US3893454A - Instrument for use in coniotomy - Google Patents

Instrument for use in coniotomy Download PDF

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Publication number
US3893454A
US3893454A US440121A US44012174A US3893454A US 3893454 A US3893454 A US 3893454A US 440121 A US440121 A US 440121A US 44012174 A US44012174 A US 44012174A US 3893454 A US3893454 A US 3893454A
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United States
Prior art keywords
knife
instrument
coniotomy
knife unit
speculum
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Expired - Lifetime
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US440121A
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English (en)
Inventor
Karl Wilhelm Hagelin
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Stille Werner AB
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Stille Werner AB
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/24—Surgical instruments, devices or methods, e.g. tourniquets for use in the oral cavity, larynx, bronchial passages or nose; Tongue scrapers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0465—Tracheostomy tubes; Devices for performing a tracheostomy; Accessories therefor, e.g. masks, filters
    • A61M16/0472—Devices for performing a tracheostomy

Definitions

  • ABSTRACT A coniotomy instrument comprising a speculum portion and a knife unit the knife of which passes through the speculum portion and is adapted on application of the instrument to be advanced in such a manner that the knife point protrudes from the fore end of the speculum portion to facilitate penetration and which, after application of the instrument, is retractable to leave a free passage for air flow through the speculum portion.
  • the speculum portion comprises two separable specula blades, each at a fore end of two tongs legs, and the knife unit comprises a U-shaped portion with two resilient U-shaped legs which slidably engage over the speculum portion and a knife blade which is centrally located between the U-shaped legs and extends through the speculum portion.
  • Tracheotomy and coniotomy are steps which can be taken in order to release an obstruction in the airpassages of vertebrates, e.g. steps which can be taken to relieve situations of such a complicated nature as to render it insufficient merely to arrange the patient in a position to permit draining of the obstruction through the patients mouth, to cleanse the mouth cavity of the patient and to move the patients tongue forward, and with which it is impossible to effect endotracheal intubation, which involves the insertion of a pharynx tube and an endotracheal tube through the mouth.
  • Tracheotomy is a surgical remedy, in which an opening is made through the wall of the trachea and the soft portions of the larynx at a position located a few cartilages beneath the thyroid cartilage.
  • This form of surgery is to be preferred when the opening is to remain for more than I or 2 days; the opening may in fact be left for many years, for example in the respiratory treatment of patients suffering from poliomyelities(sic) or in the treatment of patients who have been operated upon for cancer of the throat.
  • Such surgery requires trained operators, assistants, special instruments, and should not be carried out when pressed for time.
  • the object of the present invention is to circumvent the drawbacks of the coniotomy instruments as known hitherto by providing an inexpensive coniotomy instrument of simple design which enables coniotomy to be performed rapidly and reliably by persons only relatively briefly instructed in the use of said instrument, thereby enabling the instrument to be used not only by medical personnel but also by ambulance drivers, nurses etc.
  • the coniotomy instrument comprises a speculum portion which is adapted to be introduced into the trachea of the patient, and a knife unit the knife of which passes through the speculum portion and is adapted on application of the instrument to be advanced in such a manner that the knife point protrudes from the fore end of the speculum portion to facilitate penetration, and which, after application of the instrument, is retractable to leave a free passage for air flow through the speculum portion.
  • the speculum portion comprises two separable specula blades, each at a fore end of two tongs legs, and the knife unit comprises a U- shaped portion with two resilient legs which slidably engage over the speculum portion and a knife blade which is centrally located between the legs and extends through the speculum portion.
  • the resilient yoke legs are provided with abutment means to limit the depth of introduction of the instrument with the knife unit in its foremost position on the specula blades, and preferably the length of the knife should be such that with the instrument introduced to a maximum amount the point of the knife is situated essentially centrally of the trachea of a normal patient.
  • FIG. 1 shows in perspective a speculum portion of the coniotomy instrument of the present invention
  • FIG. 2 shows in perspective a knife unit of the coniotomy instrument according to the invention
  • FIGS. 3-5 illustrate diagrammatically how the coniotomy instrument shown in FIGS. 1 and 2 is used
  • FIG. 6 shows in perspective a greatly simplified version of a two-part speculum portion of a coniotomy instrument according to the invention.
  • FIG. 7 shows in perspective a knife unit which is slightly modified in relation to the knife unit shown in FIG. 2 and which is intended for use together with the speculum portion shown in FIG. 6.
  • the coniotomy instrument shown in FIGS. 1-2 comprises a speculum portion, generally shown at 10, and a knife unit, generally shown at II.
  • the speculum portion 10 has two frustoconical specula blades l2, 13, with an opening 14 formed therebetween.
  • the specula blades l2, 13 are formed on the front ends of two tongs legs l5, l6 capable of being moved towards and away from each other,'said legs with the illustrated embodiment being pivotally connected together at pivot point 17.
  • the legs 15, 16 are spring biassed for movement towards each other by means of a suitable spring 18.
  • the construction of the legs l5, 16, the pivot bearing 17 therebetween and the construction of the spring means actuating said legs, can be varied within wide limits. Further, the spring means may be omitted, if desirable.
  • the speculum portion 10 can also be made from a wide variety of materials, even though hitherto the most suitable material is considered to be that normally used in the manufacture of conventional hospital and nursing instruments.
  • the knife unit 11 is preferably made of steel and is designed to straddle the specula blades 12, 13.
  • the knife 11 has a knife blade 19 located centrally between two resilient legs 20, 21 of a U-shaped member.
  • the legs 20, 21 are formed integrally with a bight portion 22, also referred to herein as a back plate or web member of said U-shaped member.
  • the web member and the legs are bent from a strip-shaped blank in a manner to form wing-like grip portions 23, 24 at the junction between the web 22 and the rear ends of the legs 20, 21.
  • abutment plates 25, 26 are formed on the front ends of the legs 20, 21, said plates 25, 26 projecting laterally outwards on respective sides of the knife blade 19.
  • the knife unit 1 1 is provided with appropriate locking means which enable the knife unit 11 to be held on the specula blades 12, 12 in a predetermined position, in which the point of the knife is located inwardly of the fore ends of the specula blades 12, 13, Le. inwardly of the front end 13a of the specula blades 13 (FIG. I), for example, thereby obviating the need of providing means to protect the knife edge.
  • One example of such locking means is illustrated in FIG. 2 in the form of a small groove 27 on the inside of the leg 20, said groove being intended to snap over the edge 28 of the rear end of the specula blade 12 when the knife unit 1 1 is mounted to the speculum portion 10.
  • Many different types of locking arrangements suitable for the purpose envisaged are conceivable.
  • FIGS. 3-5 The manner in which the eoniotomy instrument shown in FIGS. 1 and 2 is used will now be described with reference to FIGS. 3-5: The shoulders of the patient are supported so that the patients neck is arched rearwardly. If time permits, the region where the incision is to be made is cleansed and a local anesthetic applied. The instrument is held in one hand with the thumb resting on the back plate 22 of the knife unit 11. In order not to unnecessarily obstruct vision of the knife unit in FIG. 3, the thumb is purposely shown wrongly positioned.
  • the knife unit 11 is affixed to the speculum portion so that, as the instrument is gripped, the knife point 19 is located behind the front ends of the specula blades 12, 13, Le.
  • the place where the incision is to be made is then localized with the index finger of the other hand and the instrument is placed at right angles to the trachea with the point of the knife 19 located as close as possible to the center line thereof. Then the knife is caused to pass through the soft portions of the throat and into the lumen of the trachea, essentially by exerting pressure with the thumb, until the abutment plates 25, 26 of the knife unit 11 engage the throat.
  • the wing members or abutment plates 25, 26 are, of course, intended to prevent the knife blade 19 from penetrating too far into the lumen of the trachea; it will be perceived that for this reason the instrument should be so dimensioned that with the abutment plates 25, 26 abutting the throat, the point of the knife 19, with a normal" patient, should reach to the center of the trachea and that tolerances should be provided for ensuring reliable function of the instrument and safety of use with respect to adult patients whose dimensions deviate from normal.
  • the thumb of said one hand is removed from the back plate 22 of the knife unit 11, whereafter the knife unit 11 is grasped between the thumb and index finger of the other hand and fully withdrawn (FIG. 4) while the speculum portion is retained in position.
  • the speculum portion 10 is then widened, to enable air to pass through.
  • the patient may be transported in this state, optionally subsequent to pivoting the speculum portion 10 so that thetongs legs lie parallel with the longitudinal direction of the trachea.
  • a tracheal cannula provided with a cuff, a shown generally by the reference 28A in FIG. 5.
  • the cannula comprises in principle a bent pipe having an inflatable cuff at its inner end. If such a cannula is used, the speculum portion may be removed, of course. Subsequent to placing the cannula in position and inflating the cuff, respiration can be given to the patient, either by means of an oxygen treatment apparatus of the like or by blowing in air.
  • the coniotomy instrument illustrated in FIGS. 6 and 7 is a simplified embodiment of the aforedescribed instrument.
  • the instrument shown in FIGS. 6 and 7 comprises two specula blades 29, 30 which are slightly bent and pivoted relative to each other either in the form of a fixed pivot connection (eventhough said parts are shown separated) or in the form of a loose pivot connection comprising a pivot cup and a pivot head at each edge of the specula blades 29, 30.
  • Each of the specula blades 29, 30 has at its rear end two grip wings 31, 32 and 33, 34, respectively.
  • the instrument shown in FIGS. 6 and 7 also has a knife unit 35, the two legs 36, 37 of which converge towards each other in a direction toward the point of the interlying knife blade 38.
  • the dimensions of the instrument area such that the rear edges of the specula blades 29, 30, when the knife is inserted, engage in recesses 39 in the legs 36, 37.
  • the front ends of the specula blades then lie close together, abutting the sides of the knife blade 38.
  • the knife unit can be retracted until the edges of the specula blades snap into recesses or grooves 40 in the yoke legs.
  • the yoke legs then move the rear portions of the specula blades together by pivoting around the pivot points of the specula blades, so that the opening between the front ends of the specula blades is widened to permit air to enter the trachea.
  • the wings 31, 32, 33 and 34 can be used as holding means when the knife unit is retracted.
  • An instrument for use in coniotomy comprising:
  • a speculum portion including blades jointly defining an air flow passage extending between an outer and an inner end thereof;
  • a knife unit having a blade movably introducible through said air flow passage and so advanceable that the point of the blade can protrude from said inner end of said speculum portion;
  • a coniotomy instrument according to claim I in which said speculum portion comprises complemental hollow semicylindrical blades.
  • a coniotomy instrument according to claim 4 in which said latch means comprises at least one groove in one of said legs.
  • a coniotomy instrument as claimed in claim 3 wherein said resilient legs have abutment means for limiting the depth of introduction of the knife blade when the knife unit is in its most advanced position on the speculum portion, and wherein the length of the knife blade is such that the point of the knife blade will extend to substantially the center of a trachea.
  • a coniotomy instrument as claimed in claim 2 wherein the knife unit is generally U-shaped and comprises a bight portion which forms a finger grip portion and two resilient legs extending from said bight portion, mutually spaced from each other, said legs being adapted to straddle the specula blades to slidably and removably hold the knife unit thereon and between which said knife blade is centrally located.

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  • Health & Medical Sciences (AREA)
  • Pulmonology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • General Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Surgery (AREA)
  • Emergency Medicine (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Dentistry (AREA)
  • Otolaryngology (AREA)
  • Surgical Instruments (AREA)
US440121A 1973-12-04 1974-02-06 Instrument for use in coniotomy Expired - Lifetime US3893454A (en)

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SE7316352A SE7316352L (de) 1973-12-04 1973-12-04

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Cited By (42)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2596272A1 (fr) * 1986-03-28 1987-10-02 Waltap Ltd Instrument et appareillage pour amenager une ouverture dans le corps d'une personne et placer une canule dans cette ouverture, notamment pour executer une tracheotomie
BE1001515A5 (fr) * 1987-03-27 1989-11-21 Waltap Ltd Necessaire utilise pour effectuer une tracheotomie.
US5186168A (en) * 1984-11-21 1993-02-16 Spofford Bryan T Transtracheal catheter system and method
US5297546A (en) * 1984-11-21 1994-03-29 Bryan T. Spofford Transtracheal catheter system and method
US5407427A (en) * 1992-06-16 1995-04-18 Loma Linda University Medical Center Trocar facilitator for endoscopic surgery
US5443484A (en) * 1992-06-16 1995-08-22 Loma Linda University Medical Center Trocar and method for endoscopic surgery
US5569300A (en) * 1995-04-12 1996-10-29 Redmon; Henry A. Dilating surgical forceps having illumination means on blade inner surface
WO1997037596A1 (en) * 1996-04-10 1997-10-16 Endoscopic Technologies, Inc. Surgical retractor and stabilizing device
US5899854A (en) * 1998-04-20 1999-05-04 University Of New Mexico Speculum and method for inserting an elongated instrument into an animal's body
US5951466A (en) * 1998-04-13 1999-09-14 Viamedics, Llc Self-seating surgical access device and method of gaining surgical access to a body cavity
US5967143A (en) * 1997-09-02 1999-10-19 Klappenberger; Jurgen Surgical instrument for emergency medicine
US5988168A (en) * 1997-05-16 1999-11-23 Bair; Aaron E. Method and apparatus for establishing a surgical airway
US6302842B1 (en) * 2001-01-11 2001-10-16 Innovative Surgical Design Llc Episiotomy retractor
US6309349B1 (en) 1996-04-10 2001-10-30 Endoscopic Technologies, Inc. Surgical retractor and stabilizing device and method for use
US6312377B1 (en) 2000-04-06 2001-11-06 Viamedics, Llc Soft tissue compression shield and method of retracting tissue
US20010053922A1 (en) * 1995-12-07 2001-12-20 Zhu Yong Hua Tissue opening locator and everter and method
US20040002708A1 (en) * 2002-05-08 2004-01-01 Stephen Ritland Dynamic fixation device and method of use
US20040054346A1 (en) * 2000-08-02 2004-03-18 Zhu Yong Hua Vascular wound closure device and method
US6746396B1 (en) 1999-04-13 2004-06-08 Viamedics, Llc Self-seating surgical access device and method of use
US20050080320A1 (en) * 2003-08-14 2005-04-14 Lee Andrew Max Multiple-blade retractor
US6890342B2 (en) 2000-08-02 2005-05-10 Loma Linda University Method and apparatus for closing vascular puncture using hemostatic material
US20050149023A1 (en) * 2001-09-28 2005-07-07 Stephen Ritland Adjustable rod and connector device and method of use
US20050234497A1 (en) * 2001-04-16 2005-10-20 David Hung Externally positioned medical dilator
US20060009768A1 (en) * 2002-04-05 2006-01-12 Stephen Ritland Dynamic fixation device and method of use
US20060079899A1 (en) * 2001-09-28 2006-04-13 Stephen Ritland Connection rod for screw or hook polyaxial system and method of use
US20070189968A1 (en) * 1999-06-11 2007-08-16 Annette Bianchi Gel composition for filling a breast milk duct prior to surgical excision of the duct or other breast tissue
US20070250100A1 (en) * 2006-01-09 2007-10-25 Medical Components, Inc. Pivoting dilator
US20080257359A1 (en) * 2007-04-17 2008-10-23 Royce Rumsey Apparatus And Related Method For Providing A Passage Into The Body
US7455639B2 (en) 2004-09-20 2008-11-25 Stephen Ritland Opposing parallel bladed retractor and method of use
US7753939B2 (en) 2000-06-30 2010-07-13 Stephen Ritland Polyaxial connection device and method
US7763047B2 (en) 2002-02-20 2010-07-27 Stephen Ritland Pedicle screw connector apparatus and method
US20110098538A1 (en) * 2009-10-23 2011-04-28 Beaver-Visitec International (Us), Inc. Speculum
US7959564B2 (en) 2006-07-08 2011-06-14 Stephen Ritland Pedicle seeker and retractor, and methods of use
US8012167B2 (en) 2003-08-14 2011-09-06 Loma Linda University Medical Center Vascular wound closure device and method
US8021399B2 (en) 2005-07-19 2011-09-20 Stephen Ritland Rod extension for extending fusion construct
US8062217B2 (en) 2007-01-26 2011-11-22 Theken Spine, Llc Surgical retractor with removable blades and method of use
US8192463B2 (en) 2007-05-24 2012-06-05 Mcloughlin Joseph Surgical retractor and related methods
US8262571B2 (en) * 2003-05-22 2012-09-11 Stephen Ritland Intermuscular guide for retractor insertion and method of use
US8795326B2 (en) 2007-10-05 2014-08-05 Covidien Lp Expanding seal anchor for single incision surgery
RU170303U1 (ru) * 2016-04-20 2017-04-19 федеральное государственное бюджетное образовательное учреждение высшего образования "Тюменский государственный медицинский университет" Министерства здравоохранения Российской Федерации (ФГБОУ ВО Тюменский ГМУ Минздрава России) Расширитель трахеи для пункционной трахеотомии
US11389609B2 (en) * 2017-06-04 2022-07-19 Unity Health Toronto Tracheotomy device and method
RU2778005C1 (ru) * 2021-07-08 2022-08-12 Федеральное государственное бюджетное образовательное учреждение высшего образования "Ставропольский государственный медицинский университет" Министерства здравоохранения Российской Федерации (ФГБОУ ВО СтГМУ Минздрава России) Устройство для расширения троакарного доступа

Citations (4)

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US831592A (en) * 1906-03-21 1906-09-25 Joseph H Ballard Gynecological appliance.
US2406647A (en) * 1946-08-27 Caponizing instrument
US3182663A (en) * 1961-03-08 1965-05-11 Abelson Louis Cricothyrotomy needle
US3476113A (en) * 1967-08-24 1969-11-04 John J Tarsitano Pocket-sized crico-thyrotomy set

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2406647A (en) * 1946-08-27 Caponizing instrument
US831592A (en) * 1906-03-21 1906-09-25 Joseph H Ballard Gynecological appliance.
US3182663A (en) * 1961-03-08 1965-05-11 Abelson Louis Cricothyrotomy needle
US3476113A (en) * 1967-08-24 1969-11-04 John J Tarsitano Pocket-sized crico-thyrotomy set

Cited By (80)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5186168A (en) * 1984-11-21 1993-02-16 Spofford Bryan T Transtracheal catheter system and method
US5297546A (en) * 1984-11-21 1994-03-29 Bryan T. Spofford Transtracheal catheter system and method
FR2596272A1 (fr) * 1986-03-28 1987-10-02 Waltap Ltd Instrument et appareillage pour amenager une ouverture dans le corps d'une personne et placer une canule dans cette ouverture, notamment pour executer une tracheotomie
BE1001515A5 (fr) * 1987-03-27 1989-11-21 Waltap Ltd Necessaire utilise pour effectuer une tracheotomie.
US5407427A (en) * 1992-06-16 1995-04-18 Loma Linda University Medical Center Trocar facilitator for endoscopic surgery
US5443484A (en) * 1992-06-16 1995-08-22 Loma Linda University Medical Center Trocar and method for endoscopic surgery
US5577993A (en) * 1992-06-16 1996-11-26 Loma Linda University Medical Center Trocar facilitator for endoscopic surgery and method of using the same
US6217602B1 (en) 1995-04-12 2001-04-17 Henry A. Redmon Method of performing illuminated subcutaneous surgery
US5569300A (en) * 1995-04-12 1996-10-29 Redmon; Henry A. Dilating surgical forceps having illumination means on blade inner surface
US20010053922A1 (en) * 1995-12-07 2001-12-20 Zhu Yong Hua Tissue opening locator and everter and method
WO1997037596A1 (en) * 1996-04-10 1997-10-16 Endoscopic Technologies, Inc. Surgical retractor and stabilizing device
US6309349B1 (en) 1996-04-10 2001-10-30 Endoscopic Technologies, Inc. Surgical retractor and stabilizing device and method for use
US5988168A (en) * 1997-05-16 1999-11-23 Bair; Aaron E. Method and apparatus for establishing a surgical airway
US5967143A (en) * 1997-09-02 1999-10-19 Klappenberger; Jurgen Surgical instrument for emergency medicine
US5951466A (en) * 1998-04-13 1999-09-14 Viamedics, Llc Self-seating surgical access device and method of gaining surgical access to a body cavity
US6488620B1 (en) 1998-04-13 2002-12-03 Viamedics, Llc Self-seating surgical access device
US5899854A (en) * 1998-04-20 1999-05-04 University Of New Mexico Speculum and method for inserting an elongated instrument into an animal's body
US6746396B1 (en) 1999-04-13 2004-06-08 Viamedics, Llc Self-seating surgical access device and method of use
US20110200695A1 (en) * 1999-06-11 2011-08-18 Annette Bianchi Gel composition for filling a breast milk duct prior to surgical excision of the duct or other breast tissue
US20070189968A1 (en) * 1999-06-11 2007-08-16 Annette Bianchi Gel composition for filling a breast milk duct prior to surgical excision of the duct or other breast tissue
US6312377B1 (en) 2000-04-06 2001-11-06 Viamedics, Llc Soft tissue compression shield and method of retracting tissue
US7753939B2 (en) 2000-06-30 2010-07-13 Stephen Ritland Polyaxial connection device and method
US20110046664A1 (en) * 2000-08-01 2011-02-24 Loma Linda University Medical Center Vascular wound closure device and method
US8491628B2 (en) 2000-08-01 2013-07-23 Loma Linda University Medical Center Vascular wound closure device and method
US20040054346A1 (en) * 2000-08-02 2004-03-18 Zhu Yong Hua Vascular wound closure device and method
US6890342B2 (en) 2000-08-02 2005-05-10 Loma Linda University Method and apparatus for closing vascular puncture using hemostatic material
US20050209637A1 (en) * 2000-08-02 2005-09-22 Zhu Yong H Apparatus for closing vascular puncture
US9320505B2 (en) 2000-08-02 2016-04-26 Loma Linda University Apparatus for closing vascular puncture
US8425552B2 (en) 2000-08-02 2013-04-23 Loma Linda University Medical Center Apparatus for closing vascular puncture
US7780699B2 (en) 2000-08-02 2010-08-24 Loma Linda University Medical Center Vascular wound closure device and method
US8702750B2 (en) 2000-08-02 2014-04-22 Loma Linda University Apparatus for closing vascular puncture
US9101731B2 (en) 2000-08-02 2015-08-11 Loma Linda University Medical Center Vascular wound closure device and method
US6302842B1 (en) * 2001-01-11 2001-10-16 Innovative Surgical Design Llc Episiotomy retractor
WO2002054961A1 (en) * 2001-01-11 2002-07-18 Innovative Surgical Design Llc Episiotomy retractor
US20050234497A1 (en) * 2001-04-16 2005-10-20 David Hung Externally positioned medical dilator
US9622790B2 (en) 2001-09-19 2017-04-18 Warsaw Orthopedic, Inc. Rod extension for extending fusion construct
US7655025B2 (en) 2001-09-28 2010-02-02 Stephen Ritland Adjustable rod and connector device and method of use
US7695498B2 (en) 2001-09-28 2010-04-13 Stephen Ritland Connection rod for screw or hook polyaxial system and method of use
US20060079899A1 (en) * 2001-09-28 2006-04-13 Stephen Ritland Connection rod for screw or hook polyaxial system and method of use
US20050149023A1 (en) * 2001-09-28 2005-07-07 Stephen Ritland Adjustable rod and connector device and method of use
US7985245B2 (en) 2001-09-28 2011-07-26 Stephen Ritland Connection rod for screw or hook polyaxial system and method of use
US7207992B2 (en) 2001-09-28 2007-04-24 Stephen Ritland Connection rod for screw or hook polyaxial system and method of use
US8221459B2 (en) 2002-02-20 2012-07-17 Stephen Ritland Pedicle screw connector apparatus and method
US7763047B2 (en) 2002-02-20 2010-07-27 Stephen Ritland Pedicle screw connector apparatus and method
US20110022094A1 (en) * 2002-02-20 2011-01-27 Stephen Ritland Pedicle Screw Connector Apparatus and Method
US20060009768A1 (en) * 2002-04-05 2006-01-12 Stephen Ritland Dynamic fixation device and method of use
US8932334B2 (en) 2002-04-05 2015-01-13 Stephen Ritland Dynamic fixation device and method of use
US20100160969A1 (en) * 2002-05-08 2010-06-24 Stephen Ritland Dynamic Fixation Device and Method of Use
US9232967B2 (en) 2002-05-08 2016-01-12 Stephen Ritland Dynamic fixation device and method of use
US9918744B2 (en) 2002-05-08 2018-03-20 Stephen Ritland Dynamic fixation device and method of use
US20100179596A1 (en) * 2002-05-08 2010-07-15 Stephen Ritland Dynamic Fixation Device and Method of Use
US20040002708A1 (en) * 2002-05-08 2004-01-01 Stephen Ritland Dynamic fixation device and method of use
US8690922B2 (en) 2002-05-08 2014-04-08 Stephen Ritland Dynamic fixation device and method of use
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SE375908B (de) 1975-05-05
SE7316352L (de) 1975-05-05

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