New! View global litigation for patent families

USRE45676E1 - System and method for spinal implant placement - Google Patents

System and method for spinal implant placement Download PDF

Info

Publication number
USRE45676E1
USRE45676E1 US13973462 US201313973462A USRE45676E US RE45676 E1 USRE45676 E1 US RE45676E1 US 13973462 US13973462 US 13973462 US 201313973462 A US201313973462 A US 201313973462A US RE45676 E USRE45676 E US RE45676E
Authority
US
Grant status
Grant
Patent type
Prior art keywords
cannula
blades
rod
end
element
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Active
Application number
US13973462
Inventor
Kingsley Richard Chin
T. Wade Fallin
Joshua A. Butters
Daniel F. Justin
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Stryker European Holdings I LLC
Original Assignee
Stryker Spine SAS
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Grant date

Links

Images

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7032Screws or hooks with U-shaped head or back through which longitudinal rods pass
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3417Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421Cannulas
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7035Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7074Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • A61B17/7083Tools for guidance or insertion of tethers, rod-to-anchor connectors, rod-to-rod connectors, or longitudinal elements
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7074Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • A61B17/7083Tools for guidance or insertion of tethers, rod-to-anchor connectors, rod-to-rod connectors, or longitudinal elements
    • A61B17/7085Tools for guidance or insertion of tethers, rod-to-anchor connectors, rod-to-rod connectors, or longitudinal elements for insertion of a longitudinal element down one or more hollow screw or hook extensions, i.e. at least a part of the element within an extension has a component of movement parallel to the extension's axis
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3417Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421Cannulas
    • A61B2017/3443Cannulas with means for adjusting the length of a cannula
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3417Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421Cannulas
    • A61B2017/3445Cannulas used as instrument channel for multiple instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39Markers, e.g. radio-opaque or breast lesions markers

Abstract

A posterior spinal fusion system may include a plurality of cannulas that mate with cages polyaxially coupled to pedicle screws. The cannulas maintain access to the pedicle screws to facilitate percutaneous insertion of a fusion rod into engagement with the cages. Each cannula has a pair of blades that may be held together by an abutment member that at least partially encircles the blades. Each abutment member abuts the skin to define a variable subcutaneous length of the corresponding cannula. Each abutment members is also lockably removable from the corresponding blades to enable the blades to pivot with respect to the connecting element to a position in which they can be withdrawn from the connecting element. The blades of each cannula are spaced apart to provide first and second slots of each cannula, through which the fusion rod can be percutaneously inserted.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS

ThisNotice: More than one reissue application has been filed for the reissue of U.S. Pat. No. 8,002,798. The reissue applications are U.S. application Ser. No. 13/972,493 and U.S. application Ser. No. 13/973,462 (the present application). The present application is a continuation reissue of U.S. application Ser. No. 13/972,493, filed on Aug. 21, 2013, which is an application for reissue of U.S. Pat. No. 8,002,798, which is a continuation-in-part of U.S. application Ser. No. 10/868,075, filed on Jun. 15, 2004, which claims the benefirbenefit of U.S. Provisional Application No. 60/518,580, filed Nov. 8, 2003, the disclosuredisclosures of which are incorporated herein by reference. This application claimU.S. Pat. No. 8,002,798 claims the benefit of U.S. Provisional Application No. 60/682,783, filed on May 19, 2005, the disclosure of which is incorporated herein by reference.

This application relates to U.S. Application Ser. No. 10/669,927, filed on Sep. 24, 2003, the disclosure of which is hereby incorporated herein by reference.

BACKGROUND OF THE INVENTION

1. The Field of the Invention

The present invention relates generally to implantable devices, and more precisely, to posterior spinal fusion systems.

2. The Relevant Technology

Many people experience joint pain in one form or another. In particular, back pain may result from the occurrence of a wide variety of spinal pathologies. Some such pathologies are currently treated by fusing adjacent vertebrae to prevent their relative motion. According to one known method, pedicle screws are implanted in the pedicles and are rigidly secured to a rod passing posterior to the pedicles.

Unfortunately, current procedures often involve the exposure of a relatively large area to permit implantation of the rod. Some current procedures cannot be used to implant a rod that secures more than two vertebrae together. Other known procedures are somewhat complex, and therefore require many parts and surgical steps. Accordingly, there is a need for new fusion rod implantation systems and methods that remedy the shortcomings of the prior art.

BRIEF DESCRIPTION OF THE DRAWINGS

Various embodiments of the present invention will now be discussed with reference to the appended drawings. It is appreciated that these drawings depict only typical embodiments of the invention and are therefore not to be considered limiting of its scope.

FIG. 1 is a perspective view of two adjacent vertebrae of a spine, with guide wires implanted in the pedicles of the right side.

FIG. 2 is a perspective view of three guide wires in isolation, positioned as though implanted in the pedicles of the right sides of three adjacent vertebrae.

FIG. 3 is a perspective view of the guide wires of FIG. 2, with dilators advanced along the guide wires to dilate surrounding tissue.

FIG. 4 is a perspective view of the guide wires and dilators of FIG. 3, with hollow dilators placed around the solid dilators.

FIG. 5 is a perspective view of the guide wires and hollow dilators of FIG. 4, with the solid dilators removed.

FIG. 6 is a perspective view of the guide wires and hollow dilators, with a tapping tool placed over one of the guide wires to tap the corresponding pedicle.

FIG. 7 is an exploded, perspective view of a cannula, abutment member, pedicle screw, cage, set screw, and a portion of a rod according to one embodiment of the invention.

FIG. 8 is a perspective view of the cannula, abutment member, pedicle screw, cage, set screw, and rod portion of FIG. 7, in assembled form.

FIG. 9 is a perspective view of a screw insertion tool according to one embodiment of the invention.

FIG. 10 is a perspective view of the screw insertion tool of FIG. 9, in engagement with the assembly of FIG. 8, excluding the rod portion and the set screw.

FIG. 11 is a perspective view of the screw insertion tool in use to implant the assembly of FIG. 8, excluding rod portions and set screws, over the first guide wire of FIG. 2.

FIG. 12 is a perspective view of a fascia clipping tool according to one embodiment of the invention.

FIG. 13 is a perspective view of the fascia clipping tool of FIG. 12 inserted into one of the cannulas of FIG. 11 to sever the adjoining fascia.

FIG. 14 is a perspective view of a rod insertion tool according to one embodiment of the invention.

FIG. 15 is a perspective view of the rod insertion tool of FIG. 14 secured to a rod to facilitate manual insertion of the rod through the cannulas of FIG. 11.

FIG. 16 is a perspective view of a rod seating tool according to one embodiment of the invention.

FIG. 17 is a perspective view of the rod seating tool of FIG. 16 inserted into one of the cannulas of FIG. 11 to help seat the rod in the cages.

FIG. 18 is a perspective view of a rod holding tool according to one embodiment of the invention.

FIG. 19 is a perspective view of the rod holding tool of FIG. 18 inserted into one of the cannulas of FIG. 11 to further manipulate the rod.

FIG. 20 is a perspective view of a set screw driver according to one embodiment of the invention.

FIG. 21 is a perspective view of the set screw driver of FIG. 20 inserted into one of the cannulas of FIG. 11 to tighten a set screw to retain the rod within the corresponding cage.

FIG. 22 is a perspective view of the pedicle screws, cages, set screws, and cannulas of FIG. 11, with the abutment members removed to permit removal of the cannulas from the cages.

FIG. 23 is a perspective view of three adjacent vertebrae of the spine, with the rod secured to the pedicle screws to provide posterior spinal fusion.

FIG. 24 is a perspective view of a cannula and cage according to one alternative embodiment of the invention, in which the cannula is secured to the cage by two frangible couplings.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

The present invention relates to systems and methods for implantation of orthopedic devices. Although the examples provided herein generally relate to insertion of a rod for a posterior spinal fusion system, the present invention may be applied to any procedure in which a device is to be implanted in the body in a minimally invasive manner. Accordingly, the scope of the present invention is not intended to be limited by the examples discussed herein, but only by the appended claims.

As used herein, a “cannula” is an elongated structure having a hollow interior that provides communication between opposite ends of the elongated structure. A “subcutaneous length” is the portion of an object that lies below the surface of a patient's skin. “Transverse” refers to an object or direction that is not parallel with, and not nearly parallel with, another object or direction. A “connecting element” is any man-made structure that is implantable to remain in the body, and is connectable to an anatomic feature and/or another implantable structure. The term “percutaneous” refers to an action carried out at least partially underneath unbroken skin.

The term “discrete” refers to parts that are not formed as a single piece, but are separate pieces from each other. The term “coupled” refers to two elements that are secured together, whether they have been formed separately and secured together via a secondary operation, or they have been formed as a single piece (i.e., formed in a coupled state). The term “securable” refers to elements that are capable of being coupled together, or are already coupled together. A “blade” is an elongated, thin structure. “Polyaxial motion” refers to motion along or about multiple orthogonal axes.

Referring to FIG. 1, a perspective view illustrates a portion of a spine 10. FIG. 1 illustrates only the bony structures; accordingly, ligaments, cartilage, and other soft tissues are omitted for clarity. The spine 10 has a cephalad direction 12, a caudal direction 14, an anterior direction 16, a posterior direction 18, and a medial/lateral axis 20, all of which are oriented as shown by the arrows bearing the same reference numerals. In this application, “left” and “right” are used with reference to a posterior view, i.e., a view from behind the spine 10. “Medial” refers to a position or orientation toward a sagittal plane (i.e., plane of symmetry that separates left and right sides from each other) of the spine 10, and “lateral” refers to a position or orientation relatively further from the sagittal plane.

As shown, the portion of the spine 10 illustrated in FIG. 1 includes a first vertebra 24, which may be the L5 (Fifth Lumbar) vertebra of a patient, and a second vertebra 26, which may be the L4 (Fourth Lumbar) vertebra of the patient. The systems and methods may be applicable to any vertebra or vertebrae of the spine 10 and/or the sacrum (not shown). In this application, the term “vertebra” may be broadly interpreted to include the sacrum.

As shown, the first vertebra 24 has a body 28 with a generally disc-like shape and two pedicles 30 that extend posteriorly from the body 28. A posterior arch, or lamina 32, extends between the posterior ends of the pedicles 30 to couple the pedicles 30 together. The first vertebra 24 also has a pair of transverse processes 34 that extend laterally from the pedicles 30 generally along the medial/lateral axis 20, and a spinous process 36 that extends from the lamina 32 along the posterior direction 18.

The first vertebra 24 also has a pair of superior facets 38, which are positioned toward the top of the first vertebra 24 and face generally medially. Additionally, the first vertebra 24 has inferior facets 40, which are positioned toward the bottom of the first vertebra 24 and face generally laterally. Each of the pedicles 30 of the first vertebra 24 has a saddle point 42, which is positioned generally at the center of the juncture of each superior facet 38 with the adjacent transverse process 34.

Similarly, the second vertebra 26 has a body 48 from which two pedicles 50 extend posteriorly. A posterior arch, or lamina 52, extends between the posterior ends of the pedicles 50 to couple the pedicles 50 together. The second vertebra 26 also has a pair of transverse processes 54, each of which extends from the corresponding pedicle 50 generally along the medial/lateral axis 20, and a spinous process 56 that extends from the lamina 52 along the posterior direction 18.

The second vertebra 26 also has a pair of superior facets 58, which are positioned toward the top of the second vertebra 26 and face generally inward. Additionally, the second vertebra 26 has inferior facets 60, which are positioned toward the bottom of the second vertebra 26 and face generally outward. Each of the pedicles 60 of the second vertebra 26 has a saddle point 62, which is positioned generally at the center of the juncture of each superior facet 58 with the adjacent transverse process 54.

The superior facets 38 of the first vertebra 24 articulate (i.e., slide and/or press) with the inferior facets 60 of the second vertebra 26 to limit relative motion between the first and second vertebrae 24, 26. Thus, the combination of each superior facet 38 with the adjacent inferior facet 60 provides a facet joint 64. The first and second vertebrae 24, 26 thus define two facet joints 64 that span the distance between the first and second vertebrae 24, 26. The inferior facets 40 of the first vertebra 40 and the superior facets 58 of the second vertebra 26 are part of other facet joints that control motion between the first and second vertebrae 24, 26 and adjacent vertebrae (not shown) and/or the sacrum (also not shown).

The vertebrae 24, 26 and/or the intervertebral disc (not shown) between them, may be damaged or diseased in some manner that makes it desirable to secure the vertebrae 24, 26 together in a manner that prevents relative motion between them. Accordingly, posterior spinal fusion may be employed to secure the pedicles 30, 50 together. FIGS. 1 through 23 illustrate one system and method for installing a posterior spinal fusion system. FIG. 24 illustrates a cannula and cage according to one alternative embodiment of the invention.

As further illustrated in FIG. 1, a first guide wire 70 has been inserted into the right-side pedicle 30 of the first vertebra 24, and a second guide wire 72 has been inserted into the right-side pedicle 50 of the second vertebra 26. The guide wires 70, 72 pass through the saddle points 42, 62, respectively, of the pedicles 30, 50. Each of the guide wires 70, 72 has a proximal end 74 and a distal end 76. As shown, the proximal ends 74 are exposed, and the distal ends 76 are implanted in the pedicles 30, 50. The distal ends 76 may be implanted by methods known in the surgical arts.

Referring to FIG. 2, a perspective view illustrates the first and second guide wires 70, 72 of FIG. 1, with the vertebrae 24, 26 removed for clarity. A third guide wire 78 is also shown. The third guide wire 78 is positioned adjacent to the first and second guide wires 70, 72 as though the third guide wire 78 were implanted in the right-hand pedicle of a vertebra (not shown) directly superior to the second vertebra 26. Accordingly, the method of FIGS. 1 through 23 may be used to secure together vertebrae on multiple levels, not just two adjacent vertebrae.

Referring to FIG. 3, a perspective view illustrates the guide wires 70, 72, 78, in conjunction with a first dilator 80, a second dilator 82, and a third dilator 88. Each of the dilators 180, 82, 88 has a proximal end 92 and a distal end 94. The proximal ends 92 may be shaped for gripping by hand, or for attachment to a handle or the like. The distal ends 94 are rounded to permit relatively gentle spreading of tissues surrounding the guide wires 70, 72, 78 by the dilators 80, 82, 88.

Each of the dilators 80, 82, 88 has a bore sized to receive the proximal end 74 of the corresponding guide wire 70, 72, or 78, so that the dilators 80, 82, 88 are able to slide along the guide wires 70, 72, 78 toward the distal ends 74, thereby spreading the tissues away from the guide wires 70, 72, 78. Each of the dilators 80, 82, 88 may optionally include a plurality of nesting elements that permit discretely gradual dilation. As an alternative to the guide wires 70, 72, 78 and the dilators 80, 82, 88, a variety of other guiding devices and/or dilation devices may be used within the scope of the present invention.

Referring to FIG. 4, a perspective view illustrates the guide wires 70, 72, 78 and dilators 80, 82, 88 of FIG. 3, with first, second, and third hollow dilators 100, 102, 104 placed around the dilators 80, 82, 88, respectively. Each of the hollow dilators 100, 102, 104 has a generally tubular shape with a proximal end 106, a distal end 108, and a bore 110 extending from the proximal end 106 to the distal end 108. Each of the bores 110 is sized to receive the outward-facing surface of the corresponding dilator 80, 82, 88.

Accordingly, the hollow dilators 100, 102, 104 may simply slide along the anterior direction 16 between the outward-facing surfaces of the dilators 80, 82, 88 and the adjoining tissues. The hollow dilators 100, 102, 104 then reach the positions shown in FIG. 4, thereby removing the dilators 80, 82, 88 from significant contact with the tissues to be dilated.

Referring to FIG. 5, a perspective view illustrates the guide wires 70, 72, 78 and hollow dilators 100, 102, 104 of FIG. 4, with the dilators 80, 82, 88 removed. The dilators 80, 82, 88 are simply withdrawn along the posterior direction 18 from within the hollow dilators 100, 102, 104 to leave the bores 110 of the hollow dilators 100, 102, 104 unobstructed.

Referring to FIG. 6, a perspective view illustrates the guide wires 70, 72, 78 and hollow dilators 100, 102, 104, with a tapping tool 120 placed over the first guide wire 70 to tap the corresponding pedicle (not shown in FIG. 6). As shown, the tapping tool 120 may have a handle 122 shaped to be gripped by hand, and a shank 124 extending from the handle 122. The shank 124 has a proximal end 126 coupled to the handle 122 and a distal end 128 having a plurality of threads 130.

The tapping tool 120 also has a bore (not shown) extending through the shank 124 and through at least a portion of the handle 122. The bore is sized to receive any of the guide wires 70, 72, 78 so that the tapping tool 120 can be guided sequentially along each of the guide wires 70, 72, 78 to tap the pedicle 30 of the first vertebra 24, the pedicle 50 of the second vertebra 26, and the pedicle of the third vertebra (not shown in FIG. 6). Tapping is carried out by rotating the handle 122 clockwise while exerting axial pressure on the handle 122 to cause the distal end 128 to penetrate the bone. After a pedicle has been tapped, the distal end 128 is withdrawn from the tapped cavity by rotating the handle 122 counterclockwise.

Referring to FIG. 7, an exploded, perspective view illustrates a connecting element 140, a cannula 142, an abutment member 144, and a rod portion 146 according to one embodiment of the invention. The rod portion 146 is a segment of a longer rod that may be used to secure the first vertebra 24, the second vertebra 26, and the third vertebra (not shown in FIG. 7) together. The connecting element 140 is used to secure the rod portion 146 to one pedicle of the vertebrae to be secured together. The cannula 142 is used to maintain access to the connecting element 140 after it has been implanted in the pedicle in a manner that facilitates percutaneous placement of the rod portion 146 and attachment of the rod portion 146 to the connecting element 140. The abutment member 144 helps to hold the cannula 142 together and keep it secured to the connecting element 140 in a manner that will be described subsequently.

As embodied in FIG. 7, the connecting element 140 has a pedicle screw 150, a cage 152, and a set screw 154. The pedicle screw 150 is the portion of the connecting element 140 that is implanted in the corresponding pedicle. The pedicle screw 150 is able to hold the cage 152 against the pedicle at any of a variety of orientations of the cage 152 with respect to the pedicle screw 150. Thus, the cage 152 is polyaxially movable with respect to the pedicle screw 150 until the set screw 154 is tightened into the cage 152 to lock the orientation of the cage 152 with respect to the pedicle screw 150.

The pedicle screw 150 has a head 160 and a shank 162. The head 160 has a convex semispherical underside that engages the cage 152 in any of a variety of relative orientations to provide the polyaxial coupling described previously. The head 160 also has a hexagonal recess 164 designed to receive a hexagonal end of a pedicle screw driver (not shown in FIG. 7), which will be shown and described subsequently. The shank 162 has a plurality of threads 166 that rotate into threaded engagement with the tapped pedicle. The pedicle screw 150 also has a bore (not shown) extending through the shank 162 and the head 160 to receive any of the guide wires 70, 72, 78 to facilitate guiding of the pedicle screw 150 into engagement with the corresponding pedicle.

The cage 152 has a base 168 in which an aperture 170 is formed. The aperture 170 is sized such that the shank 162 of the pedicle screw 150 may be inserted through the aperture 170. The head 160 of the pedicle screw 150 then rests on a concave semispherical surface of the base 168, within which the head 160 is polyaxially rotatable. The cage 152 also has a pair of arms 172 that extend from the base 168, generally parallel to each other. Each of the arms 172 has a slot 174 and an exterior recess 176. The slots 174 pass through the arms 172 to communicate with the slots 174. Each of the arms 172 has an inward-facing surface on which a plurality of threads 178 are formed to receive the set screw 154. The arms 172 define recesses therebetween, and the recesses form ends of a trough in which the rod portion 146 is able to rest.

As shown, the set screw 154 has a hexagonal recess 180 that enables the set screw 154 to be rotated by a driver that will be shown and described subsequently. The set screw 154 also has an outward-facing surface on which a plurality of threads 182 are formed to enable the set screw 154 to rotate into threaded engagement with the cage 152. Once the rod portion 146 is positioned between the arms 172 of the cage 152, the set screw 154 may be tightened to press the rod portion 146 against the head 160 of the pedicle screw 150, thereby resisting further relative rotation between the cage 152 and the pedicle screw 150.

Upon assembly, the cannula 142, which is shown in exploded form in FIG. 7, will have a proximal end 190 and a distal end 192. The cannula 142 may be dimensioned such that the proximal end 190 protrudes above the skin, while the distal end 192 is securable to the cage 152 and is insertable through the skin along with the cage 152. The cannula 142 includes a first blade 194 and a second blade 196, which may be substantially identical to each other. Each of the blades 194, 196 has a proximal end 198 corresponding to the proximal end 190 of the cannula 142, and a distal end 200 corresponding to the distal end 192 of the cannula 142.

Each proximal end 198 has a proximal tab 202, and each distal end 200 has a distal tab 204. Each proximal tab 202 has a locking ridge 206 that protrudes generally outward, and extends generally circumferentially. Each proximal tab 202 is also elongated, with a thin cross section that permits bending toward and away from the axis (not shown) of the cannula. Each distal tab 204 has bends 208 that cause the distal tab 204 to jut outward, while remaining generally parallel with the remainder of the corresponding blade 194 or 196.

Each of the distal tabs 204 is insertable through the slot 174 of the adjacent arm 172 of the cage 152 when the corresponding blade 194 or 196 is tilted to position the proximal end 198 inward relative to the distal end 200. Once the distal tabs 204 have passed through the slots 174, rotation of the blades 194 or 196 back to a position generally parallel to each other, and to the axis of the cage 152, causes the distal tabs 204 to lie within the exterior recesses 176 of the arms 172 such that the bends 208 are unable to slide back through the slots 174. Thus, the blades 194, 196 are then in a locked configuration, and cannot be detached from the cage 152 until they are again moved to the unlocked configuration, i.e., tilted to position the proximal ends 198 inward.

As long as the blades 194, 196 remain generally parallel to each other, the distal end 192 of the cannula 142 remains secured to the cage 152. Thus, the distal tabs 204 form a docking element that removably secures the cannula 142 to the connecting element 140. The abutment member 144 serves to keep the blades 194, 196 parallel to each other to keep the cannula 142 in assembled form and to simultaneously keep the cannula 142 secured to the cage 152 by keeping the blades 194, 196 from rotating into the unlocked configuration. When the cannula 142 is secured to the cage 152, the cannula 142 is in its “docked configuration.” When the cannula 142 is removed from the cage 152, the cannula 142 is in its “undocked configuration.”

As shown, the abutment member 144 is generally disc-shaped with a central opening 212 and an open side 214 that provides access to the central opening 212. The abutment member 144 also has an interior recess 216 in communication with the central opening 212. Furthermore, the abutment member 144 has a pair of arcuate slots 218 that extend around opposing portions of the central opening 212 and are generally coaxial with the central opening 212. The arcuate slots 218 are sized to receive the first and second blades 194, 196 and to keep the first and second blades 194, 196 generally parallel to each other, and perpendicular to the abutment member 144. Thus, the blades 194, 196 are unable to pivot to the unlocked configuration and the cannula 142 maintains a generally tubular shape.

After the distal ends 200 of the blades 194, 196 are coupled to the cage 152, the proximal ends 198 may be inserted through the arcuate slots 218 of the abutment member 144. Each of the locking ridges 206 has a wedge-like profile. Accordingly, as the locking ridges 206 pass through the arcuate slots 218, the proximal tabs 202 are urged to bend inward. Once the locking ridges 206 move out of the arcuate slots 218, the proximal tabs 202 snap back to an undeflected orientation, and the locking ridges 206 are then positioned outboard of the arcuate slots 218 to interfere with withdrawal of the proximal tabs 202 from the arcuate slots 218. Thus, the proximal tabs 202 act as a locking mechanism that restricts withdrawal of the abutment member 144 from around the cannula 142.

After the blades 194, 196 have been inserted into the arcuate slots 218, the abutment member 144 may be positioned at any of a range of positions along the cannula 142. Thus, upon implantation of the pedicle screw 150 in the corresponding pedicle, the abutment member 144 will abut the outward-facing surface of the patient's skin through which the cannula 142 passes. The abutment member 144 helps to stabilize the cannula 142 with respect to the tissues it passes through.

Referring to FIG. 8, a perspective view illustrates the connecting element 140, the cannula 142, the abutment member 144, and the rod portion 146 of FIG. 7, in assembled form. The shank 162 of the pedicle screw 150 has been inserted through the aperture 170 such that the head 160 of the pedicle screw 150 rests against the base 168 of the cage 152. The rod portion 146 has been positioned between the arms 172 and the set screw 154 has been rotated into engagement with the threads 166 of the arms 172 to keep the rod portion 146 in place and restrict further rotation of the cage 152 relative to the pedicle screw 150.

The distal tabs 204 have also been inserted through the slots 174 of the arms 172 of the cage 152, and the blades 194, 196 have been rotated into the locked configuration. The proximal ends 198 of the blades 194, 196 have been inserted through the arcuate slots 218 of the abutment member 144 to keep the blades 194, 196 in assembled form to define the cannula 142, and to keep the cannula 142 secured to the cage 152. When one or both of the blades 194, 196 are oriented in the unlocked configuration, the blades 194, 196 may still be said to define the cannula 142, although the cannula 142 then has a tapered shape.

Once assembled, the cannula 142 has slots 220 extending along its entire longitudinal length, along opposite sides of the cannula 142. The slots 220 extend to the cage 152, and are therefore contiguous with the recesses defined by the arms 172 of the cage 152. Upon implantation of the pedicle screw 150, the slots 220 will extend along the entire subcutaneous length of the cannula 142. Therefore, the rod portion 146 may be inserted percutaneously through the slots 220 along a direction transverse to the axis of the cannula 146, and may then be moved through the slots 220 along the anterior direction 16, directly into the trough of the cage 152.

Referring to FIG. 9, a perspective view illustrates a screw insertion tool 230 according to one embodiment of the invention. In the embodiment of FIG. 9, the screw insertion tool 230 has a driver 232 designed to rotate the pedicle screw 150 into threaded engagement with the corresponding tapped pedicle, and a countertorque member 234 that maintains the orientation of the cage 152 during rotation of the pedicle screw 150.

The driver 232 has a handle 236 designed to be rotated by hand, and a shank 238 extending from the handle 236. The shank 238 has a proximal end 240 and distal end 242 shaped to drive the pedicle screw 150. The distal end 242 has a hexagonal projection 244 that fits into the hexagonal recess 164 of the head 160 of the pedicle screw 150. The driver 232 also has a bore 246 sized to receive any of the guide wires 70, 72, 78; the bore 246 extends through at least a portion of the shank 238 and, optionally, through all or part of the handle 236 to permit the screw insertion tool 230 to be easily guided along each of the guide wires 70, 72, 78.

The countertorque member 234 has a bore 248 that extends along its entire length, through which the shank 238 of the driver 232 passes. The bore 248 is large enough to permit easy relative rotation between the driver 232 and the countertorque member 234. The countertorque member 234 also has a generally tubular shape with a proximal end 250 and a distal end 252. The proximal end 250 has a plurality of longitudinal ridges 254 designed to be gripped by a user's fingers to restrict rotation of the countertorque member 234. The distal end 252 has a plurality of threads 256 designed to threadably engage the threads 178 of the arms 172 of the cage 152.

Thus, the distal end 252 of the countertorque member 234 can be rotated into engagement with the cage 152 to secure the countertorque member 234 to the cage 152, thereby allowing a user to hold the longitudinal ridges 254 to keep the cage 152 stationary during rotation of the driver 232. The countertorque member 234 also has longitudinal slots 258 that provide access to the bore 248 of the countertorque member 234 for cleaning or other purposes.

Referring to FIG. 10, a perspective view illustrates the screw insertion tool 230 of FIG. 9, in engagement with the assembly of FIG. 8, excluding the rod portion 146 and the set screw 154. The threads 256 of the distal end 252 have been rotated into engagement with the threads 178 of the arms 172, and the hexagonal projection 244 has been inserted into the hexagonal recess 164 of the head 160 of the pedicle screw 150. The screw insertion tool 230 is thus ready to implant the pedicle screw 150 into the corresponding tapped pedicle.

In the alternative to the embodiment illustrated in FIGS. 9 and 10, a screw insertion tool may have a countertorque member that functions independently of threaded engagement with the cage 152. For example, an alternative countertorque member (not shown) may have et projections that slide into the recesses between the arms 172, or engage other features of the cage 152, to prevent relative rotation between the cage 152 and the countertorque member.

Referring to FIG. 11, a perspective view illustrates the screw insertion tool 230 in use to implant the assembly of FIG. 8, excluding rod portions 146 and set screws 154, over the first guide wire 70 of FIG. 2. The handle 236 may be used to actuate the connecting element 140, the cannula 142, and the abutment member 144 along the first guide wire 70. Upon contact of the pedicle screw 150 with the tapped pedicle 30 (not shown in FIG. 11), the handle 236 is rotated while the countertorque member 234 is restrained from rotation via application of pressure on the longitudinal ridges 254. Thus, the pedicle screw 150 is rotated into engagement with the pedicle while keeping the cage 152, the cannula 142, and the abutment member 144 at a relatively constant orientation. As shown, the cannula 142 is oriented such that the slots 220 generally face in the cephalad direction 12 and the caudal direction 14.

As also shown, a second connecting element 260 has been implanted in the pedicle 50 of the second vertebra 26 (not shown in FIG. 11). A second cannula 262 and a second abutment member 264 have been secured to the second connecting element 260 in a manner similar to that of the cannula 142 and the abutment member 144. A third connecting element 270 has been implanted in the pedicle of the third vertebra (not shown in FIG. 11). A third cannula 272 and a third abutment member 274 have been secured to the third connecting element 270 in a manner similar to that of the cannula 142 and the abutment member 144. The second connecting element 260, cannula 262, and abutment member 264 and the third connecting element 270, cannula 272, and abutment member 274 may be substantially identical to the connecting element 140, the cannula 142, and the abutment member 144, as shown in FIGS. 7 and 8.

Referring to FIG. 12, a perspective view illustrates a fascia clipping tool 280 according to one embodiment of the invention. As shown, the fascia clipping tool 280 has a first member 282 and a second member 284 pivotably secured to the first member 284 through the use of a pin 286. The first member 282 has a finger loop 288 designed to receive a user's finger, and a blade 290 extending at a predefined angle from the remainder of the first member 282. Similarly, the second member 284 has a finger loop 292 and a blade 294. The blades 290, 294 have inwardly-oriented sharp edges that provide a scissoring effect when the blades 290, 294 are brought into a parallel configuration.

Referring to FIG. 13, a perspective view illustrates the fascia clipping tool 280 of FIG. 12 inserted into the cannula 142 of FIG. 11 to sever the adjoining fascia (not shown). The skin between the cannulas 142, 262, 272 need not be severed; rather, only the subcutaneous fascia is cut to provide unimpeded percutaneous access to the cages 152 of the connecting elements 150, 260, 270. The open side 214 and the interior recess 216 of each of the abutment members 144, 264, 274 provides the appropriate range of relative motion in the cephalad and caudal directions 12, 14 for the first and second members 282, 284 to permit relatively easy cutting of the fascia with little or no damage to the surrounding tissue (not shown).

Referring to FIG. 14, a perspective view illustrates a rod insertion tool 300 according to one embodiment of the invention. As shown, the rod insertion tool 300 has a handle 302 shaped to be grasped by hand, and a shank 304 extending from the handle 302. The handle 302 has a knob 306 that can be rotated by hand to control retention of a rod (not shown in FIG. 14) by the rod insertion tool 300. The shank 304 has a proximal end 308 secured to the handle 302 and a distal end 310 that receives and is securable to the end of the rod.

More precisely, the distal end 310 may have a rod coupling 312 securable to the rod through the use of a mechanism such as a collet or gripper. Such a mechanism may be actuated by rotating the knob 306. According to alternative embodiments of the invention, an interference fit or another similar mechanism may be used to retain the rod in such a manner that the rod can be removed when a threshold removal force is applied. The shank 304 has a plurality of slots 314 distributed along the length of the shank 304 to provide access to a bore (not shown) of the shank 304 for cleaning or other purposes.

Referring to FIG. 15, a perspective view illustrates the rod insertion tool 300 of FIG. 14 secured to a rod 316 to facilitate manual insertion of the rod 316 through the cannulas 142, 262, 272 of FIG. 11. As shown, the rod 316 has a leading end 317 and a trailing end 318 secured to the rod coupling 312 of the rod insertion tool 300. Prior to insertion underneath the skin, the rod 316 may be contoured based on the morphology of the patient's spine so that the rod 316 will maintain the proper lordotic angle between the first vertebra 24, the second vertebra 26, and the third vertebra. Alternatively, the rod 316 may be pre-lordosed to provide a lordotic angle suitable for most patients. The rod 316 may optionally be selected from a kit (not shown) containing multiple, differently angled rods.

The leading end 317 is first inserted through the skin (not shown) of the patient by inserting the leading end 317 through the proximal end 190 of the cannula 142, and through the central opening 212 of the abutment member 144. Once underneath the skin, the handle 302 is manipulated to insert the leading end 317 through the opening formed in the fascia, through the slots 220 of the second cannula 262, and through at least one slot 220 of the third cannula 272 and/or through at least one recess of the cage 152 of the third connecting element 270. Then, the rod 316 may be detached from the rod insertion tool 300.

Referring to FIG. 16, a perspective view illustrates a rod seating tool 320 according to one embodiment of the invention. As shown, the rod seating tool 320 has a handle 322 shaped to be gripped by hand, and a shank 324 extending from the handle 322. The shank 324 has a proximal end 326 adjacent to the handle 322 and a distal end 328 shaped to push the rod 316 into place. More precisely, the distal end 328 may have a blade 330 with a generally thin cross section. The blade 330 may terminate in an arcuate recess 332 with a radius matching that of the rod 316.

Referring to FIG. 17, a perspective view illustrates the rod seating tool 320 of FIG. 16 inserted into the second cannula 262 of FIG. 11 to help seat the rod 316 in the cages 152 of the connecting elements 140, 260, 270. As shown, the distal end 328 of the rod seating tool 320 may simply be inserted through the second cannula 262 until the arcuate recess 332 of the blade 330 abuts the rod 316. Then, pressure is applied via the handle 322 to urge the rod 316 to slide along the slots 220, in the anterior direction 16 until the rod 316 is seated generally within the troughs of the cages 152 of the connecting elements 140, 260, 270. The distal end 328 may similarly be inserted into the cannula 142, the third cannula 272, or any combination of the cannulas 142, 262, 272 until the rod 316 has been positioned to pass through all of the cages 152.

Referring to FIG. 18, a perspective view illustrates a rod holding tool 18 according to one embodiment of the invention. The rod holding tool 18 is designed to grip the rod 316 to permit translation of the rod 316 along its axis or rotation of the rod 316 about its axis. As embodied in FIG. 18, the rod holding tool 18 has first handle 342, a second handle 344, a central body 346, a shank 348, a pin 350, a first leaf spring 352, a second leaf spring 354, and a pair of screws 356.

The first handle 342 has a proximal end 360 and a distal end 362. The proximal end 360 has a transverse extension 364 that facilitates gripping of the first handle 342, for example, with the fingers of one hand. The proximal end 360 also has a hole 366 with threads designed to receive threads (not shown) of the corresponding screw 356. The distal end 362 has a blade 368 that is pivotably coupled to the central body 346 by the pin 350.

The second handle 344 has a proximal end 370 and a distal end 372. The proximal end 370 has a hole (not shown) similar to the hole 366 of the proximal end 360 of the first handle 342. The distal end 372 may be formed as a single piece with the central body 346. The central body 346 has a slot 374 that receives the blade 368 of the distal end 362 of the first handle 342. The pin 350 passes through the slot 374 to extend through the blade 368, thereby providing the pivotable coupling between the central body 346 and the first handle 342. The central body 346 also has a projection 376 that extends generally distally.

The shank 348 has a proximal end 380 at which the shank 348 is secured to the projection 376 of the central body 346, and a distal end 382 designed to grip the rod 316 in response to pressure applied to squeeze the first and second handles 342, 344 together. More precisely, the distal end 382 has an arcuate recess 384 with a radius matched to that of the rod 316, and an arcuate extension 386 with a radius equal or similar to that of the arcuate recess 384.

The shank 348 also has a stationary arm 387 and a sliding arm 388, each of which has a generally half-circular cross sectional shape. The stationary arm 387 is rigidly attached to the projection 376, and the sliding arm 388 is slidably coupled to the stationary arm 387. The arcuate extension 386 is on the stationary arm 387, and the arcuate recess 384 is on the sliding arm 388. The sliding arm 388 is coupled to the blade 368 of the first handle 342 within the central body 346 such that pivotal motion of the first handle 342 urges the sliding arm 388 to slide distally along the stationary arm 387.

The first leaf spring 352 has a fixed end 390 secured to the first handle 342 by the corresponding screw 356, and a coupled end 392 coupled to the second leaf spring 354. Similarly, the second leaf spring 354 has a fixed end 394 secured to the second handle 344 by the other screw 356, and a coupled end 396 coupled to the coupled end 392 of the first leaf spring 352. The coupled ends 392, 396 may be interlocked in an interdigitated manner that permits relative rotation of the coupled ends 392, 396. Thus, the leaf springs 352, 354 cooperate to provide resilient force urging the first and second handles 342, 344 to move apart, thereby urging the distal end 382 of the shank 348 to release the rod 316 in the absence of force urging the handles 342, 344 together.

In order to use the rod holding tool 340, a portion of the rod 316 may first be positioned to abut the arcuate surface of the arcuate extension 386. When the first and second handles 342, 344 are squeezed together, for example, by hand, the sliding arm 388 slides distally along the stationary arm 387. As the sliding arm 388 slides along the stationary arm 387, the arcuate recess 384 moves toward the arcuate extension 386 until the arcuate surface of the arcuate recess 384 is contiguous with the arcuate surface of the arcuate extension 386. The arcuate recess 384 then cooperates with the arcuate extension 386 to capture the rod 316 so that the rod holding tool 340 can be used to axially rotate or translate the rod 316, as desired.

Referring to FIG. 19, a perspective view illustrates the rod holding tool 340 of FIG. 18 inserted into the second cannula 262 of FIG. 11 to further manipulate the rod 316. As shown, the distal end 382 of the shank 348 has been inserted through the second cannula 262 to position the arcuate extension 386 adjacent to the rod 316. The first and second handles 342, 344 have also been squeezed together to slide the arcuate recess 384 against the rod 316 to capture the rod 316. Thus, the rod 316 can be translated or rotated in any direction. More particularly, if the rod 316 is not yet rotated to the proper orientation to pass properly through the cages 152, the rod 316 may be rotated axially through the use of the rod holding tool 340. The rod 316 may also be translated axially if needed. Fluoroscopy or other known methods may be used to check the position and orientation of the rod 316 with respect to the cages 152.

Referring to FIG. 20, a perspective view illustrates a set screw driver 400 according to one embodiment of the invention. As shown in FIG. 20, the set screw driver 400 has a handle 402 and a shank 404 extending from the handle 402. The handle 402 has a pair of oppositely disposed transverse extensions 406 that protrude to facilitate manual gripping and rotation of the handle 402. The shank 404 has a proximal end 408 adjacent to the handle 402 and a distal end 410 designed to transmit torque to the set screw 154. The distal end 410 may have a hexagonal projection 412 insertable into the hexagonal recess 180 of the set screw 154.

Referring to FIG. 21, a perspective view illustrates the set screw driver 400 of FIG. 20 inserted into the cannula 142 of FIG. 11 to tighten the corresponding set screw 154 to retain the rod 316 within the corresponding cage 152. The set screws 154 may be applied after the rod 316 has been properly positioned with respect to the cages 152.

The hexagonal projection 412 may first be inserted into the hexagonal recess 180 of the set screw 154. Then, the handle 402 may be gripped and used to insert the set screw 154 into position adjacent to the threads 178 of the arms 172 of the cage 152 of the connecting element 140. The handle 402 may then be rotated clockwise to cause the threads 182 of the set screw 154 to rotate into engagement with the threads 178. The handle 402 may be rotated clockwise until the set screw 154 presses firmly against the rod 316 to keep the rod 316 in place within the corresponding cage 152, and to restrict further rotation of the cage 152 with respect to the corresponding pedicle screw 150. All three of the set screws 154 may be positioned and tightened in this manner to complete assembly of the posterior spinal fusion system.

In addition to the set screw driver 400 of FIGS. 20 and 21, a countertorque member (not shown) may be provided. Such a countertorque member may engage the cage 152 to keep the cage 152 from rotating while the set screw 154 is tightened.

Referring to FIG. 22, a perspective view illustrates the fully assembled posterior spinal fusion system including the connecting elements 140, 260, 270 and the rod 316, with the cannulas 142, 262, 272 still secured to the cages 152 of the connecting elements 140, 260, 270, but with the abutment members 144, 264, 274 removed from the cannulas 142, 262, 272. The abutment members 144, 264, 274 may be removed from the cannulas 142, 262, 272 by squeezing the proximal tabs 202 of each cannula 142, 262, 272 together, for example, with the thumb and forefinger of a hand. The locking ridges 206 are thereby moved into alignment with the arcuate slots 218 of the abutment members 144, 264, 274 so that the abutment members 144, 264, 274 can be withdrawn along the posterior direction 18 from the corresponding cannulas 142, 262, 272, respectively.

As mentioned previously, once the abutment members 144, 264, 274 have been removed, the blades 194, 196 of each cannula 142, 262, 272 may be pivoted into the unlocked configuration. The distal tabs 204 may then be withdrawn from the slots 174 of the arms 172 of the cages 152, and out of the patient's body. Then, the incisions made to accommodate the cannulas 142, 262, 272 may be closed and treated through the use of methods known in the art.

Referring to FIG. 23, a perspective view illustrates the completed posterior spinal fusion system. In addition to the first and second vertebrae 24, 26, FIG. 23 illustrates a third vertebra 428 superior to the second vertebra 26. The third vertebra 428 has features similar to those set forth in the description of the first and second vertebrae 24, 26. Most pertinently, the third vertebra 428 has pedicles 430 with saddle points 432.

As shown, the pedicle screw 150 of the first connecting element 140 is implanted in the pedicle 30 of the right side of the first vertebra 24, the pedicle screw 150 of the second connecting element 260 is implanted in the pedicle 50 of the right side of the second vertebra 26, and the pedicle screw 150 of the third connecting element 270 is implanted in the pedicle 430 of the right side of the third vertebra 428. The rod 316 passes through the troughs of the cages 152 in a manner that preserves the proper lordosis of the spine 10. The set screws 154 have been rotated into engagement with the cages 152 and tightened to keep the rod 316 in place within the troughs of the cages 152 and to substantially eliminate rotation of the cages 152 relative to their respective vertebrae 24, 26, 428.

The connecting elements 140, 260, 270 thus cooperate with the rod 316 to restrict relative motion of the vertebrae 24, 26, 428 to form a posterior vertebral fusion system. If desired, a similar system may be implanted in the left-side pedicles 30, 50, 430 of the vertebrae 24, 26, 428 through the method set forth previously to provide a bilateral system. Additionally, the present invention is not limited to a three-level fusion system, but may be used to fuse any number of vertebrae together. To fuse more than three vertebrae together, the steps set forth above may simply be repeated for each additional vertebra, and the rod may be inserted through the skin via a first cannula, and then percutaneously inserted through three or more additional cannulas.

A variety of alternative embodiments of the invention may be used in place of the method and components illustrated in FIGS. 1-23. For example, a variety of different connecting elements known in the art may be used in place of the connecting elements 140, 260, 270 shown and described previously. Polyaxially rotatable cages are an optional feature of such connecting elements. Cannulas different from the cannulas 142, 262, 272 set forth above may be used, and need not be formed of multiple separate pieces, but may instead be single piece structures. Such cannulas may have slots that terminate toward their proximal ends.

A variety of different docking elements may be used in place of the distal tabs 204 and the slots 174. Such docking elements may include threaded engagement, collets, pin-and-locking-groove systems, interference fit couplings, snap-fit couplings, and the like. Additionally, a variety of locking mechanisms may be used in place of the proximal tabs 202. Such locking mechanisms may include locking members securable to the proximal ends 190 of the cannulas 142, 262, 272 to interfere with withdrawal of the abutment members 144, 264, 274 therefrom, or locking members movably coupled to the proximal ends 190. Additionally, a wide variety of interfaces may be provided between each cannula 142, 262, 272 and the corresponding abutment member 144, 164, 274 to restrict withdrawal of the abutment members 144, 264, 274 from the cannulas 142, 262, 272.

Furthermore, each of the instruments set forth previously, including the screw insertion tool 230, the fascia clipping tool 280, the rod insertion tool 300, the rod seating tool 320, the rod holding tool 340, and the set screw driver 400, may be replaced with an alternatively configured tool that performs a similar function. The steps recited above need not necessarily be performed in the order provided, but may instead be rearranged, and some steps may be omitted and/or other steps may be added, to provide alternative methods within the scope of the invention.

According to one alternative embodiment of the invention, a connecting element may have a cage pre-attached to a cannula that provides access to the cage. Such an alternative embodiment will be shown and described in greater detail in connection with FIG. 24.

Referring to FIG. 24, a perspective view illustrates a cannula 442 and a cage 452 according to one alternative embodiment of the invention in which the cannula 442 and the cage 452 are initially secured together. The cage 452 may be part of a connecting element like the connecting elements 140, 260, 270 set forth previously. Accordingly, the cage 452 may be polyaxially coupled to a pedicle screw like the pedicle screw 150 of FIG. 7, and may be designed to receive a rod portion 146 like that of FIG. 7. The cage 452 may also receive a set screw 154 like that of FIG. 7 to keep the rod portion 146 in place and restrain pivotal relative motion between the cage 452 and the pedicle screw 150.

As shown in FIG. 24, the cage 452 has a base 168 with an aperture 170 designed to receive the pedicle screw 150. The cage 452 has a pair of arms 472 extending from the base 168. The arms 472 need not have slots 174 or exterior recesses 176 like the arms 172 of the cage 152 of FIG. 7. However, each of the arms 472 does have threads 478 that face inward to receive the set screw 154.

The cannula 442 has a generally tubular shape with a proximal end 490 and a distal end 492. The cannula 442 includes a first blade 494 and a second blade 496 positioned opposite the first blade 494. Each of the blades 494, 496 has a proximal end 498 that is substantially free, and a distal end 500 pre-attached to the corresponding arm 472 of the cage 452. In the embodiment of FIG. 24, the distal ends 500 are formed as a single piece with the arms 472, and are separated from the arms 472 by frangible portions 504 of the distal ends 500. The cannula 442 has a pair of slots 520 positioned opposite to each other to permit percutaneous insertion of the rod 316 therein, as described in connection with the previous embodiment.

Each frangible portion 504 may take the form of a necked-down region designed to fracture in response to application of a certain pre-established threshold linear force or angular moment. More precisely, each frangible portion 504 may fracture in response to force tending to tilt the blades 494, 496 to push the proximal ends 498 inward, toward the axis of the cannula 442. Thus, the frangible portions 504 define a frangible coupling between the cannula 442 and the cage 452.

In use, the cannula 442 and the cage 452 may be used in a manner similar to that set forth in FIGS. 1-23. However, the cannula 442 and the cage 452 need not be secured together, since they are formed as a single piece. Additionally, no abutment member may be necessary, although an abutment member (not shown) somewhat similar to the abutment member 144 may optionally be used to maintain the proper relative displacement of the blades 494, 496 during use. After implantation of the rod 316, removal of the blades 494, 496 from the cage 452 may be accomplished by tilting the blades 494, 496 inward as described previously to fracture the frangible portions 504, thereby permitting separation of the blades 494, 496 from the cage 452.

According to other alternative embodiments (not shown), blades may be pre-attached to a cage in a manner that does not require the blades to be formed as a single piece with the cage. For example, the blades may be welded, mechanically fastened, or otherwise pre-attached to the cage. Such embodiments may optionally have frangible portions. Alternatively, the blades may be removable in other ways, such as via removal of a mechanical fastener.

The foregoing description discloses a number of different elements that may be combined in various ways to provide a number of alternative implantable systems. Although the foregoing examples relate to implantation of a posterior spinal fusion system, the present invention may be applied to a wide variety of implants, within and outside the orthopedic area.

The present invention may be embodied in other specific forms without departing from its spirit or essential characteristics. It is appreciated that various features of the systems and methods described above can be mixed and matched to form a variety of other alternatives. As such the described embodiments are to be considered in all respects only as illustrative and not restrictive. The scope of the invention is, therefore, indicated by the appended claims rather than by the foregoing description. All changes which come within the meaning and range of equivalency of the claims are to be embraced within their scope.

Claims (77)

The invention claimed is:
1. A system for providing access to a spine of a patient, the system comprising:
a first connecting element implantable in a first vertebra of a spine; and
a first cannula adapted to receive at least a portion of a spinal fusion rod therealong, the first cannula comprising:
a first blade; and
a second blade discrete from the first blade;
wherein the first and second blades are configured to be assembled together substantially parallel to each other and mated with the first connecting element, without being directly connected to one another, in order to provide the first cannula such that the first cannula has a distal end terminating at the connecting element, whereby the first cannula provides access to the spine when the first connecting element is implanted in the first vertebra of the spine; and
wherein the first and second blades are independently detachable from the first connecting element such that the first and second blades are independently removable from the patient.
2. The system of claim 1, wherein the connecting element comprises a pedicle screw implantable in a pedicle of the first vertebra, and a cage polyaxially movable with respect to the pedicle screw.
3. The system of claim 1, wherein the first and second blades are configured to be disassembled from one another without removing the distal end from within the patient.
4. The system of claim 3, wherein each of the first and second blades comprises a locked configuration, in which the blade is secured to the connecting element, and an unlocked configuration, in which the blade is removable from the connecting element, wherein each of the first and second blades is movable between the locked and unlocked configurations in response to rotation of the blade with respect to the connecting element.
5. The system of claim 4, wherein each of the first and second blades is movable between the locked and unlocked configurations in response to rotation of the blade about an axis substantially perpendicular to a longitudinal axis of the first cannula.
6. The system of claim 1, further comprising an abutment member configured to engage the first and second blades to restrict relative motion between the first and second blades.
7. The system of claim 6, wherein the abutment member is lockable with respect to the first and second blades by a locking mechanism that restricts withdrawal of the abutment member from the first and second blades.
8. The system of claim 7, wherein the locking mechanism comprises a plurality of proximal tabs of the first and second blades, wherein the proximal tabs are bendable to permit withdrawal of the abutment member from the first and second blades.
9. The system of claim 1, further comprising an abutment member encircling at least a portion of the first cannula to abut an exterior skin surface of the patient, wherein the abutment member is movable along the first cannula to define a variable subcutaneous length of the first cannula.
10. The system of claim 9, wherein the abutment member is shaped such that a combined length of the first cannula and the abutment member does not change in response to motion of the abutment member along the first cannula.
11. The system of claim 1, wherein the first and second blades are shaped such that, when positioned to define the first cannula, the first and second blades provide a first slot in a side wall of the first cannula.
12. The system of claim 11, wherein the first and second blades are further shaped such that, when positioned to define the first cannula, the first and second blades provide a second slot in the side wall, wherein the second slot is arranged with respect to the first slot to permit passage of a rod through the first cannula along a direction transverse to a longitudinal axis of the first cannula.
13. The system of claim 12, wherein the distal end is insertable into the patient proximate the spine such that each of the first and second slots extends unbroken along an entire subcutaneous length of the cannula.
14. The system of claim 1, further comprising a second cannula securable to a second connecting element implantable in a second vertebra of the spine, and a third cannula securable to a third connecting element implantable in a third vertebra of the spine, wherein the first, second, and third cannulas cooperate to facilitate attachment of a rod to the first, second, and third connecting elements to restrict relative motion of the first, second, and third vertebrae.
15. The system of claim 1, wherein the first and second blades have arcuate profiles, whereby the first cannula is defined by a partially cylindrical shape.
16. The system of claim 1, wherein the first and second blades each have a distal end including a tab insertable into a corresponding slot of the first connecting element.
17. The system of claim 1, further comprising an abutment member configured to prevent the first and second blades from becoming disconnected from the first connecting element.
18. A system for providing access to a spine of a patient, the system comprising:
a cannula adapted to receive at least a portion of a spinal fusion rod therealong, the cannula comprising a proximal end and a distal end insertable into the patient proximate the spine, the distal end comprising a docking element discrete from and securable to a connecting element implantable in a first vertebra of the spine;
wherein the docking element is receivable by the connecting element in both a docked configuration and an undocked configuration, the distal end being secured to the connecting element in the docked configuration, and the distal end being received by and removable from the connecting element in the undocked configuration, and wherein the docking element is movable between the docked and undocked configurations in response to rotation about an axis substantially perpendicular to a longitudinal axis of the cannula.
19. The system of claim 18, wherein the connecting element comprises a pedicle screw implantable in a pedicle of the first vertebra, and a cage polyaxially movable with respect to the pedicle screw, wherein the docking element is configured to dock with the cage.
20. The system of claim 19, wherein the cannula comprises:
a first blade; and
a second blade discrete from the first blade;
wherein the first and second blades are positionable substantially parallel to each other to provide the first cannula;
wherein each of the first and second blades comprises a locked configuration, in which the blade is secured to the connecting element, and an unlocked configuration, in which the blade is removable from the connecting element.
21. The system of claim 18, wherein the docking element includes a plurality of tabs, each of the first and second blades comprising at least one of the tabs at a distal end thereof, the tabs enabling rotation of the blades between the locked configuration and the unlocked configuration.
22. The system of claim 18, further comprising an abutment member configured to engage the first and second blades to restrict relative motion between the first and second blades to restrict motion of the blades to the unlocked configuration.
23. The system of claim 22, wherein the abutment member is lockable with respect to the first and second blades by a locking mechanism that restricts withdrawal of the abutment member from the first and second blades.
24. The system of claim 23, wherein the locking mechanism comprises a proximal tab of each of the first and second blades, wherein the proximal tabs are bendable to permit withdrawal of the abutment member from the first and second blades.
25. A system for providing access to a spine of a patient, the system comprising:
a cannula adapted to receive at least a portion of a spinal fusion rod therealong, the cannula comprising a distal end insertable into the patient proximate the spine and securable to a connecting element implantable in a first vertebra of the spine, the cannula further comprising a proximal end and a longitudinal axis extending between the proximal and distal ends; and
an abutment member encircling at least a portion of the cannula and adapted to abut an outward facing surface of skin of the patient, the entire length of the abutment member along the longitudinal axis of the cannula being disposed between the proximal and distal ends of the cannula, wherein the abutment member is adapted to move along the cannula from the proximal end to the distal end such that the abutment member can be moved to a position abutting the outward facing surface of skin when the distal end of the cannula is secured to the connecting element, whereby a variable subcutaneous length of the cannula is defined, and wherein a combined length of the cannula and the abutment member does not change in response to motion of the abutment member along the cannula.
26. The system of claim 25, wherein the cannula comprises:
a first blade; and
a second blade discrete from the first blade;
wherein the first and second blades are positionable substantially parallel to each other to provide the cannula.
27. The system of claim 26, wherein the abutment member is configured to engage the first and second blades to restrict relative motion between the first and second blades.
28. The system of claim 25, wherein the abutment member is lockable with respect to the cannula by a locking mechanism that restricts withdrawal of the abutment member from the cannula.
29. The system of claim 28, wherein the locking mechanism comprises a plurality of proximal tabs of the cannula, wherein the proximal tabs are bendable to permit withdrawal of the abutment member from the cannula.
30. The system of claim 25, wherein the cannula comprises a first slot extending longitudinally along a side wall of the cannula.
31. The system of claim 25, wherein the cannula comprises a docking element that couples the cannula to a connecting element implantable in a vertebra of the spine, wherein the docking element comprises a frangible coupling configured to fracture in response to application of a threshold force against the frangible coupling to permit removal of the distal end from the connecting element.
32. A system for providing access to a spine of a patient, the system comprising:
a cannula comprising:
a first component; and
a second component discrete from the first component;
and
an abutment member;
wherein the first and second components are configured to be assembled to a connecting element implantable in a first vertebra of the spine, wherein each of the first and second components has a distal end receivable in the connecting element in a receiving position and a locked position, each of the first and second components being movable between the receiving position and the locked position in response to rotation about an axis substantially perpendicular to a longitudinal axis of the cannula, wherein the abutment member configured to engage the first and second components to restrict relative motion between the first and second components, and wherein the abutment member is lockable with respect to the first and second components by a locking mechanism that restricts withdrawal of the abutment member from the first and second blades.
33. The system of claim 32, wherein the first component comprises a first blade, and the second component comprises a second blade, wherein the first and second blades are positionable substantially parallel to each other to provide the cannula.
34. The system of claim 33, wherein the distal end comprises a docking element securable to a connecting element implantable in a first vertebra of the spine, wherein each of the first and second blades is secured to the connecting element in the locked position and received within but removable from the connecting element in the receiving position.
35. The system of claim 32, wherein the locking mechanism comprises a plurality of proximal tabs of the first and second components, wherein the proximal tabs are bendable to permit withdrawal of the abutment member from the first and second components.
36. The system of claim 32, wherein the first and second components have arcuate surfaces, whereby the cannula is defined by a partially cylindrical shape.
37. A system for providing access to a spine of a patient, the system comprising:
a cannula adapted to receive at least a portion of a spinal fusion rod therealong, the cannula having a longitudinal axis and comprising a distal end insertable into the patient proximate the spine, and a proximal end, the distal end comprising a docking element securable to a connecting element implantable in a first vertebra of the spine; and
an abutment member encircling at least a portion of the cannula, the abutment member having an abutment surface substantially normal to the longitudinal axis, the abutment surface adapted to abut an exterior skin surface of the patient, wherein the abutment member is adapted to move along the cannula from the proximal end to the distal end such that the abutment member can be moved to a position wherein the abutment surface abuts the exterior skin surface when the docking element is secured to the connecting element implanted in the first vertebra of the spine, whereby a variable subcutaneous length of the cannula is defined.
38. The system of claim 37, wherein the connecting element comprises a pedicle screw implantable in a pedicle of the first vertebra, and a cage polyaxially movable with respect to the pedicle screw.
39. The system of claim 37, wherein the abutment member is lockable with respect to the cannula by a locking mechanism that restricts withdrawal of the abutment member from the cannula.
40. The system of claim 39, wherein the locking mechanism comprises a plurality of proximal tabs of the cannula, wherein the proximal tabs are bendable to permit withdrawal of the abutment member from the cannula.
41. The system of claim 37, wherein the abutment member is shaped such that a combined length of the cannula and the abutment member does not change in response to motion of the abutment member along the cannula.
42. The system of claim 37, wherein the cannula further comprises a first slot portion formed in a side wall of the cannula.
43. The system of claim 42, wherein the cannula further comprises a second slot portion formed in the side wall, wherein the second slot is arranged with respect to the first slot to permit passage of a rod through the cannula along a direction transverse to the longitudinal axis of the cannula.
44. The system of claim 43, wherein the distal end is insertable into the patient proximate the spine such that each of the first and second slots extends unbroken along the entire subcutaneous length.
45. The system of claim 37, wherein the docking element comprises a frangible coupling configured to fracture in response to application of a threshold force against the frangible coupling to permit removal of the distal end from the connecting element.
46. The system of claim 37, wherein the cannula comprises:
a first blade; and
a second blade discrete from the first blade;
wherein the first and second blades are positionable substantially parallel to each other to provide the cannula, and wherein the abutment member is configured to engage the first and second blades to restrict relative motion between the first and second blades.
47. A system for providing access to a spine of a patient, the system comprising:
a cannula adapted to receive at least a portion of a spinal fusion rod therealong, the cannula comprising a distal end insertable into the patient proximate the spine and securable to a connecting element implantable in a first vertebra of the spine, the cannula further comprising a proximal end and a first slot extending longitudinally between the distal and proximal ends; and
an abutment member encircling at least a portion of the cannula, the abutment member having an abutment surface extending substantially laterally from an outer surface of the cannula, the abutment surface adapted to abut an exterior skin surface of the patient, wherein the abutment member is adapted to move along the cannula from the proximal end to the distal end such that the abutment member can be moved to a position wherein the abutment surface abuts the exterior skin surface when the distal end of the cannula is secured to the connecting element implanted in the first vertebra of the spine, whereby a variable subcutaneous length of the cannula is defined.
48. The system of claim 47, wherein the abutment member is lockable with respect to the cannula by a locking mechanism that restricts withdrawal of the abutment member from the cannula.
49. The system of claim 48, wherein the locking mechanism comprises a plurality of proximal tabs of the cannula, wherein the proximal tabs are bendable to permit withdrawal of the abutment member from the cannula.
50. The system of claim 47, wherein the abutment member is shaped such that a combined length of the cannula and the abutment member does not change in response to motion of the abutment member along the cannula.
51. The system of claim 47, wherein the cannula further comprises a second slot portion formed in the side wall, wherein the second slot is arranged with respect to the first slot to permit passage of a rod through the cannula along a direction transverse to a longitudinal axis of the cannula.
52. The system of claim 51, wherein the distal end is insertable into the patient proximate the spine such that each of the first and second slots extends unbroken along the entire subcutaneous length.
53. The system of claim 47, wherein the cannula comprises a docking element that couples the cannula to a connecting element implantable in a vertebra of the spine, wherein the docking element comprises a frangible coupling configured to fracture in response to application of a threshold force against the frangible coupling to permit removal of the distal end from the connecting element.
54. The system of claim 47, wherein the cannula comprises:
a first blade; and
a second blade discrete from the first blade;
wherein the first and second blades are positionable substantially parallel to each other to provide the cannula, and wherein the abutment member is configured to engage the first and second blades to restrict relative motion between the first and second blades.
55. A method for providing access to a spine of a patient, the method comprising:
implanting a first connecting element through a first incision in the skin of the patient and into a first vertebra of the spine with a first blade and a second blade coupled to the first connecting element so that each of the first and second blades extend proximally therefrom through the first incision, the first and second blades being positioned adjacent to one another to provide a first longitudinal pathway therealong between the first and second blades;
moving an implant into engagement with the first connecting element through at least a portion of the first longitudinal pathway; and
independently uncoupling the first and second blades from the first connecting element and independently removing the first and second blades from the body of the patient while the first connecting element remains implanted in the first vertebra.
56. The method of claim 55, wherein the connecting element comprises a pedicle screw having a cage connected thereto for receiving the implant, the step of implanting the first connecting element in the first vertebra comprising implanting the pedicle screw in a pedicle of the first vertebra.
57. The method of claim 55, wherein the implant is a spinal fusion rod.
58. The method of claim 55, wherein the first and second blades define opposing first and second slots therebetween, and wherein the step of moving the implant into engagement with the first connecting element comprises subcutaneously passing the implant through the first and second slots along a direction transverse to the first longitudinal pathway.
59. The method of claim 55, further comprising:
inserting a cutting tool along the first longitudinal pathway; and
using the cutting tool to cut subcutaneous tissue proximate to the first longitudinal pathway.
60. The method of claim 55, further comprising attaching the first and second blades to the first connecting element prior to the step of implanting the first connecting element in the first vertebra.
61. The method of claim 60, wherein the step of attaching the first and second blades to the first connecting element comprises inserting a first tab at a distal end of the first blade into a first slot of the first connecting element and inserting a second tab at a distal end of the second blade into a second slot of the first connecting element.
62. The method of claim 55, wherein the first and second blades are each connected to the first connecting element by a respective frangible portion, and wherein the step of uncoupling the first and second blades from the first connecting element comprises fracturing the frangible portion associated with each of the first and second blades.
63. The method of claim 62, wherein fracturing the frangible portion associated with each of the first and second blades comprises tilting each of the first and second blades with respect to the connecting element.
64. The method of claim 55, wherein each of the first and second blades comprises a locked configuration, in which the respective first and second blade is secured to the first connecting element, and an unlocked configuration, in which the respective first and second blade is received by and removable from the first connecting element.
65. The method of claim 64, further comprising rotating the first and second blades to move the first and second blades between the respective locked and unlocked configurations.
66. The method of claim 65, wherein rotating the first and second blades comprises pushing the first and second blades inward towards a central longitudinal axis defined along the longitudinal pathway.
67. The method of claim 55, further comprising engaging the first and second blades with an abutment member.
68. The method of claim 67, wherein engaging the first and second blades with an abutment member comprises maintaining the first and second blades in a substantially parallel relationship with the abutment member.
69. The method of claim 67, further comprising moving the abutment member along the first and second blades.
70. The method of claim 69, further comprising moving the abutment member to a position abutting an outward facing surface of the skin of the patient.
71. The method of claim 67, further comprising restricting withdrawal of the abutment member from the first and second blades.
72. The method of claim 55, further comprising implanting a second connecting element through a second incision in the skin of the patient and into a second vertebra of the spine with a third blade and a fourth blade coupled to the second connecting element so that each of the third and fourth blades extend proximally therefrom through the second incision, the third and fourth blades being positioned adjacent to one another to provide a second longitudinal pathway therealong between the third and fourth blades.
73. The method of claim 72, further comprising implanting a third connecting element through a third incision in the skin of the patient and into a third vertebra of the spine with a fifth blade and a sixth blade coupled to the third connecting element so that each of the fifth and sixth blades extend proximally therefrom through the third incision, the fifth and sixth blades being positioned adjacent to one another to provide a third longitudinal pathway therealong between the fifth and sixth blades.
74. A method for providing access to a spine of a patient, the method comprising:
implanting a first connecting element through a first incision in the skin of the patient and into a first vertebra of the spine with a first blade and a second blade coupled to the first connecting element so that each of the first and second blades extend proximally through the first incision when the first connecting element is implanted in the first vertebra, and wherein the first and second blades are positioned adjacent to one another to provide a first longitudinal pathway therealong between the first and second blades;
implanting a second connecting element through a second incision in the skin of the patient and into a second vertebra of the spine with a third blade and a fourth blade coupled to the second connecting element so that each of the third and fourth blades extend proximally through the second incision when the second connecting element is implanted in the second vertebra, and wherein the third and fourth blades are positioned adjacent to one another to provide a second longitudinal pathway therealong between the third and fourth blades;
moving an implant into engagement with the first and second connecting elements through at least a portion of the first longitudinal pathway;
independently uncoupling the first and second blades from the first connecting element and removing the first and second blades from the body of the patient while the first connecting element remains implanted in the first vertebra; and
independently uncoupling the third and fourth blades from the second connecting element and removing the third and fourth blades from the body of the patient while the second connecting element remains implanted in the second vertebra.
75. The method of claim 55, further comprising maintaining opposing sides of the first incision apart around the first longitudinal pathway with the first and second blades.
76. The method of claim 74, further comprising:
maintaining opposing sides of the first incision apart around the first longitudinal pathway with the first and second blades; and
maintaining opposing sides of the second incision apart around the second longitudinal pathway with the third and fourth blades.
77. The method of claim 74, wherein the first, second, third, and fourth blades are each connected to the respective connecting elements by a respective frangible portion, wherein the step of uncoupling the first and second blades from the first connecting element comprises fracturing the frangible portion associated with each of the first and second blades, and wherein the step of uncoupling the third and fourth blades from the second connecting element comprises fracturing the frangible portion associated with each of the third and fourth blades.
US13973462 2003-02-11 2013-08-22 System and method for spinal implant placement Active USRE45676E1 (en)

Priority Applications (6)

Application Number Priority Date Filing Date Title
US10669927 US7282064B2 (en) 2003-02-11 2003-09-24 Apparatus and method for connecting spinal vertebrae
US51858003 true 2003-11-08 2003-11-08
US10868075 US7955355B2 (en) 2003-09-24 2004-06-15 Methods and devices for improving percutaneous access in minimally invasive surgeries
US68278305 true 2005-05-19 2005-05-19
US11202487 US8002798B2 (en) 2003-09-24 2005-08-12 System and method for spinal implant placement
US13972493 USRE45338E1 (en) 2003-09-24 2013-08-21 System and method for spinal implant placement

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
US14824951 USRE46432E1 (en) 2003-09-24 2015-08-12 System and method for spinal implant placement

Related Parent Applications (2)

Application Number Title Priority Date Filing Date
US11202487 Reissue US8002798B2 (en) 2003-02-11 2005-08-12 System and method for spinal implant placement
US13972493 Continuation USRE45338E1 (en) 2003-02-11 2013-08-21 System and method for spinal implant placement

Related Child Applications (1)

Application Number Title Priority Date Filing Date
US11202487 Continuation US8002798B2 (en) 2003-02-11 2005-08-12 System and method for spinal implant placement

Publications (1)

Publication Number Publication Date
USRE45676E1 true USRE45676E1 (en) 2015-09-29

Family

ID=52247928

Family Applications (3)

Application Number Title Priority Date Filing Date
US13972493 Active USRE45338E1 (en) 2003-02-11 2013-08-21 System and method for spinal implant placement
US13973462 Active USRE45676E1 (en) 2003-02-11 2013-08-22 System and method for spinal implant placement
US14824951 Active USRE46432E1 (en) 2003-02-11 2015-08-12 System and method for spinal implant placement

Family Applications Before (1)

Application Number Title Priority Date Filing Date
US13972493 Active USRE45338E1 (en) 2003-02-11 2013-08-21 System and method for spinal implant placement

Family Applications After (1)

Application Number Title Priority Date Filing Date
US14824951 Active USRE46432E1 (en) 2003-02-11 2015-08-12 System and method for spinal implant placement

Country Status (1)

Country Link
US (3) USRE45338E1 (en)

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9655685B2 (en) 2006-02-06 2017-05-23 Stryker European Holdings I, Llc Rod contouring apparatus for percutaneous pedicle screw extension
USRE46432E1 (en) * 2003-09-24 2017-06-13 Stryker European Holdings I, Llc System and method for spinal implant placement
US9700357B2 (en) 2003-09-24 2017-07-11 Stryker European Holdings I, Llc Methods and devices for improving percutaneous access in minimally invasive surgeries

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9801667B2 (en) * 2007-12-07 2017-10-31 Nexus Spine, L.L.C. Instruments, tools, and methods for presson pedicle screws
EP3106110B1 (en) * 2015-06-16 2017-10-11 Biedermann Technologies GmbH & Co. KG Extension device for a bone anchor

Citations (203)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6183472B2 (en)
US3788318A (en) 1972-06-12 1974-01-29 S Kim Expandable cannular, especially for medical purposes
US3789852A (en) 1972-06-12 1974-02-05 S Kim Expandable trochar, especially for medical purposes
US3892232A (en) 1973-09-24 1975-07-01 Alonzo J Neufeld Method and apparatus for performing percutaneous bone surgery
US4269184A (en) 1980-02-28 1981-05-26 Montgomery William W Silicone tracheal cannula
US4350151A (en) 1981-03-12 1982-09-21 Lone Star Medical Products, Inc. Expanding dilator
US4409968A (en) 1980-02-04 1983-10-18 Drummond Denis S Method and apparatus for engaging a hook assembly to a spinal column
US4411259A (en) 1980-02-04 1983-10-25 Drummond Denis S Apparatus for engaging a hook assembly to a spinal column
US4448191A (en) 1981-07-07 1984-05-15 Rodnyansky Lazar I Implantable correctant of a spinal curvature and a method for treatment of a spinal curvature
US4449532A (en) 1980-07-08 1984-05-22 Karl Storz Dilator to facilitate endoscope insertion into the body
US4545374A (en) 1982-09-03 1985-10-08 Jacobson Robert E Method and instruments for performing a percutaneous lumbar diskectomy
US4562832A (en) 1984-01-21 1986-01-07 Wilder Joseph R Medical instrument and light pipe illumination assembly
US4611581A (en) 1983-12-16 1986-09-16 Acromed Corporation Apparatus for straightening spinal columns
US4790297A (en) 1987-07-24 1988-12-13 Biotechnology, Inc. Spinal fixation method and system
US4817587A (en) 1987-08-31 1989-04-04 Janese Woodrow W Ring para-spinal retractor
US4862891A (en) 1988-03-14 1989-09-05 Canyon Medical Products Device for sequential percutaneous dilation
US4899729A (en) 1985-05-30 1990-02-13 Gill Steven S Expansible cannula
US4913134A (en) 1987-07-24 1990-04-03 Biotechnology, Inc. Spinal fixation system
US4984564A (en) 1989-09-27 1991-01-15 Frank Yuen Surgical retractor device
US5010879A (en) 1989-03-31 1991-04-30 Tanaka Medical Instrument Manufacturing Co. Device for correcting spinal deformities
US5027793A (en) 1990-03-30 1991-07-02 Boehringer Mannheim Corp. Surgical retractor
US5035232A (en) 1987-10-24 1991-07-30 Aesculap Ag Retractor
US5125396A (en) 1990-10-05 1992-06-30 Ray R Charles Surgical retractor
US5139487A (en) 1990-11-28 1992-08-18 Baber Bloomfield W Laparoscopic surgical instrument apparatus
US5171279A (en) 1992-03-17 1992-12-15 Danek Medical Method for subcutaneous suprafascial pedicular internal fixation
DE3711091C2 (en) 1987-04-02 1993-01-14 Patrick Dr.Med. 7904 Erbach De Kluger
US5183464A (en) 1991-05-17 1993-02-02 Interventional Thermodynamics, Inc. Radially expandable dilator
EP0528562A2 (en) 1991-08-15 1993-02-24 Smith & Nephew Richards Inc Pedicle screw and percutaneous fixation of vertebrae
US5195541A (en) 1991-10-18 1993-03-23 Obenchain Theodore G Method of performing laparoscopic lumbar discectomy
US5197971A (en) 1990-03-02 1993-03-30 Bonutti Peter M Arthroscopic retractor and method of using the same
US5293863A (en) 1992-05-08 1994-03-15 Loma Linda University Medical Center Bladed endoscopic retractor
US5295994A (en) 1991-11-15 1994-03-22 Bonutti Peter M Active cannulas
WO1994009726A1 (en) 1992-10-23 1994-05-11 Smith & Nephew Richards Inc. Internal fixators
US5312417A (en) 1992-07-29 1994-05-17 Wilk Peter J Laparoscopic cannula assembly and associated method
DE4238339A1 (en) 1992-11-13 1994-05-19 Peter Brehm Fastening screw for spinal column support rod - has hollow slotted head with female thread to accommodate grub-screw to firmly clamp rod in place
EP0611116A1 (en) 1993-02-11 1994-08-17 SMITH & NEPHEW RICHARDS, INC. Spinal column retaining apparatus
US5377667A (en) 1992-12-03 1995-01-03 Michael T. Patton Speculum for dilating a body cavity
US5381788A (en) 1991-08-05 1995-01-17 United States Surgical Corporation Surgical retractor
US5395317A (en) 1991-10-30 1995-03-07 Smith & Nephew Dyonics, Inc. Unilateral biportal percutaneous surgical procedure
US5409488A (en) 1992-01-16 1995-04-25 Ulrich; Heinrich Spondylodesis implant
WO1995014437A1 (en) 1993-11-25 1995-06-01 Sofamor Danek Group, Inc. Implant for an osteosynthesis device, particularly for the spine, and positioning instrument therefor
US5425732A (en) 1992-01-16 1995-06-20 Ulrich; Heinrich Implant for internal fixation, particularly spondylodesis implant
US5439464A (en) 1993-03-09 1995-08-08 Shapiro Partners Limited Method and instruments for performing arthroscopic spinal surgery
US5454365A (en) 1990-11-05 1995-10-03 Bonutti; Peter M. Mechanically expandable arthroscopic retractors
US5464011A (en) 1994-10-24 1995-11-07 Bridge; Robert S. Tracheostomy tube
US5480440A (en) 1991-08-15 1996-01-02 Smith & Nephew Richards, Inc. Open surgical technique for vertebral fixation with subcutaneous fixators positioned between the skin and the lumbar fascia of a patient
EP0528177B1 (en) 1991-08-17 1996-09-11 Aesculap Ag Internal fixator for the correction of a lumbar spondyldisthesis
US5569290A (en) 1995-01-30 1996-10-29 Paul C. McAfee Method of and apparatus for laparoscopic or endoscopic spinal surgery using an unsealed anteriorly inserted transparent trochar
US5601562A (en) 1995-02-14 1997-02-11 Arthrex, Inc. Forked insertion tool and metnod of arthroscopic surgery using the same
US5601590A (en) 1993-02-04 1997-02-11 General Surgical Innovations, Inc. Expandable cannulas
WO1997014457A1 (en) 1995-10-18 1997-04-24 Stouder Albert E Jr Adjustable length cannula and trocar
DE29710979U1 (en) 1997-06-24 1997-08-21 Aesculap Ag & Co Kg Implant for fixing bone parts and tools for this implant
US5707359A (en) 1995-11-14 1998-01-13 Bufalini; Bruno Expanding trocar assembly
US5720751A (en) 1996-11-27 1998-02-24 Jackson; Roger P. Tools for use in seating spinal rods in open ended implants
US5741261A (en) 1996-06-25 1998-04-21 Sdgi Holdings, Inc. Minimally invasive spinal surgical methods and instruments
US5743907A (en) 1990-07-24 1998-04-28 Acromed Corporation Spinal column retaining method and apparatus
US5746720A (en) 1995-10-18 1998-05-05 Stouder, Jr.; Albert E. Method and apparatus for insertion of a cannula and trocar
WO1998022030A1 (en) 1996-11-18 1998-05-28 University Of Massachusetts Systems, methods, and instruments for minimally invasive surgery
US5762629A (en) 1991-10-30 1998-06-09 Smith & Nephew, Inc. Oval cannula assembly and method of use
US5772594A (en) 1995-10-17 1998-06-30 Barrick; Earl F. Fluoroscopic image guided orthopaedic surgery system with intraoperative registration
US5792044A (en) 1996-03-22 1998-08-11 Danek Medical, Inc. Devices and methods for percutaneous surgery
US5795289A (en) 1997-07-28 1998-08-18 Wyttenbach; William H. Speculum
WO1998038918A1 (en) 1997-03-07 1998-09-11 Mordechay Beyar Systems for percutaneous bone and spinal stabilization, fixation and repair
US5882344A (en) 1995-10-18 1999-03-16 Stouder, Jr.; Albert E. Adjustable length cannula and trocar
WO1999029242A1 (en) 1997-12-10 1999-06-17 Phillips Plastics Corporation Seal member for surgical trocar
US5928139A (en) 1998-04-24 1999-07-27 Koros; Tibor B. Retractor with adjustable length blades and light pipe guides
US5944658A (en) 1997-09-23 1999-08-31 Koros; Tibor B. Lumbar spinal fusion retractor and distractor system
US5957888A (en) 1995-10-10 1999-09-28 United States Surgical Corporation Surgical cannula having a variable length
US5961499A (en) 1993-02-04 1999-10-05 Peter M. Bonutti Expandable cannula
US5964761A (en) 1997-07-15 1999-10-12 Kambin; Parviz Method and instruments for percutaneous arthroscopic disc removal, bone biopsy and fixation of vertebrae
WO1999051139A2 (en) 1998-04-02 1999-10-14 Stefanov Alexander R A cannula of changeable length and shape
US5976146A (en) 1997-07-11 1999-11-02 Olympus Optical Co., Ltd. Surgical operation system and method of securing working space for surgical operation in body
US6036692A (en) 1997-02-12 2000-03-14 Sdgi Holdings, Inc. Rod introducer forceps
WO2000045720A1 (en) 1999-02-08 2000-08-10 Phillips Plastics Corporation Laparoscopic tool and method
US6152871A (en) 1996-03-22 2000-11-28 Sdgi Holdings, Inc. Apparatus for percutaneous surgery
US6159179A (en) 1999-03-12 2000-12-12 Simonson; Robert E. Cannula and sizing and insertion method
US6162170A (en) 1996-03-22 2000-12-19 Sdgi Holdings, Inc. Devices and methods for percutaneous surgery
US6175758B1 (en) 1997-07-15 2001-01-16 Parviz Kambin Method for percutaneous arthroscopic disc removal, bone biopsy and fixation of the vertebrae
US6183472B1 (en) 1998-04-09 2001-02-06 Howmedica Gmbh Pedicle screw and an assembly aid therefor
US6187000B1 (en) 1998-08-20 2001-02-13 Endius Incorporated Cannula for receiving surgical instruments
WO2001012080A1 (en) 1999-08-13 2001-02-22 Sdgi Holdings, Inc. Minimal exposure posterior spinal interbody instrumentation and technique
US6206826B1 (en) 1997-12-18 2001-03-27 Sdgi Holdings, Inc. Devices and methods for percutaneous surgery
US6226548B1 (en) 1997-09-24 2001-05-01 Surgical Navigation Technologies, Inc. Percutaneous registration apparatus and method for use in computer-assisted surgical navigation
US6235028B1 (en) 2000-02-14 2001-05-22 Sdgi Holdings, Inc. Surgical guide rod
WO2001037744A2 (en) 1999-11-23 2001-05-31 Sdgi Holdings, Inc. Surgical screw delivery system and method
WO2001041681A1 (en) 1999-12-10 2001-06-14 Nuvasive, Inc. Facet screw and bone allograft intervertebral support and fusion system
WO2001056479A1 (en) 2000-02-04 2001-08-09 Hôpital Sainte-Justine Surgical drill guide and method for using the same
WO2001060270A1 (en) 2000-02-16 2001-08-23 Axiamed, Inc. Axial spinal implant and apparatus for implanting an axial spinal implant within the vertebrae of the spine
WO2001060263A1 (en) 2000-02-16 2001-08-23 Axiamed, Inc. Apparatus for providing posterior or anterior trans-sacral access to spinal vertebrae
WO2001060234A2 (en) 2000-02-16 2001-08-23 Axiamed, Inc. Apparatus for performing therapeutic procedures in the spine
WO2001060262A1 (en) 2000-02-16 2001-08-23 Axiamed, Inc. Apparatus for forming shaped axial bores through spinal vertebrae
US20010049498A1 (en) 1998-08-20 2001-12-06 Endius Incorporated Sugical tool for use in expanding a cannula
WO2001095823A1 (en) 2000-06-13 2001-12-20 Sdgi Holdings, Inc. Percutaneous needle alignment system
US6338730B1 (en) 1993-02-04 2002-01-15 Peter M. Bonutti Method of using expandable cannula
US20020016583A1 (en) 2000-02-16 2002-02-07 Cragg Andrew H. Methods of performing procedures in the spine
US6358266B1 (en) 1990-03-02 2002-03-19 General Surgical Innovations, Inc. Active cannulas
US6371968B1 (en) 1996-05-09 2002-04-16 Olympus Optical Co., Ltd. Cavity retaining tool for bone surgery, a cavity retaining tool for general surgery, an endoscopic surgery system involving the use of a cavity retaining tool, and a procedure for surgery
US20020045904A1 (en) 1999-01-30 2002-04-18 Aesculap Ag & Co. Kg Surgical instrument for introducing intervertebral implants
US20020068975A1 (en) 2000-06-23 2002-06-06 Teitelbaum George P. Formable orthopedic fixation system with cross linking
US20020082600A1 (en) 2000-06-23 2002-06-27 Shaolian Samuel M. Formable orthopedic fixation system
US20020082598A1 (en) 2000-06-23 2002-06-27 Teitelbaum George P. Percutaneous vertebral fusion system
US20020107519A1 (en) * 2001-02-05 2002-08-08 Dixon Robert A. Dual spreader flange-tube vertebral stabilizer
US20020116006A1 (en) 2001-02-21 2002-08-22 Herb Cohen Instrumentation and method for implant insertion
WO2002085217A2 (en) 2001-04-19 2002-10-31 Spineology, Inc. Stacked intermedular rods for spinal fixation
US20020161368A1 (en) 1999-10-20 2002-10-31 Foley Kevin T. Instruments and methods for stabilization of bony structures
US6475218B2 (en) 2000-06-30 2002-11-05 Sofamor, S.N.C. Spinal implant for an osteosynthesis device
US20020173796A1 (en) 2000-02-16 2002-11-21 Cragg Andrew H. Method and apparatus for spinal augmentation
US20020198526A1 (en) 2000-06-23 2002-12-26 Shaolian Samuel M. Formed in place fixation system with thermal acceleration
US20030004517A1 (en) 2000-09-11 2003-01-02 Anderson D. Greg Percutaneous technique and implant for expanding the spinal canal
US6506151B2 (en) 1998-04-09 2003-01-14 Sdgi Holdings, Inc. Method and instrumentation for posterior interbody fusion
US6524320B2 (en) 2001-05-15 2003-02-25 Endius Incorporated Cannula for receiving surgical instruments
US6530926B1 (en) 2000-08-01 2003-03-11 Endius Incorporated Method of securing vertebrae
WO2003028566A1 (en) 2001-10-04 2003-04-10 Stryker Spine Spinal osteosynthesis assembly comprising the head of an anchoring member and a tool for fixing said head
US20030073998A1 (en) 2000-08-01 2003-04-17 Endius Incorporated Method of securing vertebrae
US20030083688A1 (en) 2001-10-30 2003-05-01 Simonson Robert E. Configured and sized cannula
WO2003037170A2 (en) 2001-10-30 2003-05-08 Nuvasive, Inc. System and methods for performing percutaneous pedicle integrity assessments
WO2003057055A1 (en) 2001-12-27 2003-07-17 Osteotech Inc. Orthopedic/neurosurgical system and method for securing vertebral bone facets
US6607530B1 (en) 1999-05-10 2003-08-19 Highgate Orthopedics, Inc. Systems and methods for spinal fixation
DE10027988C2 (en) 2000-06-06 2003-08-21 Arkadiusz Kosmala Device for stereotactically guided percutaneous implantation of the longitudinal connection of the pedicle screws
US6613050B1 (en) 1996-10-24 2003-09-02 Spinal Concepts, Inc. Method and apparatus for spinal fixation
US20030199871A1 (en) 1999-10-20 2003-10-23 Foley Kevin T. Methods and instruments for endoscopic interbody surgical techniques
US20030199872A1 (en) * 2002-04-17 2003-10-23 Stryker Spine Rod persuader
WO2003088810A2 (en) 2002-04-17 2003-10-30 Ricardo Sasso Navigation instrumentation and method for surgical device
US20030208202A1 (en) 2002-05-04 2003-11-06 Falahee Mark H. Percutaneous screw fixation system
US6648888B1 (en) * 2002-09-06 2003-11-18 Endius Incorporated Surgical instrument for moving a vertebra
US20030225408A1 (en) 2002-06-04 2003-12-04 Howmedica Osteonics Corp. Apparatus for securing a spinal rod system
US20040006344A1 (en) 2002-07-02 2004-01-08 Nguyen Thanh Van Expandable percutaneous sheath
US20040006341A1 (en) 2000-06-23 2004-01-08 Shaolian Samuel M. Curable media for implantable medical device
US6692473B2 (en) 2001-05-24 2004-02-17 John A. St. Cyr Dual lumen adjustable length cannulae for liquid perfusion or lavage
US6692434B2 (en) 2000-09-29 2004-02-17 Stephen Ritland Method and device for retractor for microsurgical intermuscular lumbar arthrodesis
US20040034351A1 (en) 2002-08-14 2004-02-19 Sherman Michael C. Techniques for spinal surgery and attaching constructs to vertebral elements
US20040039384A1 (en) 2002-08-21 2004-02-26 Boehm Frank H. Device and method for pertcutaneous placement of lumbar pedicle screws and connecting rods
WO2004021899A1 (en) 2002-09-05 2004-03-18 Endius Incorporated System and methods for performing minimally-invasive surgical procedures
WO2004028382A2 (en) 2002-09-19 2004-04-08 Sdgi Holdings, Inc. Oval dilator and retractor set and method
US6723095B2 (en) 2001-12-28 2004-04-20 Hemodynamics, Inc. Method of spinal fixation using adhesive media
WO2004037070A2 (en) 2002-10-25 2004-05-06 Hamada James S Minimal access lumbar diskectomy instrumentation and method
WO2004041100A1 (en) 2002-10-30 2004-05-21 Spinal Concepts, Inc. Spinal stabilization system insertion and methods
US6740089B2 (en) 2002-01-10 2004-05-25 Thomas T. Haider Orthopedic hook system
US6746449B2 (en) 2001-09-12 2004-06-08 Spinal Concepts, Inc. Spinal rod translation instrument
US20040133201A1 (en) 2000-08-01 2004-07-08 Alan Shluzas Methods and apparatuses for treating the spine through an access device
US20040143268A1 (en) 2002-10-10 2004-07-22 Falahee Mark H. Percutaneous facet fixation system
US20040147928A1 (en) 2002-10-30 2004-07-29 Landry Michael E. Spinal stabilization system using flexible members
US20040147936A1 (en) 2003-01-28 2004-07-29 Rosenberg William S. Spinal rod approximator
US6770074B2 (en) 1988-06-13 2004-08-03 Gary Karlin Michelson Apparatus for use in inserting spinal implants
US20040162560A1 (en) 2003-02-19 2004-08-19 Raynor Donald E. Implant device including threaded locking mechanism
US20040176763A1 (en) * 1996-03-22 2004-09-09 Foley Kevin T. Methods for percutaneous surgery
WO2004080318A1 (en) 2003-03-10 2004-09-23 Sdgi Holdings Inc. Posterior pedicle screw and plate system and methods
US20040194791A1 (en) 1992-12-03 2004-10-07 Sterman Wesley D. Methods and systems for performing thoracoscopic coronary bypass and other procedures
EP1468652A1 (en) 2003-04-16 2004-10-20 Paul M. Tsou Apparatus for endoscopic spinal surgery
US20040215190A1 (en) 2003-04-25 2004-10-28 Nguyen Thanh V. System and method for minimally invasive posterior fixation
US20040254576A1 (en) 2003-06-16 2004-12-16 Depuy Acromed, Inc. Rod reduction nut and driver tool
US20050010220A1 (en) 2003-04-24 2005-01-13 Simon Casutt Instrument system for pedicle screws
US20050010221A1 (en) 2003-07-07 2005-01-13 Dalton Brian E. Spinal stabilization implant and method of application
US20050025771A1 (en) 2003-03-04 2005-02-03 Greenville Hospital System Antitumor agents comprising a targeting portion and an immune response triggering portion
US20050043742A1 (en) 2003-08-21 2005-02-24 Aurelian Bruneau Systems and methods for positioning implants relative to bone anchors in surgical approaches to the spine
US20050043741A1 (en) 2001-03-01 2005-02-24 Michelson Gary K. Retractor for percutaneous surgery in a patient and method for use thereof
WO2005018466A2 (en) 2003-08-26 2005-03-03 Endius, Inc. Access systems and methods for minimally invasive surgery
US20050059969A1 (en) 2003-09-17 2005-03-17 Depuy Acromed, Inc. Rod approximator
US20050065517A1 (en) 2003-09-24 2005-03-24 Chin Kingsley Richard Methods and devices for improving percutaneous access in minimally invasive surgeries
US20050065515A1 (en) 2003-09-24 2005-03-24 Tae-Ahn Jahng Marking and guidance method and system for flexible fixation of a spine
US20050070917A1 (en) 2003-09-29 2005-03-31 Justis Jeff R. Instruments and methods for securing a connecting element along a bony segment
US20050080418A1 (en) 2001-10-30 2005-04-14 Simonson Robert E. Instruments and methods for minimally invasive spine surgery
US20050085813A1 (en) 2003-10-21 2005-04-21 Innovative Spinal Technologies System and method for stabilizing of internal structures
US20050090822A1 (en) 2003-10-24 2005-04-28 Dipoto Gene Methods and apparatus for stabilizing the spine through an access device
US20050090833A1 (en) 2003-10-24 2005-04-28 Dipoto Gene Methods and apparatuses for fixation of the spine through an access device
US20050124991A1 (en) 2003-12-05 2005-06-09 Tae-Ahn Jahng Method and apparatus for flexible fixation of a spine
US20050131407A1 (en) 2003-12-16 2005-06-16 Sicvol Christopher W. Flexible spinal fixation elements
US20050131421A1 (en) 2003-12-16 2005-06-16 Anderson David G. Methods and devices for minimally invasive spinal fixation element placement
US20050131408A1 (en) 2003-12-16 2005-06-16 Sicvol Christopher W. Percutaneous access devices and bone anchor assemblies
US20050131422A1 (en) 2003-12-16 2005-06-16 Anderson David G. Methods and devices for spinal fixation element placement
US20050137461A1 (en) 2003-12-18 2005-06-23 Depuy Spine, Inc. Telescoping blade assembly and instruments for adjusting an adjustable blade
US20050137593A1 (en) 2000-10-02 2005-06-23 Sulzer Spine-Tech Inc. Temporary spinal fixation apparatuses and methods
US20050149035A1 (en) 2003-10-17 2005-07-07 Nuvasive, Inc. Surgical access system and related methods
WO2005032358A3 (en) 2003-10-02 2005-07-21 Endius Inc Methods, systems and apparatuses for performing minimally invasive spinal procedures
US20050171540A1 (en) 2004-01-30 2005-08-04 Roy Lim Instruments and methods for minimally invasive spinal stabilization
US20050182410A1 (en) * 2002-09-06 2005-08-18 Jackson Roger P. Helical guide and advancement flange with radially loaded lip
US20050192570A1 (en) 2004-02-27 2005-09-01 Jackson Roger P. Orthopedic implant rod reduction tool set and method
US20050245928A1 (en) 2004-05-03 2005-11-03 Innovative Spinal Technologies System and method for displacement of bony structures
US20050251139A1 (en) * 2004-05-07 2005-11-10 Roh Jeffrey S Systems and methods that facilitate minimally invasive spine surgery
US20050277942A1 (en) 2004-05-27 2005-12-15 Kullas Karen E Method and apparatus for delivering a prosthetic fabric into a patient
US20060030839A1 (en) 2004-07-21 2006-02-09 Solco Biomedical Co., Ltd. Pedicle screw and operating device thereof
US20060036252A1 (en) 2004-08-12 2006-02-16 Baynham Bret O Polyaxial screw
US20060084980A1 (en) 2004-10-05 2006-04-20 Melkent Anthony J Spinal implants and methods with extended multi-axial anchor assemblies
US20060111713A1 (en) * 2004-11-23 2006-05-25 Jackson Roger P Spinal fixation tool set and method
US20060217735A1 (en) 2005-03-11 2006-09-28 Macdonald Joel Bone repair device and method
US20060247658A1 (en) 2005-04-28 2006-11-02 Pond John D Jr Instrument and method for guiding surgical implants and instruments during surgery
US20060247630A1 (en) * 2005-04-27 2006-11-02 Andrew Iott Percutaneous vertebral stabilization system
US20060264934A1 (en) 2005-05-18 2006-11-23 Medicinelodge, Inc. System and method for orthopedic implant configuration
US20060293680A1 (en) 2004-02-27 2006-12-28 Jackson Roger P Orthopedic implant rod reduction tool set and method
US20070043359A1 (en) 2005-07-22 2007-02-22 Moti Altarac Systems and methods for stabilization of bone structures
EP1027988B1 (en) 1998-08-27 2007-04-11 Seiko Epson Corporation Hydrophilic structure
US7261714B2 (en) 2002-04-18 2007-08-28 Aesculap Implant Systems, Inc. Screw and rod fixation assembly and device
US20070233079A1 (en) 2006-02-06 2007-10-04 Stryker Spine Rod contouring apparatus and method for percutaneous pedicle screw extension
US20080009864A1 (en) 2002-10-30 2008-01-10 Charlie Forton Instruments and methods for reduction of vertebral bodies
US20090216328A1 (en) 2004-03-19 2009-08-27 Depuy Spine, Inc. Spinal fixation element and methods
US7811288B2 (en) 2004-12-02 2010-10-12 Zimmer Spine, Inc. Instruments and methods for adjusting separation distance of vertebral bodies with a minimally invasive spinal stabilization procedure
US7842073B2 (en) 2002-04-18 2010-11-30 Aesculap Ii, Inc. Screw and rod fixation assembly and device
US20110015678A1 (en) 2004-11-23 2011-01-20 Jackson Roger P Spinal fixation tool set and method
US20110077692A1 (en) 2004-02-27 2011-03-31 Jackson Roger P Dynamic spinal stabilization assemblies, tool set and method
US20110152940A1 (en) 2005-08-25 2011-06-23 Robert Frigg Methods of spinal fixation and instrumentation
US8002798B2 (en) 2003-09-24 2011-08-23 Stryker Spine System and method for spinal implant placement
US20110245884A9 (en) 2005-01-26 2011-10-06 Warsaw Orthopedic, Inc. Reducing Instrument for Spinal Surgery
US20120089191A1 (en) 2005-07-22 2012-04-12 Exactech, Inc. Methods for stabilizing bone structures

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
USRE45338E1 (en) * 2003-09-24 2015-01-13 Stryker Spine System and method for spinal implant placement
EP1694225A4 (en) 2003-12-16 2008-12-31 Depuy Spine Inc Methods and devices for minimally invasive spinal fixation element placement

Patent Citations (335)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6183472B2 (en)
US3788318A (en) 1972-06-12 1974-01-29 S Kim Expandable cannular, especially for medical purposes
US3789852A (en) 1972-06-12 1974-02-05 S Kim Expandable trochar, especially for medical purposes
US3892232A (en) 1973-09-24 1975-07-01 Alonzo J Neufeld Method and apparatus for performing percutaneous bone surgery
US4409968A (en) 1980-02-04 1983-10-18 Drummond Denis S Method and apparatus for engaging a hook assembly to a spinal column
US4411259A (en) 1980-02-04 1983-10-25 Drummond Denis S Apparatus for engaging a hook assembly to a spinal column
US4269184A (en) 1980-02-28 1981-05-26 Montgomery William W Silicone tracheal cannula
US4449532A (en) 1980-07-08 1984-05-22 Karl Storz Dilator to facilitate endoscope insertion into the body
US4350151A (en) 1981-03-12 1982-09-21 Lone Star Medical Products, Inc. Expanding dilator
US4448191A (en) 1981-07-07 1984-05-15 Rodnyansky Lazar I Implantable correctant of a spinal curvature and a method for treatment of a spinal curvature
US4545374A (en) 1982-09-03 1985-10-08 Jacobson Robert E Method and instruments for performing a percutaneous lumbar diskectomy
US4611581A (en) 1983-12-16 1986-09-16 Acromed Corporation Apparatus for straightening spinal columns
US4562832A (en) 1984-01-21 1986-01-07 Wilder Joseph R Medical instrument and light pipe illumination assembly
US4899729A (en) 1985-05-30 1990-02-13 Gill Steven S Expansible cannula
DE3711091C2 (en) 1987-04-02 1993-01-14 Patrick Dr.Med. 7904 Erbach De Kluger
US4790297A (en) 1987-07-24 1988-12-13 Biotechnology, Inc. Spinal fixation method and system
US4913134A (en) 1987-07-24 1990-04-03 Biotechnology, Inc. Spinal fixation system
US4817587A (en) 1987-08-31 1989-04-04 Janese Woodrow W Ring para-spinal retractor
US5035232A (en) 1987-10-24 1991-07-30 Aesculap Ag Retractor
US4862891A (en) 1988-03-14 1989-09-05 Canyon Medical Products Device for sequential percutaneous dilation
US6770074B2 (en) 1988-06-13 2004-08-03 Gary Karlin Michelson Apparatus for use in inserting spinal implants
US5010879A (en) 1989-03-31 1991-04-30 Tanaka Medical Instrument Manufacturing Co. Device for correcting spinal deformities
US4984564A (en) 1989-09-27 1991-01-15 Frank Yuen Surgical retractor device
US5197971A (en) 1990-03-02 1993-03-30 Bonutti Peter M Arthroscopic retractor and method of using the same
US6358266B1 (en) 1990-03-02 2002-03-19 General Surgical Innovations, Inc. Active cannulas
US5027793A (en) 1990-03-30 1991-07-02 Boehringer Mannheim Corp. Surgical retractor
US5743907A (en) 1990-07-24 1998-04-28 Acromed Corporation Spinal column retaining method and apparatus
US6080156A (en) 1990-07-24 2000-06-27 Depuy Acromed, Inc. Spinal column retaining method and apparatus
US5125396A (en) 1990-10-05 1992-06-30 Ray R Charles Surgical retractor
US5454365A (en) 1990-11-05 1995-10-03 Bonutti; Peter M. Mechanically expandable arthroscopic retractors
US5139487A (en) 1990-11-28 1992-08-18 Baber Bloomfield W Laparoscopic surgical instrument apparatus
US5183464A (en) 1991-05-17 1993-02-02 Interventional Thermodynamics, Inc. Radially expandable dilator
US5381788A (en) 1991-08-05 1995-01-17 United States Surgical Corporation Surgical retractor
EP0528562A2 (en) 1991-08-15 1993-02-24 Smith & Nephew Richards Inc Pedicle screw and percutaneous fixation of vertebrae
US5480440A (en) 1991-08-15 1996-01-02 Smith & Nephew Richards, Inc. Open surgical technique for vertebral fixation with subcutaneous fixators positioned between the skin and the lumbar fascia of a patient
US5545228A (en) 1991-08-15 1996-08-13 Smith & Nephew Richards Inc. Offset bone bolt
US5242443A (en) 1991-08-15 1993-09-07 Smith & Nephew Dyonics, Inc. Percutaneous fixation of vertebrae
US5584887A (en) 1991-08-15 1996-12-17 Smith & Nephew Richards, Inc. Percutaneous screw adapter
EP0528177B1 (en) 1991-08-17 1996-09-11 Aesculap Ag Internal fixator for the correction of a lumbar spondyldisthesis
US5195541A (en) 1991-10-18 1993-03-23 Obenchain Theodore G Method of performing laparoscopic lumbar discectomy
US5762629A (en) 1991-10-30 1998-06-09 Smith & Nephew, Inc. Oval cannula assembly and method of use
US5395317A (en) 1991-10-30 1995-03-07 Smith & Nephew Dyonics, Inc. Unilateral biportal percutaneous surgical procedure
US5295994A (en) 1991-11-15 1994-03-22 Bonutti Peter M Active cannulas
US5425732A (en) 1992-01-16 1995-06-20 Ulrich; Heinrich Implant for internal fixation, particularly spondylodesis implant
US5409488A (en) 1992-01-16 1995-04-25 Ulrich; Heinrich Spondylodesis implant
US5728097A (en) 1992-03-17 1998-03-17 Sdgi Holding, Inc. Method for subcutaneous suprafascial internal fixation
US6033406A (en) 1992-03-17 2000-03-07 Sdgi Holdings, Inc. Method for subcutaneous suprafascial pedicular internal fixation
US5569248A (en) 1992-03-17 1996-10-29 Danek Medical, Inc. Apparatus for subcutaneous suprafascial pedicular internal fixation
US20050038434A1 (en) 1992-03-17 2005-02-17 Mathews Hallett H. Systems and methods for fixation of adjacent vertebrae
US6793656B1 (en) 1992-03-17 2004-09-21 Sdgi Holdings, Inc. Systems and methods for fixation of adjacent vertebrae
US5496322A (en) 1992-03-17 1996-03-05 Danek Medical Inc. Method for subcutaneous suprafascial pedicular internal fixation
US5171279A (en) 1992-03-17 1992-12-15 Danek Medical Method for subcutaneous suprafascial pedicular internal fixation
US5357983A (en) 1992-03-17 1994-10-25 Danek Medical, Inc. Method for subcutaneous suprafascial pedicular internal fixation
WO1993018722A1 (en) 1992-03-17 1993-09-30 Danek Medical, Inc. Method for subcutaneous suprafascial pedicular internal fixation
US5293863A (en) 1992-05-08 1994-03-15 Loma Linda University Medical Center Bladed endoscopic retractor
USD346217S (en) 1992-07-13 1994-04-19 Acromed Corporation Combined hook holder and rod mover for spinal surgery
US5312417A (en) 1992-07-29 1994-05-17 Wilk Peter J Laparoscopic cannula assembly and associated method
WO1994009726A1 (en) 1992-10-23 1994-05-11 Smith & Nephew Richards Inc. Internal fixators
EP0665731A4 (en) 1992-10-23 1997-01-08 Smith & Nephew Richards Inc Internal fixators.
DE4238339A1 (en) 1992-11-13 1994-05-19 Peter Brehm Fastening screw for spinal column support rod - has hollow slotted head with female thread to accommodate grub-screw to firmly clamp rod in place
US20040194791A1 (en) 1992-12-03 2004-10-07 Sterman Wesley D. Methods and systems for performing thoracoscopic coronary bypass and other procedures
US5377667A (en) 1992-12-03 1995-01-03 Michael T. Patton Speculum for dilating a body cavity
US5601590A (en) 1993-02-04 1997-02-11 General Surgical Innovations, Inc. Expandable cannulas
US6338730B1 (en) 1993-02-04 2002-01-15 Peter M. Bonutti Method of using expandable cannula
US5961499A (en) 1993-02-04 1999-10-05 Peter M. Bonutti Expandable cannula
EP0611116B1 (en) 1993-02-11 1996-07-17 SMITH & NEPHEW RICHARDS, INC. Spinal column retaining apparatus
EP0611116A1 (en) 1993-02-11 1994-08-17 SMITH & NEPHEW RICHARDS, INC. Spinal column retaining apparatus
US5439464A (en) 1993-03-09 1995-08-08 Shapiro Partners Limited Method and instruments for performing arthroscopic spinal surgery
WO1995014437A1 (en) 1993-11-25 1995-06-01 Sofamor Danek Group, Inc. Implant for an osteosynthesis device, particularly for the spine, and positioning instrument therefor
US5464011A (en) 1994-10-24 1995-11-07 Bridge; Robert S. Tracheostomy tube
US5569290A (en) 1995-01-30 1996-10-29 Paul C. McAfee Method of and apparatus for laparoscopic or endoscopic spinal surgery using an unsealed anteriorly inserted transparent trochar
US5601562A (en) 1995-02-14 1997-02-11 Arthrex, Inc. Forked insertion tool and metnod of arthroscopic surgery using the same
US5957888A (en) 1995-10-10 1999-09-28 United States Surgical Corporation Surgical cannula having a variable length
US5772594A (en) 1995-10-17 1998-06-30 Barrick; Earl F. Fluoroscopic image guided orthopaedic surgery system with intraoperative registration
WO1997014457A1 (en) 1995-10-18 1997-04-24 Stouder Albert E Jr Adjustable length cannula and trocar
US5746720A (en) 1995-10-18 1998-05-05 Stouder, Jr.; Albert E. Method and apparatus for insertion of a cannula and trocar
US5882344A (en) 1995-10-18 1999-03-16 Stouder, Jr.; Albert E. Adjustable length cannula and trocar
US5707359A (en) 1995-11-14 1998-01-13 Bufalini; Bruno Expanding trocar assembly
WO1998036785A1 (en) 1995-12-18 1998-08-27 Stouder Albert E Jr Method and apparatus for insertion of a cannula and trocar
US20030139648A1 (en) 1996-03-22 2003-07-24 Foley Kevin Thomas Devices and methods for percutaneous surgery
US5902231A (en) 1996-03-22 1999-05-11 Sdgi Holdings, Inc. Devices and methods for percutaneous surgery
US6152871A (en) 1996-03-22 2000-11-28 Sdgi Holdings, Inc. Apparatus for percutaneous surgery
US6007487A (en) 1996-03-22 1999-12-28 Sdgi Holdings, Inc. Tissue retractor for use through a cannula
US6162170A (en) 1996-03-22 2000-12-19 Sdgi Holdings, Inc. Devices and methods for percutaneous surgery
US6520907B1 (en) 1996-03-22 2003-02-18 Sdgi Holdings, Inc. Methods for accessing the spinal column
US5954635A (en) 1996-03-22 1999-09-21 Sdgi Holdings Inc. Devices and methods for percutaneous surgery
US5792044A (en) 1996-03-22 1998-08-11 Danek Medical, Inc. Devices and methods for percutaneous surgery
US6176823B1 (en) 1996-03-22 2001-01-23 Sdgi Holdings, Inc. Fixture for supporting a viewing element within a cannula
US6425859B1 (en) 1996-03-22 2002-07-30 Sdgi Holdings, Inc. Cannula and a retractor for percutaneous surgery
US20040176763A1 (en) * 1996-03-22 2004-09-09 Foley Kevin T. Methods for percutaneous surgery
US6206822B1 (en) 1996-03-22 2001-03-27 Sdgi Holdings, Inc. Devices and methods for percutaneous surgery
US6217509B1 (en) 1996-03-22 2001-04-17 Sdgi Holdings, Inc. Devices and methods for percutaneous surgery
US6371968B1 (en) 1996-05-09 2002-04-16 Olympus Optical Co., Ltd. Cavity retaining tool for bone surgery, a cavity retaining tool for general surgery, an endoscopic surgery system involving the use of a cavity retaining tool, and a procedure for surgery
US5885292A (en) 1996-06-25 1999-03-23 Sdgi Holdings, Inc. Minimally invasive spinal surgical methods and instruments
US5885291A (en) 1996-06-25 1999-03-23 Sdgi Holdings, Inc. Minimally invasive spinal surgical methods and instruments
US5741261A (en) 1996-06-25 1998-04-21 Sdgi Holdings, Inc. Minimally invasive spinal surgical methods and instruments
US5891147A (en) 1996-06-25 1999-04-06 Sdgi Holdings, Inc. Minimally invasive spinal surgical methods & instruments
US6613050B1 (en) 1996-10-24 2003-09-02 Spinal Concepts, Inc. Method and apparatus for spinal fixation
EP1006888B1 (en) 1996-11-18 2006-03-15 University of Massachusetts Systems and instruments for minimally invasive surgery
EP1006888A4 (en) 1996-11-18 2000-06-14 Univ Massachusetts Systems, methods, and instruments for minimally invasive surgery
WO1998022030A1 (en) 1996-11-18 1998-05-28 University Of Massachusetts Systems, methods, and instruments for minimally invasive surgery
US5720751A (en) 1996-11-27 1998-02-24 Jackson; Roger P. Tools for use in seating spinal rods in open ended implants
US6036692A (en) 1997-02-12 2000-03-14 Sdgi Holdings, Inc. Rod introducer forceps
WO1998038918A1 (en) 1997-03-07 1998-09-11 Mordechay Beyar Systems for percutaneous bone and spinal stabilization, fixation and repair
US6127597A (en) 1997-03-07 2000-10-03 Discotech N.V. Systems for percutaneous bone and spinal stabilization, fixation and repair
DE19726754A1 (en) 1997-06-24 1999-02-04 Aesculap Ag & Co Kg Implant for fixing parts of bones in particular at spine
DE19726754C2 (en) 1997-06-24 1999-07-22 Aesculap Ag & Co Kg Implant for fixing bone parts and tools for this implant
DE29710979U1 (en) 1997-06-24 1997-08-21 Aesculap Ag & Co Kg Implant for fixing bone parts and tools for this implant
US5976146A (en) 1997-07-11 1999-11-02 Olympus Optical Co., Ltd. Surgical operation system and method of securing working space for surgical operation in body
US6596008B1 (en) 1997-07-15 2003-07-22 Parviz Kambin Method and instruments for percutaneous arthroscopic disc removal, bone biopsy and fixation of the vertebral
US6175758B1 (en) 1997-07-15 2001-01-16 Parviz Kambin Method for percutaneous arthroscopic disc removal, bone biopsy and fixation of the vertebrae
US5964761A (en) 1997-07-15 1999-10-12 Kambin; Parviz Method and instruments for percutaneous arthroscopic disc removal, bone biopsy and fixation of vertebrae
US5795289A (en) 1997-07-28 1998-08-18 Wyttenbach; William H. Speculum
US5944658A (en) 1997-09-23 1999-08-31 Koros; Tibor B. Lumbar spinal fusion retractor and distractor system
US6226548B1 (en) 1997-09-24 2001-05-01 Surgical Navigation Technologies, Inc. Percutaneous registration apparatus and method for use in computer-assisted surgical navigation
WO1999029242A1 (en) 1997-12-10 1999-06-17 Phillips Plastics Corporation Seal member for surgical trocar
US6197002B1 (en) 1997-12-10 2001-03-06 Phillips Plastics Corporation Laparoscopic tool and method
US6206826B1 (en) 1997-12-18 2001-03-27 Sdgi Holdings, Inc. Devices and methods for percutaneous surgery
WO1999051139A2 (en) 1998-04-02 1999-10-14 Stefanov Alexander R A cannula of changeable length and shape
WO1999051139A3 (en) 1998-04-02 1999-11-18 Alexander R Stefanov A cannula of changeable length and shape
US6183472B1 (en) 1998-04-09 2001-02-06 Howmedica Gmbh Pedicle screw and an assembly aid therefor
US6506151B2 (en) 1998-04-09 2003-01-14 Sdgi Holdings, Inc. Method and instrumentation for posterior interbody fusion
US5928139A (en) 1998-04-24 1999-07-27 Koros; Tibor B. Retractor with adjustable length blades and light pipe guides
US6652553B2 (en) 1998-08-20 2003-11-25 Endius Incorporated Surgical tool for use in expanding a cannula
US20030199884A1 (en) 1998-08-20 2003-10-23 Endius Incorporated Method for performing a surgical procedure and a cannula for use in performing the surgical procedure
US20010011170A1 (en) 1998-08-20 2001-08-02 Endius Incorporated Method for performing a surgical procedure and a cannula for use in performing the surgical procedure
US20010049498A1 (en) 1998-08-20 2001-12-06 Endius Incorporated Sugical tool for use in expanding a cannula
US6837891B2 (en) 1998-08-20 2005-01-04 Endius Incorporated Cannula for receiving surgical instruments
US6811558B2 (en) 1998-08-20 2004-11-02 Endius Incorporated Method for performing a surgical procedure and a cannula for use in performing the surgical procedure
US6800084B2 (en) 1998-08-20 2004-10-05 Endius Incorporated Method for performing a surgical procedure and a cannula for use in performing the surgical procedure
US6187000B1 (en) 1998-08-20 2001-02-13 Endius Incorporated Cannula for receiving surgical instruments
EP1027988B1 (en) 1998-08-27 2007-04-11 Seiko Epson Corporation Hydrophilic structure
US20020045904A1 (en) 1999-01-30 2002-04-18 Aesculap Ag & Co. Kg Surgical instrument for introducing intervertebral implants
US20010029353A1 (en) 1999-02-08 2001-10-11 Phillips Plastics, Inc. Laparoscopic tool and method
WO2000045720A1 (en) 1999-02-08 2000-08-10 Phillips Plastics Corporation Laparoscopic tool and method
US6159179A (en) 1999-03-12 2000-12-12 Simonson; Robert E. Cannula and sizing and insertion method
US6607530B1 (en) 1999-05-10 2003-08-19 Highgate Orthopedics, Inc. Systems and methods for spinal fixation
US6923811B1 (en) 1999-05-10 2005-08-02 Spray Venture Partners Systems and methods for spinal fixation
US20040059333A1 (en) 1999-05-10 2004-03-25 Allen Carl Systems, methods, devices and device kits for fixation of bones and spinal vertebrae
US6200322B1 (en) 1999-08-13 2001-03-13 Sdgi Holdings, Inc. Minimal exposure posterior spinal interbody instrumentation and technique
WO2001012080A1 (en) 1999-08-13 2001-02-22 Sdgi Holdings, Inc. Minimal exposure posterior spinal interbody instrumentation and technique
US20050021031A1 (en) 1999-10-20 2005-01-27 Foley Kevin T. Instruments and methods for stabilization of bony structures
US7011660B2 (en) 1999-10-20 2006-03-14 Sdgi Holdings, Inc. Instruments and methods for stabilization of bony structures
US20030060826A1 (en) 1999-10-20 2003-03-27 Foley Kevin T. Instruments and methods for stabilization of bony structures
US20030199871A1 (en) 1999-10-20 2003-10-23 Foley Kevin T. Methods and instruments for endoscopic interbody surgical techniques
US20060111714A1 (en) 1999-10-20 2006-05-25 Foley Kevin T Instruments and methods for stabilization of bony structures
US20020161368A1 (en) 1999-10-20 2002-10-31 Foley Kevin T. Instruments and methods for stabilization of bony structures
US6530929B1 (en) 1999-10-20 2003-03-11 Sdgi Holdings, Inc. Instruments for stabilization of bony structures
US20060200135A1 (en) 1999-10-20 2006-09-07 Sherman Michael C Instruments and methods for stabilization of bony structures
EP1248568B1 (en) 1999-11-23 2003-09-17 SDGI Holdings, Inc. Surgical screw delivery system
WO2001037744A2 (en) 1999-11-23 2001-05-31 Sdgi Holdings, Inc. Surgical screw delivery system and method
US6287313B1 (en) 1999-11-23 2001-09-11 Sdgi Holdings, Inc. Screw delivery system and method
WO2001037744A3 (en) 1999-11-23 2002-06-06 Rick Sasso Surgical screw delivery system and method
US20010027320A1 (en) 1999-11-23 2001-10-04 Rick Sasso Screw delivery system and method
US6562046B2 (en) 1999-11-23 2003-05-13 Sdgi Holdings, Inc. Screw delivery system and method
WO2001041681A1 (en) 1999-12-10 2001-06-14 Nuvasive, Inc. Facet screw and bone allograft intervertebral support and fusion system
US6485518B1 (en) 1999-12-10 2002-11-26 Nuvasive Facet screw and bone allograft intervertebral support and fusion system
WO2001056479A1 (en) 2000-02-04 2001-08-09 Hôpital Sainte-Justine Surgical drill guide and method for using the same
US6235028B1 (en) 2000-02-14 2001-05-22 Sdgi Holdings, Inc. Surgical guide rod
US20030195518A1 (en) 2000-02-16 2003-10-16 Cragg Andrew H. Methods and apparatus for performing therapeutic procedures in the spine
WO2001060234A3 (en) 2000-02-16 2002-03-28 Axiamed Inc Apparatus for performing therapeutic procedures in the spine
US6790210B1 (en) 2000-02-16 2004-09-14 Trans1, Inc. Methods and apparatus for forming curved axial bores through spinal vertebrae
WO2001060270A1 (en) 2000-02-16 2001-08-23 Axiamed, Inc. Axial spinal implant and apparatus for implanting an axial spinal implant within the vertebrae of the spine
WO2001060232A3 (en) 2000-02-16 2002-03-07 Axiamed Inc Apparatus for forming curved axial bores through spinal vertebrae
US6558390B2 (en) 2000-02-16 2003-05-06 Axiamed, Inc. Methods and apparatus for performing therapeutic procedures in the spine
US6558386B1 (en) 2000-02-16 2003-05-06 Trans1 Inc. Axial spinal implant and method and apparatus for implanting an axial spinal implant within the vertebrae of the spine
WO2001060262A9 (en) 2000-02-16 2002-10-17 Axiamed Inc Apparatus for forming shaped axial bores through spinal vertebrae
US20020016583A1 (en) 2000-02-16 2002-02-07 Cragg Andrew H. Methods of performing procedures in the spine
US6575979B1 (en) 2000-02-16 2003-06-10 Axiamed, Inc. Method and apparatus for providing posterior or anterior trans-sacral access to spinal vertebrae
US6740090B1 (en) 2000-02-16 2004-05-25 Trans1 Inc. Methods and apparatus for forming shaped axial bores through spinal vertebrae
US20020173796A1 (en) 2000-02-16 2002-11-21 Cragg Andrew H. Method and apparatus for spinal augmentation
WO2001060270A9 (en) 2000-02-16 2002-11-07 Axiamed Inc Axial spinal implant and apparatus for implanting an axial spinal implant within the vertebrae of the spine
WO2001060262A1 (en) 2000-02-16 2001-08-23 Axiamed, Inc. Apparatus for forming shaped axial bores through spinal vertebrae
WO2001060263A1 (en) 2000-02-16 2001-08-23 Axiamed, Inc. Apparatus for providing posterior or anterior trans-sacral access to spinal vertebrae
US20030229353A1 (en) 2000-02-16 2003-12-11 Cragg Andrew H. Method and apparatus for providing posterior or anterior trans-sacral access to spinal vertebrae
US20010049527A1 (en) 2000-02-16 2001-12-06 Cragg Andrew H. Methods and apparatus for performing therapeutic procedures in the spine
US20030204189A1 (en) 2000-02-16 2003-10-30 Cragg Andrew H. Axial spinal implant and method and apparatus for implanting an axial spinal implant within the vertebrae of the spine
WO2003088878A1 (en) 2000-02-16 2003-10-30 Trans1 Inc. Method and apparatus for spinal augmentation
WO2001060232A9 (en) 2000-02-16 2002-10-10 Axiamed Inc Apparatus for forming curved axial bores through spinal vertebrae
WO2001060234A2 (en) 2000-02-16 2001-08-23 Axiamed, Inc. Apparatus for performing therapeutic procedures in the spine
DE10027988C2 (en) 2000-06-06 2003-08-21 Arkadiusz Kosmala Device for stereotactically guided percutaneous implantation of the longitudinal connection of the pedicle screws
WO2001095823A1 (en) 2000-06-13 2001-12-20 Sdgi Holdings, Inc. Percutaneous needle alignment system
US20040106934A1 (en) 2000-06-13 2004-06-03 Sdgi Holdings, Inc. Percutaneous Needle Alignment System
US6605095B2 (en) 2000-06-13 2003-08-12 Sdgi Holdings, Inc. Percutaneous needle alignment system and associated method
US20010053915A1 (en) 2000-06-13 2001-12-20 Jeffrey Grossman Percutaneous needle alignment system
US6749614B2 (en) 2000-06-23 2004-06-15 Vertelink Corporation Formable orthopedic fixation system with cross linking
US20040215193A1 (en) 2000-06-23 2004-10-28 Shaolian Samuel M. Formable orthopedic fixation system
US20020082598A1 (en) 2000-06-23 2002-06-27 Teitelbaum George P. Percutaneous vertebral fusion system
US20020198526A1 (en) 2000-06-23 2002-12-26 Shaolian Samuel M. Formed in place fixation system with thermal acceleration
US20040087950A1 (en) 2000-06-23 2004-05-06 Teitelbaum George P. Percutaneous vertebral fusion system
US20020068975A1 (en) 2000-06-23 2002-06-06 Teitelbaum George P. Formable orthopedic fixation system with cross linking
US6821277B2 (en) 2000-06-23 2004-11-23 University Of Southern California Patent And Copyright Administration Percutaneous vertebral fusion system
US20040082954A1 (en) 2000-06-23 2004-04-29 Teitelbaum George P. Formable orthopedic fixation system with cross linking
US20040006341A1 (en) 2000-06-23 2004-01-08 Shaolian Samuel M. Curable media for implantable medical device
US20020082600A1 (en) 2000-06-23 2002-06-27 Shaolian Samuel M. Formable orthopedic fixation system
US20050149022A1 (en) 2000-06-23 2005-07-07 Shaolian Samuel M. Curable media for implantable medical device
US20040082961A1 (en) 2000-06-23 2004-04-29 Teitelbaum George P. Percutaneous vertebral fusion system
US6475218B2 (en) 2000-06-30 2002-11-05 Sofamor, S.N.C. Spinal implant for an osteosynthesis device
US20040133201A1 (en) 2000-08-01 2004-07-08 Alan Shluzas Methods and apparatuses for treating the spine through an access device
US20050021030A1 (en) 2000-08-01 2005-01-27 Endius Incorporated Method of securing vertebrae
US20050113833A1 (en) 2000-08-01 2005-05-26 Davison Thomas W. Method of securing vertebrae
US6530926B1 (en) 2000-08-01 2003-03-11 Endius Incorporated Method of securing vertebrae
US20030073998A1 (en) 2000-08-01 2003-04-17 Endius Incorporated Method of securing vertebrae
US20050033297A1 (en) 2000-08-01 2005-02-10 Davison Thomas W. Method of securing vertebrae
US20040236317A1 (en) 2000-08-01 2004-11-25 Davison Thomas W. Method of securing vertebrae
US20040082960A1 (en) 2000-08-01 2004-04-29 Davison Thomas W. Method of securing vertebrae
US20030004517A1 (en) 2000-09-11 2003-01-02 Anderson D. Greg Percutaneous technique and implant for expanding the spinal canal
US6692434B2 (en) 2000-09-29 2004-02-17 Stephen Ritland Method and device for retractor for microsurgical intermuscular lumbar arthrodesis
US20050137593A1 (en) 2000-10-02 2005-06-23 Sulzer Spine-Tech Inc. Temporary spinal fixation apparatuses and methods
US20020107519A1 (en) * 2001-02-05 2002-08-08 Dixon Robert A. Dual spreader flange-tube vertebral stabilizer
US20020116006A1 (en) 2001-02-21 2002-08-22 Herb Cohen Instrumentation and method for implant insertion
US6929647B2 (en) 2001-02-21 2005-08-16 Howmedica Osteonics Corp. Instrumentation and method for implant insertion
US20050043741A1 (en) 2001-03-01 2005-02-24 Michelson Gary K. Retractor for percutaneous surgery in a patient and method for use thereof
WO2002085217A9 (en) 2001-04-19 2002-12-12 Spineology Inc Stacked intermedular rods for spinal fixation
WO2002085217A2 (en) 2001-04-19 2002-10-31 Spineology, Inc. Stacked intermedular rods for spinal fixation
US6524320B2 (en) 2001-05-15 2003-02-25 Endius Incorporated Cannula for receiving surgical instruments
US6692473B2 (en) 2001-05-24 2004-02-17 John A. St. Cyr Dual lumen adjustable length cannulae for liquid perfusion or lavage
WO2003020110A2 (en) 2001-08-29 2003-03-13 Vertelink Corporation Formed in place fixation system with thermal acceleration
WO2003020110A3 (en) 2001-08-29 2003-07-24 Vertelink Corp Formed in place fixation system with thermal acceleration
US6746449B2 (en) 2001-09-12 2004-06-08 Spinal Concepts, Inc. Spinal rod translation instrument
WO2003028566A1 (en) 2001-10-04 2003-04-10 Stryker Spine Spinal osteosynthesis assembly comprising the head of an anchoring member and a tool for fixing said head
US20030083688A1 (en) 2001-10-30 2003-05-01 Simonson Robert E. Configured and sized cannula
US20050080418A1 (en) 2001-10-30 2005-04-14 Simonson Robert E. Instruments and methods for minimally invasive spine surgery
WO2003037170A9 (en) 2001-10-30 2004-12-16 Nuvasive Inc System and methods for performing percutaneous pedicle integrity assessments
WO2003037170A2 (en) 2001-10-30 2003-05-08 Nuvasive, Inc. System and methods for performing percutaneous pedicle integrity assessments
WO2003057055A1 (en) 2001-12-27 2003-07-17 Osteotech Inc. Orthopedic/neurosurgical system and method for securing vertebral bone facets
US6723095B2 (en) 2001-12-28 2004-04-20 Hemodynamics, Inc. Method of spinal fixation using adhesive media
US6740089B2 (en) 2002-01-10 2004-05-25 Thomas T. Haider Orthopedic hook system
WO2003079914A1 (en) 2002-03-19 2003-10-02 Depuy Acromed, Inc. Percutaneous technique and implant for expanding the spinal canal
US6660006B2 (en) * 2002-04-17 2003-12-09 Stryker Spine Rod persuader
US20030199872A1 (en) * 2002-04-17 2003-10-23 Stryker Spine Rod persuader
WO2003088810A3 (en) 2002-04-17 2004-07-29 Ricardo Sasso Navigation instrumentation and method for surgical device
WO2003088810A2 (en) 2002-04-17 2003-10-30 Ricardo Sasso Navigation instrumentation and method for surgical device
US7842073B2 (en) 2002-04-18 2010-11-30 Aesculap Ii, Inc. Screw and rod fixation assembly and device
US7261714B2 (en) 2002-04-18 2007-08-28 Aesculap Implant Systems, Inc. Screw and rod fixation assembly and device
US20030208202A1 (en) 2002-05-04 2003-11-06 Falahee Mark H. Percutaneous screw fixation system
US20030225408A1 (en) 2002-06-04 2003-12-04 Howmedica Osteonics Corp. Apparatus for securing a spinal rod system
EP1374786A3 (en) 2002-06-04 2007-12-19 Howmedica Osteonics Corp. Apparatus for securing a spinal rod system
US20040006344A1 (en) 2002-07-02 2004-01-08 Nguyen Thanh Van Expandable percutaneous sheath
WO2004004584A1 (en) 2002-07-02 2004-01-15 Vertelink Corporation Expandable percutaneous sheath
US20040034351A1 (en) 2002-08-14 2004-02-19 Sherman Michael C. Techniques for spinal surgery and attaching constructs to vertebral elements
WO2004017847A3 (en) 2002-08-21 2004-07-01 Frank H Boehm Jr Device and method for percutaneous placement of lumbar pedicle screws and connecting rods
US20040039384A1 (en) 2002-08-21 2004-02-26 Boehm Frank H. Device and method for pertcutaneous placement of lumbar pedicle screws and connecting rods
WO2004017847A2 (en) 2002-08-21 2004-03-04 Boehm Frank H Jr Device and method for percutaneous placement of lumbar pedicle screws and connecting rods
US7306603B2 (en) 2002-08-21 2007-12-11 Innovative Spinal Technologies Device and method for percutaneous placement of lumbar pedicle screws and connecting rods
EP1545355B1 (en) 2002-08-21 2008-12-10 Boehm, Frank H. Device for percutaneous placement of lumbar pedicle screws and connecting rods
WO2004021899A1 (en) 2002-09-05 2004-03-18 Endius Incorporated System and methods for performing minimally-invasive surgical procedures
US20050182410A1 (en) * 2002-09-06 2005-08-18 Jackson Roger P. Helical guide and advancement flange with radially loaded lip
US6648888B1 (en) * 2002-09-06 2003-11-18 Endius Incorporated Surgical instrument for moving a vertebra
WO2004028382A2 (en) 2002-09-19 2004-04-08 Sdgi Holdings, Inc. Oval dilator and retractor set and method
US20040143268A1 (en) 2002-10-10 2004-07-22 Falahee Mark H. Percutaneous facet fixation system
US6849064B2 (en) 2002-10-25 2005-02-01 James S. Hamada Minimal access lumbar diskectomy instrumentation and method
WO2004037070A2 (en) 2002-10-25 2004-05-06 Hamada James S Minimal access lumbar diskectomy instrumentation and method
WO2004037074A2 (en) 2002-10-25 2004-05-06 Endius Incorporated Method of securing vertebrae
WO2004037070A3 (en) 2002-10-25 2005-03-31 James S Hamada Minimal access lumbar diskectomy instrumentation and method
US20040093001A1 (en) 2002-10-25 2004-05-13 Hamada James S. Minimal access lumbar diskectomy instrumentation and method
WO2004041100A1 (en) 2002-10-30 2004-05-21 Spinal Concepts, Inc. Spinal stabilization system insertion and methods
US7250052B2 (en) 2002-10-30 2007-07-31 Abbott Spine Inc. Spinal stabilization systems and methods
US20120123477A1 (en) 2002-10-30 2012-05-17 Zimmer Spine, Inc. Spinal stabilization systems and methods
US20040147928A1 (en) 2002-10-30 2004-07-29 Landry Michael E. Spinal stabilization system using flexible members
US20040138662A1 (en) 2002-10-30 2004-07-15 Landry Michael E. Spinal stabilization systems and methods
US20080009864A1 (en) 2002-10-30 2008-01-10 Charlie Forton Instruments and methods for reduction of vertebral bodies
US20040172022A1 (en) 2002-10-30 2004-09-02 Landry Michael E. Bone fastener assembly for a spinal stabilization system
US20040143265A1 (en) 2002-10-30 2004-07-22 Landry Michael E. Spinal stabilization systems and methods using minimally invasive surgical procedures
WO2004058045A2 (en) 2002-12-20 2004-07-15 Vertelink Corporation Curable media for implantable medical device
US20040147936A1 (en) 2003-01-28 2004-07-29 Rosenberg William S. Spinal rod approximator
US20040162560A1 (en) 2003-02-19 2004-08-19 Raynor Donald E. Implant device including threaded locking mechanism
US20050025771A1 (en) 2003-03-04 2005-02-03 Greenville Hospital System Antitumor agents comprising a targeting portion and an immune response triggering portion
WO2004080318A1 (en) 2003-03-10 2004-09-23 Sdgi Holdings Inc. Posterior pedicle screw and plate system and methods
EP1468652A1 (en) 2003-04-16 2004-10-20 Paul M. Tsou Apparatus for endoscopic spinal surgery
US20050010220A1 (en) 2003-04-24 2005-01-13 Simon Casutt Instrument system for pedicle screws
US20040215190A1 (en) 2003-04-25 2004-10-28 Nguyen Thanh V. System and method for minimally invasive posterior fixation
US7083621B2 (en) 2003-04-25 2006-08-01 Sdgi Holdings, Inc. Articulating spinal fixation rod and system
US20050038432A1 (en) 2003-04-25 2005-02-17 Shaolian Samuel M. Articulating spinal fixation rod and system
US20040254576A1 (en) 2003-06-16 2004-12-16 Depuy Acromed, Inc. Rod reduction nut and driver tool
US20050010221A1 (en) 2003-07-07 2005-01-13 Dalton Brian E. Spinal stabilization implant and method of application
US20050043742A1 (en) 2003-08-21 2005-02-24 Aurelian Bruneau Systems and methods for positioning implants relative to bone anchors in surgical approaches to the spine
WO2005018466A3 (en) 2003-08-26 2005-06-16 Gene Dipoto Access systems and methods for minimally invasive surgery
WO2005018466A2 (en) 2003-08-26 2005-03-03 Endius, Inc. Access systems and methods for minimally invasive surgery
WO2005023123A1 (en) 2003-09-09 2005-03-17 Endius, Inc. Apparatuses and methods for treating the spine through an access device
US20050059969A1 (en) 2003-09-17 2005-03-17 Depuy Acromed, Inc. Rod approximator
US20110238120A1 (en) 2003-09-24 2011-09-29 Stryker Spine Methods and devices for improving percutaneous access in minimally invasive surgeries
US20050065515A1 (en) 2003-09-24 2005-03-24 Tae-Ahn Jahng Marking and guidance method and system for flexible fixation of a spine
US20050065517A1 (en) 2003-09-24 2005-03-24 Chin Kingsley Richard Methods and devices for improving percutaneous access in minimally invasive surgeries
US7955355B2 (en) 2003-09-24 2011-06-07 Stryker Spine Methods and devices for improving percutaneous access in minimally invasive surgeries
US8002798B2 (en) 2003-09-24 2011-08-23 Stryker Spine System and method for spinal implant placement
US20050070917A1 (en) 2003-09-29 2005-03-31 Justis Jeff R. Instruments and methods for securing a connecting element along a bony segment
WO2005032358A3 (en) 2003-10-02 2005-07-21 Endius Inc Methods, systems and apparatuses for performing minimally invasive spinal procedures
US20050149035A1 (en) 2003-10-17 2005-07-07 Nuvasive, Inc. Surgical access system and related methods
US20050085813A1 (en) 2003-10-21 2005-04-21 Innovative Spinal Technologies System and method for stabilizing of internal structures
US20050090822A1 (en) 2003-10-24 2005-04-28 Dipoto Gene Methods and apparatus for stabilizing the spine through an access device
US20050090833A1 (en) 2003-10-24 2005-04-28 Dipoto Gene Methods and apparatuses for fixation of the spine through an access device
WO2005072081A2 (en) 2003-11-08 2005-08-11 Stryker Spine Methods and devices for improving percutaneous access in minimally invasive surgeries
US20050124991A1 (en) 2003-12-05 2005-06-09 Tae-Ahn Jahng Method and apparatus for flexible fixation of a spine
US20050131407A1 (en) 2003-12-16 2005-06-16 Sicvol Christopher W. Flexible spinal fixation elements
US20050131408A1 (en) 2003-12-16 2005-06-16 Sicvol Christopher W. Percutaneous access devices and bone anchor assemblies
US20050131421A1 (en) 2003-12-16 2005-06-16 Anderson David G. Methods and devices for minimally invasive spinal fixation element placement
US20100137915A1 (en) 2003-12-16 2010-06-03 Depuy Spine, Inc. Methods and devices for spinal fixation element placement
US8105361B2 (en) 2003-12-16 2012-01-31 Depuy Spine, Inc. Methods and devices for minimally invasive spinal fixation element placement
US20050154389A1 (en) * 2003-12-16 2005-07-14 Depuy Spine, Inc. Methods and devices for minimally invasive spinal fixation element placement
US20050131422A1 (en) 2003-12-16 2005-06-16 Anderson David G. Methods and devices for spinal fixation element placement
US20050137461A1 (en) 2003-12-18 2005-06-23 Depuy Spine, Inc. Telescoping blade assembly and instruments for adjusting an adjustable blade
US20050171540A1 (en) 2004-01-30 2005-08-04 Roy Lim Instruments and methods for minimally invasive spinal stabilization
US20060293680A1 (en) 2004-02-27 2006-12-28 Jackson Roger P Orthopedic implant rod reduction tool set and method
US7160300B2 (en) 2004-02-27 2007-01-09 Jackson Roger P Orthopedic implant rod reduction tool set and method
US20120158070A1 (en) 2004-02-27 2012-06-21 Jackson Roger P Orthopedic implant rod reductiion tool set and method
US20050192570A1 (en) 2004-02-27 2005-09-01 Jackson Roger P. Orthopedic implant rod reduction tool set and method
US20090228056A1 (en) 2004-02-27 2009-09-10 Jackson Roger P Orthopedic implant rod reduction tool set and method
US20110077692A1 (en) 2004-02-27 2011-03-31 Jackson Roger P Dynamic spinal stabilization assemblies, tool set and method
US20090216328A1 (en) 2004-03-19 2009-08-27 Depuy Spine, Inc. Spinal fixation element and methods
US20050245928A1 (en) 2004-05-03 2005-11-03 Innovative Spinal Technologies System and method for displacement of bony structures
US20050251139A1 (en) * 2004-05-07 2005-11-10 Roh Jeffrey S Systems and methods that facilitate minimally invasive spine surgery
US20050277942A1 (en) 2004-05-27 2005-12-15 Kullas Karen E Method and apparatus for delivering a prosthetic fabric into a patient
US20060030839A1 (en) 2004-07-21 2006-02-09 Solco Biomedical Co., Ltd. Pedicle screw and operating device thereof
US20060036252A1 (en) 2004-08-12 2006-02-16 Baynham Bret O Polyaxial screw
US20060084980A1 (en) 2004-10-05 2006-04-20 Melkent Anthony J Spinal implants and methods with extended multi-axial anchor assemblies
US20110015678A1 (en) 2004-11-23 2011-01-20 Jackson Roger P Spinal fixation tool set and method
US20060111713A1 (en) * 2004-11-23 2006-05-25 Jackson Roger P Spinal fixation tool set and method
US7811288B2 (en) 2004-12-02 2010-10-12 Zimmer Spine, Inc. Instruments and methods for adjusting separation distance of vertebral bodies with a minimally invasive spinal stabilization procedure
US8192440B2 (en) 2004-12-02 2012-06-05 Zimmer Spine, Inc. Instruments and methods for adjusting separation distance of vertebral bodies with a minimally invasive spinal stabilization procedure
US20110245884A9 (en) 2005-01-26 2011-10-06 Warsaw Orthopedic, Inc. Reducing Instrument for Spinal Surgery
US20060217735A1 (en) 2005-03-11 2006-09-28 Macdonald Joel Bone repair device and method
US20100331901A1 (en) 2005-04-27 2010-12-30 Andrew Iott Percutaneous Vertebral Stabilization System
US20060247630A1 (en) * 2005-04-27 2006-11-02 Andrew Iott Percutaneous vertebral stabilization system
US7758617B2 (en) 2005-04-27 2010-07-20 Globus Medical, Inc. Percutaneous vertebral stabilization system
US20060247658A1 (en) 2005-04-28 2006-11-02 Pond John D Jr Instrument and method for guiding surgical implants and instruments during surgery
WO2006116662A1 (en) 2005-04-28 2006-11-02 Warsaw Orthopedic, Inc. Instrument and method for guiding surgical implants and instruments during surgery
US20060264934A1 (en) 2005-05-18 2006-11-23 Medicinelodge, Inc. System and method for orthopedic implant configuration
US8177817B2 (en) 2005-05-18 2012-05-15 Stryker Spine System and method for orthopedic implant configuration
US20120197302A1 (en) 2005-05-18 2012-08-02 Stryker Spine System and method for orthopedic implant configuration
US20070043359A1 (en) 2005-07-22 2007-02-22 Moti Altarac Systems and methods for stabilization of bone structures
US20120089191A1 (en) 2005-07-22 2012-04-12 Exactech, Inc. Methods for stabilizing bone structures
US20110152940A1 (en) 2005-08-25 2011-06-23 Robert Frigg Methods of spinal fixation and instrumentation
US20070233079A1 (en) 2006-02-06 2007-10-04 Stryker Spine Rod contouring apparatus and method for percutaneous pedicle screw extension
US20090099605A1 (en) 2006-02-06 2009-04-16 Stryker Spine Rod contouring apparatus for percutaneous pedicle screw extension

Non-Patent Citations (33)

* Cited by examiner, † Cited by third party
Title
Bare Bones; Monthly Executive Summary, vol. 12, No. 1, p. 1-4, Jan. 2003.
Charles Hartjen; The Atavi System, Surgical Technique Brochure. Endius, p. 1-17.
Diapason, Surgical Technique Catalog, Diapasan Spinal System, Jan. 2002.
Encore Spine; Degenerative System, Encore Surgical Product Brochure, p. 1-6, Oct. 2002.
Kambin et al, "Percutaneous Posterolateral Lumbar Discectomy and Decompression with a 6.9-millimeter cannula", The Journal of Bone and Joint Surgery, pp. 822-831, Jul. 1991.
Kambin et al., Anterior Column Support for Failed Fusion, Revision Spine Surgery, pp. 589-600, from 1999.
Kambin, "Arthroscopic Microdiscectomy", The Journal of Arthroscopy, vol. 8, No. 3, pp. 287-295, 1992.
Kambin, "Arthroscopic Microdiskectomy", The Mount Sinai Journal of Medicine, vol. 58, No. 2, Mar. 1991, pp. 159-164.
Kambin, "Posterolateral Percutaneous suction-excision of herniated lumbar intervertebral discs", Clinical Orthopaedics and Related Research. No. 207, pp. 37-42, Jun. 1988.
Kambin, Arthroscopic Lumbar Intervertebral Fusion, Chapter 95, The Adult Spine, vol. 2, pp. 2037-2046, 1997.
Kambin, Minimally Invasive Techniques in Spinal Surgery Current Practice, Neurosurgical Focus, wwwspineuniversecom, 16 pages, printed Aug. 24, 2005.
Kambin, Posterolateral Percutaneous Lumbar Discectomy and Decompression Arthroscopic Microdiscectomy, Section IV. pp. 67-100, 1991.
Kambin, Posterolateral Percutaneous Lumbar Interbody Fusion, Arthroscopic Microdiscectomy, pp. 117-121, 1991.
Kambin, The Role of Minimally Invasive Surgery in Spinal Disorders, Advance Operative Orthopedics, vol. 3, pp. 147-171, 1995.
Leu et al., Percutaneous Fusion of the Lumbar Spine, State of the Art Reviews, vol. 6, No. 3, pp. 593-604, Sep. 1992.
Maxcess; Decompression Surgical Technique. Nuvasive Creative Spine Technology Product Brochure, p. 1-16.
Maxcess; XLIF 90° Surgical Technique. Nuvasive Creative Spine Technology Product Brochure, p. 1-26, 2005.
Moss Miami Surgical Texhnique, DePuy, 14 pages, 1998.
Nex-Link; Spinal Fixation System. Spinal Concepts Web Page information, 1 page.
Nuvasive; SpheRx DBR Minimally Disruptive Fixation, Nuvasive web page information. 1 page.
Office Action from U.S. Appl. 10/868,075, dated Sep. 18, 2008.
Office Action from U.S. Appl. 11/526,785, dated Jan. 8, 2009.
Pathfinder; Minimally Invasive Pedicie Fixation System. Spinal Concepts Product Brochure p. 1-4, May 2003.
Pathfinder; Minimally invasive Spinal Fixation System and Surgical Technique. Spinal Concepts Product Brochure, p. 1-26.
Smith and Nephew; 6.5mm and 4.0mm Cannulated Screws, Surgical Technique, p. 1-24, 1998.
Sofamor Danek; Eclipse CD Horizon Eclipse Implants and Instruments, Information from the Sofamor Danek Web page, p. 1-3, printed Mar. 29, 2005.
Sofamor Danek; Metrx, X-Tube, Refraction System; Sofamor Danek Web page information p. 1-2, printed Mar. 29, 2005.
Sofamor Danek; Sextant CD Horizon Rod Insertion System, Sofamor Danek Web page.
Sofamor Danek; Sextant CD Horizon Sextant Rod Insertion System, Surgical Technique, Techniques, p. 1-29, 2003.
Spinal Concepts; Access Dilation Port, Spinal Concepts Web Page information 2 pages, 2004.
Synthes; MIRA for M.I.S.S, Surgical Technique Brochure. Synthes, p. 1-7.
U.S. Appl. No. 11/526,785, filed Sep. 25, 2006.
U.S. Appl. No. 12/316,637, filed Dec. 15, 2008.

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
USRE46432E1 (en) * 2003-09-24 2017-06-13 Stryker European Holdings I, Llc System and method for spinal implant placement
US9700357B2 (en) 2003-09-24 2017-07-11 Stryker European Holdings I, Llc Methods and devices for improving percutaneous access in minimally invasive surgeries
US9655685B2 (en) 2006-02-06 2017-05-23 Stryker European Holdings I, Llc Rod contouring apparatus for percutaneous pedicle screw extension

Also Published As

Publication number Publication date Type
USRE46432E1 (en) 2017-06-13 grant
USRE45338E1 (en) 2015-01-13 grant

Similar Documents

Publication Publication Date Title
US7815664B2 (en) Systems and methods for spinal stabilization with flexible elements
US7776040B2 (en) System for use in spinal stabilization
US7578822B2 (en) Instrument for compression or distraction
US7520879B2 (en) Surgical instruments and techniques for percutaneous placement of spinal stabilization elements
US20070213716A1 (en) Methods and instruments for spinal derotation
US5931777A (en) Tissue retractor and method for use
US7794464B2 (en) Spinal derotation instruments and methods
US20050245928A1 (en) System and method for displacement of bony structures
US20100004695A1 (en) System and method for manipulating a spinal construct
US20100114180A1 (en) Multi-planar, taper lock screw with additional lock
US20080021455A1 (en) Articulating Sacral or Iliac Connector
US7491207B2 (en) Rod persuader
US20070167949A1 (en) Screw systems and methods for use in stabilization of bone structures
US7462182B2 (en) Reducing instrument for spinal surgery
US20080287994A1 (en) Pedicle Screw and Rod System
US20080021454A1 (en) Sacral or iliac connector
US20050090833A1 (en) Methods and apparatuses for fixation of the spine through an access device
US20110022088A1 (en) Spinal rod insertion tool and method
US20050251192A1 (en) Access device having discrete visualization locations
US20080300686A1 (en) Percutaneous interspinous process device and method
US20100087860A1 (en) Spinous process fixation implant
US20060030850A1 (en) Methods and apparatuses for percutaneous implant delivery
US20050251138A1 (en) Bone plate and method for using bone plate
US20040147937A1 (en) Spinal rod approximators
US20070239159A1 (en) Systems and methods for stabilization of bone structures

Legal Events

Date Code Title Description
AS Assignment

Owner name: CHIN, KINGSLEY R., FLORIDA

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:CHIN, KINGSLEY R.;FALLIN, T. WADE;BUTTERS, JOSHUA A.;AND OTHERS;SIGNING DATES FROM 20050816 TO 20050829;REEL/FRAME:036415/0570

AS Assignment

Owner name: MANTIS, L.L.S., PENNSYLVANIA

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:CHIN, KINGSLEY R.;FALLIN, T. WADE;JUSTIN, DANIEL F.;AND OTHERS;REEL/FRAME:036434/0717

Effective date: 20051102

AS Assignment

Owner name: STRYKER SPINE, FRANCE

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:MANTIS, L.L.S.;REEL/FRAME:036446/0517

Effective date: 20051104

AS Assignment

Owner name: STRYKER EUROPEAN HOLDINGS VI, LLC, MICHIGAN

Free format text: NUNC PRO TUNC ASSIGNMENT;ASSIGNOR:STRYKER SPINE SAS;REEL/FRAME:037152/0825

Effective date: 20151008

Owner name: STRYKER EUROPEAN HOLDINGS I, LLC, MICHIGAN

Free format text: NUNC PRO TUNC ASSIGNMENT;ASSIGNOR:STRYKER EUROPEAN HOLDINGS VI, LLC;REEL/FRAME:037153/0391

Effective date: 20151008

RF Reissue application filed

Effective date: 20150812

AS Assignment

Owner name: MANTIS, L.L.S., PENNSYLVANIA

Free format text: CORRECTIVE ASSIGNMENT TO CORRECT THE EXHIBIT A OMITTED INSIDE THE ASSIGNMENT DOCUMENT PREVIOUSLY RECORDED AT REEL: 036434 FRAME: 0717. ASSIGNOR(S) HEREBY CONFIRMS THE ASSIGNMENT;ASSIGNORS:CHIN, KINGSLEY R.;FALLIN, T. WADE;JUSTIN, DANIEL F.;AND OTHERS;REEL/FRAME:042992/0104

Effective date: 20051102