WO2005055843A1 - Clipping-type surgical instrument for spinal implant - Google Patents

Clipping-type surgical instrument for spinal implant Download PDF

Info

Publication number
WO2005055843A1
WO2005055843A1 PCT/FR2004/003093 FR2004003093W WO2005055843A1 WO 2005055843 A1 WO2005055843 A1 WO 2005055843A1 FR 2004003093 W FR2004003093 W FR 2004003093W WO 2005055843 A1 WO2005055843 A1 WO 2005055843A1
Authority
WO
WIPO (PCT)
Prior art keywords
surgical instrument
tube
instrument according
characterized
plate
Prior art date
Application number
PCT/FR2004/003093
Other languages
French (fr)
Inventor
Tiphaine Leport
Jean-Yves Leroy
Pascal Rokegem
Guy Viart
Original Assignee
Eurosurgical
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
Priority to FR0314130A priority Critical patent/FR2862863B1/en
Priority to FR0314130 priority
Priority to US10/898,320 priority
Priority to US10/898,320 priority patent/US20050119667A1/en
Application filed by Eurosurgical filed Critical Eurosurgical
Publication of WO2005055843A1 publication Critical patent/WO2005055843A1/en

Links

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
    • A61B17/7074Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • A61B17/7091Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for applying, tightening or removing longitudinal element-to-bone anchor locking elements, e.g. caps, set screws, nuts or wedges
    • 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

Abstract

The invention relates to a clipping-type surgical instrument for spinal implant. The inventive instrument consists of a main body (101) having a fixed handle (104), a mobile handle (105) and a drive device (108), said drive device comprising: a first plate (131) which is loaded elastically by a spring (132), a cylindrical push element (130) and a second plate (133) which is loaded elastically by a spring (134). According to the invention, under the effect of the spring (132), the aforementioned first plate (131) is designed to come into contact with and press against the profile of the mobile handle (105) such that, when said handle is actuated, the cylindrical push element (130) can move in translation inside a tube (102) owing to the butting of the first plate (131), in order for a blocking element (4) to be introduced into the head (8) of the bone-anchoring element (2) using a push force F, said blocking element having been pre-positioned and guided into the tube (102)

Description

SURGICAL INSTRUMENT TYPE SPINAL IMPLANT CLIPSEUSE

The present invention relates to a surgical instrument clipseuse type allowing the introduction and development of a locking member in the head of a bone anchoring element belonging to a spinal implant. US Patent is known from 6,648,888 a surgical instrument having means for immobilizing the head of the bone anchoring element of a spinal implant and means for introducing a locking element in the U-shaped head of the bone anchoring element for fastening in rotation and in translation to a connecting rod.

It is noted that the locking element consists of a threaded locking screw cooperating by rotation with the threaded inner portion of the U-shaped head of the bone anchoring element for fastening by pressure of the connecting rod in the bottom of said U-shaped head

U.S. Patent ART It is known 6139 549 a surgical instrument having means for immobilizing the head of the bone anchoring element of a spinal implant and means for introducing a blocking member in the U-shaped head of the bone anchoring element for fastening in rotation and in translation to a connecting rod.

It is noted that the locking element consists of a first ring which snaps over the outer portion of the U-shaped head of the bone anchoring element and a second ring co-operating firstly with the connecting rod and on the other hand by means of a threaded shaft with the first ring to achieve fixation in rotation and in translation of the connecting rod.

The surgical instrument according to the present invention is intended to improve and facilitate the introduction of each inside of the U-shaped head locking member of the corresponding bone anchoring element.

The surgical instrument according to the present invention is more particularly intended for spinal implants made of bone anchoring element comprising a U-shaped head designed to cooperate with a locking element allowing through a clamping screw the immobilization in translation and in rotation of a connecting rod connecting each bone anchorage element to each other.

The surgical instrument according to the present invention comprises a main body having a stationary handle, a movable handle and a drive device which consists of a first elastically loaded by a plate spring, a cylindrical plunger and a second platinum elastically loaded by a spring, said first plate being adapted to come under the effect of the spring bearing against the profile of the movable handle for upon actuation of the latter the translational movement of the cylindrical plunger to inside a tube through the buttressing of the first plate for insertion under a thrust force F of a locking element, previously positioned and guided within the tube, in the head of the bone anchoring element.

The surgical instrument according to the present invention includes a movable handle which cooperates with the fixed handle via a rotation axis and a leaf spring, for operating under a pressure force the drive device and to return to its resting position after release of the pressure force.

The surgical instrument according to the present invention includes a movable handle which comprises above the rotational axis of a head having a convex profile.

The surgical instrument according to the present invention includes a movable handle which comprises above the rotational axis of a head having a convex profile from which extends a fork, each of the arms has a free end with a rounded profile.

The surgical instrument according to the present invention comprises a frame which consists of two vertical and opposite walls interconnected by upper and lower perforated walls, said vertical wall being integral with the horizontal tube having an internal bore within the framework while the wall is opposite a hole carried by the same main axis as that of the internal bore, said upper wall having a central recess of rectangular shape and an extension extending beyond the vertical wall and wherein an elongated groove is pierced, while the bottom wall comprises another course arranged underneath it, said recess having at the fixed handle internal shoulders for forming a stop.

The surgical instrument according to the present invention comprises first and second plates which are guided and retained in the frame by means of a fixing screw cooperating with a horizontal hole provided with a threaded portion pierced in the upper wall of said frame .

The surgical instrument according to the present invention comprises a second stage which comprises an extension extending above the groove in the extension of the upper wall of the frame.

The surgical instrument according to the present invention comprises a second plate whose upper part is pierced with an oblong hole. The surgical instrument according to the present invention comprises a second plate that includes opposite the extension profile beak-shaped forming a keeper.

The surgical instrument according to the present invention comprises a main body having a stationary handle, a movable handle acting on a driving device guided inside the main body and allowing following the pressing force applied to the movable handle, d on the one hand the immobilization of the surgical instrument on the head of the bone anchoring element and secondly the introduction under a thrust force F of a locking element, previously positioned and guided to the inside a tube of the main body, in the head of the bone anchoring element.

The surgical instrument according to the present invention includes a locking tube comprising at one of its ends bifurcated branches each provided with notches so that the free ends of each arm of the movable handle respectively cooperate with said notches to allow the action of the movable handle the slide lock tube around the tube and at the opposite end a cylindrical sleeve extending through parallel tongues.

The surgical instrument according to the present invention includes a locking tube comprising at one of its ends a cap having an ergonomic external profile ensuring perfect gripping by the surgeon to allow him to move translationally locking tube around the tube or towards the free end of said tube or in a direction away from said free end.

The surgical instrument according to the present invention comprises a cover which comprises, opposite to the locking tube, and in its upper inner part and a cooperating groove, when placing said cover on the frame, with the extension of the second plate of the drive device.

The surgical instrument according to the present invention comprises a cylindrical pusher which passes through the frame through the hole in the vertical wall for slidably coming into the inner bore of the tube.

The surgical instrument according to the present invention comprises a cylindrical pusher which comprises from its head a first cylindrical portion which is extended by a second cylindrical portion outer diameter less than that of the first part.

The surgical instrument according to the present invention comprises a drive device which consists of a first spring loaded platen by a spring and 'disposed inside the frame so as to cooperate with the recesses of the upper and lower walls and cylindrical lifter and a second plate spring-loaded by a spring and disposed within the groove of the extension of the upper wall so as to cooperate with the cylindrical pusher, said first plate being adapted to come under the effect of spring, resting against the curved profile of the head of the movable handle for upon actuation of the latter the translational movement of the cylindrical plunger inside the tube, with the bracing of the first plate.

The surgical instrument according to the present invention comprises a tube which comprises an extension of the cylindrical inner bore and at its free end a further internal bore whose internal profile is complementary to that of the external locking element to able to receive and guide the latter before its introduction into the head of the bone anchoring element.

The surgical instrument according to the present invention comprises a cylindrical tube which extends at its free end by a substantially rectangular profile sleeve, each parallel to and opposite wall has a U-shaped notch intended to cooperate with the connecting rod the spinal implant.

The surgical instrument according to the present invention comprises a cylindrical tube whose internal profile of the sleeve is in one direction, of dimensions slightly greater than those of the internal bore to conform to the input thereof, the abutment shoulders .

The surgical instrument according to the present invention comprises a cylindrical tube which comprises on its external profile of the flat portions which extend on each wall of the sleeve, each flat being pierced at the first and second tube holes opening into the interior of the bore and at the walls of the sleeve of a third through hole.

The surgical instrument according to the present invention comprises a cylindrical tube whose each first hole has an internal thread for cooperation with a clamping screw for fixing in each of two flat elastic strips.

The surgical instrument according to the present invention comprises a cylindrical tube in which each elastic strip is integral with a finger cooperating with the corresponding second hole and within the bore to allow the retainer inside the latter elements blocking.

The surgical instrument according to the present invention comprises a cylindrical tube in which each elastic strip is integral with a pin cooperating with the third hole of the sleeve in order to penetrate inside the latter when the blades are deformed by a pushing force external from the locking tube tongues in order to enable the fixation of the surgical instrument on the head of the bone anchoring element.

The surgical instrument according to the present invention comprises a cylindrical tube whose internal bore is provided for receiving a number of locking elements.

The following description from the accompanying drawings given as non-limiting examples, will understand the invention, its characteristics and the benefits it can provide:

Figure 1 is an exploded perspective view illustrating by example a bone anchoring element of a spinal implant for which the surgical instrument according to the present invention may be used. Figure 2 is a view showing the surgical instrument according to the present invention.

Figure 3 is a detail view showing the drive mechanism of the surgical instrument according to the present invention.

Figure 4 is a perspective view illustrating the movable handle of the surgical instrument according to the present invention. Figure 5 is a perspective view showing the frame of the main body of the surgical instrument according to the present invention.

Figure 6 is a view illustrating the cylindrical plunger of the surgical instrument according to the present invention.

Figures 7 and 8 are detail views showing the free end of the main body being fixed to that of the bone anchoring element.

Figures 9 and 10 are views showing the various steps of use of the surgical instrument according to the present invention.

Figure 11 is a view showing a variant of the surgical instrument according to the present invention. Figures 12 to 14 are views illustrating the embodiment of Figure 11 of the surgical instrument according to the present invention.

Figure 15 is a view showing the second stage of the driving device of the embodiment of the surgical instrument according to the present invention.

There is shown in Figure 1, an exemplary embodiment of a spinal implant 1 comprising a bone anchoring element 2 for locking in rotation and in translation to a connecting rod 3 at each instrumented vertebra of a column spinal.

The bone anchor 2 element cooperates with a locking member 4 allowing by means of a clamping screw 5 the fixation in rotation and in translation of the connecting rod 3. The bone anchoring element 2 comprises an anchor 6 and a receiving portion part 7 which consists of a U-shaped head 8 open in its upper part to cooperate with the connecting rod 3 and the locking element 4.

The anchorage portion 6 can have either the form of a hook, a threaded profile secured or not the receiving portion 7 to be fixed on / or in the vertebral body of the vertebra to be instrumented.

The head 8 comprises two vertical walls 9, 10 disposed one opposite the other and in parallel planes in order to define a first central opening 11 U-shaped carried by the axis XX 'of the connecting rod 3 and the base 12 has a profile in the cylinder portion.

Each vertical wall 9, 10 is separated, for example, the bottom 12 of the central opening 11 by a vertical slot 13 giving a certain elasticity to each wall towards the center of the head 8 along the geometric axis VV '.

The vertical walls 9, 10 respectively comprise at each end a gripping portion 14, 15 disposed one opposite the other and on either side of the central opening 11.

Each vertical wall 9, 10 has on its inner face and between the hooking portions 14, 15 a vertical housing 16 having a profile in the cylinder portion provided on each side of a groove 17 for guiding the locking element 4 when it is put in place by means of a surgical instrument 100 in the head 8 of the bone anchoring element 2.

Each vertical wall 9, 10 is pierced between the hooking portions 14, 15 with a hole 18 opening into the interior of the central opening 11 and intended to cooperate with the surgical instrument 100 during introduction of the locking element 4.

The locking element 4 presents a substantially rectangular external profile having a direction parallel to the axis XX 'and in its lower portion a housing 19 having a profile cylinder portion to receive and cooperate with the connecting rod 3.

The locking element 4 comprises in its middle a clamping screw 5 which opens to the interior of the housing 19 to come into pressure contact against the connection rod 3 to allow its immobilisation in rotation and in translation.

The four locking element comprises in a plane parallel to the axis XX 'of the lugs 20, 21 in tooth form separated by a vertical housing 22 bordered laterally by ribs 23 allowing the guidance of said locking member during its introduction into the head 8 of the anchoring element 2.

a surgical instrument has been shown in Figures 2 and 3100 for the establishment and introduction of the locking element 4 between the walls 9, 10 of the head 8 of the anchoring element 2. The instrument surgical 100 comprises a body 101 comprising a horizontal pipe 102 extending from an apertured frame 103 secured in a direction parallel to the axis ZZ 'of handle 104 so-called "fixed handle".

The fixed handle 104 interacts with a further handle 105 called "movable handle" which is connected to the first by a rotation axis 106 and a leaf spring 107 for operating, under the force of pressure, means drive 108.

Is illustrated in Figure 4 having the movable handle 105 above the axis of rotation 1 06 a head 109 having a curved profile 110 from which extends a fork 111 which each of the legs 112 has a free end 113 to rounded profile.

There is shown in Figure 5, the frame 103 of the body 101 which is composed of two vertical and opposite walls 114 and 115 interconnected by perforated walls upper 1 16 and lower 117.

The vertical wall 114 is secured to the horizontal tube 102 having an internal bore 118 opening into the interior of the frame 103, while the opposite wall 115 is pierced by a hole 119 carried by the same main axis than the internal bore 118.

The top wall 116 has a central opening 120 of rectangular shape, while the lower wall 117 includes another course 121 disposed below the 120. The recess 121 is provided at the fixed handle 104 internal shoulders 122 for forming stubborn.

The top wall 11 6 of frame 103 includes an extension 123 which extends beyond the vertical wall 115 is pierced and wherein an oblong groove 124.

The top wall 1 16 of the frame 103 passes through a horizontal hole 155 having a threaded bore 156 for retaining a fixing screw 157. The surgical instrument 100 comprises locking means which consist of a locking tube 125 comprising at one of its ends 127 branches forked each provided with notches 126. the tube 125 has at the opposite end of the forked 127 a cylindrical sleeve 128 extending through parallel tongues 129 .

The lock tube 125 is arranged around the tube 102 so that the free ends 113 of each arm 112 of the movable handle 105 respectively cooperate with the notches 126 of each leg 127 to allow the action of the movable handle 105 sliding the locking tube 125 around the tube 102.

The surgical instrument 100 comprises a cylindrical plunger 130 which passes through the frame 103 through the hole 119 formed in the vertical wall 115 to come to slide in the inner bore 118 of the tube 102 (Figure 6).

The cylindrical pusher 130 is constituted by a rod comprising at one of its ends a head 152 shaped curved disc allowing the use by the surgeon of said pusher. The cylindrical lifter 130 account from his head 152 a first cylindrical portion 153 which is extended by a second cylindrical portion 154 of outer diameter smaller than that of the first part.

The instrument driving means 100 are formed of a drive device 108 which is constituted by a first plate 131 disposed inside the frame 103 in a vertical direction parallel to the axis ZZ 'so to cooperate with the recesses 120 and 121 of the upper 116 and lower walls 117 to allow its lateral guidance while traveling.

The plate 131 is pierced at its middle with a through hole allowing passage of the cylindrical lifter 130. The drive device 108 comprises a compression spring 132 that arranged around the cylindrical pusher 130 so as to bear against the plate 131 and the vertical wall 114 of the frame 103. the drive 108 of the surgical instrument 100 is also constituted by a second plate 133 that is positioned along a direction substantially parallel to the axis ZZ 'and to be guided retained within the groove 124 of the extension 123 of the top wall 116 of the frame 103. Note that the first and second plates 131 and 133 are perforated in their upper part with a hole, not shown, allowing the restraint and guiding the said plates in the frame 103 through the fixing screw 157 cooperating with the horizontal hole 155 and its threaded portion 156 drilled in the top wall 116.

The second plate 133 is pierced at its middle with a through hole allowing passage of the cylindrical pusher 130 so that it passes through, along a horizontal axis Y Y ', the frame 103 of the surgical instrument 100. The drive device 108 includes a compression spring 134 which is arranged around the cylindrical pusher 130 so as to bear against the plate 133 and the vertical wall 115 of the frame 103.

The first plate 131 is provided to come under the effect of the spring 132, resting against the curved profile 110 of the head 109 of the movable handle 105 for upon actuation of the latter the translational movement of the cylindrical pusher 130 inside the tube 102 and the frame 103.

There is shown in Figures 7 and 8 the free end of tube 102 located opposite to the frame 103 of the body 101 of the surgical instrument 100.

The cylindrical internal bore 118 of tube 102 extends at its free end by a further bore 135 which in cross section a substantially rectangular profile and shape complementary to the external one of the locking element 4 of the spinal implant 1.

Indeed, the internal bore 135 is provided for receiving a number of locking element 4, such as at least 10 locking elements 4, to present the above each bone anchoring element 2 their implementation.

Thus, the internal bore 135 comprises, on each wall 136 parallel and opposite, a guiding groove 137 for receiving each of the ribs 23 of the locking element 4, corresponding. The cylindrical tube 102 extends at its free end by a sleeve 138 of substantially rectangular profile which each wall 139 parallel to and opposite a notch 140 comprises U-shaped for cooperating with the connecting rod 3 of the spinal implant 1 .

It is noted that the walls 139 of the sleeve 138 are arranged in planes perpendicular to those containing walls 136 of the inner bore 135.

It is found that the internal profile of the sleeve 138 is in a direction of dimensions slightly greater than those of the internal bore 135 in order to comply with the entry of the latter shoulders 151 forming a stop.

The cylindrical tube 102 includes on its outer profile and in planes parallel to those containing walls 136 of the internal bore 135 of the flats 141 which extend on each wall 142 of the sleeve 138.

At the cylindrical tube 102 each flat 141 is pierced with a first hole 143 and second hole 144 opening into the grooves 137 of the bore 135.

At the walls 142 of the sleeve 138, each flat 141 is pierced with a third hole 145 which is carried by the same main axis than the first hole 143 and the second hole 144. Each hole 143 has a first internal thread for to cooperate with a tightening screw 146 for fixing in each flat 141 of two leaf springs 147 and 148.

Each spring blade 147 is secured to a finger 149 cooperating with the second hole 144 and into the interior of the bore 135 to allow the retainer inside the latter 4 locking elements.

Each spring blade 148 is secured to a pin 150 cooperating with the third hole 145 of the sleeve 138 in order to penetrate inside the latter when the slats 148 are deformed by an external pushing force.

description easy to understand the above and Figures 8 and 9 the operation of the first embodiment of the surgical instrument 100 is as follows:

The procedure for loading of the locking members 4 inside the tube 102 and more particularly within the bore 135. The locking elements 4 are inserted through the lower end of tube 102 at the sleeve 138. during the passage of each element of biocage 4, the locking fingers 149 diverge due to the elasticity of the lamellae 147, thus permitting the introduction of at least ten locking elements 4 within the bore 135 the tube 102.

One proceeds to the installation of the surgical instrument 100 of the head 8 of the bone anchoring element 2 of the spinal implant 1 such that the head is positioned in the sleeve 138 and bearing against the shoulders 151 forming a stop. The orientation of the surgical instrument 100 is defined by the connecting rod 3 which is to be introduced into the stem passage, constituted by the notches 140. In this position, the pegs 150 of the leaf springs 148 are positioned in front of holes 18 formed in the head 8 of the bone anchoring element 2.

the surgical instrument 100 is actuated by acting a pressure on the movable handle 105 allowing through the branches 112 to move in translation tube 125 toward the free end of the tube 102. During this movement in translation , the tube 125 supports by means of the tongues 129 of elastic lamellae 148, thus blocking the pins 150 in the side holes 18 formed in the head 8 of the bone anchoring element 2. This first movement of the handle 105 allows the fixation of the surgical instrument 100 of the bone anchoring element 2.

The introduction of the locking element 4 is carried out by a continuation of the pressure on the handle 105 extending its rotational movement and allowing on one hand to release the ends of each branch 112 of the notches 126 of the tube 125 which terminates the translation of the tube 125 and on the other hand come into contact via the domed profile 110 with the plate 131. with the thrust exerted on the lower end of the plate 131, the latter arc - boute on the cylindrical lifter 130. the continuous movement of the handle 105 causing the plate 131 allows, for bracing the latter to move in translation the cylindrical pusher 130 inside the tube 102.

The cylindrical pusher 130 abuts on the last blocking element 4 placed in the internal bore 135 applying on all locking members 4 contained in the bore 135, a thrust force F, allowing the expulsion of locking member 4 lying directly above the head 8 of the bone anchoring element 2 and its introduction into said head 8. the release of the surgical instrument 100 is obtained by releasing the pressure on the handle 105 that returns through the leaf spring 107 in its rest position. Returning to its rest position, the handle 105 drives the tube 125 through the notches 126, thereby freeing the slats 148 which thanks to their elasticity deviate from the tube 102. The pins 150 out of the holes 18 thereby releasing the instrument surgical 100 of the head 8 of the bone anchoring element 2.

Thanks to the spring 132, the plate 131 returns to its rest position, in abutment on the shoulders 122 of the recess 121 of the frame 103. The cylindrical pusher 130 does not shrink, thanks to the pressure exerted by the plate 133 rainbow boutée through the spring 134.

When the last blocking element 4 was introduced, the cylindrical lifter

130 and more particularly the first cylindrical portion 153 has reached the end of the bore 118 of the tube 102, while the second cylindrical portion 154 is for its part inserted into the bore 135 without penetrating inside the sleeve 138. In pressing the plate 133, the cylindrical pusher 130 is released and can be reassembled. New locking elements 4 may then be introduced as previously explained.

There is shown in Figures 11-15 an alternative embodiment of the surgical instrument 100 described previously for the establishment and introduction of the locking element 4 between the walls 9, 10 of the head 8 of the element anchor 2. the surgical instrument 100 comprises a body 101 comprising a horizontal pipe 102 extending from an apertured frame 103 secured in a direction parallel to the axis ZZ 'of handle 104 so-called "handle fixed. "

The fixed handle 104 interacts with a further handle 105 called "movable handle" which is connected to the first by a rotation axis 106 and a leaf spring 107 for operating, under the force of pressure, the device drive 108 described above.

The variant of the surgical instrument 100 will be described only as regards the elements that have been modified, namely: the movable handle 105, the locking tube 125 and its drive around the tube 102, and the second plate 133 of the device drive 108 knowing that all the other parts are of identical structure and function. The movable handle 105 has been modified and no longer includes a fork 1 11, but only the curved profile 110 which bears against the first plate 131 of the driving device 108.

With regard to the second plate 133 of the drive device 108, the latter is positioned along a direction substantially parallel to the axis ZZ 'so as to be guided and retained within the groove 124 of the extension 123 of the top wall 116 of the frame 103. It was noted that the second plate 133 has an extension 158 extending above the groove 124 of the extension 123 of the top wall 116 of the frame 103.

The upper part of the second plate 133 is formed with a slot 159 cooperating with the fixing screw 157 allowing, for a loose attachment, guiding and retaining the first and second plates within the frame 103, knowing that the first plate 131 is formed with a not shown hole for the passage of the screw 157. the slot 159 allows the guidance in translation of the plate 133 around the screw 157, when removing the cover 180.

The second plate 133 comprises, opposite the extension 158 a profile shaped beak 160 forming a keeper for the translational displacement of said second stage.

It is noted that the lock tube 125 no longer comprises, opposite tabs 129 of the branches 127 forked each provided with notches 126. The lock tube 125 has a cylindrical profile which is integral with opposite tongues 129 of a cover 180 having an ergonomic external profile ensuring perfect gripping by the surgeon to allow him to move translationally locking tube 125 around the tube 102, either in the direction of the free end of tube 102, either in a direction away from said free end.

The cover 180 includes opposite the locking tube 125 and in its upper inner part and a cooperating groove 181, during the placement of said cover over the frame 103, with the extension 158 of the second plate 133 of the device drive 108 for guiding in translation of the cover 180.

Also the cooperation of the extension 1 58 in the groove 181 allows to limit the hood displacement path 180 and therefore the locking tube 125 relative to tube 102.

It is easily understood from the above description and Figures 11-15 that the operation of the second embodiment of the surgical instrument 100 is as follows:

To this end, the translational movement by the surgeon by means of the cover 180, the locking tube 125 in the direction of the free end of tube 102, provides support to come by means of the tongues 129 of elastic lamellae 148, tube 102, thus blocking the pins 150 in the side holes 18 made in the head 8 of the bone anchorage element 2. This translational movement of the tube 125 allows the attachment of the surgical instrument 100 of the element bone anchor 2.

The introduction of the locking member 4 is effected by pressure on the handle 105 to come into contact via the domed profile 110 with the plate 131. With the thrust exerted on the lower end of the plate 131, the latter is buttressed on the cylindrical pusher 130.

The continuous movement of the handle 105 causing the plate 131 allows, for bracing the latter to move in translation the cylindrical pusher 130 inside the tube 102.

The cylindrical pusher 130 abuts on the last blocking element 4 placed in the internal bore 135 applying on all locking members 4 contained in the bore 135, a thrust force F, allowing the expulsion of locking member 4 lying directly above the head 8 of the bone anchoring element 2 and its introduction into said head 8.

Also, the release of the surgical instrument 100 is obtained by moving in translation, by the surgeon by means of the cover 180, the locking tube 125 in a direction away from the free end of the tube 102 thereby releasing the slats 148 which thanks to their elasticity deviate from the tube 102.

The pins 150 out of the holes 18, thus releasing the surgical instrument 1 00 of the head 8 of the bone anchoring element 2. It is noted that removal of the locking tube 125 is obtained when the pusher 130 is completely removed from surgical instrument 100. Indeed, the withdrawal of the plunger 130 allows translational movement of the second plate 133 by means of a pressure on the striker plate 160 so that the extension 158 is disengaged from the groove 181 of the cover 180.

The displacement of the second plate 133 is provided by the elongated hole 159 for guiding in translation of the second plate 133 around the screw 157.

It should also be understood that the above description has been given only by way of example and does not limit the scope of the invention which would not depart by replacing the described execution details by any other equivalent.

Claims

1. A surgical instrument having immobilizing means (125) on the head (8) of the bone anchoring element (2) of a spinal implant (1) and drive means (108) for introducing a locking element (4) in the head (8) in U-shape of the bone anchoring element (2) for fastening in rotation and in translation to a connecting rod (3) characterized in that it comprises a main body (101) comprising a fixed handle (104), a movable handle (105) and a drive device (108) comprises a first plate (131) elastically loaded by a spring (132), a cylindrical plunger (130) and a second platen (133) resiliently loaded by a spring (134), said first plate (131) being adapted to come under the effect of spring (132) bearing against the profile of the movable handle (105) upon actuation of the latter the translational movement of the cylindrical lifter (130) inside a tube (102) with the bracing of the first plate (131) for insertion under a thrust force F of a locking element (4), previously positioned and guided within the tube (102), the head (8) of the bone anchoring element (2).
2. A surgical instrument according to claim 1, characterized in that the movable handle (105) cooperates with the fixed handle (104) via an axis of rotation (106) and a leaf spring (107) for operating under a pressure force of the drive device (108) and to return to its rest position after release of the pressure force.
3. A surgical instrument according to claim 2, characterized in that the movable handle (105) comprises, above the axis of rotation (106) a head (109) having a curved profile (110).
4. A surgical instrument according to claim 2, characterized in that the movable handle (105) comprises, above the axis of rotation (106) a head (109) having a curved profile (110) from which extend a fork (111), each of the legs (112) has a free end (113) with a rounded profile.
5. A surgical instrument according to claim 1, characterized in that the frame (103) consists of two vertical and opposite walls (1 14, 115) interconnected by perforated top walls (116) and lower (117), said vertical wall (114) being integral with the horizontal tube (102) having an internal bore (118) opening into the interior of the frame (103), while the opposite wall (115) is pierced with a hole (119) carried by the same main axis than the internal bore (118), said top wall (116) having a central recess (120) of rectangular shape and an extension (123) extending beyond the vertical wall (115) and wherein is drilled an elongate groove (1 24), while the bottom wall (117) has a further recess (121) disposed below one (120), said recess (121) having at the fixed handle ( 104) internal shoulders (122) for forming stubborn.
6. A surgical instrument according to claim 1, characterized in that the first and second plates (131, 133) are guided and retained in the frame (103) via a fixing screw (157) cooperating with a hole horizontal (155) provided with a threaded portion (156) pierced in the upper wall (116) of said frame.
7. A surgical instrument according to claim 1, characterized in that the second plate (133) includes an extension (158) extending above the groove (124) of the extension (123) of the upper wall (116) of the frame (103).
8. A surgical instrument according to claim 7, characterized in that the second plate (133) is pierced with an oblong hole (159).
9. A surgical instrument according to claim 7, characterized in that the second plate (133) comprises, opposite the extension (158) a profile shaped spout (160) forming a keeper.
10. A surgical instrument according to claim 1, characterized in that it comprises a main body (101) comprising a fixed handle (104), a movable handle (105) acting on a driving device (108) guided to the inside the main body (101) and according to the pressing force applied to the movable handle (105) on the one hand the immobilization of the surgical instrument (100) on the head (8) of the element bone anchor (2) and secondly the introduction under a thrust force F of a locking element (104), previously positioned and guided within a tube (102) of the main body (101) in the head (8) of the bone anchoring element (2).
11. A surgical instrument according to claim 10, characterized in that the locking means consist of a locking tube (125) comprising at one of its ends of the legs (127) bifurcated each provided with notches (126) so that the free ends (113) of each leg (112) of the movable handle (105) respectively cooperating with said notches (126) to allow the action of the movable handle (105) the sliding of the tube locking (125) around the tube (102) and at the opposite end a cylindrical sleeve (128) extending through parallel tabs (129).
12. A surgical instrument according to claim 1, characterized in that the locking means consist of a locking tube (125) comprising at one of its ends a cover (1 80) having an ergonomic external profile ensuring perfect gripping by the surgeon to allow him to move translationally locking tube (125) around the tube (102) is towards the free end of said tube (102) or in a direction away from said free end .
13. A surgical instrument according to claim 12, characterized in that the cover (180) comprises, opposite to the locking tube (125), and in its upper inner part and a groove (181) cooperating, when the power positioning said cover on the frame (103) with the extension (158) of the second plate (133) of the drive device (108).
14. A surgical instrument according to claim 1, characterized in that it comprises a cylindrical plunger (130) which passes through the frame (103) through the hole (119) formed in the vertical wall (115) to come in slidable the internal bore (118) of the tube (102).
15. A surgical instrument according to claim 14, characterized in that the cylindrical plunger (130) comprises from its head (152) a first cylindrical portion (153) which is extended by a second cylindrical portion (154) of smaller outer diameter than the first portion.
16. A surgical instrument according to claim 1, characterized in that the drive device (108) comprises a first plate (131) resiliently loaded by a spring (132) and disposed within the frame (103) so as to cooperate with recesses (120, 121) of the upper walls (116) and lower (117) and the cylindrical pusher (130) and a second platen (133) resiliently loaded by a spring (134) and arranged to inside the groove (124) of the extension (123) of the upper wall (116) so as to cooperate with the cylindrical pusher (13O), said first plate (131) being adapted to come under the effect of spring (132) bearing against the curved profile (110) of the head (109) of the movable handle (105) upon actuation of the latter the translational movement of the cylindrical plunger (130) within the tube (102) with the bracing of the first plate ( 131).
17. A surgical instrument according to claim 5, characterized in that the tube (102) has in the extension of the cylindrical inner bore (118) and at its free end a further internal bore (135) whose internal profile is complementary to the external of the locking element (4) in order to receive and guide the latter before its introduction into the head (8) of the bone anchoring element (2).
18. A surgical instrument according to claim 17, characterized in that the cylindrical tube (102) extends at its free end by a sleeve (138) of substantially rectangular profile which each wall (139) parallel and opposite has a notch ( 140) U-shaped for cooperating with the connecting rod (3) of the spinal implant (1).
19. A surgical instrument according to claim 18, characterized in that the internal profile of the sleeve (138) is in one direction, of slightly greater than those dimensions of the internal bore (135) in order to comply with the entry of the latter shoulders (151) forming a stop.
20. A surgical instrument according to claim 19, characterized in that the cylindrical tube (102) has on its external profile of the flat portions (141) extending on each wall (142) of the sleeve (138), each flat (141) being pierced at the tube (102) of first and second holes (143, 144) opening inside the bore (135) and at the walls (142) of the sleeve (138) of a third through hole ( 145).
21. A surgical instrument according to claim 20, characterized in that each first hole (143) has an internal thread for cooperation with a clamping screw (146) for fixing in each flat (141) of two elastic laminae (147, 148).
22. A surgical instrument according to claim 21, characterized in that each elastic blade (147) is integral with a finger (149) cooperating with the second hole (144) corresponding to and within the bore (135) for allow the retained inside thereof locking members (4).
23. A surgical instrument according to claim 21, characterized in that each elastic blade (148) is integral with a pin (150) cooperating with the third hole (145) of the sleeve (138) in order to penetrate inside the latter when the lamellae (148) are deformed by an external pushing force from the tongues (129) of the release tube (125) to allow attachment of the surgical instrument (100) on the head (8) of 'bone-anchoring element (2).
24. A surgical instrument according to claim 17, characterized in that the internal bore (135) of the tube (102) is provided for receiving a number of clamping member (4).
PCT/FR2004/003093 2003-12-02 2004-12-02 Clipping-type surgical instrument for spinal implant WO2005055843A1 (en)

Priority Applications (4)

Application Number Priority Date Filing Date Title
FR0314130A FR2862863B1 (en) 2003-12-02 2003-12-02 clipseuse type surgical instrument for spinal implant
FR0314130 2003-12-02
US10/898,320 2004-07-26
US10/898,320 US20050119667A1 (en) 2003-12-02 2004-07-26 Clip-type surgical instrument for spinal implant

Publications (1)

Publication Number Publication Date
WO2005055843A1 true WO2005055843A1 (en) 2005-06-23

Family

ID=34680401

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/FR2004/003093 WO2005055843A1 (en) 2003-12-02 2004-12-02 Clipping-type surgical instrument for spinal implant

Country Status (1)

Country Link
WO (1) WO2005055843A1 (en)

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1942814A2 (en) * 2005-09-29 2008-07-16 K2M, Inc. Single action anti-torque rod reducer
US9486256B1 (en) 2013-03-15 2016-11-08 Nuvasive, Inc. Rod reduction assemblies and related methods
US10136927B1 (en) 2013-03-15 2018-11-27 Nuvasive, Inc. Rod reduction assemblies and related methods

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
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
US6139549A (en) 1996-04-09 2000-10-31 Waldemar Link (Gmbh & Co.) Spinal fixing device
US6183472B1 (en) * 1998-04-09 2001-02-06 Howmedica Gmbh Pedicle screw and an assembly aid therefor
EP1269930A2 (en) * 2001-06-29 2003-01-02 DePuy Acromed, Inc. Tool and system for aligning and applying fastener to implanted anchor
US6648888B1 (en) 2002-09-06 2003-11-18 Endius Incorporated Surgical instrument for moving a vertebra

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
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
US6139549A (en) 1996-04-09 2000-10-31 Waldemar Link (Gmbh & Co.) Spinal fixing device
US6183472B1 (en) * 1998-04-09 2001-02-06 Howmedica Gmbh Pedicle screw and an assembly aid therefor
EP1269930A2 (en) * 2001-06-29 2003-01-02 DePuy Acromed, Inc. Tool and system for aligning and applying fastener to implanted anchor
US6648888B1 (en) 2002-09-06 2003-11-18 Endius Incorporated Surgical instrument for moving a vertebra

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1942814A2 (en) * 2005-09-29 2008-07-16 K2M, Inc. Single action anti-torque rod reducer
EP1942814A4 (en) * 2005-09-29 2009-09-02 K2M Inc Single action anti-torque rod reducer
US9486256B1 (en) 2013-03-15 2016-11-08 Nuvasive, Inc. Rod reduction assemblies and related methods
US10136927B1 (en) 2013-03-15 2018-11-27 Nuvasive, Inc. Rod reduction assemblies and related methods

Similar Documents

Publication Publication Date Title
EP2018248B1 (en) Surgical stapler
US8377104B2 (en) Dual action rod reducing and locking device and method
JP3852948B2 (en) Fasteners and insert mounting device
US6241748B1 (en) Gastrointestinal compression clips
EP0306298B1 (en) A staple cartridge and an anvilless surgical stapler
US7217292B2 (en) Trial intervertebral distraction spacers
US6976988B2 (en) Insertion tool for use with tapered trial intervertebral distraction spacers
US8323318B2 (en) Flexible tie fastening system
US8197519B2 (en) Bone support apparatus
JP4707738B2 (en) The spinal implant assembly
JP2552894B2 (en) Improved anvil and driver assembly for a skin stapling instrument of the surgical
US8430885B2 (en) Tissue distraction device
US8221471B2 (en) Pedicle screw fixation system
US4665916A (en) Surgical stapler apparatus
US7153310B2 (en) Vertebral bone distraction instruments
EP1399086B1 (en) Intervertebral disc prosthesis
US7815666B2 (en) Dynamic cervical plate
US8096996B2 (en) Rod reducer
US5122130A (en) Forceps for inserting intervertebral device
RU2275871C2 (en) Device and method for piercing skin with micro protrusions
EP2548521B1 (en) Endoscopic clip applier
US4699154A (en) Tissue sampling device
US7090679B2 (en) Spinal osteosynthesis assembly comprising the head of an anchoring member and a tool for fixing said head
EP2016924B1 (en) Expanding interbody implant and articulating inserter
US6368342B1 (en) Strernum closure device and pincers for mounting staples and approximator brackets

Legal Events

Date Code Title Description
AK Designated states

Kind code of ref document: A1

Designated state(s): AE AG AL AM AT AU AZ BA BB BG BR BW BY BZ CA CH CN CO CR CU CZ DE DK DM DZ EC EE EG ES FI GB GD GE GH GM HR HU ID IL IN IS JP KE KG KP KR KZ LC LK LR LS LT LU LV MA MD MG MK MN MW MX MZ NA NI NO NZ OM PG PH PL PT RO RU SC SD SE SG SK SL SY TJ TM TN TR TT TZ UA UG US UZ VC VN YU ZA ZM ZW

AL Designated countries for regional patents

Kind code of ref document: A1

Designated state(s): GM KE LS MW MZ NA SD SL SZ TZ UG ZM ZW AM AZ BY KG KZ MD RU TJ TM AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HU IE IS IT LT LU MC NL PL PT RO SE SI SK TR BF BJ CF CG CI CM GA GN GQ GW ML MR NE SN TD TG

121 Ep: the epo has been informed by wipo that ep was designated in this application
NENP Non-entry into the national phase in:

Ref country code: DE

WWW Wipo information: withdrawn in national office

Country of ref document: DE

122 Ep: pct application non-entry in european phase