This disclosure relates to the field of medical screws. More particularly, the disclosure relates to a facet screw system that provides a visual indication that the screw system is desirably set in the bone.
Facet screw fixation is an alternative to pedicle screw fixation in surgical fixation of the spine. Facet screws are typically less invasive than pedicle screws. Facet screws can be installed, for example, across the facet joint of a spinal column to fuse or at least immobilize to some degree the facet joint.
Improvement is desired in the construction of facet screws. For example, during the installation of the screws, it can be difficult to determine when the screw is desirably set in the bone.
The disclosure relates to an improved facet screw system that facilitates determination of when the screw is desirably set in the bone.
The disclosure relates to a medical screw system configured to facilitate determination of when the screw system is desirably set in a bone during implantation of the screw at a surgical site.
In one aspect, the system includes a screw and a washer. The screw has a head, a tip, and a shank extending between the head and the tip having a first thread set thereon. The washer has a central ring surrounding a head receiving pocket configured for receiving the head of the screw, and a plurality of arms spaced around and extending outwardly from the ring. The arms each have a bone contacting surface that engages the bone when the screw is implanted into the bone. A groove is defined on the washer between the arms and an exterior of the central ring. The groove is configured to enable the arms to flex when the screw system becomes desirably set into the bone.
The screw system is implanted into the bone by positioning the head of the screw onto the washer with head of the screw received by the pocket of the washer and the first thread set of the screw extending past the arms of the washer. The screw system is implanted onto the bone by screwing the first thread set into the bone until the screw is desirably set.
The arms of the washer flex when the screw becomes desirably set into the bone. This advantageously provides a visual indication that the screw is desirably set in the bone.
Further advantages of the disclosure are apparent by reference to the detailed description when considered in conjunction with the figures, which are not to scale so as to more clearly show the details, wherein like reference numbers indicate like elements throughout the several views, and wherein:
With reference to the drawings, the disclosure relates to a facet screw system 10 having a facet screw 12 and a washer 14. The facet screw system 10 is configured as a non-permanent assembly of the screw 12 and the washer 14 so that in the uninstalled state, that is, not installed into a bone, the screw 12 and the washer 14 are easily separated. During installation of the screw system 10 into a bone, the screw 12 and the washer 14 cooperate to facilitate determination of when the screw 12 is desirably set in the bone.
The screw 12 includes a head 20, a tip 22, and a shank 24 extending between the head 20 and the tip 22. The head 20 is a polyaxial head having a substantially hemispherical shape with a curved exterior surface 26 and a substantially planar upper rim 28 surrounding a recess 30 configured for receiving a driving tip of a screw driver or the like. The head 20 includes threads 32 located on the curved exterior surface 26. The threads 32 are configured for threading into the cortical bone when the screw 20 is installed into the bone.
The tip 22 includes a plurality, preferably three, tapping flutes 40 to facilitate placement of the screw 12 into the bone by the surgeon without having to tap the screw 12 into the bone. The flutes 40 are preferably uniformly spaced apart about the perimeter of the tip 22.
The shank 24 includes a proximal thread set 50 and a distal thread set 52. The proximal set 50 has a finer pitch and a larger minor diameter compared to the pitch and minor diameter of the distal thread set. The proximal thread set 50 begins immediately below the head 20. The distal thread set 52 tapers into the tip 22, having the threads thereof decreasing in height to taper into the tip 22.
An unthreaded or smooth space 54 is located on the shaft 24 between the thread sets 50, 52. The space 24 is located a constant distance from the head 20 of the screw 12 regardless of screw length, this distance corresponding to the position of the gap of a facet joint, which is about 10 mm from the superior cortex. The space 54 also has a constant length, regardless of screw length, of about 3 mm.
The washer 14 has a central ring 60 surrounding a polyaxial head receiving pocket 62 configured for receiving the polyaxial head 20 of the screw 12. A plurality of arms 64 are uniformly spaced around and extend outwardly from the ring 60. The arms 64 are each configured to have a pointed bone contacting surface 66 that bites into the bone when the screw assembly 10 is tightened into the bone. As mentioned above, the screw 12 and the washer 14 cooperate to facilitate determination of when the screw 12 is desirably set in the bone. In this regard, a feature of the washer 14 is the inclusion of a gap or groove 68 machined on top of the washer between the arms 64 and the exterior of the central ring 60 (
For the purpose of example, installation of the facet screw system 10 may be accomplished by (1) Initially penetrating the cortical bone of the superior facet as by use of a bone awl. (2) Seating a drill/tap guide over the hole created with the awl to control trajectory of drilling and tapping, and to protect soft tissue. (3) Drilling until the desired depth is achieved across the facet joint. (4) Tapping the threads in the hole to minimize insertion torque of the screw. In this regard, drilling and tapping should be done using fluoroscopy to determine proper screw trajectory and depth. (5) Loading the screw and washer on the screw driver and begin to place screw in pilot hole. Alternatively, loading the screw only on the driver and placing the washer on the superior facet over the pilot hole. (6) Inserting the screw through the washer and into the pilot hole. (7) With guidance by fluoroscopy, determining the final seating position of the screw, with observance of flexure of the arms 64 providing further indication of desired screw seating.
The foregoing description of preferred embodiments for this disclosure has been presented for purposes of illustration and description. It is not intended to be exhaustive or to limit the disclosure to the precise form disclosed. Obvious modifications or variations are possible in light of the above teachings. The embodiments are chosen and described in an effort to provide the best illustrations of the principles of the disclosure and its practical application, and to thereby enable one of ordinary skill in the art to utilize the disclosure in various embodiments and with various modifications as are suited to the particular use contemplated. All such modifications and variations are within the scope of the disclosure as determined by the appended claims when interpreted in accordance with the breadth to which they are fairly, legally, and equitably entitled.
Number | Name | Date | Kind |
---|---|---|---|
4805602 | Puno et al. | Feb 1989 | A |
5474555 | Puno et al. | Dec 1995 | A |
5527312 | Ray | Jun 1996 | A |
5558674 | Heggeness et al. | Sep 1996 | A |
5624442 | Mellinger et al. | Apr 1997 | A |
6001101 | Augagneur et al. | Dec 1999 | A |
6228087 | Fenaroli et al. | May 2001 | B1 |
6485518 | Cornwall et al. | Nov 2002 | B1 |
6540747 | Marino | Apr 2003 | B1 |
6547795 | Schneiderman | Apr 2003 | B2 |
6562046 | Sasso | May 2003 | B2 |
6648893 | Dudasik | Nov 2003 | B2 |
6808526 | Magerl et al. | Oct 2004 | B1 |
6951561 | Warren et al. | Oct 2005 | B2 |
7060068 | Tromanhauser et al. | Jun 2006 | B2 |
7083622 | Simonson | Aug 2006 | B2 |
7452369 | Barry | Nov 2008 | B2 |
7530993 | Assell et al. | May 2009 | B2 |
7563275 | Falahee et al. | Jul 2009 | B2 |
7591837 | Goldsmith | Sep 2009 | B2 |
7608094 | Falahee | Oct 2009 | B2 |
7608104 | Yuan et al. | Oct 2009 | B2 |
7611526 | Carl et al. | Nov 2009 | B2 |
7615069 | Paul | Nov 2009 | B2 |
7658753 | Carl et al. | Feb 2010 | B2 |
7662183 | Haines | Feb 2010 | B2 |
7699878 | Pavlov et al. | Apr 2010 | B2 |
7704279 | Moskowitz et al. | Apr 2010 | B2 |
7708764 | Simonson | May 2010 | B2 |
7708765 | Carl et al. | May 2010 | B2 |
7717919 | Assell et al. | May 2010 | B2 |
7731737 | DiPoto | Jun 2010 | B2 |
7740635 | Lieberman | Jun 2010 | B2 |
7749251 | Obenchain et al. | Jul 2010 | B2 |
7763050 | Winslow et al. | Jul 2010 | B2 |
7776049 | Curran et al. | Aug 2010 | B1 |
7776090 | Winslow et al. | Aug 2010 | B2 |
7799057 | Hudgins et al. | Sep 2010 | B2 |
7824429 | Culbert et al. | Nov 2010 | B2 |
7833255 | Chow et al. | Nov 2010 | B2 |
7935136 | Alamin et al. | May 2011 | B2 |
8002799 | Chin et al. | Aug 2011 | B2 |
8021392 | Petersen | Sep 2011 | B2 |
8043334 | Fisher et al. | Oct 2011 | B2 |
8052728 | Hestad | Nov 2011 | B2 |
8080046 | Suddaby | Dec 2011 | B2 |
8123786 | Lins | Feb 2012 | B2 |
8133261 | Fisher et al. | Mar 2012 | B2 |
8206400 | Falahee | Jun 2012 | B2 |
20030040746 | Mitchell et al. | Feb 2003 | A1 |
20030208202 | Falahee | Nov 2003 | A1 |
20050049705 | Hale et al. | Mar 2005 | A1 |
20050149030 | Serhan et al. | Jul 2005 | A1 |
20060036259 | Carl et al. | Feb 2006 | A1 |
20060036323 | Carl et al. | Feb 2006 | A1 |
20060036324 | Sachs et al. | Feb 2006 | A1 |
20060085010 | Lieberman | Apr 2006 | A1 |
20060276790 | Dawson et al. | Dec 2006 | A1 |
20070088358 | Yuan et al. | Apr 2007 | A1 |
20070122764 | Balfour et al. | May 2007 | A1 |
20070123868 | Culbert et al. | May 2007 | A1 |
20070233256 | Ohrt et al. | Oct 2007 | A1 |
20080013678 | Magerl et al. | Jan 2008 | A1 |
20080065094 | Assell et al. | Mar 2008 | A1 |
20080082171 | Kuiper et al. | Apr 2008 | A1 |
20080097436 | Culbert et al. | Apr 2008 | A1 |
20080147079 | Chin et al. | Jun 2008 | A1 |
20080177332 | Reiley et al. | Jul 2008 | A1 |
20080255619 | Schneiderman et al. | Oct 2008 | A1 |
20080255622 | Mickiewicz et al. | Oct 2008 | A1 |
20080262555 | Assell et al. | Oct 2008 | A1 |
20080319484 | Fauth | Dec 2008 | A1 |
20090005818 | Chin et al. | Jan 2009 | A1 |
20090024169 | Triplett et al. | Jan 2009 | A1 |
20090099602 | Aflatoon | Apr 2009 | A1 |
20090138053 | Assell et al. | May 2009 | A1 |
20090192551 | Cianfrani et al. | Jul 2009 | A1 |
20090275993 | Phan et al. | Nov 2009 | A1 |
20090312798 | Varela | Dec 2009 | A1 |
20090312800 | Chin et al. | Dec 2009 | A1 |
20090318980 | Falahee | Dec 2009 | A1 |
20100069960 | Chaput | Mar 2010 | A1 |
20100069961 | DiPoto et al. | Mar 2010 | A1 |
20100069969 | Ampuero et al. | Mar 2010 | A1 |
20100094346 | Matityahu | Apr 2010 | A1 |
20100094356 | Varela et al. | Apr 2010 | A1 |
20110112582 | Abdelgany | May 2011 | A1 |
20110144702 | Leroux et al. | Jun 2011 | A1 |
20110182693 | Helgerson et al. | Jul 2011 | A1 |
20110245620 | Hamada | Oct 2011 | A1 |
20110257691 | Sutterlin et al. | Oct 2011 | A1 |
20110264147 | Culbert | Oct 2011 | A1 |
20110270312 | Assell et al. | Nov 2011 | A1 |
20120022603 | Kirschman | Jan 2012 | A1 |
20120046695 | Blain | Feb 2012 | A9 |