advance said slide assembly forward.
7. Claim 7. The surgical device of Claim 4 wherein said slide

   lock is constructed and arranged to be released from engagement

   with said slide assembly by hand.
8. Claim 8. The surgical device of Claim 1 wherein said slide

   assembly includes a slide head, said slide head includes at

   least one transverse bore sized and shaped to cooperate with a

   wire lock having a wire lock bore sized to cooperate with an

   outer surface of a wire chuck to position and retain said wire

   chuck within said slide assembly.
9. Claim 9. The surgical device of Claim 8 wherein said wire

   chuck includes a shoulder to provide a positive stop to prevent

   longitudinal movement of said wire chuck without movement of

   said wire lock.
10. Claim 10. The surgical device of Claim 9 wherein said wire

    lock is moveable by hand between a first position whereby said

    wire chuck is immovable longitudinally with respect to said

    slide head, and a second position whereby said wire chuck is

    moveable longitudinally with respect to said slide head.
11. Claim 11. The surgical device of Claim 1 wherein said

    tubular barrel includes at least one tangent pin aperture, said

    tangent pin aperture cooperating with at least one tangent pin

    to prevent rotation of said slide assembly during longitudinal

    traversal of said slide assembly within said tubular barrel.
12. Claim 12. The surgical device of Claim 11 wherein said

    slide assembly includes a tangent surface on a side surface of

    said slide assembly, said tangent surface constructed and

    arranged to cooperate with said at least one tangent pin to

    prevent rotation of said slide assembly.
13. Claim 13. The surgical device of Claim 1 wherein said guide

    wire is a biopsy needle, said guide wire being cannulated.
14. Claim 14. The surgical device of Claim 1 wherein said bone

    screw is a pedicle screw.
15. Claim 15. The surgical device of Claim 1 wherein said quick

    release chuck and said driving tool are provided with

    intermeshing shapes, which allow said surgical tool to rotate

    said driving tool in either direction rotationally.