This application contains subject matter which is related to the subject matter of the following applications, which are hereby incorporated herein by reference in their entirety:
The present invention relates generally to orthopaedic implants used for the correction of spinal injuries or deformities, and more specifically, but not exclusively, concerns apparatuses and methods for fixing a particular segment or level of the spine, to allow for deformity correction or healing thereof.
In the field of spinal surgery, it is known to place implants into vertebrae for a number of reasons, including: (a) correcting an abnormal curvature of the spine; (b) to maintain appropriate vertebral spacing and provide support for broken or otherwise injured vertebrae; and (c) to perform other treatments in the spinal column.
Typical spinal implant or bone stabilization systems utilize a rod as the support and stabilizing element. In such a system, a series of two or more bone fasteners are inserted into two or more vertebrae to be instrumented. A rod or other stabilizing device is then placed within or attached to the head(s) of the bone fastener(s), or is placed within a coupling device that links the rod and the head(s) of the bone fastener(s). The connections between these multiple components are then secured, thereby fixing the supporting construct to multiple levels in the spinal column.
To advance the state of orthopaedic implants, enhancement to such bone stabilization systems are believed desirable, and are addressed herein.
Briefly summarized, the present invention comprises in one aspect a locking device for use in a bone stabilization system. The bone stabilization system includes a bone anchor, a coupling mechanism and a stabilization member. The coupling mechanism is configured to couple the stabilization member to the bone anchor. The locking device includes a seating member and a posted member. The seating member is operatively associated with the coupling mechanism for securing the stabilization member within the coupling mechanism, and is configured with at least one opening therein. The posted member includes an interface member and at least one post extending therefrom. The posted member is configured for disposition between the seating member and the stabilization member with the at least one post extending from the interface member being received into the at least one opening of the seating member when the seating member is employed to secure the stabilization member within the coupling mechanism. Further, the at least one post is sized to facilitate control of the stabilization member as the seating member operatively engages the coupling mechanism to secure the stabilization member within the coupling mechanism with the posted member disposed between the seating member and the stabilization member.
In another aspect, a bone stabilization system is provided which includes a bone anchor, a stabilization member and a coupling mechanism. The coupling mechanism is configured to operatively connect the bone anchor and the stabilization member. The bone stabilization system further includes a locking device which operatively connects to the coupling mechanism to secure the stabilization member within the coupling mechanism. The locking device includes a seating member and a posted member. The seating member is operatively associated with the coupling mechanism for securing the stabilization member within the coupling mechanism, and is configured with at least one opening therein. The posted member includes an interface member and at least one post extending therefrom. The posted member is configured for disposition between the seating member and the stabilization member with the at least one post extending from the interface member being received into the at least one opening of the seating member when the seating member is employed to secure the stabilization member within the coupling mechanism. Advantageously, the at least one post is sized to facilitate control of the stabilization member as the seating member operatively engages the coupling mechanism to secure the stabilization member within the coupling mechanism with the posted member disposed between the seating member and the stabilization member.
In yet another aspect, a surgical drive tool is presented for inserting/extracting a locking device of a bone stabilization system. The bone stabilization system includes a bone anchor, a coupling mechanism, and a stabilization member, wherein the coupling mechanism is configured to couple the stabilization member to the bone anchor. The locking device includes a seating member operatively associated with the coupling mechanism for securing the stabilization member within the coupling mechanism. The seating member is configured with at least one opening therein. The locking device further includes a posted member, which includes an interface member and at least one post extending therefrom. The posted member is configured for disposition between the seating member and the stabilization member with the at least one post extending from the interface member being received into the at least one opening of the seating member when the seating member is employed to secure the stabilization member within the coupling mechanism.
The surgical drive tool comprises a first component and a second component. The first component is configured to operatively engage the seating member to facilitate positioning of the seating member within the coupling mechanism, while the second component is configured to operatively engage the at least one post of the posted member to facilitate maintaining the posted member fixed and in physical contact with the stabilization member as the first component is employed to secure the seating member within the coupling mechanism, and thereby secure the stabilization member within the coupling mechanism between the posted member and the coupling mechanism.
In a further aspect, a method for stabilizing a spinal column is presented. This method includes: providing a bone stabilization system comprising a bone anchor, a stabilization member, a coupling mechanism, and a locking device, wherein the coupling mechanism is configured to couple the stabilization member to the bone anchor, and the locking device is operatively associated with the coupling mechanism, and wherein the locking device further comprises a seating member configured to threadably engage the coupling mechanism and a posted member configured to control the stabilization member as the seating member threadably engages the coupling mechanism, the posted member comprising an interface member and at least one post extending therefrom, and wherein the seating member includes at least one opening therein; positioning the stabilization member in the coupling mechanism; positioning the posted member with the at least one post thereof within the at least one opening of the seating member, and threading the seating member into the coupling mechanism while holding the at least one post of the posted member fixed and in physical contact with the stabilization member, thereby maintaining control of the stabilization member as the seating member engages the coupling mechanism; and continuing to threadably advance the seating member into the coupling mechanism, thereby causing the posted member to become fixed between the seating member and the stabilization member, and securing the stabilization member between the posted member and the coupling mechanism.
Further, additional features and advantages are realized through the techniques of the present invention. Other embodiments and aspects of the invention are described in detail herein and are considered a part of the claimed invention.
The subject matter which is regarded as the invention is particularly pointed out and distinctly claimed in the claims at the conclusion of the specification. The foregoing and other objects, features and advantages of the invention are apparent from the following detailed description taken in conjunction with the accompanying drawings in which:
Generally stated, presented herein is an enhanced locking device for a bone stabilization or anchor system, as well as surgical drive tools for inserting/extracting the locking device and surgical methods for stabilizing a column employing a bone stabilization system and the enhanced locking device. The bone stabilization system includes a bone anchor (e.g., a screw), a coupling mechanism (e.g., an integral head) and a stabilization member (e.g., a rod), wherein the coupling mechanism is configured to couple the stabilization member to the bone anchor. The enhanced locking device includes a seating member (e.g., a setscrew) and a posted member. The seating member is operatively associated with the coupling mechanism for securing the stabilization member within the coupling mechanism, and includes at least one opening therein. The posted member includes an interface member and at least one post extending therefrom. The posted member is configured for disposition between the seating member and the stabilization member with the at least one post extending from the interface member being received into the at least one opening of the seating member when the seating member is employed to secure the stabilization member within the coupling mechanism. The at least one post is sized to facilitate handling of the separate seating member and posted member pieces, as well as control of the stabilization member as the seating member operatively engages the coupling mechanism to secure the stabilization member within the coupling mechanism with the posted member disposed between the seating member and the stabilization member. Various embodiments of the seating member and posted member, as well as various embodiments of the surgical drive tool are described below with reference to
In one implementation, the locking device may be formed with a deformable saddle member 50 to reduce the resultant stresses realized in stabilization member 30 by decreasing the generation of surface stress risers when fixed within coupling mechanism 10 by being fabricated from the same or similar material as stabilization member 30 and having a concave distal interface surface that further deforms to the shape of stabilization member 30.
With further reference to
In this example, seating member 22 threadably engages with internal threads 12 of coupling mechanism 10, although it should be understood by those skilled in the art that other configurations are possible, including a seating member configured to include an external cam surface (not shown) that engages with an internal cam surface (not shown) located on the internal surface of coupling arms 11. In an unlocked position, stabilization member can move freely within channel 14. When in a locked position, with the locking device substantially engaged with internal threads 12 of the coupling mechanism, pressure or a compressive force is applied across the distal interface surface of the saddle member onto the stabilization member.
Stabilization member 30 (see
As one detailed example, saddle member 50 may be fabricated from a deformable plastic material, such as polyetheretherketone (PEEK) polymer. Alternatively, saddle member 50 may be fabricated from another deformable material selected from the group consisting of carbon fiber composite polymers, UHMWPE, shape memory metals, resorbable polymers, bio-inert polymeric materials, thermoplastic polymers, thermoset polymers and any combinations of these materials. In one implementation, the material used to comprise saddle member 50 will have a flexural modulus that is equivalent or similar to the flexural modulus of stabilization member 30. One possible range of the flexural modulus of saddle member 50 is from about 30 to 115 MPa.
Bone anchor 40 is typically configured as a bone screw, although alternative bone anchors may be utilized including bone fixation posts (not shown), bone staples (not shown), hooks (not shown), and moveable head screws (not shown). It should be understood by those skilled in the art that the bone anchor-coupling mechanism structures described herein are presented by way of example only and that other configurations may be used, including coupling mechanism 10 being configured integrally with bone anchor 40.
As shown, seating member 120 includes a threaded portion 122 and a drive tool receiving portion 124 having, in this example, a hexagonal-shaped perimeter. A central cannulation or opening 126 extends through seating member 120 and is sized to receive a post 155 of posted member 150. Those skilled in the art will understand from the description provided herein that multiple posts 155 may be provided extending from an interface member 165 of the posted member 150, in which case multiple corresponding openings 126 would be provided within seating member 120. Various posted member embodiments are presented below with reference to
Post 155 is sized to extend from interface member 165 a sufficient distance D to allow a surgical drive instrument to couple thereto to facilitating holding the posted member and the seating member together, as well as to hold the posted member fixed and in physical contact with the stabilization member to facilitate control of the stabilization member as the seating member 120 is operatively engaged with the coupling mechanism 110. Various embodiments of a surgical drive tool are presented below with reference to
The distance D that the post extends from the interface member may vary with the implementation, and may even extend a distance greater than the height H of the seating member, as well as be provided with a break-off line to facilitate removal of a break-off portion of the post after seating of the seating member within the coupling mechanism. In the embodiment of
In operation, a surgical drive tool component engages post 255 as seating member 120 threadably engages coupling mechanism 110 to hold the posted member fixed and in physical contact with stabilization member 130 to maintain the stabilization member in a fixed position during placement of the locking device in operative position with the coupling mechanism. When in operative position, the locking device locks the posted member, and in particular, interface member 265 between seating member 120 and stabilization member 130 to fixate the stabilization member relative to the coupling mechanism.
In the embodiment of
Seating member 120 may be fabricated from a titanium alloy, for example, the alloy Ti-6Al-4V. Alternatively, the seating member may be fabricated from one or more of CP titanium, cobalt-chromium, a 300 series stainless steel, carbon fiber materials, carbon fiber composites, resorbable polymers, bio-inert polymeric materials, thermoplastic polymers, thermoset polymers, or any combination of these materials. The posted member may be fabricated of the same material as the seating member, or different material. For example, the posted member may be fabricated of a material which elastically deforms, and thereby fixedly secures the stabilization member when the locking device is threadably advanced into the coupling mechanism. By way of example, the posted member could be formed from a deformable plastic material, such as polyetheretherkeytone (PEEK) polymer. Alternatively, the posted member could be fabricated from another deformable material comprising carbon fiber composite polymers, UHMWPE, shape memory metals, resorable polymers, bio-inert polymeric materials, thermoplastic polymers, thermoset polymers, or any combination of these materials. Still further, the posted member could be fabricated from a biocompatible metal or metal alloy.
In this embodiment, the first and second components are interconnected by a gear and pawl mechanism 1040. As shown in the cross-sectional view of
In view of the above description, those skilled in the art will note that a method for stabilizing a spinal column is presented herein. This method includes: providing a bone stabilization system comprising a bone anchor, a stabilization member, a coupling mechanism, and a locking device, wherein the coupling mechanism is configured to couple the stabilization member to the bone anchor, and the locking device is operatively associated with the coupling mechanism, and wherein the locking device further includes a seating member configured to threadably engage the coupling mechanism and a posted member configured to control the stabilization member as the seating member threadably engages the coupling mechanism, the posted member comprising an interface member and at least one post extending therefrom, and wherein the seating member includes at least one opening therein; positioning the stabilization member in the coupling mechanism; positioning the posted member with the at least one post thereof within the at least one opening of the seating member, and threading the seating member into the coupling mechanism while holding the at least one post of the posted member fixed and in physical contact with the stabilization member, thereby maintaining control of the stabilization member as the seating member engages the coupling mechanism; and continuing to threadably advance the seating member into the coupling mechanism, thereby causing the posted member to become fixed between the seating member and the stabilization member, and securing the stabilization member between the posted member and the coupling mechanism.
In further aspects, the method includes employing a surgical drive tool for performing the threading of the seating member into the coupling mechanism and the holding of the at least one post of the posted member fixed and in physical contact with the stabilization member. The surgical drive tool includes a first component configured to operatively engage the seating member to facilitate the threading of the seating member into the coupling mechanism and a second component configured to operatively engage the at least one post of the posted member to facilitate holding of the at least one post of the posted member fixed and in physical contact with the stabilization member.
The method can further include breaking off at least one of a portion of the seating member after threadable engagement of the seating member within the coupling mechanism, or a portion of at least one post of the posted member. Providing of the seating member can include providing a circumferential break-off line extending around the perimeter thereof, and continuing to advance the seating member can include continuing to advance the seating member within the coupling mechanism until break off of a break-off portion of the seating member along the circumferential break-off line thereof is achieved. Further, the providing can include providing the at least one post of the posted member with a circumferential break-off line extending around the perimeter thereof, and the method can further include breaking off a portion of the at least one post after threadably advancing the seating member into the coupling mechanism, and causing the posted member to become fixedly positioned between the seating member and the stabilization member.
To summarize, those skilled in the art will note from the above description that provided herein is an enhanced locking device for a bone stabilization system, as well as surgical drive tools for inserting/extracting the locking device and surgical methods for stabilizing a column employing a bone stabilization system and the enhanced locking device. The bone stabilization system includes a bone anchor, a coupling mechanism, and a stabilization member, wherein the coupling mechanism is configured to couple the stabilization member to the bone anchor. The enhanced locking device includes a seating member and a posted member. The seating member is operatively associated with the coupling mechanism for securing a stabilization member within the coupling mechanism, and includes at least one opening therein. The posted member includes an interface member and at least one post extending therefrom. The posted member is configured for disposition between the seating member and the stabilization member with the at least one post extending from the interface member being received into the at least one opening of the seating member when the seating member is employed to secure the stabilization member within the coupling mechanism.
Advantageously, the at least one post is sized to facilitate handling of the separate seating member and posted member pieces, as well as to control the stabilization member as the seating member operatively engages the coupling mechanism to secure the stabilization member within the coupling mechanism with the posted member disposed between the seating member and the stabilization member. Numerous variations on the seating member and posted member designs, as well as various embodiments of the surgical drive tool, are depicted and described herein.
By way of example, the distal surface of the interface member of the posted member can comprise a number of different geometries, including planar and saddle-style contoured. A saddle-style contoured geometry that follows the outer periphery of the stabilization member is beneficial for semi-rigid stabilization members because the surface allows the force on the stabilization member to be distributed across the entire geometry. Those skilled in the art will note, however, that the geometric shape of the distal interface surface of the posted member is not limited to the surfaces described herein. Further, the outer profile of the interface member is not constrained to being enclosed by the perimeter of the coupling mechanism. That is, the interface member may extend past the through slots in the coupling mechanism.
The one or more posts of the posted member can be located along the central axis of the interface member, or offset therefrom. Based on load distribution of the locking device to the stabilization member, it may be desirable to offset the one or more posts from the central axis of the interface member. Typically, the direction the posts could shift would either be cranial or caudal, based on how the bone anchor is situated. However, the post is not limited to these orientations. By offsetting the post from the center axis of the interface member, load may be distributed along the interface member, but allow for variable load characteristics to be present, for example, to maintain a semi-rigid stabilization member in a desired manner.
The surgical drive tool presented herein is designed to grip the outer geometry of the one or more posts of the posted member, as well as to grip the drive tool receiving portion of the seating member, either externally or internally. The surgical drive tool may have a barb-style or cam-style inner shaft that would grip the outer geometry of the post, locking it in place the further the post is inserted into the surgical drive tool. In addition, the surgical drive tool could have a one-way clutch that would allow rotation of the drive tool in a direction for tightening of the seating member into the coupling mechanism, and if the drive tool is rotated in the opposite direction from the “driving” direction, then the instrument tightens on the post to separate at least a portion of the post from the posted member. The surgical drive tool may also have an internal shaft with geometry such that it would grip the upper most portion of the post, i.e., a hexagonal-style or a hexalobular-shaped geometry.
In use, the upper portion of the seating member is inserted and retained within the surgical drive tool, after which the posted member is inserted through the seating member into the surgical drive tool. The drive tool grips the one or more posts via the external geometry of the posts and allows the seating member of the locking device to be held in place between the posted member and the surgical drive tool. Once the locking device has been seated into the coupling mechanism, the post is then separated and removed, or the height of the post is reduced by twist-off so that the remaining post height does not extend an unacceptable level past the seating member. Removal of the post could be performed by a number of methods, including cutting of the post, or employing a twist off technique such as described above.
Although the preferred embodiments have been depicted and described in detail herein, it will be apparent to those skilled in the relevant art that various modifications, additions and substitutions can be made without departing from its essence and therefore these are to be considered to be within the scope of the following claims.
Number | Name | Date | Kind |
---|---|---|---|
5964760 | Richelsoph | Oct 1999 | A |
6053917 | Sherman et al. | Apr 2000 | A |
6077262 | Schläpfer et al. | Jun 2000 | A |
6139549 | Keller | Oct 2000 | A |
6296642 | Morrison et al. | Oct 2001 | B1 |
6302888 | Mellinger et al. | Oct 2001 | B1 |
6371957 | Amrein et al. | Apr 2002 | B1 |
6440132 | Jackson | Aug 2002 | B1 |
6458132 | Choi | Oct 2002 | B2 |
6485494 | Haider | Nov 2002 | B1 |
6565565 | Yuan et al. | May 2003 | B1 |
6716214 | Jackson | Apr 2004 | B1 |
6783527 | Drewry et al. | Aug 2004 | B2 |
6786903 | Lin | Sep 2004 | B2 |
6793657 | Lee et al. | Sep 2004 | B2 |
6896677 | Lin | May 2005 | B1 |
6981973 | McKinley | Jan 2006 | B2 |
7022122 | Amrein et al. | Apr 2006 | B2 |
7625394 | Molz et al. | Dec 2009 | B2 |
20010047173 | Schlapfer et al. | Nov 2001 | A1 |
20020032443 | Sherman et al. | Mar 2002 | A1 |
20020133159 | Jackson | Sep 2002 | A1 |
20030125741 | Biedermann et al. | Jul 2003 | A1 |
20030125742 | Yuan et al. | Jul 2003 | A1 |
20030167058 | Shluzas | Sep 2003 | A1 |
20040030342 | Trieu et al. | Feb 2004 | A1 |
20040039383 | Jackson | Feb 2004 | A1 |
20040049196 | Jackson | Mar 2004 | A1 |
20040053196 | Mayer et al. | Mar 2004 | A1 |
20040158247 | Sitiso et al. | Aug 2004 | A1 |
20040172022 | Landry et al. | Sep 2004 | A1 |
20040172032 | Jackson | Sep 2004 | A1 |
20040186478 | Jackson | Sep 2004 | A1 |
20040204711 | Jackson | Oct 2004 | A1 |
20040215190 | Nguyen et al. | Oct 2004 | A1 |
20040236330 | Purcell et al. | Nov 2004 | A1 |
20040243129 | Moumene et al. | Dec 2004 | A1 |
20040260283 | Wu et al. | Dec 2004 | A1 |
20050021031 | Foley et al. | Jan 2005 | A1 |
20050043735 | Ahmad | Feb 2005 | A1 |
20050049588 | Jackson | Mar 2005 | A1 |
20050049589 | Jackson | Mar 2005 | A1 |
20050085813 | Spitler | Apr 2005 | A1 |
20050113927 | Malek | May 2005 | A1 |
20050131410 | Lin | Jun 2005 | A1 |
20050187548 | Butler et al. | Aug 2005 | A1 |
20050187549 | Jackson | Aug 2005 | A1 |
20050187555 | Biedermann et al. | Aug 2005 | A1 |
20050192570 | Jackson | Sep 2005 | A1 |
20050203516 | Biedermann et al. | Sep 2005 | A1 |
20050228379 | Jackson | Oct 2005 | A1 |
20050228388 | Brodke et al. | Oct 2005 | A1 |
20050240180 | Vienney et al. | Oct 2005 | A1 |
20050261678 | Truckai et al. | Nov 2005 | A1 |
20050261687 | Garamszegi et al. | Nov 2005 | A1 |
20050277924 | Roychowdhury | Dec 2005 | A1 |
20050277927 | Guenther et al. | Dec 2005 | A1 |
20050277928 | Boschert | Dec 2005 | A1 |
20050283157 | Coates et al. | Dec 2005 | A1 |
20060025767 | Khalili | Feb 2006 | A1 |
20060025771 | Jackson | Feb 2006 | A1 |
20060036242 | Nilsson et al. | Feb 2006 | A1 |
20060058794 | Jackson | Mar 2006 | A1 |
20060064089 | Jackson | Mar 2006 | A1 |
20060074418 | Jackson | Apr 2006 | A1 |
Number | Date | Country |
---|---|---|
2796545 | Jan 2001 | FR |
WO 9606576 | Mar 1996 | WO |
9702786 | Jan 1997 | WO |
WO 9714366 | Apr 1997 | WO |
9832386 | Jul 1998 | WO |
0197701 | Dec 2001 | WO |
2005102195 | Nov 2005 | WO |
Number | Date | Country | |
---|---|---|---|
20070288002 A1 | Dec 2007 | US |