Patent Application
20240115396
The present technology is generally related to instruments for determining an appropriate size, location, and/or orientation of an orthopedic implant to be implanted between adjacent boney structures. Various instruments may include a trial including screw trajectory indicators that serve as physical approximations of a bone screw trajectory for visually identifying an appropriate location or access to the bone for an interbody implant between adjacent vertebra, for example.
Interbody implants may be placed between adjacent boney structures in a patient. Some interbody implants may be placed between adjacent vertebra in a human spine, for example. Interbody implants may include an aperture or slot or hole to receive a bone screw that fixes the interbody implant to the adjacent vertebra to stabilize the device between the vertebra until fusion between the vertebra above and below occurs. In at least one method of operation, an interbody implant may be placed into a disc space once the cartilaginous material of the disc is removed and thereafter bone screws may be driven through an aperture or slot or hole of the implant into the adjacent vertebral bodies to stabilize or fixate the device into position. The stabilization or fixation maintains the relative position for the two vertebra to fuse together in order to realign and relieve the pressure off of the nerves exiting from the foramen between the vertebra. Without the use of a trial, in. many instances, it may be difficult for a surgeon to ascertain a suitable size, location, and/or orientation of the interbody implant such that the bone screws will align and clear any boney anatomy that may be in the way along an optimal bone screw trajectory for a specific patient. For example, a surgeon may have difficulty knowing what an appropriate size, location, and/or orientation of an interbody implant may be such that the aperture or slot or hole for supporting the bone screw is positioned optimally such that the bone screw will clear boney anatomy or osteophytes to penetrate into the adjacent vertebral bodies at a desired location such as the cortical rim. This may require the surgeon to remove additional osteophytes or boney anatomy in order to ensure the screws have a clear trajectory for placement. When using trials without screw trajectory indicators, the need to perform additional bone removal is only determined after the interbody is placed, the placement of bone screws is seen to be impeded, and then the interbody is subsequently removed.
The techniques of this disclosure generally relate to trialing instruments for assisting a surgeon in visualizing a target path and/or trajectory of a bone screw extending through an orthopedic implant. In one aspect, the present disclosure provides an orthopedic trial instrument. In various embodiments, the trial instrument may include a shaft extending from a first end to a second end, a handle coupled to the shaft, and a first interbody trial disposed on the first end. In various embodiments, the first interbody trial may include a first bone screw indicator configured to visually represent a corresponding bone screw trajectory.
In another aspect, the disclosure provides for a double-sided orthopedic trial instrument. The instrument may include a shaft extending in a longitudinal direction from a first end to a second end, a handle disposed at a medial position of the shaft, and a first interbody trial disposed on the first end. In various embodiments, the first interbody trial may include at least one bone screw protrusion configured to visually represent a corresponding bone screw trajectory. In various embodiments, a second interbody trial may be disposed on the second end. In disclosed embodiments, the second interbody trial may include at least one bone screw protrusion configured to visually represent a corresponding bone screw trajectory.
In another aspect, the disclosure provides for an orthopedic trialing instrument kit. In various embodiments, the trialing instrument kit may include a first double-sided orthopedic trial instrument and a second double-sided orthopedic trial instrument. In disclosed embodiments, the first double-sided orthopedic trial instrument may include a first shaft extending in a longitudinal direction from a first end to a second end, a first handle disposed at a medial position of the first shaft, and a first interbody trial disposed on the first end. In disclosed embodiments, the first interbody trial may include a first bone screw indicator configured to visually represent a corresponding bone screw trajectory and a second bone screw indicator configured to visually represent a corresponding bone screw trajectory. In disclosed embodiments, a second interbody trial may be disposed on the second end. The second interbody trial may include a third bone screw indicator configured to visually represent a corresponding bone screw trajectory and a fourth bone screw indicator configured to visually represent a corresponding bone screw trajectory. In disclosed embodiments, the second double-sided orthopedic trial instrument may include a second shaft extending in a longitudinal direction from a third end to a fourth end, a second handle disposed at a medial position of the second shaft, and a third interbody trial disposed on the third end. In disclosed embodiments, the third interbody trial may include a fifth bone screw protrusion configured to visually represent a corresponding bone screw trajectory and a sixth bone screw protrusion configured to visually represent a corresponding bone screw trajectory. In disclosed embodiments, a fourth interbody trial may be disposed on the fourth end. The fourth interbody trial may include a seventh bone screw protrusion configured to visually represent a corresponding bone screw trajectory and an eighth bone screw protrusion configured to visually represent a corresponding bone screw trajectory.
The details of one or more aspects of the disclosure are set forth in the accompanying drawings and the description below. Other features, objects, and advantages of the techniques described in this disclosure will be apparent from the description and drawings, and from the claims.
Embodiments of the present disclosure relate generally, for example, to spinal stabilization systems, and more particularly, to surgical instruments for use with spinal stabilization systems. Embodiments of the devices and methods are described below with reference to the Figures.
The following discussion omits or only briefly describes certain components, features and functionality related to medical implants, installation tools, and associated surgical techniques, which are apparent to those of ordinary skill in the art. It is noted that various embodiments are described in detail with reference to the drawings, in which like reference numerals represent like parts and assemblies throughout the several views, where possible. Reference to various embodiments does not limit the scope of the claims appended hereto because the embodiments are examples of the inventive concepts described herein. Additionally, any example(s) set forth in this specification are intended to be non-limiting and set forth some of the many possible embodiments applicable to the appended claims. Further, particular features described herein can be used in combination with other described features in each of the various possible combinations and permutations unless the context or other statements clearly indicate otherwise.
Terms such as “same,” “equal,” “planar,” “coplanar,” “parallel,” “perpendicular,” etc. as used herein are intended to encompass a meaning of exactly the same while also including variations that may occur, for example, due to manufacturing processes. The term “substantially” may be used herein to emphasize this meaning, particularly when the described embodiment has the same or nearly the same functionality or characteristic, unless the context or other statements clearly indicate otherwise.
Referring to
In the example embodiment, interbody trial tool 100 may extend in a longitudinal direction 1 between a first interbody trial 20 and a second interbody trial 30. A medial portion of the interbody trial tool 100 may comprise a handle 10 or gripping portion. In various embodiments, the handle 10 may optionally include a smooth planar surface 12 to facilitate with gripping of a cylindrically shaped handle 10 (as shown in
As seen best in
In one aspect, the first and second bone screw indicators, 21 and 22 respectively, further provide feedback to a surgeon of proper placement of an implant within a patient by indicating the trajectory that a screw would require or occupy should an implant be placed at the same location as the first interbody trial portion 20. For example, should the trial 20 be positioned such that the bone screw indicators 21, 22 interfere with patient anatomy, the position of the trial 20 should be adjusted to improve access to the contemplated or intended screws. In this manner, the first and second bone screw indicators, 21 and 22 respectively, provide visual feedback as to the contemplated trajectory of screws as well as the access required to insert and drive such screws.
In various embodiments, the first and second bone screw indicators 21, 22 may be a solid protrusion taking the shape of a cylinder, a rectangle, and/or a polygon, for example. In various embodiments, the shape may simulate the envelope of a target path for the largest feature and/or extent a bone screw may take down the target path. In various embodiments, the first and second bone screw indicators 21, 22 may have an aperture therein for serving as a drill guide for drilling pilot holes for a corresponding interbody implant. For example, first bone screw indicator 21 may include a first pilot hole 121 that extends through first interbody trial portion 20 thereby defining first bone screw trajectory 211 and second bone screw indicator 22 may include a second pilot hole 122 that extends through first interbody trial portion 20 thereby defining second bone screw trajectory 222 (see
It should be understood that various aspects disclosed herein may be combined in different combinations than the combinations specifically presented in the description and accompanying drawings. For example, features, functionality, and components from one embodiment may be combined with another embodiment and vice versa unless the context clearly indicates otherwise. Similarly, features, functionality, and components may be omitted unless the context clearly indicates otherwise. It should also be understood that, depending on the example, certain acts or events of any of the processes or methods described herein may be performed in a different sequence, may be added, merged, or left out altogether (e.g., all described acts or events may not be necessary to carry out the techniques).
Unless otherwise specifically defined herein, all terms are to be given their broadest possible interpretation including meanings implied from the specification as well as meanings understood by those skilled in the art and/or as defined in dictionaries, treatises, etc. It must also be noted that, as used in the specification and the appended claims, the singular forms “a,” “an” and “the” include plural referents unless otherwise specified, and that the terms “comprises” and/or “comprising,” when used in this specification, specify the presence of stated features, elements, and/or components, but do not preclude the presence or addition of one or more other features, steps, operations, elements, components, and/or groups thereof.
