Patent Application
20100069967
The present invention relates to instruments and methods for use with a spinal fixation plate, and in particular to instruments that can be used to extend a dynamic spinal fixation plate to an expanded configuration, for example, a fully extended configuration, to facilitate implantation.
Advancing age, as well as injury, can lead to changes in the bones, discs, joints, and ligaments of the spine, producing pain from nerve compression. Under certain circumstances, alleviation of pain can be provided by performing spinal fusion. Spinal fusion is a procedure that generally involves the removal of the disc between two or more adjacent vertebrae and the subsequent joining of the vertebrae with a bone fixation device to facilitate growth of new osseous tissue between the vertebrae. The new osseous tissue fuses the joined vertebrae such that the vertebrae are no longer able to move relative to each other. Bone fixation devices can stabilize and align the injured bone segments to ensure the proper growth of the new osseous tissue between the damaged segments. Bone fixation devices are also useful for promoting proper healing of injured or damaged vertebral bone segments caused by trauma, tumor growth, or degenerative disc disease.
One such bone fixation device is a bone fixation plate that is used to stabilize, align, and, in some cases, immobilize adjacent skeletal parts such as bones. Typically, the fixation plate is a rigid metal or polymeric plate positioned to span bones or bone segments that require stabilization, alignment, and/or immobilization with respect to one another. The plate may be fastened to the respective bones, usually with bone screws, so that the plate remains in contact with the bones and fixes them in a desired position. Bone plates can be useful in providing the mechanical support necessary to keep vertebrae in proper position and bridge a weakened or diseased area such as when a disc, vertebral body or fragment has been removed or during spinal fusion.
Such plates have been used to stabilize, align, and/or immobilize a variety of bones, including vertebrae of the spine. For example, a bone plate may include a plurality of screw openings, such as holes or slots, for screw placement. The bone plate may be placed against the damaged vertebrae and bone screws or other bone anchors can be used to secure the bone plate to the vertebrae. In the case of spinal fusion, for example, a prosthetic implant or bone graft may be positioned between the adjacent vertebrae to promote growth of osseous tissue and fusion of the vertebrae.
In spinal fusion procedures, conventional bone plates generally immobilize the connected vertebrae, imposing a rigid compressive load on the vertebrae. Gaps may develop in the new osseous tissue growing between the vertebrae, which can result in decoupling of the compressive load on the osseous tissue and the implant or graft positioned between the vertebrae. To address this problem, dynamic plates have been proposed that aim to permit the vertebrae to collapse axially during fusion. Examples of such dynamics plates are disclosed in commonly owned U.S. patent application Ser. No. 10/664,238, filed Sep. 17, 2003, entitled “Bone Fixation Plates,” which is hereby incorporated by reference. Such exemplary dynamic plates are preferably implanted in the fully extended state. Manipulation of the plate during implantation can be challenging, as the segments of the plate may move relative to one another. There is a need for an instrument to assist in implanting dynamic plates in an extended state
Disclosed herein are instruments and methods that facilitate the handling and insertion of dynamic spinal fixation plates to the bone portions to be stabilized, aligned, and/or immobilized.
In an exemplary embodiment of the present invention, an instrument for holding a plate having more than one segment has a first portion configured to hold a portion of a first segment of the plate and a second portion configured to fit between two adjacent segments of the plate to create a space therebetween.
An alternate embodiment of the present invention, an instrument for holding a plate includes a body portion with first and second ends, a handle extending from the body portion, an arm extending from the body portion to fit between adjacent plate segments and a leg extending from the body portion configured to attach to one segment of the plate.
In another embodiment of the present invention, the instrument has a pair of resilient legs biased in a closed position configured to expand to a second position to fit over a portion of a first segment of the plate and return to the first position to securely hold the first segment of the plate and an arm portion having a thickness configured to fit between adjacent segments of the plate to create a space therebetween.
Other embodiments provide features that will prevent accidentally leaving the instrument attached to the plate and implanted in the patient. This feature can be an extension of the leg such that when the clip is attached to the plate at least one screw hole is blocked by the leg preventing insertion of a bone screw. In another embodiment, this feature can be a tube projecting up from the legs. In yet another embodiment, the clip can be used with another style dynamic plate, which has a plurality of screw slots for placement of the screws and allows the screws to translate with respect to the plate. The clip covers a portion of each slot on the plate such that the screw can only be placed in one position in the slot. The clip directs the optimal placement of the screw within the slot.
The present invention also includes methods for using an instrument for implanting a plate having more than one segment. An exemplary method involves expanding the two segments of the plate to create a space therebetween, attaching the instrument to the plate between the segments, manipulating the instrument to position the plate into proximity with the bone while retaining the plate in the expanded state with the instrument, attaching at least one segment of the plate to the bone, and removing the instrument from the plate.
Another method for implanting a plate having first and second spaced apart screw slots for receiving a bone anchor involves positioning an instrument to obstruct a portion of the screw slots of at least one segment of said plate to bone, attaching the instrument to the plate to obstruct a portion of the first and second screw slots, attaching the plate to bone by placing a bone anchor through the unobstructed portion of each screw slot, and removing the instrument from the plate.
The invention will be more fully understood from the following detailed description taken in conjunction with the accompanying drawings, in which:
The present invention provides instruments and methods for holding a dynamic multi-segment spinal fixation plate for proper implantation into bone. In general, the instrument has a first portion configured to hold a portion of a first segment of the plate and a second portion configured to fit between two adjacent segments of the plate to create a space therebetween. For ease of handling a handle may project from the body.
In the exemplary embodiment, the legs 40 of the clip 20 attach to one segment of a plate, for example, segment 12 of the exemplary plate 10. In one embodiment, such as the illustrated embodiment, the legs 40 of the clip 20 are resilient and biased towards a closed position. The legs 40 may be expanded to a second position to fit over a plate segment. Once released, the legs 40 returns to the original closed position and securely hold the plate segment. In other embodiments, the attachment can be a snap fit in which the legs 40 deform to fit around the plate segment. In alternative embodiments, the exemplary clip 20 may be connected to the plate by an adhesive, for example, provided on the undersurface of the legs 40 or other component of the clip 20 to allow the clip 10 to temporarily adhere to a plate segment. In alternative embodiments, the clip 20 may be attached to the plate 10 by a screw or tapered boss interacting with a bore in a plate segment. Preferably, the clip 20 is attached to the plate by an attachment mechanism, such as one of the mechanisms discussed above, that is sufficient to allow the plate 10 to be picked up and/or manipulated by the clip 20.
As shown in
In an alternate embodiment, the clip can include a feature for minimizing the risk of accidentally leaving the clip attached to the plate at the conclusion of a surgical procedure. This feature can have many different forms. For example, an exemplary clip 20′, illustrated in FIGS. 3A and 3B, is generally analogous in construction to the clip 20, discussed above, may include an extension 50 from one side of the legs 40 extending in a direction generally parallel to the longitudinal axis of the clip 20′. When the clip 20′ is attached to the plate 10, the extension 50 is configured, e.g., has a size and shape, to at least partially block at least one of the screw holes 16 on the plate 10. As a result, the surgeon cannot insert a bone screw through the blocked or partially blocked hole to fully attach the plate to the bone without removing the clip 20′ as illustrated in
A person skilled in the art will appreciate that the plate 10 can include multiple segments.
Another embodiment of a clip 20″ is shown in
An alternate embodiment of a dynamic spinal fixation plate 100 is shown in
In another embodiment of the present invention, an exemplary clip 200 attaches to the plate 100 in the same manner as described above and has a handle 228 extending from the body of the clip 200 to facilitate handling of the plate 100 during insertion, as illustrated in
One of ordinary skill in the art will appreciate further features and advantages of the invention based on the above-described embodiments. Accordingly, the invention is not to be limited by what has been particularly shown and described, except as indicated by the appended claims. All publications and references cited herein are expressly incorporated herein by reference in their entirety.
This application is a divisional of U.S. patent application Ser. No. 11/128,799, filed May 13, 2005, which claims priority to U.S. Provisional Patent Application No. 60/581,692, filed Jun. 21, 2004, both of which are incorporated herein by reference.
| Number | Date | Country | |
|---|---|---|---|
| 60581692 | Jun 2004 | US |
| Number | Date | Country | |
|---|---|---|---|
| Parent | 11128799 | May 2005 | US |
| Child | 12562536 | US |
