WO2014142797A1 - Vis de pédicule à pointe d'alêne et son procédé d'implantation - Google Patents

Vis de pédicule à pointe d'alêne et son procédé d'implantation Download PDF

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Publication number
WO2014142797A1
WO2014142797A1 PCT/US2013/030324 US2013030324W WO2014142797A1 WO 2014142797 A1 WO2014142797 A1 WO 2014142797A1 US 2013030324 W US2013030324 W US 2013030324W WO 2014142797 A1 WO2014142797 A1 WO 2014142797A1
Authority
WO
WIPO (PCT)
Prior art keywords
screw
flute
bone
tip
thread
Prior art date
Application number
PCT/US2013/030324
Other languages
English (en)
Inventor
Jean-Pierre Mobasser
Original Assignee
Jean-Pierre Mobasser
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
Application filed by Jean-Pierre Mobasser filed Critical Jean-Pierre Mobasser
Priority to PCT/US2013/030324 priority Critical patent/WO2014142797A1/fr
Publication of WO2014142797A1 publication Critical patent/WO2014142797A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical 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
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7032—Screws or hooks with U-shaped head or back through which longitudinal rods pass
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical 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
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7035—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • A61B17/7037—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other wherein pivoting is blocked when the rod is clamped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical 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
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8625—Shanks, i.e. parts contacting bone tissue
    • A61B17/863—Shanks, i.e. parts contacting bone tissue with thread interrupted or changing its form along shank, other than constant taper
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical 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
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8625—Shanks, i.e. parts contacting bone tissue
    • A61B17/8635—Tips of screws

Definitions

  • the claimed technology relates generally to medical devices and more
  • pedicle screws A variety of threaded fasteners have been developed for use in orthopedic surgical procedures to secure bone fragments, reattach ligaments or soft tissue to bones, or to hold bones in relative position to one another.
  • One variety of bone screws used in the vertebrae of the spine are called pedicle screws, so named because they are inserted into the pedicle of the vertebral body.
  • Pedicle screws are commonly used along with rods and screws to immobilize a portion of the spinal column.
  • pedicle screws are inserted into a series of vertebrae and one or more metal rods are secured to the heads of the screws, typically using set screws or some other securing means.
  • FIG. 1 is a side view of a bone screw according to one embodiment of the disclosed invention.
  • FIG. 2 is a perspective view of the bone screw shown in FIG. 1.
  • FIG. 3 is a side view of a bone screw according to another embodiment of the disclosed invention.
  • FIG. 4 is a perspective view of the bone screw shown in FIG. 3.
  • FIG. 5 is a side, cross sectional view of a bone screw being inserted into the pedicle of a spine according to one embodiment of the disclosed invention.
  • Bone screw 10 comprises several segments or portions which begin at a distal end 12 and extend along a longitudinal axis 20 to a proximal end 14. Located at distal end 12 of bone screw 10 is a tip portion 40 comprising an awl tip 30 and a helical, radially outward-extending thread 80.
  • the awl tip is sized and configured so as to be capable of cutting, boring, or otherwise creating a pilot hole when placed against bone and torsional and/or downward force is applied to the screw, thereby eliminating the need for the separate steps for placing a pilot hole, drilling, probing, and tapping the hole during implantation.
  • the leading or distal edge 82 of the thread 80 begins at the proximal edge 32 of the awl tip 30.
  • the thread actually overlaps a portion of the awl tip.
  • the leading edge of the thread is positioned such that as the awl tip excavates a hole in the bone, the leading edge engages the walls of the hole and draws the screw body into the bone.
  • tip portion 40 further includes one or more flutes 70 for conveying bone material away from the awl tip 30 and/or thread 80 during insertion of the screw into bone.
  • the flute 70 may also include a cutting edge 75 for engaging and removing bone material.
  • the flute show in FIG. 1 is longitudinally disposed in the surface of the screw along axis 20, however other shapes, styles, and configurations of fluting may be used.
  • tip portion 40 Adjacent to the proximal end of tip portion 40 is the distal end of a shank portion
  • head portion 60 is shown comprising a U-shaped rod fixation element having a cradle 100 for receiving and securing rods (not shown) such as those commonly used in spinal procedures.
  • Cradle 100 may further include a locking portion 120 (as shown in FIG.
  • a locking member such as a set screw
  • a variety of locking means such as threads, bayonet style closure, and the like.
  • a locking member such as a set screw
  • other types and styles of head assemblies may also be used with the disclosed invention such as a polyaxial head assembly, a hex head assembly, and any other mono-axial, mutli-axial, or fixed head design as known in the art.
  • FIG. 3 A bone screw 130 according to another embodiment of the disclosed invention is shown in FIG. 3.
  • Bone screw 130 comprises several segments or portions which begin at a distal end 136 and extend along a longitudinal axis 132 to a proximal end 134.
  • a tip portion 140 Located at distal end 136 of bone screw 130 is a tip portion 140 comprising an awl tip 170 and a helical, radially outward-extending thread 200.
  • tip portion 140 further includes one or more flutes 180 for conveying bone material away from the awl tip 170 and/or thread 200 during insertion of the screw into bone.
  • the flute 180 may also include a cutting edge 190 for engaging and removing bone material.
  • the flute show in FIG. 3 is an axially wound or spiral flute about the central body of screw 130 disposed along axis 132.
  • Adjacent to tip portion 140 Adjacent to tip portion 140 is a shank portion 150.
  • the thread 200 from tip portion 140 continues through shank portion 150 to approximately the head portion 160 in this particular example. In other examples, a part of shank portion 150 may be unthreaded.
  • Flute 180 which begins in tip portion 140 continues through a portion of shank portion 150.
  • Adjacent to shank portion 150 and continuing to the proximal end 134 of screw 130 is a head portion 210.
  • head portion 210 is shown comprising a U-shaped rod fixation element having a cradle 220 for receiving and securing rods (not shown) such as those commonly used in spinal procedures.
  • Cradle 220 may further include a locking portion 230 (as shown in FIG.
  • Placement of a bone screw according to the presently disclosed invention does not require the multi-step procedure commonly used in the industry and previously described.
  • One method of implanting a bone screw according to the presently disclosed invention comprises placing the awl tip against the vertebra at the desired entry point, typically at the surface of a pedicle. Torsional force is applied to the bone screw using a driving tool engaged with the head of the screw.
  • the driving tool will be an image guided and navigated tool, such as a screw driver, to allow the surgeon to confirm the correct trajectory of the screw through the bone.
  • guidance techniques such as anatomic landmarks or fluoroscopy may also be used to insure proper screw placement.
  • the awl tip engages and begins to carve a hole into the bone. Once the awl has carved a hole of sufficient depth the threads will engage the bone. Typically, the thread (or threads if a multi-thread design is used) of the screw begin immediately adjacent to the awl tip so as to reduce the depth to which the screw must be driven before the screw engages the bone.
  • the threads act to draw the screw down into the vertebra while the awl tip continues to carve out bone at the tip of the screw.
  • the screw also includes one or more flutes, the flutes act to channel bone material away from the tip and thread so as to increase performance of the screw. As the threads act to pull the screw down into the bone less force will need to be applied by the surgeon. Proper placement of the screw can be confirmed using imaging. Additional confirmation may be provided using neuromonitoring to insure there is no nerve irritation. Once the desired implantation depth is reached, additional elements such as rods, plates, and the like, may be secured to the screw using appropriate means.
  • FIG. 5 shows the implantation of a bone screw in a vertebra according to one embodiment of the disclosed invention.
  • a bone screw 250 such as those previously described is implanted in vertebra 240.
  • An awl tip 270 allows the screw 250 to be driven into the bone of the vertebra, specifically through the body of a pedicle 242 and into the vertebral body 244.
  • Bone screw 250 includes a head portion 260 which is configured and adapted to engage a suitable driving tool 280 which allows for implantation of the screw.
  • driving tool 280 is an image guided and navigated tool, such as a screw driver, to allow for confirmation of the trajectory of the screw through the pedicle. Image guided navigation allows a surgeon to confirm proper placement of the screw in the bone.
  • the harder cortical bone walls of the pedicle will encourage the screw to follow a trajectory through the softer, cancellous bone found in the center of the pedicle.
  • Imaging may be used to confirm proper screw placement.
  • neuromonitoring may be used to confirm there is no nerve root irritation while the screw is being placed.
  • additional elements such as rods, plates, and the like, may be secured to the screw using appropriate means. Reducing the number of steps in the implantation procedure using the devices and methods previously described decreases the time required for a procedure. Less time in the operating room means less blood loss, decreased risk of infection and the patient spends less time sedated, thereby reducing the possibility of anesthesia-related complications. Elimination of preparatory steps required for the placement of current bone screw designs also decreases the opportunities for mistakes during implantation, especially during long procedures involving the implantation of multiple screws where surgeon fatigue can become a factor.

Abstract

L'invention concerne une vis à os et son procédé d'insertion. Dans un exemple, la vis à os comprend une pointe d'alêne pour créer un trou de guidage dans le pédicule d'une vertèbre sans avoir à percer préalablement un trou de départ. Un ou plusieurs filets situés de manière adjacente à la pointe d'alêne se vissent sur la paroi du trou de guidage et tire la vis dans l'os, ce qui permet d'éliminer la nécessité de percer et de tarauder un trou dans l'os avant l'implantation de la vis.
PCT/US2013/030324 2013-03-12 2013-03-12 Vis de pédicule à pointe d'alêne et son procédé d'implantation WO2014142797A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/US2013/030324 WO2014142797A1 (fr) 2013-03-12 2013-03-12 Vis de pédicule à pointe d'alêne et son procédé d'implantation

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/US2013/030324 WO2014142797A1 (fr) 2013-03-12 2013-03-12 Vis de pédicule à pointe d'alêne et son procédé d'implantation

Publications (1)

Publication Number Publication Date
WO2014142797A1 true WO2014142797A1 (fr) 2014-09-18

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PCT/US2013/030324 WO2014142797A1 (fr) 2013-03-12 2013-03-12 Vis de pédicule à pointe d'alêne et son procédé d'implantation

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10820936B2 (en) 2016-11-04 2020-11-03 Orthopedic Renovation Technologies, Llc Pedicle screw removal tool and method of use
US11534223B2 (en) 2016-11-04 2022-12-27 Orthopedic Renovation Technologies, Llc Pedicle screw removal tool and method of use

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5074728A (en) * 1991-04-16 1991-12-24 Hsu Kun Shan Drill-coexistent screw
US20030165796A1 (en) * 2002-03-04 2003-09-04 Carmichael Robert P. Self-drilling implant
US20060149263A1 (en) * 2004-12-17 2006-07-06 Zimmer Spine, Inc. Self drilling bone screw
US20080177335A1 (en) * 2006-10-26 2008-07-24 Warsaw Orthopedic Inc. Bone screw
US20100241129A1 (en) * 2009-03-18 2010-09-23 Integrated Spinal Concepts, Inc. Image-Guided Minimal-Step Placement Of Screw Into Bone
US20120136398A1 (en) * 2010-05-28 2012-05-31 Jean-Pierre Mobasser Awl-tipped pedicle screw and method of implanting same

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5074728A (en) * 1991-04-16 1991-12-24 Hsu Kun Shan Drill-coexistent screw
US20030165796A1 (en) * 2002-03-04 2003-09-04 Carmichael Robert P. Self-drilling implant
US20060149263A1 (en) * 2004-12-17 2006-07-06 Zimmer Spine, Inc. Self drilling bone screw
US20080177335A1 (en) * 2006-10-26 2008-07-24 Warsaw Orthopedic Inc. Bone screw
US20100241129A1 (en) * 2009-03-18 2010-09-23 Integrated Spinal Concepts, Inc. Image-Guided Minimal-Step Placement Of Screw Into Bone
US20120136398A1 (en) * 2010-05-28 2012-05-31 Jean-Pierre Mobasser Awl-tipped pedicle screw and method of implanting same

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10820936B2 (en) 2016-11-04 2020-11-03 Orthopedic Renovation Technologies, Llc Pedicle screw removal tool and method of use
US11534223B2 (en) 2016-11-04 2022-12-27 Orthopedic Renovation Technologies, Llc Pedicle screw removal tool and method of use

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