Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
  • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
  • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
  • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
  • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
  • A61B17/7041—Screws or hooks combined with longitudinal elements which do not contact vertebrae with single longitudinal rod offset laterally from single row of screws or hooks
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
  • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
  • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
  • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
  • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
  • A61B17/7035—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
  • A61B90/03—Automatic limiting or abutting means, e.g. for safety
  • A61B2090/037—Automatic limiting or abutting means, e.g. for safety with a frangible part, e.g. by reduced diameter

Definitions

• the present invention generally relates to an open dorsal adjusting connector apparatus used for connection of implants with spinal rods.
• the apparatus can be useful for correction of spinal injuries or deformities, and more specifically, but not exclusively, concerns apparatuses allowing for mutually exclusive connection between implants and rods, as well as permitting dorsal height adjustment.
• Typical implant and connection systems include several pieces, which commonly are useful and may be associated with only specific other pieces.
• Bone screws, hooks, and clamps are well known as fixation devices, which are connected or adjoined to a particular bone as a connection between the bone and the connection system which can include a support and/or stabilizing member such as a spinal rod.
• fixation devices which are connected or adjoined to a particular bone as a connection between the bone and the connection system which can include a support and/or stabilizing member such as a spinal rod.
• a series of two or more screws may be inserted into two or more vertebrae to be instrumented.
• a rod is then placed within or coupled to the screws, or is placed within a connecting device that links the rod and a screw, and the connections are tightened.
• FIG. 1 is a perspective view of a connecting assembly relative to vertebrae according to one disclosed embodiment.
• FIG. 2 is a perspective view of the connecting assembly according to the embodiment shown in FIG. 1.
• FIG. 3 is an exploded perspective view of the connecting assembly according to the embodiment shown in FIG. 2.
• FIG. 4 is a cross-sectional view of the connecting assembly according to the embodiment shown in FIG. 2.
• FIG. 5 is a top view of a component of the connecting assembly according to the embodiment shown in FIG. 2.
• FIG. 6 is a top view of a component of the connecting assembly according to the embodiment shown in FIG. 2.
• FIG. 7 is a perspective view of a connecting assembly according to another disclosed embodiment.
• Connecting assembly 20 is operable to connect an implant 22, such as a Schanz-type screw with a threaded anchoring portion, with an elongated member 24, such as a spinal rod.
• implant 22 is inserted into a vertebra 26 and member
• member 24 is utilized to maintain one or more vertebrae at a desired position.
• the implant utilized in conjunction with connecting assembly 20 can be any appropriate bone anchor or bone-engaging mechanism.
• member 24 can be any appropriate elongated member such as a bar, connector, or other orthopedic construct. Further, member 24 may have one of a number of desired lengths.
• connecting assembly 20 includes a body 30 having two upright portions 31 defining a channel 32 configured to accommodate elongated member 24.
• the width of channel 32 is approximately the same as or slightly larger than the diameter of member 24, which allows easier insertion of member 24 in channel 32, allows for compensation for contouring of member 24, and also allows use of a range of member diameters or widths with the same channel 32.
• channel 32 is configured to allow a snap-fit of member 24 therein.
• Body 30 further defines a hole 34 extending therethrough and configured for receipt of additional components of assembly 20.
• Body 30 includes concave extensions 36 to permit pivoting of implant 22, as will be explained further below.
• Connecting assembly 20 further includes a collet 38 to receive implant 22, a ring member 40 for insertion in hole 34, a washer 42 and a nut 44.
• FIG. 3 is an expanded view of connecting assembly 20 to better illustrate the components of the illustrated embodiment.
• Channel 32 is substantially U-shaped with a longitudinal axis Ll, with member 24 generally extending along longitudinal axis Ll.
• Upright portions 31 can include internal threaded portions 33 to be threadedly coupled with a retaining member (not shown) to secure member 24 in channel 32.
• Internal threaded portions 33 can include reverse angle threads, i.e. a thread in which the forward face points downward and inward as disclosed in U-S. Patent 6,296,642, incorporated herein by reference in its entirety.
• the retaining member is a generally cylindrical set screw with external threads, but may alternatively be another type of holding or locking mechanism.
• member 24 may be thereby self-secured in channel 32.
• member 24 can be secured in channel 32 by other appropriate methods as would generally occur to one skilled in the art.
• channel 32 is at least partially open along the longitudinal axis Ll to accommodate top loading of member 24. It should be appreciated that channel 32 can be configured and shaped differently as would generally occur to one skilled in the art.
• Hole 34 extends through body 30 along longitudinal axis L2 and in the illustrated embodiment has a generally circular cross-sectional dimension. In one embodiment, hole 34 is substantially perpendicular to channel 34 and substantially parallel to upright portions 31. However, it should be appreciated that hole 34 can include other cross- sectional shapes, orientations and dimensions. Channel 32 and hole 34 are not in communication in the illustrated embodiment. Additionally, channel 32 and hole 34 could be positioned differently relative to each other in a manner that would maintain the functions of connecting assembly 20.
• collet 38 includes a threaded portion 50 along at least a portion of a proximal end 51. Threaded portion 50 includes one or more flat sections 52. In one embodiment, collet 38 includes two flat sections 52 positioned substantially diametrically opposite each other along the outside of collet 38. An aperture 53 extends through collet 38. Collet 38 further includes a convex section 54 adjacent a distal end 55, the function of which will be explained in greater detail below. Additionally, collet 38 includes one or more slots 56. In one embodiment, there are four slots 56 equally positioned about a circumference of collet 38 and which are generally parallel to aperture 53. Collet 38 is generally cylindrically shaped, except for flat sections 52, with a circular cross-sectional dimension.
• collet 38 is larger than an outer cross-sectional dimension of collet 38 at other points in the illustrated embodiment.
• Collet 38 is sized and shaped so as to fit and move easily within hole 34, a portion of ring member 40, washer 42, and nut 44.
• collet 38 can be configured or shaped differently in other embodiments.
• Ring member 40 is generally annular, having a gap 60 to allow expansion and contraction of ring member 40, and including a threaded interior portion 62. Threaded interior portion 62 is configured to threadedly couple with threaded portion 50 of collet 38 to enable positioning of ring member 40 about a portion of collet 38. Ring member 40 has unstressed or natural outer diameter Dl, i.e. a diameter measured when ring member 40 is under no contractive
• Ring member 40 has an inner diameter D2 just slightly larger than an outer diameter D3 of threaded portion 50 of collet 38 to permit ring member 40 to engage collet 38.
• washer 42 includes a concave lower surface 64 translatable along extensions 36 of body 30 to allow movement, such as pivoting, of collet 38 and implant 22 relative to body 30.
• Nut 44 includes threaded interior portion 68 configured to threadedly couple with threaded portion 50 of collet 38. Referring to FIG. 4, there is shown a cross-sectional view of connector device 20 as assembled, including body 30, nut 44, washer 42, ring member 40, and collet 38. As illustrated in FIG.
• ring member 40 includes a concave surface 70.
• concave surface 70 is located on an inner lower surface of ring member 40.
• Concave surface 70 is configured to contact convex section 54 of collet 38 during operation of connector device 20, as will be explained in greater detail below.
• FIG. 5 is a top view of ring member 40 showing the illustrated embodiment of gap 60 and threaded interior portion 62.
• Ring member 40 defines an aperture 61 configured to receive a portion of collet 38.
• threaded interior portion 62 of ring member 40 is configured to threadedly couple with threaded portion 50 of collet 38 to permit insertion of collet 38 in ring member 40.
• FIG. 6 is a top view of washer 42 illustrating interior flat surfaces 72.
• Flat surfaces 72 of washer 42 are configured to be adjacent or contact flat sections 50 of collet 38 to prevent rotation of collet 38 in hole 34 of body 30.
• flat surfaces 72 could number more or less than two, but preferably there are the same number of flat sections 72 of washer 42 as the number of flat sections 52 of collet 38.
• annular ring member 40 is positioned about collet 38.
• threaded interior portion 62 of ring member 40 is threaded about threaded portion 50 of collet 38 and then positioned adjacent or about collet 38 proximal convex section 54.
• annular ring member 40 and collet 38 can be joined in a different manner as would occur to one skilled in the art.
• Collet 38 is inserted into hole 34 in body 30-
• ring member 40 can be placed in hole 34 with collet 38 being inserted into ring member 40 and hole 34 substantially simultaneously.
• Washer 42 and nut 44 are placed about a portion of collet 38 that extends through hole 34 of body 30.
• washer 42 and nut 44 are placed about collet 38 after insertion of implant 22 therein.
• Assembly 20 may be assembled prior to use in a surgical procedure. However, it should be appreciated that in an alternative embodiment, connecting assembly 20 can be assembled during the surgical procedure. To treat the condition or injury of the patient, the surgeon obtains access to the surgical site in a manner well known in the art, e.g. through incision and retraction of tissues.
• the surgeon may connect one or more implants, such as bone screws, to adjacent or nearby vertebrae that require compression or distraction in order to relieve or improve their condition.
• implants such as bone screws
• pilot holes in vertebrae e.g. in pedicles, may be made, and screws may be inserted into or otherwise connected to two or more vertebrae.
• implant 22 is inserted into a bony structure, such as vertebrae 26, at a desired position.
• Implant 22 can be threaded into bone to a desired depth. Implant 22 is received in aperture 53 of collet 38 to a position where collet 38 encompasses a desired section of implant 22. It should be appreciated that implant 22 can be inserted into a bony structure before or after insertion of implant 22 into collet 38. Additionally, implant 22 may be variably positioned in collet 38, for example with a substantial amount extending out of proximal end 51, or with little or none of implant 22 extending from proximal end 51. Connecting assembly 20 can be positioned at any of an infinite number of distances from vertebrae 26 along implant 22.
• Washer 42 permits pivoting of implant 22 and collet 38 relative to body 30, transverse to longitudinal axis L2, as a function of concave lower surface 64 of washer 42 being translatable along extensions 36 of body 30.
• washer 42 allows implant 22 to be positioned in any of a number of angular positions relative to body 30.
• Nut 44 is threaded onto threaded portion 50 of collet 38 to secure implant 22 at the desired angular position. Tightening nut 44 moves collet 38 within hole 34 and secures contact of washer 42 against body 30. This movement of collet 38 expands ring member 40 to a limited position where ring member 40 is contacting an inner surface of hole 34.
• ring member 40 The expansion of ring member 40 is caused by movement of convex section 54 of collet 38 into ring member 40. Once ring member 40 reaches the limited position, further movement of collet 38 into ring member 40 causes contraction of collet 38 around implant 22 by way of slots 56. Concave surface 70 of ring member 40 facilitates movement of convex section 54 of collet 38 into ring member 40. The contraction of collet 38 around implant 22 locks implant 22 at the desired angular and/or translational position. Thereafter, member 24 is placed in channel 32 of body 30. Channel 32 is configured such that member 24 is loaded into channel 32 in a direction parallel to longitudinal axis L2 of hole 34. Additionally, a retaining member can be received in channel 32 of body 30 to secure member 24 therein.
• Connecting assembly 120 includes a body 130 defining a hole 134 and including upright portions 131 defining a side loading channel 132 extending along longitudinal axis L3. Hole 134 extends through body 130 along a longitudinal axis L4 and has a generally circular cross-sectional shape. Additionally, in one embodiment, hole 134 is substantially perpendicular to channel 132.
• connecting assembly 120 includes collet 38, ring member 40, washer 42, and nut 44.
• Connecting assembly 120 further includes a hole 140 in communication with channel 132.
• Hole 140 is configured for receipt of a retaining member 142.
• Retaining member 142 is operable to secure member 24 in channel 132.
• retaining member 142 is a cylindrically shaped set screw with external threads.
• hole 140 is absent and retaining member 142 is received in channel 132 through an opening 143.
• Side loading channel 132 is configured, in one embodiment, such that member 24 is loaded into channel 132 in a direction substantially perpendicular to longitudinal axis L4 of hole 134.
• ring member 40 is absent and movement of collet 38 in hole 34 and/or hole 134 is operable to secure collet 38 about implant 22.
• nut 44 and/or washer 42 are replaced with another such tightening mechanism as would generally occur to one skilled in the art.
• connector device 20 is composed of biocompatible materials such as titanium, stainless steel, certain ceramics or plastics, or others. While the invention has been illustrated and described in detail in the drawings and foregoing description, the same is to be considered as illustrative and not restrictive in character. It should be understood that only the preferred embodiments have been shown and described and that all changes and modifications that come within the spirit of the invention are desired to be protected.

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• Health & Medical Sciences (AREA)
• Orthopedic Medicine & Surgery (AREA)
• Life Sciences & Earth Sciences (AREA)
• Neurology (AREA)
• Surgery (AREA)
• Heart & Thoracic Surgery (AREA)
• Engineering & Computer Science (AREA)
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• Medical Informatics (AREA)
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• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
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• 2006
  • 2006-04-27 WO PCT/US2006/015926 patent/WO2007130007A1/en active Application Filing
  • 2006-04-27 JP JP2009507650A patent/JP5038401B2/ja not_active Expired - Fee Related
  • 2006-04-27 CN CNA200680054382XA patent/CN101426434A/zh active Pending
  • 2006-04-27 EP EP06751570A patent/EP2015691A1/de not_active Withdrawn

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