JP2018510663A - Spacer with temporary fixing plate - Google Patents

Abstract

One system for spinal fusion includes one spacer, one plate, one attachment member, and one first temporary fixation screw. The spacer includes a first coupling opening, and the first coupling opening is provided with a first thread having a thread pitch that is greater than or equal to one third of the depth of the opening. Yes. The plate includes a first mounting opening and a second coupling opening. The mounting member includes one mating thread that engages the first thread. The mounting member is shaped to couple the spacer and the plate when it is inserted through the second coupling opening and rotated to engage the first thread of the first coupling opening. . The first temporary fixation screw is shaped to attach the plate to the first vertebra as it is inserted through the first attachment opening and advanced toward the first vertebra. [Selection] Figure 1

Description

Cross-reference of related applications

  This application is filed on Feb. 27, 2014, which is hereby incorporated by reference in its entirety, as “Systems and Methods for Insertion of Spinal Implants”. And claims priority to US Provisional Patent Application No. 61 / 945,314. This application was also filed on Feb. 17, 2015, which is hereby incorporated by reference in its entirety, and entitled “Lateral Space with Temporary Fixation Plate”. It claims the priority of US Provisional Patent Application No. 62 / 117,384.

  The present invention relates generally to the field of spinal surgery, and more particularly to an interbody spacer with a temporary fixation plate.

  The spine is a flexible column formed from a plurality of bones called vertebrae. The vertebrae are hollow and stacked, forming one strong hollow column to support the skull and trunk. The hollow core of the spine houses and protects the spinal nerves. Different vertebrae are connected to each other by articular processes and intervertebral fibrocartilage bodies. Various spinal disorders can cause spinal misalignment, curvature, and / or twisting, or can result in vertebral fracture and / or collapsed vertebrae. Often it is necessary to surgically correct these spinal disorders.

  The spine consists of seven cervical (neck) vertebrae, twelve thoracic (thoracic) vertebrae, five lumbar (lower dorsal) vertebrae, and a fused vertebrae in the sacrum and tailbone to help form the hip joint. Including. While the shape of the individual vertebrae differ from each other in these regions, each is essentially a short hollow shaft that houses a bundle of nerves known as the spinal cord. Individual nerves, such as those that transmit signals to the arms and legs, enter and exit the spinal cord through the gaps between the vertebrae.

  The intervertebral disc acts as a shock absorber, softens the impact on the vertebrae, and prevents the individual bones from contacting each other. The intervertebral disc also helps keep multiple vertebrae in place. The weight of the upper body is transmitted to the hip joint and leg through the spine. The spine is kept upright by the action of the back muscles connected to the vertebrae. The normal spine has no side bays, but has a series of curves from front to back, making it a gentle “S-shape”. If there is no suitable shape and / or curvature due to scoliosis, neuromuscular disease, cerebral palsy, or other disease, it may be necessary to straighten or adjust the spine to achieve the proper curvature.

  In general, curvature correction is accomplished by placing the vertebrae in their proper positions and performing operations to ensure their position using a robust system of screws, rods, intervertebral spacers, and / or plates. . The various components of the system can be surgically inserted via open surgery or minimally invasive surgery. The components can also be inserted into the spine via a variety of approaches including an anterior approach, a lateral approach, and a posterior approach, as well as other intermediate approaches.

  The spinal fixation system can be used in surgery to align, adjust, and / or fix the position of the spinal column, ie, the vertebrae, in a desired spatial relationship relative to each other. Many spinal fixation systems employ a single spinal rod to support the spine and to properly position the spinal elements for various therapeutic purposes. Vertebral anchors, including pins, bolts, screws, and hooks, bite vertebrae and connect support rods to different vertebrae. The size, length, and shape of the cylindrical rod depend on the size, number, and position of the vertebrae that are held by the device under the desired spatial relationship relative to each other.

  In lateral spine surgery, the patient can first be placed sideways. One spacer / cage / vertebral body can be inserted into the disc space between adjacent vertebrae after removing part or all of the disc. The patient must then rotate toward the back or anterior, thereby loading additional fixation structures such as screws, rods and / or plates. However, the spacer may move forward or backward while the patient is rotating. This movement can destroy adjacent tissues such as vasculature and nervous system parts. The damage caused by such movement is a threat to patient recovery and can cause paralysis, severe blood loss, or even other irreversible damage. Thus, the present invention includes one or more features that allow temporary fixation of the spacer while the patient is rotated toward the position for attachment of the fixation structure.

  The spinal fusion system includes one spacer, one plate, one attachment member, and one first temporary fixation screw. The spacer includes a first coupling opening, which is provided with a first thread having a thread pitch that is greater than or equal to one third of its depth. The plate includes a first mounting opening and a second coupling opening. The mounting member includes a mating thread that mates with the first thread. The mounting member is configured to couple the spacer and the plate when the mounting member is inserted through the second coupling opening and rotated to engage the first thread of the first coupling opening. Yes. The first temporary fixation screw is configured to attach the plate to the first vertebra as the first temporary fixation screw is inserted through the first attachment opening and advanced into the first vertebra.

  Another feature is that the thread pitch is greater than or equal to the depth of the first coupling opening of the spacer. Yet another feature is that the thread pitch is greater than or equal to twice the depth of the first coupling opening of the spacer.

  Another feature is that the first component opening includes a second thread having a second thread pitch equal to the first thread pitch.

  Another feature is that the first thread includes a trapezoidal thread with a long lead.

  Yet another feature is to bite the first coupling opening with less than one full thread of the first thread in one-half turn of the mounting member to couple the spacer with the plate.

  Yet another feature is that the plate includes a pair of fork-shaped protrusions extending distally for mating with the pair of recessed portions of the spacer. The spacer further includes a distal end for insertion between the two vertebrae, an intermediate portion having a pair of recessed portions on the outer surface of the intermediate portion, and a coupling opening. One proximal end.

  Another feature is that the plate includes a second mounting opening. The system further includes a second temporary fixation screw that attaches the plate to the second vertebra when the second temporary fixation screw is inserted through the second attachment opening and advanced into the second vertebra. It is configured as follows.

FIG. 1 is an isometric view of one exemplary implant based on the basic properties of the present disclosure. FIG. 2 is an isometric view of the implant of FIG. 1 viewed from the opposite direction to FIG. FIG. 3 is a side view of the implant illustrated in FIG. FIG. 4 is a top view of the implant illustrated in FIG. FIG. 5 is an exploded view of the implant of FIG. FIG. 6 is an exploded view of the implant of FIG. FIG. 7 is a side view of the implant plate of FIG. 1 as viewed in detail. 8 is a cross-sectional view of the implant of FIG. 7 as viewed in detail along the plane A. FIG. FIG. 9 is an isometric view of another exemplary implant based on the basic properties of the present disclosure. FIG. 10 is an isometric view of the implant of FIG. 9 viewed from the opposite direction to FIG. FIG. 11 illustrates one attachment member of one typical implant based on the basic nature of the present disclosure. FIG. 12 illustrates one attachment member of one typical implant based on the basic nature of the present disclosure. FIG. 13 is a bottom view of the mounting member. 14 is a cross-sectional view in the plane B of the attachment member of FIG.

  Embodiments of the present invention will now be described with reference to the accompanying figures, wherein numerals indicate similar elements throughout the description. The terminology used in the description herein is not intended to be construed as any limiting or limiting means, as it is merely used in conjunction with a detailed description of a particular embodiment of the present invention. It is because it is only done. In addition, embodiments of the present invention may include several novel features, none of which is associated with the desired feature, only one of which, or is described herein. It is not essential to the practice of the present invention. The terms proximal and distal are here applied to indicate specific ends of the elements of the instrument described herein. The proximal end refers to the end of one instrument that is closer to the operator of the instrument when the instrument is used. The distal end refers to the end of one instrument that is further away from the operator and extends toward the surgical area of the patient and / or implant.

  The above-described features and other features and advantages of the present invention can be easily understood by reading the detailed description of the embodiments based on the following experiments and the accompanying drawings. The detailed description of the invention and the accompanying drawings do not limit the scope of the claims defined by the appended claims and their equivalents, but merely serve to explain the present invention.

  Referring to FIGS. 1-8, one exemplary implant 100 can be seen to include one spacer 102, one plate 104, one or more temporary fixation screws 106, and one attachment member 108. . The spacer 102 may be configured for insertion through the outer surface of the spine into the intervertebral space between two adjacent vertebrae. The spacer 102 may include various indentations and openings for receiving the mating features of the plate 104 and the mounting member 108. A fixation screw 106 can be used to attach the plate 104 to two adjacent vertebrae.

  During a lateral spinal fusion procedure, the spacer 102 can be initially inserted through a single opening in the side of the patient. For example, in lumbar lateral interbody fusion [LLIF], the patient can be placed sideways while providing an opening in the spine from the abdominal side. The spacer 102 can be compressed between the vertebrae while applying some amount of force to limit the movement of the spacer 102. However, it is typically recommended that the spacer 102 be held in place by applying additional compressive force by a locking mechanism such as a rod, screw, and plate. In order to insert the fixation mechanism, the patient must be rotated from the side to the prone or supine position.

  During rotation, the spacer 102 may be displaced and move backward toward the patient's spinal cord or move forward toward the patient's vasculature. Accordingly, the plate 104 can be attached to the spacer 102 and the two adjacent vertebrae using temporary fixation screws 106 and attachment members 108. Fixing screw 106 may include a thread for engagement.

  The spacer 102 includes one upper surface 110 and one lower surface 112 for interlocking with two adjacent vertebrae. Both surfaces 110 and 112 may include teeth 114 or folds to resist lateral movement of the implant 100. At the distal end of the spacer 102, a bullet nose 116 may facilitate insertion of the spacer 102 into the intervertebral space. The spacer 102 includes a front wall 118 and a back wall 120 joined by a proximal side wall 122 and a distal side wall 124. One intermediate wall 126 may extend from the front wall 118 toward the rear wall 120, thereby providing additional reinforcement to the spacer 102. The spacer 102 further includes a recess 128 that extends through a portion of the proximal side wall 122 and into the front wall 118 and the rear wall 120. The indentation 128 may include a contour that is shaped to accept a protrusion of the insertion tool or a protrusion 130 that extends from the plate 104. Proximal side wall 122 also includes a first coupling opening 132 that is shaped to receive attachment member 108.

  The plate 104 includes an opening 134 that is shaped to accept the temporary fixation screw 106. The opening 134 may include a diameter that is smaller than the diameter of the head of the screw 106. The plate 104 includes a protrusion 130 extending distally from the plate 104 for mating with the recess 128 of the spacer 102. The plate 104 includes one mounting opening 136 that is shaped to receive the mounting member 108. The mounting opening 136 includes a diameter that is smaller than the diameter of the head of the mounting member 108.

  The attachment member 108 may include a thread 138 for engaging the mating thread 140 of the spacer 102. The aforementioned coupling mechanism for the plate and spacer is typically less than the depth D of the threaded opening in the spacer, sometimes on the order of at least 3 times, and typically Includes threads with a thread pitch TP on the order of six times, i.e. at least six peaks of the screw mesh with the spacer. Thus, the thread pitch is at least D / 3, or more typically on the order of D / 6.

  Referring to FIGS. 11-14, it can be seen that the thread 138 of the mounting member 108 can include a TP that is larger than the thread pitch described above. For example, the thread 138 can include a TP that is one third or more of the depth D of the first coupling opening 132 in the proximal wall 122 of the spacer 102. The thread 138 allows the spacer 102 to be securely coupled to the plate 104 with less than one full thread of the thread 138 by a half rotation of the mounting member 108.

  In some embodiments, the thread 138 includes a single thread with a long lead (pitch) trapezoidal shape as seen in the cross-sectional view of FIG. In some embodiments, thread 138 includes an improved acme screw. In some embodiments, the threads include a first thread 138a and a second thread 138b having two separate leads that form a two-lead two-thread. In some embodiments, the thread 138 is greater than or equal to approximately twice D, with 2 leads and D being the depth of the first coupling opening 132 of the spacer 102 (or the thickness of the proximal wall 122). Including substantially steep thread pitch. In some embodiments, the threads 138 allow a secure connection between the spacer 102 and the plate 104 by a 180 degree rotation of the mounting member 108.

  FIGS. 9-10 illustrate another exemplary implant 200 that includes the same or similar features as the first implant 100. However, the implant 200 is provided with one single temporary fixing screw 106. Otherwise, the same features described above with reference to the implant 100 exist.

  Embodiments of the method and system according to the present invention have been described herein. As noted in other paragraphs, these embodiments are described for illustrative purposes only and are not intended to be limiting. Other embodiments are possible and are encompassed by the present invention. Such embodiments will be readily apparent to one of ordinary skill in the relevant arts having the usual capabilities based on the teachings contained herein. Accordingly, the breadth and scope of the present invention should not be limited by any of the above-described embodiments, but should be defined in accordance with the claims set forth below and their equivalents.

  Although the present invention has been described in connection with various embodiments, it will be understood that the present invention may be further modified. This application is intended to cover generally any variation, use, or application of the invention based on the principles of the invention, and is known and practiced in the fields related to the invention. Developments from the present invention within the scope of are also intended to be included.

Claims (10)

A spinal fusion system, the spinal fusion system comprising:
A spacer including a first coupling opening, the first coupling opening having a thread pitch greater than or equal to one-third of the depth of the first coupling opening. A spacer including two first threads;
A plate comprising a first mounting opening and a second coupling opening;
A mounting member including a mating thread that fits the first thread, the mounting member being inserted through the second coupling opening, and the first A mounting member shaped to couple the spacer and the plate when rotated to engage the first thread of the coupling opening; and a first temporary fixing screw. The first temporary fixation screw is inserted through the first attachment opening and is shaped to attach the plate to the first vertebra as it travels through one first vertebra. 1 temporary fixing screw,
System for spinal fusion.   The spinal fusion system of claim 1, wherein the thread pitch is greater than or equal to a depth of the first coupling opening of the spacer.   The spinal fusion system of claim 1, wherein the thread pitch is greater than or equal to twice the depth of the first coupling opening of the spacer.   The spinal fusion device of claim 1, further comprising a second thread in the first coupling opening, the second thread including a second thread pitch equal to the first thread pitch. system.   The spinal fusion system of claim 1, wherein the first thread includes one long lead trapezoidal thread.   The spine of claim 1, wherein the spine engages less than one full thread of the first thread of the first coupling opening when the mounting member is rotated one-half turn to couple the spacer to the plate. Fixation system.   The spinal fusion system of claim 1, wherein the plate includes a pair of protrusions that are fork-shaped and extend distally to engage with the pair of recesses in the spacer. The spacer is
A distal end for insertion between the two vertebrae;
An intermediate portion comprising a pair of indentations on one outer surface of the intermediate portion;
A proximal end including the coupling opening;
The spinal fusion system of claim 1, further comprising:   The spinal fusion system of claim 1, further comprising a second attachment opening in the plate.   A second temporary fixation screw, the second temporary fixation screw being inserted through the second attachment opening and moving toward the second vertebra when the plate is moved through the second The spinal fusion system of claim 9, further comprising a second temporary fixation screw configured to attach to the vertebra.

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