JP2009517174A - Side mounted adjustable bone anchor - Google Patents

Abstract

  A side-mounted bone anchor is provided that can be used in the cervical, thoracic, lumbar, or sacral regions of the spine or other orthopedic locations. In one embodiment, the anchor includes an anchoring portion, a receiving portion, and an internal component that is at least partially rotatable relative to the receiving portion. The anchoring part is attached to the bone. A rod or other elongated support member is received in the receiving portion in contact with the internal component. The rod and internal parts can be rotated substantially in a plane for versatility, and a set screw is screwed into the receiving portion to lock the rod within the receiving portion.

Description

  The present invention relates to bone anchors that are particularly useful for engaging vertebrae. In one particular embodiment, the present invention allows loading from the side of an elongated rod or other member that extends along the spinal column, while at the same time allowing the rod to be adjusted substantially in a plane, A bone screw assembly is contemplated.

  Several techniques and systems have been developed that correct and stabilize the spine and promote fusion at various heights of the spine. In one type of system, a bendable rod is placed longitudinally along the length of the spinal column or spinal column. The rod is preferably bendable to correspond to the normal curvature of the spinal column in the particular area where it is mounted. For example, the rod can be bent to create a normal kyphotic curvature in the thoracic region of the spinal column, or a lordotic curvature in the lumbar region. According to such a system, the rod is engaged with various vertebrae along the length of the spine by several fixing elements. Various fixation elements configured to engage a specific portion of the vertebra can be provided. For example, one such fixation element is a hook configured to engage a lamina. Another very common fixation element is a spinal screw that can be screwed into various aspects of the vertebra.

  In a typical procedure using a bendable rod, the rod is located on one or both sides of the spinal column or spinous process. A plurality of bone screws are screwed into parts of several vertebral bodies, for example into the pedicles of these vertebrae. The rod (s) are connected or affixed to the bone screws to apply a corrective / stabilizing force on the spinal column.

  An example of a rod-type spinal fixation system is available from Medtronic Sofamor Danek, Inc. TSRH ™ Spinal System sold by The TSRH ™ System includes an elongate rod and various hooks, screws, and bolts, all configured to create a segmental structure across the entire spinal column. In one aspect of the TSRH ™ System, the spinal rod is connected to various vertebral fixation elements by eyebolts. In this configuration, the fixation element is engaged to the rod laterally adjacent to the spinal rod. In another aspect of the TSRH ™ System, a variable angle screw is engaged to the spinal rod by an eyebolt. The variable angle screw allows the bone screw to pivot in a single plane parallel to the plane of the spinal rod. Details of this variable angle screw can be found in US Pat. No. 5,261,909 to Sutterlin et al., Owned by the assignee of the present invention. One goal achieved by the TSRH ™ System is that the surgeon can apply vertebral fixation elements such as spinal hooks and bone screws to the spinal column at the appropriate anatomical location. The TSRH ™ System also allows the surgeon to easily engage each fixation element with a bent spinal rod for final fastening.

  Other rod-type fastening systems are available from Medtronic Sofamor Danek, Inc. Cotrel-Dubosset / CD Spinal System sold by Like the TSRH ™ System, the CD ™ System provides a variety of fixation elements for engagement between the elongated rod and the spinal column. In one aspect of the CD ™ System, the fixation element itself includes a body that defines a slot in which the spinal rod is received. The slot includes a threaded bore into which a threaded plug is engaged to clamp the rod within the body of the securing element. The CD ™ System includes a hook and bone screw with this “open-back” configuration. Details of this technique can be found in US Pat. No. 5,0055,362 to Cotrel. One benefit of this feature of the CD ™ System is that the fixation element is positioned directly below the elongated rod. This helps to reduce the overall bulkiness of the implant structure and minimizes trauma to the surrounding tissue.

  The foregoing and other vertebral anchors have passages for elongated rods or other members that open upward, i.e., in a direction that is straight away from the bone to which the anchor is attached. The convenience of such a structure is obvious because the anchor can be initially placed in the bone and then the rod can be essentially placed over the anchor in the passage. However, in many cases, the surgeon may wish to use the anchor to translate the vertebral body into the rod. This translation is usually accompanied by a horizontal component as well as a vertical component. Side-mounted implants, along with their associated instruments, can simplify the performance of this type of procedure. The use of such an implant reduces the interference from the lateral tissue, may preload the locking component before inserting the anchor, and even temporarily capture the rod before final fastening. Can bring about innovative means.

  To address these problems, bone anchors with passageways that open to the sides have been developed. However, there remains a need in the industry for new and improved side-mounted bone anchors.

An apparatus for attaching to a vertebra and spinal rod according to the present invention is a bone anchor portion having a threaded shaft with a longitudinal axis and a neck portion, wherein the threaded shaft is a longitudinal axis, And a bone anchor portion having a cancellous bone thread suitable for connection to the vertebra; and a substantially C-shaped receiving portion, wherein the receiving portion is integrally connected to the neck portion of the bone anchor portion Having a lower leg, an upper leg, and an intermediate portion, wherein the receiving portion has a passage substantially perpendicular to the axis, and the rod passes through the passage in the receiving portion. The receiving portion further includes an internal threaded hole through the upper leg, the receiving portion further comprising openings in the lower leg and the intermediate portion. Including and receiving A receiving portion further comprising at least one external imprint adapted to correspond to a holding tool; and an internal component coupled to the receiving portion, whereby at least a portion of the internal component is The inner part has a post portion extending into the intermediate part of the receiving part, the inner part having a first end and a second end, the inner part being adapted to be within the opening of the receiving part; The first end of the seating portion is attached to the column portion of the internal component, the second end has a flat portion, and the seating portion An inner part having a substantially cylindrical inner surface, the inner surface having an arc of up to about 120 degrees and the legs having grooves;
An annular member that surrounds at least a portion of the leg of the internal component such that at least a portion of the annular member is in the groove and the internal component and the receiving portion rotate relative to each other; The annular member is positioned so that the annular member is positioned and the legs of the internal part and the annular member cannot be withdrawn from the opening of the receiving portion as possible. An annular member;

  The side-mounted bone anchor device of the present invention is a substantially C-shaped receiving portion, the receiving portion having a lower leg, an upper leg, and an intermediate portion, wherein the receiving portion Has a passage between the upper leg and the lower leg that is substantially perpendicular to the intermediate part, the receiving part being a recess in the lower leg, And a receiving portion further comprising a hole in said intermediate portion; a bone anchor portion comprising a longitudinal axis coupled to said lower leg of said receiving portion, said axis being substantially in said intermediate portion A bone anchor portion that is generally parallel; and an internal component that includes a column portion and a seating portion, wherein the arm portion is substantially straight and the seating portion has a substantially cylindrical inner surface. The seating portion has a first end and a second end. The first end of the seating portion is attached to the post portion, and the second end has a flat portion that is not parallel to the post portion, and the internal component The column portion of the receiving portion is in the hole, does not extend beyond the intermediate portion, the seating portion is adjacent to the recess of the receiving portion, and the internal part is the receiving portion An internal component that is rotatable about the post portion; and a set screw coupled to the receiving portion, whereby the set screw and the seating portion of the internal component are Adapted to contact an elongate member positioned within the passage to lock the elongate member, the seating portion and the receiving portion relative to each other.

  For the purpose of promoting an understanding of the principles of the invention, reference will now be made to the embodiments illustrated in the drawings and specific language will be used to describe the embodiments. Nonetheless, it is not intended that the scope of the invention be limited, and variations and other modifications of the apparatus shown herein, which normally occur to those skilled in the art to which the invention pertains, It will be appreciated that other applications of the principles of the invention shown herein are contemplated.

  1-4, one embodiment of a side-mounted bone screw 20 is shown. The bone screw 20 can be made for attachment to vertebrae such as the cervical vertebrae, thoracic vertebrae, lumbar vertebrae, and / or sacral vertebrae structures, or other bones or tissues. Similarly, aspects of the bone screw 20 described herein can be included in vertebral hooks, bone clamps, and other orthopedic implant devices.

  The screw 20 in the embodiment shown in FIG. 1 includes a shaft 22, a receiving portion 24, and an internal component 26. The shaft 22 is an elongated part having one or more threads 30 in at least a portion, eg, a relatively lower portion. The thread 30 may be a cancellous thread configured to be suitable for implantation into a vertebra or similar bone. The thread 30 may be self-tapping or intermittent, or may have more than one crest winding around the shaft 22, or other suitable configuration. . A neck portion 32 is provided at a relatively upper portion of the shaft 22. Neck portion 32 may be above thread 30 or may also include thread (s) or threaded portions. In one embodiment in which the shaft 22 is integrally joined to the receiving portion 24, such as by integral formation or construction or a rigid attachment, the neck 32 is attached to the receiving portion 24.

  With further reference now to FIGS. 5-9, the depicted embodiment of the receiving portion 24 is substantially C-shaped, with an upper leg 40, a lower leg 42, and an intermediate joining them. Part 44. The upper leg 40 has a screw hole 46 into which a set screw 48 can be screwed. The bore 46 may have a longitudinal axis that intersects the upper leg 40 perpendicularly, or the longitudinal axis is angled with respect to the upper leg 40, for example, toward the intermediate portion 44. It may be made.

  The lower leg 42 may be connected to the shaft 22. As described above, in one embodiment, the shaft 22 is integrally joined to the receiving portion 24. As shown in FIGS. 2 and 4, the shaft 22 may be attached to the receiving portion 24 at a relatively forward portion of the lower leg 42 in one particular embodiment. The shaft 22 may also be attached to the receiving portion 24 at other portions of the receiving portion 24. As an example, the shaft 22 may be mounted at the central portion of the leg 42, i.e., in a region that is substantially equidistant from the intermediate portion 44 and the front or open portion of the receiving portion 24. The shaft 22 can also be attached to the legs 42 in the rear portion, i.e. in the region relatively close to the middle portion 44 or in the region at the middle portion 44.

  The intermediate portion 44 joins the leg portions 40 and 42. The legs 40 and 42 and the intermediate portion 44 generally comprise a substantially C-shape with a passage 52 substantially unilaterally of the intermediate portion 44 and having a mouth 54 between the legs 40 and 42. Form. In one particular embodiment, the mouth 54 is somewhat wider than the width of the passage 52 and further enters the receiving portion 24. For example, as shown in FIGS. 2 and 6, the passage 52 can taper substantially uniformly from the mouth 54 toward the intermediate portion 44.

  The illustrated embodiment of the receiving portion 24 further includes a cavity 56 in the lower leg 42 and the intermediate portion 44. The cavity 56 is relatively shallow in a region or hollow 58 that substantially corresponds to the lower leg 42. The cavity 56 may be substantially cylindrical and relatively deep in the region or hole 60 and may be in or through the intermediate portion 44. Alternatively, at least a portion of the cavity 56 in the region 60 of the intermediate portion 44 has a substantially constricted (hourglass) shape (eg, some of the upper and lower ends than the region between the upper and lower ends). Wide). To help hold the internal component 26, a rim or flange 61 extends at least partially around the region 60 of the cavity 56 at a location that is relatively far from the passageway 52, as further described below. To do. The rim or flange 61 may extend substantially the entire perimeter of the region 60 of the cavity 56 or may extend a distance somewhat shorter than its perimeter.

  In one particular embodiment, one or more ridges 62 are provided in the receiving portion 24 in the region of the cavity 56 or in the region adjacent to the cavity 56. The raised portion 62 is provided to engage the back surface of the internal component 26 when the screw 20 is locked. In the embodiment shown here, the ridge 62 is positioned substantially perpendicular to the direction of the rod in the passage 52. The ridge 62 can be positioned substantially parallel or oblique to such a rod, can be positioned in a substantially chevron-shaped configuration, or the inner part 26 and the receiving part. It can be seen that they can be positioned in any other manner that helps to lock the 24 against movement relative to each other. Alternatively, splines or other engagement structures can be provided on the internal component 26 (eg, on its external surface 67) and on the receiving portion 24 in the region 58 of the cavity 56.

  The internal component 26 includes a rounded seat portion 63 and a column portion 64. The seating portion 63 has a curved inner surface 66, a curved outer surface 67, and a substantially flat front surface 68. The inner surface 66, in one particular embodiment, has a substantially cylindrical shape, which can have the same or similar radius as the rod to be used with the screw 20. The inner surface 66 and the front surface 68 can be united at the edge 70. In one particular embodiment, the total arc of the inner surface 66 from the column portion 64 to the edge 70 is less than 180 degrees and can be about 120 degrees. It will be appreciated that other embodiments of the inner component 26 can have an inner surface that includes an arc equal to or somewhat greater than 180 degrees. In such a case, a rod having substantially the same diameter as such an internal surface can form a snap or interference fit with such an internal surface. Needless to say, rods with a much smaller diameter than such an inner surface will fit without interference.

  The column portion 64 extends from one end of the seating portion 63. In the embodiment shown here, the column portion 64 and the seating portion 63 are substantially in the same plane. The post portion 64 is a substantially rectangular cross-section with two substantially smooth side surfaces 72 and substantially smooth curved top and bottom surfaces 74. A groove 76 is provided in at least one of the surfaces 72 or 74 of the post portion 64, and in one particular embodiment, the plane containing the groove 76 intersects the post portion 64 substantially perpendicularly.

  The inner part 26 is in the cavity 56 of the receiving part 24 such that the column part 64 is in the region 60 of the cavity 56 and the seating part 63 is at least partly in the region 58 of the cavity 56. Inserted. When this insertion is complete, the inner part 26 can rotate around the post portion 64 relative to the receiving portion 24. The seating portion 63 rotates in a plane generally determined by the placement of the screw 20. For example, when the screw 20 is attached to a vertebra, the internal component 26 can rotate so that the seating portion is generally in the sagittal plane. As another example, when the screw 20 is used with a side connector so that the screw 20 is about 90 degrees left or right from the rod or spinal column, the internal component 26 has the seating portion generally in the coronal plane. Can be rotated. In one embodiment in which the region 58 of the cavity 56 is substantially cylindrical, the inner component 26 may be in the receiving portion 24 as long as the seating portion 63 does not interfere with the upper leg 40 or other portions of the receiving portion 24. On the other hand, it can rotate in a perfect circle. In one embodiment where the region 58 of the cavity 56 is constricted, the side of the hourglass portion of the cavity 56 is the surface after the internal component 26 and the receiving portion 24 have been rotated through a specific angle relative to each other. Since one or both of 72 are engaged, the amount of possible rotation of internal component 26 relative to receiving portion 24 is limited. The curved surface 74 of the column portion 64 does not interfere with the similarly curved boundary of the hourglass portion of the cavity 56.

  To place the rod in the receiving part 24 adjacent to the inner part 26 and hold the inner part 26 in the receiving part 24 while allowing the aforementioned relative rotation before locking the screw 20 to such a rod. An annular clip 80 can be provided. The clip 80 is a substantially circular C-shaped member having an inner diameter 82, an outer diameter 84, and a gap 86. In other embodiments, a similar clip 80 'with a gap 86' can include an internal extension 88 '. The clip 80 can be elastically deformable by widening or narrowing the gap 86 to a greater extent than is present in the normal unloaded state of the clip 80. When the internal part 26 is inserted into the receiving part 24, the clip 80 is placed around the post part 64 of the internal part 26. In one embodiment, the clip 80 is positioned such that at least a portion of the clip 80, eg, the inner diameter 82, and possibly more, is in the groove 76 of the post portion 64. The clip 80 ′ can be placed such that at least a portion, for example, some or all of the extension 88 ′ is in the groove 76. When the clip 80 is around the post portion 64, the post portion 64 cannot be withdrawn from the cavity 56 of the receiving portion 24 due to interference between the clip 80 and the rim or flange 61. Clip 80 does not interfere with the rotational movement of internal component 26 relative to receiving portion 24. Alternatively, other methods of holding the internal component 26 at the receiving portion 24 can be used, such as peening the column portion 62 within the cavity 56. As with clip 80, it is preferred, but not necessarily, that such alternative methods allow internal component 26 to rotate relative to receiving portion 24 prior to final locking of screw 20.

  Set screw 48 includes a male thread adapted to engage screw hole 46. In one embodiment, the set screw 48 includes an imprint (imprint) 89 adapted to engage a tool that tightens and / or loosens the set screw 48 in or on the top surface. . The imprint 89 may be internal, such as a hexagonal or hexalobed opening, or external, such as a hexagonal head. It can be seen that internal printing may be preferred because there is no addition to the overall height or profile of the screw 20 or a smaller addition. Set screw 48 may further include a curved, pointed, conical, or other surface 49 at the bottom. Such a surface engages the rod within the receiving portion 24, which will be described further below. The set screw 48 can be placed at least partially within the screw hole 46 such that the set screw 48 does not extend into the passage 52 at all, or a very small amount of the set screw 48 extends into the passage 52. Alternatively, the set screw can be left in the hole 46 until the rod is inserted into the receiving portion 24, and then inserted into the hole 46 and applied to the rod, as further described below.

  In addition to the features of the previous embodiments, the receiving portion 24 can further include one or more indentations 90 that receive a gripping or positioning tool. The indentation 90 is shown on both sides of the receiving portion 24 in one embodiment, in the region within the upper leg 40 and the intermediate portion 44, or in the region adjacent to the upper leg 40 and the intermediate portion 44. It can be seen that the recess 90 can be in any part of the receiving part 24. The indentation 90 of the embodiment shown here has an inlet portion 92 and a retaining portion 94. The retaining portion 94 has a rounded or somewhat circular portion 96 with corners 98. Holding with one or more rounded or circular protrusions at or adjacent to the end (s) of a holding or gripping tool (not shown) Or a gripping tool can be used. Such protrusion (s) are inserted at the inlet portion (s) 92 and are curved, angled or hooked around the corner portion 98 to form a circular portion. 96 can be reached. As such, such tools can be used to hold, position, manipulate, or otherwise act on or act on the screw 20.

  In use, a surgeon initially begins with open, minimally invasive, or other techniques on the skin and subcutaneous tissue, for example, to gain access to the desired surgical site, as is generally known in the art. Prepare the surgical site by making an incision. In this description, spinal surgery is described as a primary example of the use of the above-described embodiments. After the vertebra is accessible, the surgeon prepares a hole in the vertebra. A screw 20 is then introduced into the surgical site and screwed or otherwise inserted into the vertebral hole. A retention tool (not shown) with a protrusion connected to the screw 20 through the recess 90 can be used to hold the screw 20 and begin or fully insert the screw 20 into the vertebral hole. It can be seen that if the shaft 22 is self-tapping, it is not necessary to tap holes in the vertebrae or otherwise thread the vertebral holes. If a hook or other implant is used rather than a screw, the shaft 22 (in the form of a hook blade or other structure) engages it around a pedicle, process or other vertebra, or other It will be connected to the vertebrae, such as by contact with the method.

  When the anchor 20 is coupled to the bone, the rod can be moved to the surgical site, contoured as desired, and then inserted through the mouth 54 into the passage 52 of the receiving portion 24. The rod is placed in the receiving part 24 until it is adjacent to or contacts the seating part 63 of the inner part 26. The rod can be pressed against the surface 68 of the inner part 26, which provides a cam action that pushes the seating portion 63 of the inner part 26 relatively downward so that the rod is adjacent to the inner surface 66 of the seating portion 63. It will be. In that position, the rod and internal component 26 are rotatable in a plane that is substantially relative to the receiving portion 24, eg, substantially in the sagittal plane relative to the spinal column. Such rotation is substantially about the axis of the column portion 64 of the internal component 26. After the rod and internal component 26 are in the desired position relative to the receiving portion 24, a set screw 48 is screwed down through the upper leg 40 of the receiving portion 24 and contacts the rod. The screw 48 presses the rod against the seating portion 63 of the inner part 26, pressing the outer surface 67 of the inner part 26 against the lower leg 42 of the receiving part 24, for example against one or more ridges 62. In one embodiment where the set screw 48 has a curved or conical bottom surface 49, such a bottom surface 49 pushes the rod in a direction substantially toward the intermediate portion 44 and / or the lower leg 42 of the receiving portion 24. There is a tendency. In one embodiment where the set screw 48 has a pointed bottom surface 49, such point (s) can bite into the rod. The rod is now locked to the inner part 26 and the receiving part 24, and the inner part 26 is locked to the receiving part 24.

  Additional screws 20 can be placed in adjacent or relatively distant bone tissue so as to connect to the same or additional rods. In addition, other components such as alternative screw or hook devices, clamps, connectors, similar devices, etc., in combination with such rod (s) and such bone tissue (s) Can be detained. Bone morphogenetic protein (BMP), demineralized bone matrix (DBM), bone, as desired by the surgeon or as required by a given trauma or other physical condition Bone growth materials, such as implants, other materials, may again be used in conjunction with portions of the aforementioned structure to treat or correct the patient's physical condition.

  The material for the set screw 48, the internal part 26, the ridge 62, and / or the rod can be selected such that some deformation or penetration relative to each other can occur between the parts. For example, if the set screw 48 is provided with one or more tips or edges on the bottom surface (eg, a curved or conical surface 49), the set screw 48 may be tightened to lock the rod within the receiving portion 24. Such a tip or edge (or the entire material of the set screw 48) can be made of a material harder than the rod so that the set screw 48 bites into the rod as it is being done. As another example, if the internal component 26 is made of a softer material than the raised portion 62 of the receiving portion 24, the raised portion 62 may bite into the outer surface 67 of the internal component 26 when locking the structure. it can.

  While the invention has been shown and described in detail in the drawings and the foregoing description, they are to be considered as illustrative rather than restrictive in character, and only preferred embodiments have been shown and described. It will be understood that only protection of all changes and modifications included in the spirit of the invention is desired.

  For example, certain embodiments of the screw 20 can be sized for placement at any height of the spinal column. It will be appreciated that the relative sizes of the components of the assembly are modified for the particular vertebra (s) to be mounted. For example, components for lumbar or sacral placement can be relatively larger than for cervical placement. Similarly, the relative dimensions of the column portion 64 of the internal part 26 and the region 60 of the cavity 56 and / or the relative dimensions of the rod and the receiving portion 24 may be greater or greater than the rod relative to the receiving portion 24. It can be selected to allow a small degree of angle formation.

  The aforementioned components may be formed from stainless steel and may be formed from other biocompatible materials such as titanium, certain plastics or ceramics, materials that allow bone growth.

  Furthermore, although the embodiments discussed above relate to bone screws, other bone fixation members can be adapted to implement the features disclosed herein. For example, as described above, the shaft 22 can be a vertebral hook blade rather than a threaded element.

  Also, although preferred embodiments of the present invention engage bone screws with rods, it is understood that various longitudinal members are contemplated. For example, an elongate bar can be placed in the passage of the receiving portion so as to be clamped between the internal part 26 and the set screw 48. Such a rod or longitudinal member can be part of a side connector or other component used in orthopedics. The invention can equally well be applied to smooth rods or bars, or longitudinal members having various surface features such as notches and threads.

  The entire disclosure of the US patent application entitled “SIDE LOADING BONE ANCHOR”, filed Dec. 1, 2004, is hereby incorporated by reference.

1 is a side view of one embodiment of a side-mounted sagittal adjustable bone anchor. FIG. FIG. 2 is a side view of the embodiment shown in FIG. 1 rotated 90 degrees relative to FIG. FIG. 2 is a side view of the embodiment shown in FIG. 1 rotated 180 degrees relative to FIG. 4 is a cross-sectional view of the embodiment shown in FIG. 1 taken in the direction of the arrows along line 4-4 of FIG. FIG. 2 is a side view of a portion of the embodiment shown in FIG. FIG. 6 is a side view of the portion shown in FIG. 5 rotated 90 degrees with respect to FIG. 5. It is sectional drawing seen in the direction of the arrow along line 7-7 of FIG. FIG. 6 is a side view of the portion shown in FIG. 5 rotated 180 degrees with respect to FIG. 5. It is sectional drawing seen in the direction of the arrow along line 9-9 of FIG. FIG. 2 is a top view of one embodiment of internal components that can be used with the apparatus shown in FIG. 1. FIG. 11 is a side view of the embodiment shown in FIG. 10. FIG. 11 is a rear view of the embodiment shown in FIG. 10. It is a front view of embodiment shown by FIG. FIG. 2 is a top view of one embodiment of a clip that can be used with the apparatus shown in FIG. 1. FIG. 15 is a side view of the embodiment shown in FIG. 14. FIG. 6 is a top view of another embodiment of a clip that can be used with the apparatus shown in FIG. 1.

Claims (19)

A device for attachment to vertebrae and spinal rods,
A bone anchor portion having a threaded shaft with a longitudinal axis and a neck, the threaded shaft having a longitudinal axis and a cancellous bone thread suitable for connection to a vertebra; A bone anchor part,
A substantially C-shaped receiving portion, the receiving portion having a lower leg, an upper leg, and an intermediate portion integrally connected to the neck portion of the bone anchor portion; The receiving portion has a passage substantially perpendicular to the axis within which the rod can be inserted into the passage, the receiving portion extending through the upper leg. Further comprising an internal screw hole, wherein the receiving portion further includes an opening in the lower leg and the intermediate portion, the receiving portion being adapted to correspond to a holding tool A receiving portion further comprising one external imprint;
An internal component coupled to the receiving portion, such that at least a portion of the internal component is within the opening of the receiving portion, and the internal component is within the intermediate portion of the receiving portion. The inner part has a seating part having a first end and a second end, wherein the first end of the seating part is the said part of the inner part; Attached to a column portion, the second end has a flat portion, the seating portion has a substantially cylindrical inner surface, and the inner surface has an arc of up to about 120 degrees. An internal part, wherein the leg has a groove;
An annular member that surrounds at least a portion of the leg of the internal component such that at least a portion of the annular member is in the groove and the internal component and the receiving portion rotate relative to each other; The annular member is positioned so that the annular member is positioned and the legs of the internal part and the annular member cannot be withdrawn from the opening of the receiving portion as possible. And an annular member.   The apparatus of claim 1, wherein the opening of the receiving portion comprises a portion having a substantially constricted shape.   The apparatus of claim 1, wherein the receiving portion includes at least one ridge adjacent to the opening of the receiving portion and adjacent to the seating portion of the internal component.   The apparatus of claim 1, wherein the receiving portion forms a tapered path from the mouth toward the intermediate portion.   The external imprint of the receiving portion includes at least one recess for receiving a tool portion, the recess having an inlet portion, a holding portion with a substantially circular portion, the holding portion and the inlet The apparatus of claim 1, further comprising: a corner between the parts, whereby a tool part can be inserted through the inlet part in one direction and reach the holding part in another direction. .   An elongate member is in the passage and is adjacent to the seating portion of the internal part, and the device further includes a set screw threaded into the upper leg and contacting the rod; The apparatus of claim 1, whereby the rod, the internal component, and the receiving portion are locked together. A side-mounted bone anchor device,
A substantially C-shaped receiving portion, the receiving portion having a lower leg, an upper leg, and an intermediate portion, wherein the receiving portion is the upper leg and the lower leg. A receiving passage between the portions, the passage substantially perpendicular to the intermediate portion, the receiving portion further comprising a recess in the lower leg, and a hole in the intermediate portion; Part,
A bone anchor portion comprising a longitudinal axis coupled to the lower leg of the receiving portion, the axis being substantially parallel to the intermediate portion;
An internal part including a column part and a seating part, wherein the arm part is substantially straight, the seating part has a substantially cylindrical inner surface, and the seating part comprises a first part; And the second end, the first end of the seating portion is attached to the column portion, and the second end is parallel to the column portion. The column part of the inner part is in the hole and does not extend beyond the intermediate part, and the seating part is a recess in the receiving part. An internal part, wherein the internal part is rotatable about the post part with respect to the receiving part; and
A set screw coupled to the receiving portion;
Thereby, the set screw and the seating portion of the internal part are adapted to contact an elongate member positioned in the passage to connect the elongate member, the seating portion, and the receiving portion. , Device locked against each other.   The apparatus of claim 7, wherein the receiving portion includes at least one ridge adjacent to the recess, the ridge adapted to contact the internal component.   9. The device of claim 8, wherein the ridge deforms the internal component when the device is locked.   The seating of the inner part as the rod contacts the flat surface when the flat surface of the inner part is angled so that the rod is side mounted to the receiving member. The apparatus of claim 7, wherein a portion is pushed toward the recess.   The apparatus of claim 7, wherein the flat surface of the inner part and the inner surface of the inner part meet at a ridge substantially perpendicular to the column portion.   The apparatus of claim 7, wherein the hole has at least a waist-shaped portion.   The apparatus of claim 12, wherein the waisted portion of the hole has curved upper and lower surfaces.   The apparatus of claim 7, wherein the post portion includes substantially smooth sides and substantially smooth and curved top and bottom surfaces.   The column portion includes a groove, the receiving portion includes a rim surrounding at least a portion of the hole, and the device is at least partially within the groove and includes a clip member adjacent to the rim; The apparatus of claim 7 further comprising:   A spinal rod is in the passage and adjacent to the seating portion of the internal part, the device further includes a set screw threaded into the upper leg and contacting the rod; The device according to claim 7, wherein the rod, the internal part and the receiving part are locked together.   The apparatus of claim 7, wherein the upper leg has a back surface that is non-perpendicular to the middle portion.   The apparatus of claim 7, wherein the passage tapers toward the intermediate portion.   The apparatus of claim 18, wherein the flat surface of the internal part defines a portion of the tapered passage.

Images