US20190279532A1 - Growing Spine Model - Google Patents
Growing Spine Model Download PDFInfo
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- US20190279532A1 US20190279532A1 US16/242,446 US201916242446A US2019279532A1 US 20190279532 A1 US20190279532 A1 US 20190279532A1 US 201916242446 A US201916242446 A US 201916242446A US 2019279532 A1 US2019279532 A1 US 2019279532A1
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- segment
- spinal construct
- hollow member
- end member
- shape
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- G—PHYSICS
- G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
- G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
- G09B23/00—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes
- G09B23/28—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine
- G09B23/30—Anatomical models
- G09B23/32—Anatomical models with moving parts
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- G—PHYSICS
- G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
- G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
- G09B23/00—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes
- G09B23/28—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine
- G09B23/30—Anatomical models
- G09B23/34—Anatomical models with removable parts
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- G—PHYSICS
- G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
- G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
- G09B23/00—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes
-
- G—PHYSICS
- G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
- G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
- G09B23/00—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes
- G09B23/28—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine
- G09B23/30—Anatomical models
Definitions
- the present disclosure relates to orthopedic surgical devices for stabilizing and fixing the bones and joints of a body.
- the present disclosure relates to a growing spine model that simulates the effects of expanding vertebral bodies apart and the three dimensional impact on a spinal column.
- the spinal column is a complex system of bones and connective tissues that provide support for the human body and protection for the spinal cord and nerves.
- the human spine is comprised of thirty-three vertebrae at birth and twenty-four as a mature adult. Between each pair of vertebrae is an intervertebral disc, which maintains the space between adjacent vertebrae and acts as a cushion under compressive, bending, and rotational loads and motions.
- the problems may include, but are not limited to, scoliosis, kyphosis, excessive lordosis, spondylolisthesis, slipped or ruptured disc, degenerative disc disease, vertebral body fracture, and tumors. Persons suffering from any of the above conditions typically experience extreme and/or debilitating pain, and often times diminished nerve function.
- orthopedic surgeons receive training in the use of orthopedic devices and the performance of surgical methods to correct vertebral column injuries and diseases by the application of methods and devices on cadavers.
- the amount of training for each surgeon is limited by the expense, availability, scheduling, and other logistic requirements associated with the use of cadavers.
- spine surgeons when planning for a surgical procedure on a specific patient, are normally limited to a study of two-dimensional radiographic data and a complete lack of hands-on manipulation rehearsal of a method prior to operating on a patient.
- Software based tools for orthopedic image review, analysis, and preoperative planning are becoming conventional tools of the orthopedic surgeon. While advances in surgical planning have been made, they are simply limited to improvements in providing two-dimensional data for study and planning. To receive hands-on training or to rehearse a surgical method, a surgeon is still limited to the use of cadavers.
- biomechanical behavior and particularly soft tissue forces on the spinal column when applying methods and devices to a cadaver are far different from that which are normally experienced in a surgical procedure on a living patient.
- the present disclosure is directed to a three-dimensional modeling system for hands-on training and/or surgical rehearsal of surgical methods, devices, and instruments that provides a clinician with an anatomically and biomechanically realistic model of a spine in a non-surgical environment.
- the system includes a spine movement device that interacts with a spine model so as to configure the spine in a desired alignment, with selected degrees of force vectors biasing the spine in selected positions to provide a modeling system that can be used as a surgeon training device or as a spinal surgery rehearsal platform.
- the spine movement device of the system of the present disclosure may be used with any of a variety of spine models that can be selected by size and conformation to simulate, for example, pediatric, adult, and geriatric spinal columns.
- the system can be prepared to simulate the anatomy and biomechanics of a patient such that a three-dimensional hands-on surgery rehearsal platform is provided.
- the system of the present disclosure is useful for simulating common deformities such as scoliosis, kyphosis, sagittal imbalance, and other spinal abnormalities.
- manual rehearsal of planned methods in the treatment of spinal deformities and conditions may provide a faster, more effective, and safer surgical correction for a patient.
- the system of the present disclosure can simulate a spine as it is growing, simulating the growth of vertebral bodies and discs.
- a spinal surgery modeling system includes a spine model including vertebral bodies defining disc spaces between adjacent vertebral bodies, and a spine movement device.
- the spine movement device includes a plurality of cylinders, a plurality of pistons, and a plurality of inflation members.
- Each cylinder of the plurality of cylinders includes an elongate body defining a bore, and an inlet and an outlet.
- Each piston of the plurality of pistons includes an elongate body having a proximal end and a distal end, and the distal end of each piston extends into the inlet and frictionally engages the bore of one cylinder of the plurality of cylinders.
- Each inflation member of the plurality of inflation members is disposed within one of the disc spaces of the spine model and is fluidly coupled to the outlet of one cylinder of the plurality of cylinders.
- the plurality of pistons are movable with respect to the plurality of cylinders to hydraulically inflate or deflate the plurality of inflation members.
- the spine movement device may further includes a plurality of tubes.
- Each tube of the plurality of tubes may fluidly connect the outlet of one cylinder of the plurality of cylinders with one inflation member of the plurality of inflation members.
- the spine movement device may further include a back plate having plurality of openings extending therethrough, wherein each cylinder of the plurality of cylinders is positioned through one opening of the plurality of openings.
- the spine movement device further includes a front plate positioned in spaced relation relative to the back plate, and the proximal ends of the plurality of pistons are secured to the front plate.
- the front plate includes a plurality of recesses aligned with the plurality of openings of the back plate and mechanically engaged with the proximal ends of the plurality of pistons to lock the plurality of pistons to the front plate.
- the spine movement device may further include a linear actuating member having an elongated body extending through the front and back plates for moving the plurality of pistons proximally and distally with respect to the plurality of cylinders.
- the elongated body of the linear actuating member extends through central apertures defined in each of the front and back plates, and each opening of the plurality of openings of the front and back plates are disposed around the respective central aperture.
- the central aperture of the back plate is a threaded aperture that engages a threaded portion of the linear actuating member.
- the spine movement device further includes a rotatable handle secured to a proximal end of the linear actuating member.
- the spine movement device further includes an intermediate plate having plurality of opening extending therethrough that are aligned with the plurality of openings of the back plate, wherein the proximal end of each cylinder of the plurality of cylinders includes a catch positioned between the intermediate plate and the back plate.
- the spinal surgery modeling system may further include at least one spinal construct attached to the spine model.
- the at least one spinal construct includes a plurality of screws and an adjustable rod.
- the adjustable rod may include a center member and first and second end members. Each of the first and second end members may include a first segment slidably engagable with an interior surface of the center member, and a second segment including a connecting portion securable to at least one of the plurality of screws.
- the first segment of each of the first and second end members has an I-beam shape and the second segment of each of the first and second end members has a compound shape including an elongate round portion, an elongate head portion, and a neck portion connecting the elongate round portion with the elongate head portion.
- a method of simulating a spine includes: positioning an inflation member within a disc space between vertebral bodies of a spine model, the inflation member fluidly coupled to a cylinder of a spine movement device, the spine movement device including a piston having a distal end frictionally engaged with a bore of the cylinder; and moving the piston distally within the bore of the cylinder to displace a fluid disposed within the cylinder into the inflation member to expand the inflation member and increase a distance between the vertebral bodies.
- moving the piston distally includes rotating a handle secured to a linear actuating member of the spine movement device to impart linear motion to the piston.
- the method may further include moving the piston proximally within the bore of the cylinder to draw the fluid into the bore of the cylinder to deflate the inflation member and decrease the distance between the vertebral bodies.
- the method may further include implanting a spinal construct in the spine model.
- implanting the spinal construct includes securing an adjustable rod to the spine model with screws such that moving the piston distally exerts a force on the screws moving the screws away from each other and moving end members of the adjustable rod relative to a center member of the adjustable rod.
- a method of using an adjustable rod includes: implanting a first screw and a second screw in spaced relation relative to each other in vertebral bodies of a spine; and securing a first end member of an adjustable rod to the first screw and a second end member of the adjustable rod in the second screw, the first and second end members being in slidable engagement with a center member extending between the first and second screws.
- FIG. 1 is a front, perspective view of a spinal surgery modeling system in accordance with an embodiment of the present disclosure
- FIG. 2 is a back, perspective view of the spinal surgery modeling system of FIG. 1 ;
- FIG. 3 is a front, perspective view of a spine movement device of the spinal surgery modeling system of FIG. 1 ;
- FIG. 4 is a back, perspective view of the spine movement device of FIG. 3 ;
- FIG. 5 is an exploded view of the spine movement device of FIG. 3 ;
- FIG. 6A is a side view of the spine movement device of FIG. 3 in a first position
- FIG. 6B is a side view of the spine movement device of FIG. 3 in a second position
- FIG. 7A is a side view of the spinal surgery modeling system of FIG. 1 in a first position
- FIG. 7B is an enlarged view of a portion of a spine model of the spinal surgery modeling system, shown in the area of detail 7 B identified in FIG. 7A ;
- FIG. 8A is a front view of the spinal surgery modeling system of FIG. 7A ;
- FIG. 8B is an enlarged view of a portion of a spine model of the spinal surgery modeling system, shown in the area of detail 8 B identified in FIG. 8A ;
- FIG. 9A is a side view of the spinal surgery modeling system of FIG. 1 in a second position
- FIG. 9B is an enlarged view of a portion of a spine model of the spinal surgery modeling system, shown in the area of detail 9 B identified in FIG. 9A ;
- FIG. 10A is a front view of the spinal surgery modeling system of FIG. 9A ;
- FIG. 10B is an enlarged view of a portion of a spine model of the spinal surgery modeling system, shown in the area of detail 10 B identified in FIG. 10A ;
- FIG. 11A is a front, perspective view of a spinal construct of the spinal surgical modeling system of FIG. 1 ;
- FIG. 11B is an exploded view of the spinal construct of FIG. 11A ;
- FIG. 12A is a side view of a central member of the spinal construct of FIG. 11A ;
- FIG. 12B is a cross-sectional view of the central member of FIG. 12A , taken along line 12 B- 12 B of FIG. 12A ;
- FIG. 13A is a side view of an end member of the spinal construct of FIG. 11A ;
- FIG. 13B is a cross-sectional view of the end member of FIG. 13A , taken along line 13 B- 13 B of FIG. 13A ;
- FIG. 13C is a cross-sectional view of the end member of FIG. 13A , taken along line 13 C- 13 C of FIG. 13A ;
- FIG. 14A is a front, perspective view of a spinal construct for use with the spinal surgery modeling system of FIG. 1 in accordance with another embodiment of the present disclosure
- FIG. 14B is an exploded view of the spinal construct of FIG. 14A ;
- FIG. 15A is a side view of a central member of the spinal construct of FIG. 14A ;
- FIG. 15B is a cross-sectional view of the central member of FIG. 15A , taken along line 15 B- 15 B of FIG. 15A ;
- FIG. 16A is a perspective view of a polyaxial pedicle screw
- FIG. 16B is an exploded, perspective view of the polyaxial pedicle screw of FIG. 16A ;
- FIG. 16C is a perspective view of a set screw usable with the polyaxial pedicle screw of FIGS. 16A and 16B ;
- FIG. 17A is an end view of a spinal construct including a taper lock screw and an adjustable rod in accordance with another embodiment of the present disclosure
- FIG. 17B is a partial cross-sectional view of a portion of the taper lock screw of FIG. 17A shown in a partially locked position;
- FIG. 17C is an end, cross-sectional view of the taper lock screw of FIG. 17A in an unlocked position with the adjustable rod.
- the term “clinician” refers to a doctor, nurse, or other care provider and may include support personnel.
- proximal refers to the portion of a structure closer to a clinician, while the term “distal” refers to the portion of the same structure further from the clinician.
- cephalad indicates a direction toward a patient's head, whereas the term “caudad” indicates a direction toward a patient's feet.
- lateral indicates a direction toward a side of the body of a patient, i.e., away from the middle of the body of the patient, whereas the term “medial” refers to a position toward the middle of the body of a patient.
- anterior indicates a direction toward a patient's back
- anterior indicates a direction toward a patient's front
- terms such as front, rear, upper, lower, top, bottom, and similar directional terms are used simply for convenience of description and are not intended to limit the disclosure.
- a spinal surgery modeling system 10 includes a spine model 20 , a spine movement device 30 , and optionally, one or more spinal constructs, such an adjustable rod 60 and screws 70 .
- the spine model 20 and the spine movement device 30 may each be removably or fixedly attached to a base 12 , and the adjustable rod 60 and screw 70 may be affixed to the spine model 20 .
- the spine model 20 may be a cadaveric or synthetic anatomically and mechanically correct spine model of a pediatric, adult, or geriatric spine which may exhibit any of a variety of spine pathologies.
- the spine movement device 30 includes a main frame 32 including a back plate 34 having a proximal surface 34 a , a distal surface 34 b , a threaded central aperture 34 c , and a plurality of openings 34 d disposed around the central aperture 34 c .
- Cylinders 36 are positioned through the openings 34 d of the back plate 34 .
- Each cylinder 36 includes an elongated body 36 a defining a bore 36 b which may have a substantially consistent diameters along the length thereof, a proximal end 36 c including an inlet 36 d and a catch 36 e that engages the proximal surface 34 a of the back plate 34 , and a distal end 36 f including an outlet 36 g .
- the outlets 36 g of each cylinder 36 is fluidly connected to a tube or tubing 38 that is fluidly connected to an inflation member 40 , such as a balloon.
- An intermediate plate 42 includes a central aperture 42 a and a plurality of openings 42 b disposed around the central aperture 42 a that are sized and positioned to correspond with the openings 34 d of the back plate 34 .
- the intermediate plate 42 is placed adjacent to the proximal surface 34 a of the back plate 34 , with openings 42 b aligned with openings 34 d and the catch 36 e of each cylinder 36 positioned between the intermediate plate 42 and the back plate 34 .
- the intermediate plate 42 is secured to the back plate 34 with fixation members 44 , such as screws.
- Pistons 46 include an elongated body 46 a that may be the length of the elongated body 36 a of the cylinders 36 , a proximal end 46 b that is secured to a front plate 48 , and a distal end 46 c that is dimensioned to frictionally engage the bore 36 b of the cylinders 36 .
- the front plate 48 includes a proximal surface 48 a , a distal surface 48 b , and a central aperture 48 c extending through the proximal and distal surfaces 48 a , 48 b .
- the distal surface 48 b includes a plurality of recesses 48 d that are aligned with the openings 34 d of the back plate 34 and mechanically engage and lock the proximal end 46 b of the pistons 46 thereto.
- the front plate 48 is positioned in spaced relation with respect to the back plate 34 with the distal ends 46 c of the pistons 36 disposed within the bore 36 b of the cylinders 36 .
- a linear actuating member 50 such as a threaded screw, includes an elongated body 50 a having a proximal end 50 b and a distal end 50 c .
- the elongated body 50 a of the linear actuating member 50 is positioned through the central apertures 34 c , 42 a , and 48 c of the back, intermediate, and front plates 34 , 42 , and 48 , respectively.
- a handle 52 is secured to the proximal end 50 b of the linear actuating member 50 and a nut 54 is disposed on the distal end 50 c of the linear actuating member 50 adjacent the distal surface 34 b of the back plate 34 to secure the components of the device 30 together.
- Rotation of the handle 52 rotates the linear actuating member 50 , which in turn imparts linear motion to the linear actuating member 50 as linear actuating member 50 engages the threaded central aperture 34 c of the back plate 34 .
- the linear motion thereby causes the front plate 48 to move proximally or distally with respect to the back plate 34 , and in turn, causes the pistons 46 to move proximally or distally within the bores 36 b of the cylinders 36 .
- a fluid (not shown), such as a liquid or gas, is disposed within the bores 36 b of the cylinders 36 such that distal movement of the pistons 46 displaces the fluid and hydraulically inflates/expands the inflation members 40 , and proximal movement of the pistons 46 draws the fluid back into the bores 36 b of the cylinders 36 , hydraulically deflating the inflation members 40 .
- the amount of fluid contained within each of the cylinders 36 may be the same or different.
- each inflation member 40 is positioned within the disc space between each of the vertebral bodies 22 of the spine model 20 , as shown in FIGS. 7A-8B .
- a user rotates the handle 52 of the spine movement device 30 to drive the linear actuating member 50 distally thereby displacing fluid from the cylinders 36 into the inflation members 40 .
- expansion of the inflation members 40 increases the distance between the vertebral bodies 22 simulating, for example, growth of a spine.
- the vertebral bodies 22 of the spine model 20 are freely accessible to a user of the system 10 . Accordingly, various spinal constructs, such as a rod 60 and screws 70 , may be placed on the vertebral bodies 22 to allow the user to practice methods of placing such spinal constructs on a spine and/or to observe the interaction of the spinal constructs with a spine.
- various spinal constructs such as a rod 60 and screws 70 , may be placed on the vertebral bodies 22 to allow the user to practice methods of placing such spinal constructs on a spine and/or to observe the interaction of the spinal constructs with a spine.
- an adjustable rod 60 may include a center member 62 and end members 64 .
- Each end member 64 includes a first segment 64 a which slidably engages an interior surface 62 a of the center member 62 that includes a complementary geometry to that of the first segment 64 a .
- the interior surface 62 a of the center member 62 is shown as a continuous, closed square-shaped surface, it should be understood that the interior surface 62 a may have any shape suitable for slidably engaging end members 64 , such as tubular, ovular, elliptical, or rectangular, for example, among other shapes that are complementary to the shape of the first segment 64 a of the end members 64 .
- the interior surface 62 a ′ of a center member 62 ′ of an adjustable rod 60 ′ may be a semi-continuous surface, having, for example, a c-shaped profile, as shown in FIGS. 14A-15B .
- Each end member 64 also includes a second segment 64 b that includes a connecting portion 64 c that may be secured to a screw 70 .
- adjustable rod 60 may be used outside of the disclosed spine model 20 and used, in situ, as a standalone spinal implant.
- adjustable rod 60 may be configured as follows.
- Center member 62 may include one or more stops that function to control the expansion and/or contraction of the adjustable rod 60 .
- one end member 64 may be fixed relative to center member 60 , while the other end member 64 is slidable between a minimum amount of extension and a maximum amount of extension with respect to center member 62 .
- both end members 64 may be slidable with respect to center member 62 between a minimum amount of extension and a maximum amount of extension.
- one end member 64 may have a different range of travel as compared to the other end member 64 .
- one or both end members 64 may be free to expand and inhibited from contracting relative to center member 62 .
- Each end member 64 is shown having a combination configuration with a portion having an I-beam shape (e.g., first segment 64 a ) and a portion with a compound shape (e.g., second segment 64 b ).
- the compound shape includes an elongate round portion, an elongate head portion, and a neck portion connecting the elongate round portion with the elongate head portion. It is contemplated that the entire length of one or both end members 64 has the compound shape and that center member 62 may be configured to receive the compound shape instead of the I-beam shape as shown in FIGS. 11A and 11B . It is also contemplated that center member 62 may receive one end member 64 with an I-beam shape and another end member 64 having a compound shape.
- adjustable rod 60 may be used with the components and/or instruments (e.g., rod reducers, rod benders, bone screws, etc.) disclosed in U.S. patent application Ser. No. 13/636,416, filed on Nov. 8, 2012 and which published as U.S. Patent Application Publication No. 2013/0144342, and in U.S. Pat. No. 8,882,817, both of which are herein incorporated by reference in their entireties.
- instruments e.g., rod reducers, rod benders, bone screws, etc.
- FIGS. 16A-16C An embodiment of a screw usable with the end members 64 is shown in FIGS. 16A-16C , generally, as a polyaxial pedicle screw 70 ′ including a housing 72 ′, a compression ring or cap 74 ′, an anvil 76 ′, a bone screw member 78 ′, and a set screw 80 ′.
- the housing 72 ′ includes opposing walls 72 a ′ and 72 b ′ that define a U-shaped channel 71 ′ therebetween.
- the internal surfaces of opposing walls 72 a ′ and 72 b ′ include threaded portions 75 ′ that are threadably engagable with external threads 82 ′ of the set screw 80 ′ ( FIG.
- the housing 72 ′ includes a collar 77 ′ extending therefrom that is adapted to facilitate the securement of the compression ring or cap 74 ′ to the housing 72 ′ once the bone screw member 78 ′ is secured to the housing 72 ′.
- the collar 77 ′ has a cut out 77 a ′ that provides a recess for the reception of a portion of the bone screw member 78 ′, namely a neck 78 a ′, and facilitates the positioning of the bone screw member 78 ′ within the housing 72 ′ from a distal end of the housing 72 ′.
- the bone screw member 78 ′ includes a head 78 b ′ and a threaded shaft 78 c ′ extending from the head 78 b ′.
- the bone screw member 78 ′ may be a self-starting fastener or self-tapping fastener.
- the compression ring or cap 74 ′ may be slid over the threaded shaft 78 c ′ of the bone screw member 78 ′ and affixed to the collar 77 ′ of the housing 72 ′ to further secure the bone screw member 78 ′ to the housing 72 ′.
- the bone screw member 78 ′ is selectively positionable at plurality of angles relative to the housing 72 ′ and may be fixedly securable relative to the housing 72 ′ at a cone angle ⁇ in the range of 60 to 80 degrees, preferably 70 degrees, from the longitudinal axis “L” extending through the polyaxial pedicle screw 70 ′.
- the anvil 76 ′ is positionable within the housing 72 ′ adjacent the head 78 b ′ of the bone screw member 78 ′ to facilitate the securement of the end member 64 within the housing 72 ′.
- the set screw 80 ′ is positionable within the housing 72 ′, e.g., via threading engagement, to secure the end member 64 within the housing 72 ′ adjacent the anvil 76 ′.
- the pedicle screw 70 ′ is fastenable to a bone structure (e.g. vertebra) and the housing 72 ′ is repositionable in a plurality of directions with respect to the bone screw member 78 ′ as discussed above.
- the housing 72 ′ is rotatable about the longitudinal axis “L” extending through the polyaxial pedicle screw 70 ′ as well as pivotable relative to the longitudinal axis “L” and the bone screw member 78 ′.
- a connecting portion 64 c of an end member 64 (see e.g., FIG. 13B ) is positionable in the U-shaped channel 71 ′ of the housing 72 ′ and is nested against the anvil 76 ′. The end member 64 is then secured to the pedicle screw 70 ′ using the set screw 80 ′.
- FIGS. 17A-17C Another embodiment of a screw usable with the end members 64 is shown in FIGS. 17A-17C , generally, as a multi-planar taper lock screw 70 ′′ including a dual layered housing 72 ′′ and a screw shaft 74 ′′ having a spherically configured screw head 76 ′′ rotatably coupled with housing 72 ′′.
- the taper lock screw 70 ′′ enables manipulation of the screw shaft 74 ′′ about multiple axes, whereby the taper lock screw 70 ′′ is capable of releasably securing an end member 64 of an adjustable rod with taper lock screws 70 ′′ on multiple vertebral bodies that are aligned in the spinal column on different planes due to the natural curvature of the spine.
- Dual layered housing 72 ′′ includes an outer housing 72 a ′′ and an inner housing 72 b ′′.
- Outer housing 72 a ′′ can be selectively positioned relative to inner housing 72 b ′′ to fully lock screw head 76 ′′ and end member 64 in position within inner housing 72 b ′′ ( FIG. 17A ), or alternatively to selectively partially lock screw head 76 ′′ and/or end member 64 in position while permitting a sliding and/or rotating motion of the end member 64 relative to screw head 76 ′′, and the screw head 76 ′′ relative to the housing 72 ′′, respectively ( FIG. 17B ).
- outer housing 72 a ′′ is configured such that at least a portion of an inner surface of outer housing 72 a ′′ is capable of sliding over a portion of an outer surface of inner housing 72 b ′′ in upward and downward directions along the longitudinal axis of taper lock screw 70 ′′.
- outer housing 72 a ′′ is slid upward in relation to inner housing 72 b ′′ an inner surface of outer housing 72 a ′′ causes inner housing 72 b ′′ to impart compressive force radially inward to secure end member 64 at least partially disposed therein.
- Inner housing 72 b ′′ defines a connecting rod slot 78 ′′ that is configured and dimensioned to accommodate and retain the end member geometry of end member 64 in the inner housing 72 b ′′ without impairing the locking ability of the taper lock screw 70 ′′.
- Inner walls that define connecting rod slot 78 ′′ imparts compressive force to end member 64 disposed in connecting rod slot 78 ′′, whereby the inner walls serve to securely lock and hold end member 64 in its relative position to inner housing 72 b ′′. This required forced is provided by the operational engagement of a locking device (not shown) with the taper lock screw 70 ′′ that results in an upward sliding motion of the outer housing 72 a ′′ relative to the inner housing 72 b ′′.
- Inner housing 72 b ′′ further defines a screw head articulation recess 71 ′′ in a lower portion of inner housing 72 b ′′ that has a complementary surface configuration to the generally spherical shape of screw head 76 ′′ to facilitate multi-planar rotational articulation of screw head 76 ′′ within articulation recess 71 ′′.
- the lower-most portion of inner housing 72 b ′′ defines a screw shaft exit portal 73 ′′ that is sized small enough to retain the spherical screw head 76 ′′ within screw head articulation recess 71 ′′, but that is large enough to allow multi-directional movement of screw shaft 74 ′′ that extends exterior to inner housing 72 b′′.
- One suitable taper lock screw is commercially available from K2M, Inc. (Leesburg, Va.) under the trade name MESATM.
- suitable multi-planar taper lock screws are shown and described in U.S. Patent Application Publication No. 2008/0027432 and in U.S. Patent Application Publication No. 2007/0093817, both of which are herein incorporated by reference in their entireties.
- other types of screws such as, e.g., a fixed screw in which the head of the screw has no movement relative to the screw shaft, a mono-axial screw such as that disclosed in U.S. Patent Application Publication No. 2009/0105716, and a uni-axial screw such as that disclosed in U.S. Patent Application Publication No. 2009/0105769 may be utilized.
- Suitable mono-axial and uni-axial screws are also commercially available under the trade name MESATM.
- the screws 70 are implanted, in spaced relation from each other, into vertebral bodies 22 of the spine model 20 .
- the spine movement device 30 is actuated and the distance between the vertebral bodies 22 increases (for example, during movement from the first position of FIGS. 7A-8B to the second position of FIGS. 9A-10B ), a force is exerted on the screws 70 moving them away from each other, which in turn moves the end members 64 relative to the center member 62 .
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Abstract
A spinal surgery modeling system includes a spine model and a spine movement device. The spinal surgery modeling system provides a three-dimensional hands-on model that can be configured to have any desired variation of spinal alignment of the spine model by hydraulic actuation of the spine movement device to simulate the biomechanical feel and behavior of a patient's spine. The spine model may include various vertebral body or disc conditions and allows a clinician to examine and/or adjust the model and observe the three-dimensional outcome of such adjustments.
Description
- This present application is a continuation of U.S. patent application Ser. No. 14/798,591, filed Jul. 14, 2015, which claims the benefit of, and priority to, U.S. Provisional Patent Application Ser. No. 62/024,127, which was filed on Jul. 14, 2014, the entire contents of which are hereby incorporated herein by reference.
- The present disclosure relates to orthopedic surgical devices for stabilizing and fixing the bones and joints of a body. Particularly, the present disclosure relates to a growing spine model that simulates the effects of expanding vertebral bodies apart and the three dimensional impact on a spinal column.
- The spinal column is a complex system of bones and connective tissues that provide support for the human body and protection for the spinal cord and nerves. The human spine is comprised of thirty-three vertebrae at birth and twenty-four as a mature adult. Between each pair of vertebrae is an intervertebral disc, which maintains the space between adjacent vertebrae and acts as a cushion under compressive, bending, and rotational loads and motions.
- There are various disorders, diseases, and types of injury that the spinal column may experience in a lifetime. The problems may include, but are not limited to, scoliosis, kyphosis, excessive lordosis, spondylolisthesis, slipped or ruptured disc, degenerative disc disease, vertebral body fracture, and tumors. Persons suffering from any of the above conditions typically experience extreme and/or debilitating pain, and often times diminished nerve function.
- Conventionally, orthopedic surgeons receive training in the use of orthopedic devices and the performance of surgical methods to correct vertebral column injuries and diseases by the application of methods and devices on cadavers. The amount of training for each surgeon is limited by the expense, availability, scheduling, and other logistic requirements associated with the use of cadavers.
- Further, spine surgeons, when planning for a surgical procedure on a specific patient, are normally limited to a study of two-dimensional radiographic data and a complete lack of hands-on manipulation rehearsal of a method prior to operating on a patient. In recent years there has been a growing number of orthopedic practices and hospitals that have made the transition from film to all digital environments. Software based tools for orthopedic image review, analysis, and preoperative planning are becoming conventional tools of the orthopedic surgeon. While advances in surgical planning have been made, they are simply limited to improvements in providing two-dimensional data for study and planning. To receive hands-on training or to rehearse a surgical method, a surgeon is still limited to the use of cadavers.
- With such training and rehearsal limitations, it is not uncommon during an actual surgical procedure for a surgeon to encounter unforeseen anatomical or biomechanical conditions that may require an immediate revision of the surgical plan as it proceeds. The need to provide more, less expensive ways to train surgeons or to permit hands-on surgery planning and rehearsal in the use of spinal surgery methods and devices is particularly needed in the treatment of spine conditions, such as scoliosis. It is not uncommon in the surgical treatment of scoliosis that forceful manipulation and realignment of the spinal column can be a long, complicated mechanical effort that often includes a serious threat of damage to the spinal cord.
- Further, the biomechanical behavior and particularly soft tissue forces on the spinal column when applying methods and devices to a cadaver are far different from that which are normally experienced in a surgical procedure on a living patient.
- Thus, a need exists for a three-dimensional hands-on spinal surgery modeling system that can be used by surgeons for training in the use of devices and methods, and that can also be used in the planning and manual rehearsal of surgical procedures for patients.
- The present disclosure is directed to a three-dimensional modeling system for hands-on training and/or surgical rehearsal of surgical methods, devices, and instruments that provides a clinician with an anatomically and biomechanically realistic model of a spine in a non-surgical environment. The system includes a spine movement device that interacts with a spine model so as to configure the spine in a desired alignment, with selected degrees of force vectors biasing the spine in selected positions to provide a modeling system that can be used as a surgeon training device or as a spinal surgery rehearsal platform.
- The spine movement device of the system of the present disclosure may be used with any of a variety of spine models that can be selected by size and conformation to simulate, for example, pediatric, adult, and geriatric spinal columns.
- The system can be prepared to simulate the anatomy and biomechanics of a patient such that a three-dimensional hands-on surgery rehearsal platform is provided.
- The system of the present disclosure is useful for simulating common deformities such as scoliosis, kyphosis, sagittal imbalance, and other spinal abnormalities. In addition to the training benefits provided by the system, manual rehearsal of planned methods in the treatment of spinal deformities and conditions may provide a faster, more effective, and safer surgical correction for a patient.
- The system of the present disclosure can simulate a spine as it is growing, simulating the growth of vertebral bodies and discs.
- In accordance with an aspect of the present disclosure, a spinal surgery modeling system includes a spine model including vertebral bodies defining disc spaces between adjacent vertebral bodies, and a spine movement device. The spine movement device includes a plurality of cylinders, a plurality of pistons, and a plurality of inflation members. Each cylinder of the plurality of cylinders includes an elongate body defining a bore, and an inlet and an outlet. Each piston of the plurality of pistons includes an elongate body having a proximal end and a distal end, and the distal end of each piston extends into the inlet and frictionally engages the bore of one cylinder of the plurality of cylinders. Each inflation member of the plurality of inflation members is disposed within one of the disc spaces of the spine model and is fluidly coupled to the outlet of one cylinder of the plurality of cylinders. The plurality of pistons are movable with respect to the plurality of cylinders to hydraulically inflate or deflate the plurality of inflation members.
- The spine movement device may further includes a plurality of tubes. Each tube of the plurality of tubes may fluidly connect the outlet of one cylinder of the plurality of cylinders with one inflation member of the plurality of inflation members.
- The spine movement device may further include a back plate having plurality of openings extending therethrough, wherein each cylinder of the plurality of cylinders is positioned through one opening of the plurality of openings. In embodiments, the spine movement device further includes a front plate positioned in spaced relation relative to the back plate, and the proximal ends of the plurality of pistons are secured to the front plate. In some embodiments, the front plate includes a plurality of recesses aligned with the plurality of openings of the back plate and mechanically engaged with the proximal ends of the plurality of pistons to lock the plurality of pistons to the front plate.
- The spine movement device may further include a linear actuating member having an elongated body extending through the front and back plates for moving the plurality of pistons proximally and distally with respect to the plurality of cylinders. In embodiments, the elongated body of the linear actuating member extends through central apertures defined in each of the front and back plates, and each opening of the plurality of openings of the front and back plates are disposed around the respective central aperture. In some embodiments, the central aperture of the back plate is a threaded aperture that engages a threaded portion of the linear actuating member. In certain embodiments, the spine movement device further includes a rotatable handle secured to a proximal end of the linear actuating member.
- In embodiments, the spine movement device further includes an intermediate plate having plurality of opening extending therethrough that are aligned with the plurality of openings of the back plate, wherein the proximal end of each cylinder of the plurality of cylinders includes a catch positioned between the intermediate plate and the back plate.
- The spinal surgery modeling system may further include at least one spinal construct attached to the spine model. In embodiments, the at least one spinal construct includes a plurality of screws and an adjustable rod. The adjustable rod may include a center member and first and second end members. Each of the first and second end members may include a first segment slidably engagable with an interior surface of the center member, and a second segment including a connecting portion securable to at least one of the plurality of screws. In some embodiments, the first segment of each of the first and second end members has an I-beam shape and the second segment of each of the first and second end members has a compound shape including an elongate round portion, an elongate head portion, and a neck portion connecting the elongate round portion with the elongate head portion.
- In accordance with another aspect of the present disclosure, a method of simulating a spine includes: positioning an inflation member within a disc space between vertebral bodies of a spine model, the inflation member fluidly coupled to a cylinder of a spine movement device, the spine movement device including a piston having a distal end frictionally engaged with a bore of the cylinder; and moving the piston distally within the bore of the cylinder to displace a fluid disposed within the cylinder into the inflation member to expand the inflation member and increase a distance between the vertebral bodies.
- In embodiments, moving the piston distally includes rotating a handle secured to a linear actuating member of the spine movement device to impart linear motion to the piston.
- The method may further include moving the piston proximally within the bore of the cylinder to draw the fluid into the bore of the cylinder to deflate the inflation member and decrease the distance between the vertebral bodies.
- The method may further include implanting a spinal construct in the spine model. In embodiments, implanting the spinal construct includes securing an adjustable rod to the spine model with screws such that moving the piston distally exerts a force on the screws moving the screws away from each other and moving end members of the adjustable rod relative to a center member of the adjustable rod.
- In accordance with yet another aspect of the present disclosure, a method of using an adjustable rod includes: implanting a first screw and a second screw in spaced relation relative to each other in vertebral bodies of a spine; and securing a first end member of an adjustable rod to the first screw and a second end member of the adjustable rod in the second screw, the first and second end members being in slidable engagement with a center member extending between the first and second screws.
- Other aspects, features, and advantages will be apparent from the description, drawings, and the claims.
-
FIG. 1 is a front, perspective view of a spinal surgery modeling system in accordance with an embodiment of the present disclosure; -
FIG. 2 is a back, perspective view of the spinal surgery modeling system ofFIG. 1 ; -
FIG. 3 is a front, perspective view of a spine movement device of the spinal surgery modeling system ofFIG. 1 ; -
FIG. 4 is a back, perspective view of the spine movement device ofFIG. 3 ; -
FIG. 5 is an exploded view of the spine movement device ofFIG. 3 ; -
FIG. 6A is a side view of the spine movement device ofFIG. 3 in a first position; -
FIG. 6B is a side view of the spine movement device ofFIG. 3 in a second position; -
FIG. 7A is a side view of the spinal surgery modeling system ofFIG. 1 in a first position; -
FIG. 7B is an enlarged view of a portion of a spine model of the spinal surgery modeling system, shown in the area ofdetail 7B identified inFIG. 7A ; -
FIG. 8A is a front view of the spinal surgery modeling system ofFIG. 7A ; -
FIG. 8B is an enlarged view of a portion of a spine model of the spinal surgery modeling system, shown in the area ofdetail 8B identified inFIG. 8A ; -
FIG. 9A is a side view of the spinal surgery modeling system ofFIG. 1 in a second position; -
FIG. 9B is an enlarged view of a portion of a spine model of the spinal surgery modeling system, shown in the area ofdetail 9B identified inFIG. 9A ; -
FIG. 10A is a front view of the spinal surgery modeling system ofFIG. 9A ; -
FIG. 10B is an enlarged view of a portion of a spine model of the spinal surgery modeling system, shown in the area ofdetail 10B identified inFIG. 10A ; -
FIG. 11A is a front, perspective view of a spinal construct of the spinal surgical modeling system ofFIG. 1 ; -
FIG. 11B is an exploded view of the spinal construct ofFIG. 11A ; -
FIG. 12A is a side view of a central member of the spinal construct ofFIG. 11A ; -
FIG. 12B is a cross-sectional view of the central member ofFIG. 12A , taken alongline 12B-12B ofFIG. 12A ; -
FIG. 13A is a side view of an end member of the spinal construct ofFIG. 11A ; -
FIG. 13B is a cross-sectional view of the end member ofFIG. 13A , taken alongline 13B-13B ofFIG. 13A ; -
FIG. 13C is a cross-sectional view of the end member ofFIG. 13A , taken alongline 13C-13C ofFIG. 13A ; -
FIG. 14A is a front, perspective view of a spinal construct for use with the spinal surgery modeling system ofFIG. 1 in accordance with another embodiment of the present disclosure; -
FIG. 14B is an exploded view of the spinal construct ofFIG. 14A ; -
FIG. 15A is a side view of a central member of the spinal construct ofFIG. 14A ; -
FIG. 15B is a cross-sectional view of the central member ofFIG. 15A , taken alongline 15B-15B ofFIG. 15A ; -
FIG. 16A is a perspective view of a polyaxial pedicle screw; -
FIG. 16B is an exploded, perspective view of the polyaxial pedicle screw ofFIG. 16A ; -
FIG. 16C is a perspective view of a set screw usable with the polyaxial pedicle screw ofFIGS. 16A and 16B ; -
FIG. 17A is an end view of a spinal construct including a taper lock screw and an adjustable rod in accordance with another embodiment of the present disclosure; -
FIG. 17B is a partial cross-sectional view of a portion of the taper lock screw ofFIG. 17A shown in a partially locked position; and -
FIG. 17C is an end, cross-sectional view of the taper lock screw ofFIG. 17A in an unlocked position with the adjustable rod. - Corresponding reference characters indicate corresponding parts throughout the drawings.
- Detailed embodiments of the present disclosure are disclosed herein; however, it is understood that the following description and each of the accompanying figures are provided as exemplary embodiments of the present disclosure. Thus, the specific structural and functional details provided in the following description are non-limiting, and various modifications may be made without departing from the spirit and scope of the present disclosure.
- In this disclosure, the term “clinician” refers to a doctor, nurse, or other care provider and may include support personnel. As used herein, the term “proximal” refers to the portion of a structure closer to a clinician, while the term “distal” refers to the portion of the same structure further from the clinician. The term “cephalad” indicates a direction toward a patient's head, whereas the term “caudad” indicates a direction toward a patient's feet. The term “lateral” indicates a direction toward a side of the body of a patient, i.e., away from the middle of the body of the patient, whereas the term “medial” refers to a position toward the middle of the body of a patient. The term “posterior” indicates a direction toward a patient's back, and the term “anterior” indicates a direction toward a patient's front. Additionally, in the drawings and in the description that follows, terms such as front, rear, upper, lower, top, bottom, and similar directional terms are used simply for convenience of description and are not intended to limit the disclosure.
- As shown in
FIGS. 1 and 2 , a spinalsurgery modeling system 10 includes aspine model 20, aspine movement device 30, and optionally, one or more spinal constructs, such anadjustable rod 60 and screws 70. Thespine model 20 and thespine movement device 30 may each be removably or fixedly attached to abase 12, and theadjustable rod 60 and screw 70 may be affixed to thespine model 20. Thespine model 20 may be a cadaveric or synthetic anatomically and mechanically correct spine model of a pediatric, adult, or geriatric spine which may exhibit any of a variety of spine pathologies. - Turning now to
FIGS. 3-6B , in conjunction withFIGS. 1 and 2 , thespine movement device 30 includes amain frame 32 including aback plate 34 having aproximal surface 34 a, adistal surface 34 b, a threadedcentral aperture 34 c, and a plurality ofopenings 34 d disposed around thecentral aperture 34 c.Cylinders 36 are positioned through theopenings 34 d of theback plate 34. Eachcylinder 36 includes an elongated body 36 a defining abore 36 b which may have a substantially consistent diameters along the length thereof, aproximal end 36 c including aninlet 36 d and acatch 36 e that engages theproximal surface 34 a of theback plate 34, and a distal end 36 f including an outlet 36 g. The outlets 36 g of eachcylinder 36 is fluidly connected to a tube ortubing 38 that is fluidly connected to aninflation member 40, such as a balloon. - An
intermediate plate 42 includes acentral aperture 42 a and a plurality ofopenings 42 b disposed around thecentral aperture 42 a that are sized and positioned to correspond with theopenings 34 d of theback plate 34. Theintermediate plate 42 is placed adjacent to theproximal surface 34 a of theback plate 34, withopenings 42 b aligned withopenings 34 d and thecatch 36 e of eachcylinder 36 positioned between theintermediate plate 42 and theback plate 34. Theintermediate plate 42 is secured to theback plate 34 withfixation members 44, such as screws. -
Pistons 46 include anelongated body 46 a that may be the length of the elongated body 36 a of thecylinders 36, aproximal end 46 b that is secured to afront plate 48, and adistal end 46 c that is dimensioned to frictionally engage thebore 36 b of thecylinders 36. Thefront plate 48 includes aproximal surface 48 a, adistal surface 48 b, and acentral aperture 48 c extending through the proximal anddistal surfaces distal surface 48 b includes a plurality ofrecesses 48 d that are aligned with theopenings 34 d of theback plate 34 and mechanically engage and lock theproximal end 46 b of thepistons 46 thereto. Thefront plate 48 is positioned in spaced relation with respect to theback plate 34 with the distal ends 46 c of thepistons 36 disposed within thebore 36 b of thecylinders 36. - A
linear actuating member 50, such as a threaded screw, includes an elongated body 50 a having aproximal end 50 b and adistal end 50 c. The elongated body 50 a of thelinear actuating member 50 is positioned through thecentral apertures front plates handle 52 is secured to theproximal end 50 b of thelinear actuating member 50 and anut 54 is disposed on thedistal end 50 c of thelinear actuating member 50 adjacent thedistal surface 34 b of theback plate 34 to secure the components of thedevice 30 together. - Rotation of the
handle 52 rotates thelinear actuating member 50, which in turn imparts linear motion to thelinear actuating member 50 as linear actuatingmember 50 engages the threadedcentral aperture 34 c of theback plate 34. The linear motion thereby causes thefront plate 48 to move proximally or distally with respect to theback plate 34, and in turn, causes thepistons 46 to move proximally or distally within thebores 36 b of thecylinders 36. A fluid (not shown), such as a liquid or gas, is disposed within thebores 36 b of thecylinders 36 such that distal movement of thepistons 46 displaces the fluid and hydraulically inflates/expands theinflation members 40, and proximal movement of thepistons 46 draws the fluid back into thebores 36 b of thecylinders 36, hydraulically deflating theinflation members 40. The amount of fluid contained within each of thecylinders 36 may be the same or different. - In an exemplary method of use, each
inflation member 40 is positioned within the disc space between each of thevertebral bodies 22 of thespine model 20, as shown inFIGS. 7A-8B . A user rotates thehandle 52 of thespine movement device 30 to drive thelinear actuating member 50 distally thereby displacing fluid from thecylinders 36 into theinflation members 40. As shown inFIGS. 9A-10B , expansion of theinflation members 40 increases the distance between thevertebral bodies 22 simulating, for example, growth of a spine. - The
vertebral bodies 22 of thespine model 20 are freely accessible to a user of thesystem 10. Accordingly, various spinal constructs, such as arod 60 and screws 70, may be placed on thevertebral bodies 22 to allow the user to practice methods of placing such spinal constructs on a spine and/or to observe the interaction of the spinal constructs with a spine. - As shown in
FIGS. 11A-13C , in conjunction withFIGS. 7A-10B , anadjustable rod 60 may include acenter member 62 andend members 64. Eachend member 64 includes afirst segment 64 a which slidably engages aninterior surface 62 a of thecenter member 62 that includes a complementary geometry to that of thefirst segment 64 a. While theinterior surface 62 a of thecenter member 62 is shown as a continuous, closed square-shaped surface, it should be understood that theinterior surface 62 a may have any shape suitable for slidablyengaging end members 64, such as tubular, ovular, elliptical, or rectangular, for example, among other shapes that are complementary to the shape of thefirst segment 64 a of theend members 64. As another example, theinterior surface 62 a′ of acenter member 62′ of anadjustable rod 60′ may be a semi-continuous surface, having, for example, a c-shaped profile, as shown inFIGS. 14A-15B . Eachend member 64 also includes asecond segment 64 b that includes a connectingportion 64 c that may be secured to ascrew 70. - It is contemplated that
adjustable rod 60,center member 62, and endmembers 64 may be used outside of the disclosedspine model 20 and used, in situ, as a standalone spinal implant. In use as a spinal implant,adjustable rod 60 may be configured as follows.Center member 62 may include one or more stops that function to control the expansion and/or contraction of theadjustable rod 60. In particular, oneend member 64 may be fixed relative to centermember 60, while theother end member 64 is slidable between a minimum amount of extension and a maximum amount of extension with respect tocenter member 62. Alternatively, bothend members 64 may be slidable with respect tocenter member 62 between a minimum amount of extension and a maximum amount of extension. Further, oneend member 64 may have a different range of travel as compared to theother end member 64. Further still, one or bothend members 64 may be free to expand and inhibited from contracting relative to centermember 62. - Each
end member 64 is shown having a combination configuration with a portion having an I-beam shape (e.g.,first segment 64 a) and a portion with a compound shape (e.g.,second segment 64 b). The compound shape includes an elongate round portion, an elongate head portion, and a neck portion connecting the elongate round portion with the elongate head portion. It is contemplated that the entire length of one or bothend members 64 has the compound shape and thatcenter member 62 may be configured to receive the compound shape instead of the I-beam shape as shown inFIGS. 11A and 11B . It is also contemplated thatcenter member 62 may receive oneend member 64 with an I-beam shape and anotherend member 64 having a compound shape. It is also within the scope of the present disclosure thatadjustable rod 60 may be used with the components and/or instruments (e.g., rod reducers, rod benders, bone screws, etc.) disclosed in U.S. patent application Ser. No. 13/636,416, filed on Nov. 8, 2012 and which published as U.S. Patent Application Publication No. 2013/0144342, and in U.S. Pat. No. 8,882,817, both of which are herein incorporated by reference in their entireties. - An embodiment of a screw usable with the
end members 64 is shown inFIGS. 16A-16C , generally, as apolyaxial pedicle screw 70′ including ahousing 72′, a compression ring or cap 74′, ananvil 76′, abone screw member 78′, and aset screw 80′. Thehousing 72′ includes opposingwalls 72 a′ and 72 b′ that define aU-shaped channel 71′ therebetween. The internal surfaces of opposingwalls 72 a′ and 72 b′ include threadedportions 75′ that are threadably engagable withexternal threads 82′ of theset screw 80′ (FIG. 16C ) to facilitate the securement of anend member 64 of anadjustable rod FIGS. 11A and 14A ) within thechannel 71′ of thehousing 72′ adjacent theanvil 76′. Thehousing 72′ includes acollar 77′ extending therefrom that is adapted to facilitate the securement of the compression ring or cap 74′ to thehousing 72′ once thebone screw member 78′ is secured to thehousing 72′. Thecollar 77′ has a cut out 77 a′ that provides a recess for the reception of a portion of thebone screw member 78′, namely aneck 78 a′, and facilitates the positioning of thebone screw member 78′ within thehousing 72′ from a distal end of thehousing 72′. - The
bone screw member 78′ includes ahead 78 b′ and a threadedshaft 78 c′ extending from thehead 78 b′. Thebone screw member 78′ may be a self-starting fastener or self-tapping fastener. The compression ring or cap 74′ may be slid over the threadedshaft 78 c′ of thebone screw member 78′ and affixed to thecollar 77′ of thehousing 72′ to further secure thebone screw member 78′ to thehousing 72′. Once inserted, thebone screw member 78′ is selectively positionable at plurality of angles relative to thehousing 72′ and may be fixedly securable relative to thehousing 72′ at a cone angle α in the range of 60 to 80 degrees, preferably 70 degrees, from the longitudinal axis “L” extending through thepolyaxial pedicle screw 70′. Theanvil 76′ is positionable within thehousing 72′ adjacent thehead 78 b′ of thebone screw member 78′ to facilitate the securement of theend member 64 within thehousing 72′. Theset screw 80′ is positionable within thehousing 72′, e.g., via threading engagement, to secure theend member 64 within thehousing 72′ adjacent theanvil 76′. - As assembled, the
pedicle screw 70′ is fastenable to a bone structure (e.g. vertebra) and thehousing 72′ is repositionable in a plurality of directions with respect to thebone screw member 78′ as discussed above. To this end, thehousing 72′ is rotatable about the longitudinal axis “L” extending through thepolyaxial pedicle screw 70′ as well as pivotable relative to the longitudinal axis “L” and thebone screw member 78′. A connectingportion 64 c of an end member 64 (see e.g.,FIG. 13B ) is positionable in theU-shaped channel 71′ of thehousing 72′ and is nested against theanvil 76′. Theend member 64 is then secured to thepedicle screw 70′ using theset screw 80′. - Another embodiment of a screw usable with the
end members 64 is shown inFIGS. 17A-17C , generally, as a multi-planartaper lock screw 70″ including a dual layeredhousing 72″ and ascrew shaft 74″ having a spherically configuredscrew head 76″ rotatably coupled withhousing 72″. Thetaper lock screw 70″ enables manipulation of thescrew shaft 74″ about multiple axes, whereby thetaper lock screw 70″ is capable of releasably securing anend member 64 of an adjustable rod with taper lock screws 70″ on multiple vertebral bodies that are aligned in the spinal column on different planes due to the natural curvature of the spine. - Dual
layered housing 72″ includes anouter housing 72 a″ and aninner housing 72 b″.Outer housing 72 a″ can be selectively positioned relative toinner housing 72 b″ to fully lockscrew head 76″ andend member 64 in position withininner housing 72 b″ (FIG. 17A ), or alternatively to selectively partially lockscrew head 76″ and/orend member 64 in position while permitting a sliding and/or rotating motion of theend member 64 relative to screwhead 76″, and thescrew head 76″ relative to thehousing 72″, respectively (FIG. 17B ). Specifically,outer housing 72 a″ is configured such that at least a portion of an inner surface ofouter housing 72 a″ is capable of sliding over a portion of an outer surface ofinner housing 72 b″ in upward and downward directions along the longitudinal axis oftaper lock screw 70″. Whenouter housing 72 a″ is slid upward in relation toinner housing 72 b″ an inner surface ofouter housing 72 a″ causesinner housing 72 b″ to impart compressive force radially inward to secureend member 64 at least partially disposed therein. -
Inner housing 72 b″ defines a connectingrod slot 78″ that is configured and dimensioned to accommodate and retain the end member geometry ofend member 64 in theinner housing 72 b″ without impairing the locking ability of thetaper lock screw 70″. Inner walls that define connectingrod slot 78″ imparts compressive force to endmember 64 disposed in connectingrod slot 78″, whereby the inner walls serve to securely lock and holdend member 64 in its relative position toinner housing 72 b″. This required forced is provided by the operational engagement of a locking device (not shown) with thetaper lock screw 70″ that results in an upward sliding motion of theouter housing 72 a″ relative to theinner housing 72 b″.Inner housing 72 b″ further defines a screwhead articulation recess 71″ in a lower portion ofinner housing 72 b″ that has a complementary surface configuration to the generally spherical shape ofscrew head 76″ to facilitate multi-planar rotational articulation ofscrew head 76″ withinarticulation recess 71″. The lower-most portion ofinner housing 72 b″ defines a screwshaft exit portal 73″ that is sized small enough to retain thespherical screw head 76″ within screwhead articulation recess 71″, but that is large enough to allow multi-directional movement ofscrew shaft 74″ that extends exterior toinner housing 72 b″. - One suitable taper lock screw is commercially available from K2M, Inc. (Leesburg, Va.) under the trade name MESA™. In addition, suitable multi-planar taper lock screws are shown and described in U.S. Patent Application Publication No. 2008/0027432 and in U.S. Patent Application Publication No. 2007/0093817, both of which are herein incorporated by reference in their entireties. It is contemplated that other types of screws such as, e.g., a fixed screw in which the head of the screw has no movement relative to the screw shaft, a mono-axial screw such as that disclosed in U.S. Patent Application Publication No. 2009/0105716, and a uni-axial screw such as that disclosed in U.S. Patent Application Publication No. 2009/0105769 may be utilized. Suitable mono-axial and uni-axial screws are also commercially available under the trade name MESA™.
- With reference again to
FIGS. 7A-10B , in conjunction withFIGS. 11A-13C , in use, thescrews 70 are implanted, in spaced relation from each other, intovertebral bodies 22 of thespine model 20. As thespine movement device 30 is actuated and the distance between thevertebral bodies 22 increases (for example, during movement from the first position ofFIGS. 7A-8B to the second position ofFIGS. 9A-10B ), a force is exerted on thescrews 70 moving them away from each other, which in turn moves theend members 64 relative to thecenter member 62. - A number of embodiments have been described. Nevertheless, it will be understood that various modifications may be made without departing from the spirit and scope of the disclosure.
Claims (20)
1. A spinal construct comprising:
a plurality of screws; and
an adjustable rod including:
a hollow member defining a bore therethrough; and
a first end member including a first segment in direct slidable engagement with the bore of the hollow member and a second segment securable to at least one screw of the plurality of screws, the first segment having a first shape and the second segment having a second shape different from the first shape, and the bore of the hollow member having a complementary geometry to that of the first segment.
2. The spinal construct according to claim 1 , wherein the first segment of the first end member is rotationally fixed relative to the hollow member.
3. The spinal construct according to claim 1 , wherein the first shape of the first segment of the first end member is an I-beam shape.
4. The spinal construct according to claim 1 , wherein the second shape of the second segment of the first end member is a compound shape.
5. The spinal construct according to claim 4 , wherein the compound shape includes an elongate round portion, an elongate head portion, and a neck portion connecting the elongate round portion with the elongate head portion.
6. The spinal construct according to claim 3 , wherein the bore of the hollow member has an I-beam shape.
7. The spinal construct according to claim 1 , wherein the hollow member has a fixed axial length and the bore extends longitudinally through the fixed axial length, and the bore is open at the first and second ends of the hollow member.
8. The spinal construct according to claim 1 , wherein the first end member is freely extendable and retractable relative to the hollow member.
9. The spinal construct according to claim 1 , wherein the adjustable rod further includes a second end member including a third segment engageable with the bore of the hollow member and a fourth segment securable to at least one screw of the plurality of screws.
10. The spinal construct according to claim 9 , wherein the third segment of the second end member has a third shape different from a fourth shape of the fourth segment of the second end member.
11. The spinal construct according to claim 9 , wherein the first and second end members are axially movable relative to the hollow member.
12. The spinal construct according to claim 11 , wherein the first and second end members are freely extendable and retractable relative to the hollow member.
13. The spinal construct according to claim 9 , wherein the second end member has a different range of travel relative to the hollow member than the first end member.
14. The spinal construct according to claim 9 , wherein the third segment of the second end member has a third shape that is different from the first shape of the first segment of the first end member.
15. The spinal construct according to claim 14 , wherein the first segment of the first end member and the third segment of the second end member are each in direct slidable engagement with the bore of the hollow member.
16. A spinal construct comprising:
a plurality of screws; and
an adjustable rod including:
a hollow member defining a bore therethrough; and
a first end member including a first segment in direct slidable engagement with the bore of the hollow member and a second segment securable to at least one screw of the plurality of screws, the first segment having an I-beam shape and the second segment having a compound shape including an elongate round portion, an elongate head portion, and a neck portion connecting the elongate round portion with the elongate head portion, wherein the bore of the hollow member has an I-beam shape.
17. The spinal construct of claim 16 , wherein the adjustable rod further includes a second end member including a third segment engageable with the bore of the hollow member and a fourth segment securable to at least one screw of the plurality of screws.
18. The spinal construct of claim 17 , wherein the first and second end members are axially movable relative to the hollow member.
19. The spinal construct of claim 16 , wherein the first segment of the first end member is rotationally fixed relative to the hollow member.
20. The spinal construct of claim 16 , wherein the second end member has a different range of travel relative to the hollow member than the first end member.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
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US16/242,446 US20190279532A1 (en) | 2014-07-14 | 2019-01-08 | Growing Spine Model |
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US201462024127P | 2014-07-14 | 2014-07-14 | |
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US16/242,446 US20190279532A1 (en) | 2014-07-14 | 2019-01-08 | Growing Spine Model |
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Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US10102776B2 (en) * | 2016-11-17 | 2018-10-16 | Warsaw Orthopedic, Inc. | Simulation device and method for using same |
US10529255B2 (en) | 2017-06-02 | 2020-01-07 | Synaptive Medical (Barbados) Inc. | Spinal training simulator |
WO2019059330A1 (en) * | 2017-09-22 | 2019-03-28 | 株式会社Micotoテクノロジー | Medical simulator |
EP3911261A1 (en) * | 2019-01-14 | 2021-11-24 | Nuvasive, Inc. | Prediction of postoperative global sagittal alignment based on full-body musculoskeletal modeling and posture optimization |
US11376076B2 (en) * | 2020-01-06 | 2022-07-05 | Carlsmed, Inc. | Patient-specific medical systems, devices, and methods |
CN112598983B (en) * | 2020-12-10 | 2022-08-16 | 珠海维尔康生物科技有限公司 | Simulation spine, simulation spine inner core and spine puncture model |
Family Cites Families (35)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE605262C (en) | 1934-11-08 | Rudolf Braeunig | Spine of a skeletal model | |
US2108229A (en) | 1935-07-05 | 1938-02-15 | Martha M Metz | Anatomical skeleton |
US2197975A (en) | 1938-03-21 | 1940-04-23 | James L Price | Anatomical demonstrating device |
US3513569A (en) | 1967-12-29 | 1970-05-26 | Thorston D Herou | Vertebrae structure |
JPS5895732A (en) | 1981-12-03 | 1983-06-07 | Fuji Photo Film Co Ltd | Substrate for photographic paper |
US5330473A (en) | 1993-03-04 | 1994-07-19 | Advanced Spine Fixation Systems, Inc. | Branch connector for spinal fixation systems |
US5389099A (en) | 1993-07-28 | 1995-02-14 | Hartmeister; Ruben | Keyhole rod bender |
US5672059A (en) | 1995-03-20 | 1997-09-30 | Browne-Wilkinson; Oliver | Orthopaedic human skeletal demonstration aids |
DE69630317T2 (en) | 1995-06-06 | 2004-08-05 | SDGI Holding, Inc., Wilmington | DEVICE FOR CONNECTING NEIGHBORING SPINE SUPPORT BARS |
FR2794357B1 (en) | 1999-06-01 | 2001-09-14 | Frederic Fortin | DISTRACTION DEVICE FOR BONES OF CHILDREN HAVING HANGING AND ADJUSTMENT MEANS FOR TRACKING GROWTH |
US20060079892A1 (en) | 2001-10-31 | 2006-04-13 | Suranjan Roychowdhury | Adjustable tandem connectors for corrective devices for the spinal column and other bones and joints |
DE102004009919B4 (en) * | 2004-02-20 | 2007-02-08 | Schott Ag | Syringe, especially for medical applications |
US7942908B2 (en) | 2005-02-02 | 2011-05-17 | Depuy Spine, Inc. | Adjustable length implant |
US20060264937A1 (en) * | 2005-05-04 | 2006-11-23 | White Patrick M | Mobile spine stabilization device |
US7988694B2 (en) | 2005-09-29 | 2011-08-02 | K2M, Inc. | Spinal fixation system having locking and unlocking devices for use with a multi-planar, taper lock screw |
US20070173855A1 (en) * | 2006-01-17 | 2007-07-26 | Sdgi Holdings, Inc. | Devices and methods for spacing of vertebral members over multiple levels |
US7699874B2 (en) | 2006-03-01 | 2010-04-20 | Warsaw Orthopedic, Inc. | Low profile spinal rod connector system |
US7563274B2 (en) | 2006-04-25 | 2009-07-21 | Warsaw Orthopedic, Inc. | Surgical instruments and techniques for controlling spinal motion segments with positioning of spinal stabilization elements |
US8475499B2 (en) * | 2006-07-14 | 2013-07-02 | DePuy Synthes Products, LLC. | Rod to rod connectors and methods of adjusting the length of a spinal rod construct |
US8162991B2 (en) | 2006-07-27 | 2012-04-24 | K2M, Inc. | Multi-planar, taper lock screw |
US20080086130A1 (en) | 2006-10-06 | 2008-04-10 | Depuy Spine, Inc. | Torsionally stable fixation |
US8372121B2 (en) * | 2007-02-08 | 2013-02-12 | Warsaw Orthopedic, Inc. | Adjustable coupling systems for spinal stabilization members |
US7942676B2 (en) | 2007-06-21 | 2011-05-17 | Charles Murdach | Human spine model |
US20110092859A1 (en) * | 2007-06-25 | 2011-04-21 | Neubardt Seth L | System for determining and placing spinal implants or prostheses |
US8038701B2 (en) | 2007-10-22 | 2011-10-18 | K2M, Inc. | Uni-planar, taper lock bone screw |
US8287576B2 (en) | 2007-10-23 | 2012-10-16 | K2M, Inc. | Mono-axial, taper lock bone screw |
US8113847B2 (en) | 2007-10-23 | 2012-02-14 | K2M, Inc. | Spinal surgery modeling system |
US8777995B2 (en) | 2008-02-07 | 2014-07-15 | K2M, Inc. | Automatic lengthening bone fixation device |
US7959612B2 (en) * | 2008-04-21 | 2011-06-14 | Medtronic Vascular, Inc. | Dual syringe injector system |
US20100106192A1 (en) | 2008-10-27 | 2010-04-29 | Barry Mark A | System and method for aligning vertebrae in the amelioration of aberrant spinal column deviation condition in patients requiring the accomodation of spinal column growth or elongation |
US8162984B2 (en) | 2009-02-20 | 2012-04-24 | K2M, Inc. | Forced growth axial growing spine device |
AU2011276535B2 (en) | 2010-06-28 | 2015-03-12 | K2M, Inc. | Spinal stabilization system |
EP2605716B1 (en) | 2010-08-20 | 2021-04-21 | K2M, Inc. | Spinal fixation system |
EP2712560B1 (en) | 2012-09-07 | 2014-12-24 | K2M, Inc. | Growing spinal rod system |
WO2014159191A1 (en) * | 2013-03-14 | 2014-10-02 | The Cleveland Clinic Foundation | A method of producing a patient-specific three dimensional model having hard tissue and soft tissue portions |
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- 2015-07-14 EP EP15176613.6A patent/EP2975599B1/en not_active Not-in-force
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2019
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US20160012753A1 (en) | 2016-01-14 |
EP2975599B1 (en) | 2017-10-18 |
EP2975599A1 (en) | 2016-01-20 |
US10198970B2 (en) | 2019-02-05 |
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