Patent Application
20160183981
The present invention relates to methods and devices for anchoring spinal rods.
Expandable prosthetic rib (EPR) devices are designed to mechanically stabilize the thorax of a patient to correct three-dimensional thoracic deformities, and to provide improvements in volume for respirations and lung growth in infantile and juvenile patients diagnosed with thoracic insufficiency syndrome. Once the initial implantation procedure is complete and an EPR device is implanted into a patient's body, the EPR device may allow for some adjustability, such as expansion, anatomic distraction, and replacement of some components of the EPR device through subsequent surgical procedures, which are generally less invasive than the initial implantation procedure. Available EPR devices are typically elongated devices that are attached to one or more of the patient's ribs and to the patient's pelvis, such that the EPR device extends along the spine of the patient.
EPR devices are typically attached to the patient's rib via a cradle, which extends from the posterior side towards the anterior side of the patient. The cradle typically substantially encloses the patient's rib to prevent the EPR device from becoming displaced during breathing or other movements of the patient. Ribs in infants and children are typically very small, so the EPR device that attaches to such a very small rib can damage the rib and/or adjacent bodily structures due to high load distribution, can damage the rib and/or adjacent bone due to the EPR device having a size that is large enough to catch on the very small rib and/or adjacent bone, and/or can puncture the patient's pleura due to the EPR device having a size that is large enough to move into dangerous contact with the pleura during the patient's normal activities post-implantation and thereby cause the patient's lung to collapse due to the punctured pleura.
Some available EPR devices have an end that is typically attached to the patient's pelvis via a S-shaped hook, which S-shaped hook may generally extend from the posterior side of the patient to the anterior side of the patient. Available S-shaped hooks typically rest on top of the iliac crest of the patient, and due to their S-shape, tend to inherently have a limited contact area with the iliac crest.
Accordingly, there is a need for improved methods and devices for anchoring spinal rods.
The present invention generally provides methods and devices for anchoring spinal rods. In one embodiment, a surgical device is provided that includes a first connector having a first seat configured to seat a bone, and a second connector having a second seat and a third seat each configured to seat the bone. The second connector can be configured to move relative to the first connector when the first seat is seating the bone so as to cause the second and third seats to seat the bone with the first seat being positioned between the second and third seats such that the bone connector is configured to have three points of contact with the bone when the first and second connectors are connected to the bone. One of the first and second connectors can be configured to seat an elongate rod such that the seated rod is movable relative to at least one of the first and second connectors in at least one direction.
The device can have any number of variations. For example, each of the first, second, and third seats can include an arcuate extension. For another example, the first seat can include an elongate post and each of the second and third seats can include an arcuate extension. For yet another example, the first and second connectors can be configured to be secured in a fixed position relative to one another so as to secure the bone seated in the first, second, and third seats. For still another example, the movement of the second connector relative to the first connector can include rotational movement of the second connector about a pivot point defined by the first connector. For another example, the movement of the second connector relative to the first connector can include longitudinal sliding movement of the second connector along a longitudinal axis defined by the first connector. For yet another example, the first and second connectors can be movable along a longitudinal length of the seated rod. For another example, the seated rod can be angularly movable relative to the first and second connectors. For yet another example, the first connector can be configured to seat the elongate rod. For still another example, the second connector can be configured to seat the elongate rod.
In some embodiments, the device can include a second bone connector that includes a third connector having a fourth seat configured to seat a second bone, and a fourth connector having a fifth seat and a sixth seat each configured to seat the second bone. The fourth connector can be configured to move relative to the third connector when the fourth seat is seating the second bone so as to cause the fifth and sixth seats to seat the second bone with the fourth seat being positioned between the fifth and sixth seats such that the second bone connector is configured to have three points of contact with the second bone when the third and fourth connectors are connected to the second bone. One of the third and fourth connectors can be configured to seat the elongate rod.
In another embodiment, a surgical device is provided that includes a first connector including a first seat configured to seat a rib, and a second connector including a second seat configured to seat the rib. The first and second connectors can be configured to be secured in a fixed position relative to one another with the rib seated by the first and second seats. The device can also include an elongate rod configured to be seated by one of the first and second connectors and be movable relative thereto when the first and second connectors are in the fixed position relative to one another so as to allow adjustability of the elongate rod relative to the rib.
The device can vary in any number of ways. For example, the movement of the elongate rod relative to the first and second connectors can include sliding movement of the elongate rod along a longitudinal axis of the elongate rod. For another example, the movement of the elongate rod relative to the first and second connectors can include pivoting movement of the elongate rod about a pivot point defined by a connection point between one end of the elongate rod and the one of the first and second connectors that seats the elongate rod. For yet another example, the one of the first and second connectors can be configured to have the elongate rod side loaded thereto. For still another example, the one of the first and second connectors can be configured to have the elongate rod end loaded thereto. For another example, the first and second seats can each include a curved seat. For yet another example, one of the first and second seats can include a curved seat and the other of the first and second seats can include an elongate post.
In some embodiments, the first connector can include a first opening therein, and the second connector can include a second opening therein. The device can also include a set screw configured to be received in the first and second openings so as to fix the first and second connectors in the fixed position relative to one another with the rib seated by the first and second seats.
In some embodiments, the device can include a third connector including a third curved seat configured to receive a second rib therein, and a fourth connector including a fourth curved seat configured to receive the second rib therein. The elongate rod can be configured to be seated by one of the third and fourth connectors and be movable relative thereto so as to allow adjustability of the elongate rod relative to the second rib.
In another embodiment, a surgical device is provided that includes a first connector including a first curved seat configured to receive a bone therein, and a second connector that is discrete from the first connector such that each of the first and second connectors are configured to be movable independent of each other. The second connector can include a second curved seat configured to receive the bone therein. The second connector can be configured to rotate relative to the first connector, having the bone received in the first curved seat thereof, about a pivot point defined by the first connector so as to cause the second curved seat to rotate relative to the first curved seat so as to receive the bone therein.
The device can vary in any number of ways. For example, the device can include an elongate rod configured to be seated by one of the first and second connectors and configured to be adjusted in position relative to the first and second connectors having the bone received in the first and second curved seats. For another example, the second connector can include a third curved seat configured to receive the bone therein. For yet another example, the second connector can be configured to slide linearly relative to the first connector after the rotation of the second connector.
In another embodiment, a surgical device is provided that includes a first connector including a first bone securing member, and a second connector including a second bone securing member. The second connector can be configured to slide linearly with respect to the first connector so as to adjust a spacing between the second bone and the first bone securing member and thereby engage a bone between the first and second bone securing members. The first and second connectors can be configured to be secured in a fixed position relative to one another so as to fix the bone in position between the first and second bone securing members. One of the first and second bone securing members can include a curved member extending from the one of the first and second connectors, and the other of the first and second bone securing members can include an elongate post.
The device can have any number of variations. For example, the device can include an elongate rod configured to be seated by one of the first and second connectors and configured to be adjusted in position relative to the first and second connectors having the bone positioned between the first and second bone securing members. For another example, the one of the first and second bone securing members can include a second curved member extending from the one of the first and second connectors.
In another embodiment, a surgical device is provided that includes a first component having a first interface configured to grasp one side of an anatomical structure, and a second component having a second interface configured to grasp an opposite side of the anatomical structure. The first and second components can be separate entities which can be mechanically connected by a mechanical connection having at least one degree of movement. At least one of the first and second components can include a third interface configured to connect to an object at a second mechanical connection. The second mechanical connection can provide at least one degree of movement.
The device can vary in any number of ways. For example, the at least one degree of movement can be at least partially locked. For another example, the at least one degree of movement can be at least partially mobile. For yet another example, the at least one degree of movement can be at least partially mobile. For still another example, the mechanical connection can provide the at least one degree of movement only as translation. For another example, the mechanical connection can include a hinge joint. For yet another example, the mechanical connection can include a ball-and-socket joint. For another example, the mechanical connection can not allow any movement between the first and second components. For yet another example, the first interface can be geometrically complementary to the anatomical structure where the first interface grasped the anatomical structure. For another example, the second interface can be geometrically complementary to the anatomical structure where the second interface grasped the anatomical structure. For yet another example, the first interface can be malleable in the form of a foam or in the form of a gel-like substance. For another example, the second interface can be malleable in the form of a foam or in the form of a gel-like substance. For still another example, a pressure distribution at the first and second interfaces can be uniform. For yet another example, the first and second interfaces can be convex. For another example, the first interface can include a double blade. For still another example, stress provoked in the anatomical structure by the first and second components can be less than a mechanical threshold of the anatomical structure. For yet another example, stress provoked in the anatomical structure by the first and second components can be less than a threshold for provoking a negative biological reaction in a subject including the anatomical structure. For another example, the object can include a longitudinal carrier. For yet another example, the at least one degree of movement can be configured to be at least partially locked. For another example, wherein the at least one degree of movement can be configured to be at least partially mobile. For still another example, the at least one degree of movement of the second mechanical connection can be configured to allow only translation. For yet another example, the second mechanical connection can include a hinge joint. For another example, the second mechanical connection can include a ball-and-socket joint. For still another example, the second mechanical connection can be configured to prevent any relative movement between the at least one of the first and second components and the object.
For another example, the device can include a third component that is a separate entity from the first and second components. The second mechanical connection can be via the third component. For yet another example, the third component can include a rod-receiving channel. The rod-receiving channel can be open vertical to a longitudinal axis of the third connector, or the rod-receiving channel can be open along the longitudinal axis of the third connector. For another example, the third component can share a common interface with the at least one of the first and second components. In some embodiments, the common interface can includes a hinge joint. In some embodiments, the common interface can includes a ball-and-socket joint. In some embodiments, the common interface can be configured to prevent movement of the third component relative to the at least one of the first and second components. In some embodiments, the common interface can be configured to allow the at least one of the first and second components to click onto the third component to form the second mechanical connection.
In another embodiment, a surgical device is provided that includes a first section including a first surface, and a second section including a second surface that is diametrically opposed to the first surface such that the first and second surfaces are configured to engulf an anatomical structure from two opposed sides of the anatomical structure and by fitting around a complementary part of the anatomical structure. At least one of the first and second sections can include an interface configured to connect to an object at a mechanical connection. The mechanical connection can provide at least one degree of movement.
The device can have any number of variations. For example, the first surface can be geometrically complementary to the complementary part of the anatomical structure. For another example, the second surface can be geometrically complementary to the complementary part of the anatomical structure. For yet another example, the first surface can be malleable and can be in the form of a foam or in the form of a gel-like substance. For still another example, the second surface can be malleable and can be in the form of a foam or in the form of a gel-like substance. For another example, a pressure distribution at the first and second interfaces can be uniform. For still another example, the first and second surfaces can be convex. For yet another example, the first surface can include a double blade. For still another example, stress provoked in the anatomical structure by the first and second sections can be less than a mechanical threshold of the anatomical structure. For another example, stress provoked in the anatomical structure by the first and second sections can be less than a threshold for provoking a negative biological reaction in a subject including the anatomical structure. For yet another example, the object can include a longitudinal carrier. For another example, the at least one degree of movement can be configured to be at least partially locked. For yet another example, the at least one degree of movement can be configured to be at least partially mobile. For still another example, the at least one degree of movement can be configured to allow only translation. For another example, the mechanical connection can include a hinge joint. For still another example, the mechanical connection can include a ball-and-socket joint. For yet another example, the mechanical connection can be configured to prevent any relative movement between the at least one of the first and second sections and the object.
For another example, the device can include a connector that is a separate entity from the first and second sections. The mechanical connection can be provided by the connector. In some embodiments, the connector can include a rod-receiving channel. The rod-receiving channel can be open vertical to a longitudinal axis of the connector, or the rod-receiving channel can be open along the longitudinal axis of the connector. In some embodiments, the connector can share a common interface with the at least one of the first and second sections. In some embodiments, the common interface can include a hinge joint. In some embodiments, the common interface can include a ball-and-socket joint. In some embodiments, the common interface can be configured to prevent movement of the connector relative to the at least one of the first and second sections. In some embodiments, the common interface can be configured to allow the at least one of the first and second sections to click onto the connector to form the mechanical connection.
In another aspect, a surgical system is provided that in one embodiment includes a first bone connector configured to connect to a first bone. The first bone connector can include a first connector having a first curved seat configured to seat the first bone, and a second connector configured to attach to the first connector. The second connector can have a second curved seat and a third curved seat each configured to seat the first bone. The second and third seats can be laterally offset from one another and can each be laterally offset from the first curved seat when the first and second curved seats seat the bone. The device can also include a second bone connector configured to connect to a second bone, and an elongate rod configured to be seated by the first bone connector and by the second bone connector so as to extend between the first and second bones.
The system can have any number of variations. For example, the elongate rod can be one of angularly adjustable and longitudinally slidable relative to the first bone connector when seated by the first bone connector. The elongate rod can be one of angularly adjustable and longitudinally slidable relative to the second bone connector when seated by the second bone connector. For another example, the first bone can be one of a first rib, a first pelvic bone, and a first vertebra, and the second bone can be one of a second rib, a second pelvic bone, and a second vertebra. The first bone can be the first rib, and the second bone can be the second rib.
In another aspect, a surgical method is provided that in one embodiment includes engaging a rib with a first seat of a first connector and subsequently rotating a second connector relative to the first connector so as to move a second seat of a second connector toward the first seat and engage the rib with the second seat. The method can also include, with the rib engaged by the first and second seats, securing the first and second connectors in a fixed position relative to one another. The method can also include adjusting a position of an elongate rod coupled to the first and second connectors relative to the first and second connectors.
The method can vary in any number of ways. For example, the elongate rod can be adjusted after the securing. For another example, the elongate rod can be adjusted before the securing. For yet another example, the adjusting can include pivoting the elongate rod about an end of the elongate rod. For still another example, the adjusting can include longitudinally sliding the elongate rod.
The invention will be more fully understood from the following detailed description taken in conjunction with the accompanying drawings, in which:
Certain exemplary embodiments will now be described to provide an overall understanding of the principles of the structure, function, manufacture, and use of the devices and methods disclosed herein. One or more examples of these embodiments are illustrated in the accompanying drawings. Those skilled in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments and that the scope of the present invention is defined solely by the claims. The features illustrated or described in connection with one exemplary embodiment may be combined with the features of other embodiments. Such modifications and variations are intended to be included within the scope of the present invention.
Various exemplary methods and devices are provided for anchoring spinal rods. In general, devices are provided that can be configured to attach to a rib of a patient to facilitate anchoring of an elongate rod, e.g., a spinal rod, coupled thereto. In some embodiments, a device configured to attach to a rib of a patient to facilitate anchoring of an elongate rod coupled thereto can include first and second connectors each configured to attach to a rib of a patient. The first and second connectors can be independent elements, which can facilitate secure engagement of the rib by the first and second connectors since each of the first and second connectors can be independently positioned relative to the rib. The first and second connectors can be configured to be movable relative to one another, which can help the first and second connectors each securely couple to the rib. A rod can be configured to couple to the device, thereby allowing the first and second connectors to secure the rod within the patient. The rod can be configured to move relative to the first and second connectors and the rib after the first and second connectors have been connected to the rib, thereby allowing the rod's position to be desirably adjusted in view of the patient's particular anatomy and the patient's particular treatment. The rod can be configured to attach to a second device attached to another portion of the patient's anatomy, e.g., another bone such as a rib, pelvic bone, or vertebra, thereby securing the rod in a fixed position to facilitate treatment, e.g., to facilitate correction of a thoracic deformity. The second device can be identical to the first device, or the second device can have another configuration. In embodiments in which the first and second devices are configured to attached to first and second ribs, respectively, the rod can be anchored without any device being attached to a bone of the patient, e.g., the pelvis or the vertebra, other than the first and second ribs in order to anchor the rod to, e.g., correct a spinal deformity of the patient. The first and second devices can thus cooperate to define a rib-to-rib connector configured to anchor the rod within the patient's body. In embodiments in which the first device is configured to attach to a rib and the second device is configured to attach to a pelvic bone, e.g., the ilium, the first and second devices can cooperate to define a rib-to-pelvis connector configured to anchor the rod within the patient's body. In embodiments in which the first device is configured to attach to a rib and the second device is configured to attach to a vertebra, the first and second devices can cooperate to define a rib-to-vertebra connector configured to anchor the rod within the patient's body.
In one embodiment of using the device, the first connector can be positioned to engage the rib, and with the rib engaged by the first connector, the second connector can be moved relative to the first connector so as to engage the rib between the first and second connectors. The rod coupled to the second connector can then be adjusted in position relative to the first and second connectors and the rib, which can help ensure that the rod is properly positioned for treatment.
In some embodiments, the device can be configured to have three points of contact with the rib engaged by the device's first and second connectors. The three points of contact can help distribute the load of the device on the rib to help prevent the rib from being damaged by the device. The device being configured to have three points of contact with a rib instead of one or two points of contact with the rib, the device can be configured to more evenly distribute the load on the rib, thereby reducing chances of damaging the rib. The three points of contact can be arranged axially along a longitudinal axis of the rib, which can facilitate distribution of the load along a longitudinal length of the rib rather than concentrating the load in a more localized axial position of the rib, such as with a device having two points of contact with a rib at a same axial position along the rib.
In some embodiments, at least one of the first and second connectors can include at least one arcuate extension configured to seat a rib so as to couple the rib thereto. In an exemplary embodiment, the first connector can include a seat in the form of one arcuate extension, and the second connector can include a seat in the form of two arcuate extensions. Each of the arcuate extensions can be configured to contact the rib such that the device has three points of contact with the rib. The three arcuate extensions can be configured to be arranged at different axial positions along the rib engaged thereby, which can help improve load distribution on the rib. In another exemplary embodiment, one of the first and second connectors can include a seat in the form of two arcuate extensions, and the other of the first and second connectors can include a seat in another form, e.g., an elongate post. The three seats can be configured to arranged at different axial positions along the rib engaged thereby, which can help improve load distribution on the rib.
In some embodiments, a device configured to attach to a bone of a patient to facilitate anchoring of an elongate rod coupled thereto can be configured to allow cross connection, such as cross connection to the patient's thoracic vertebra and go around the patient's transverse process. The device can be configured to couple to a first elongate rod, e.g., a spinal rod, configured to be coupled to a second device attached to a second part of the patient's anatomy (e.g., a bone other than the bone to which the first device is coupled), and can be configured to be coupled to a second elongate rod, e.g., a cross connector rod, configured to be coupled to a third device attached to a third part of the patient (e.g., a bone other than the bone to which the first device is coupled and other than the bone to which the second device is attached). The device can thus be versatile for use in a variety of different patient treatment plans. In some embodiments, a device configured for cross-connection can be configured to have three points of contact with a rib engaged by the device, e.g., by the device's first and second connectors.
In some embodiments, a device configured for cross-connection can include a first connector, a second connector configured to be movably coupled to the first connector, and a receiver element configured to be movably coupled to the first and second connectors and configured to receive a spinal rod. The receiver element can be configured to be monoaxially movable relative to the first and second connectors, or the receiver element can be configured to be polyaxially movable relative to the first and second connectors. The device can be configured to have a lower profile than traditional devices configured for cross-connection, which can help reduce chances of the device damaging the patient, e.g., damaging a bone, puncturing a pleura, etc., and/or can help make the device easier to implant since it can be more easily positioned in small spaces tam devices having larger profiles.
In some embodiments, a device configured for cross-connection can include a seating element configured to be movably coupled to the second connector and configured to movably seat the spinal rod therein. The seating element can be configured to facilitate positioning of the spinal rod relative to the second connector, which can help the spinal rod be desirably positioned relative to the patient's particular anatomy. The spinal rod can be configured to be fixed in position relative to the second connector by being secured in position between the receiver element and the seating element, such as by a set screw being screwed into the receiver element.
In some embodiments, a device configured for cross-connection can include an installation tool configured to facilitate insertion of and/or positioning of the second connector in the patient's body. The installation tool can be configured to be manipulated from outside the patient's body while the second connector is positioned within the patient's body. The second connector can include a first mating element, e.g., a groove formed therein. The installation tool can include a second mating element, e.g., a protrusion, configured to releasably mate with the first mating element. The first and second mating elements can be configured to be mated together during insertion of the second connector into the patient's body, which can allow the installation tool to be manipulated, e.g., held and moved by hand, to insert the second connector into the patient's body. The first and second mating elements can be configured to be mated together when the second connector is located within the patient's body, which can allow the installation tool to be manipulated to desirably position the second connector within the patient's body. When the second connector is in a desired position, the installation tool can be removed from the second connector by releasing the first and second mating elements from mating engagement, e.g., by sliding the protrusion out of the groove. In some embodiments, the second connector can be inserted into the patient's body without using the installation tool, and the installation tool can be mated to the second connector already located in the patient's body.
In some embodiments, a surgical device configured to anchor a spinal rod can be configured to attach to a
The elongate rod 106 can have a variety of sizes, shapes, and configurations, as will be appreciated by a person skilled in the art. As in this illustrated embodiment, the elongate rod 106 can include a spinal rod and can have an elongate cylindrical shape.
The first connector 102 can have a variety of sizes, shapes, and configurations. As in this illustrated embodiment, the first connector 102 can include a C-shaped member having a first, top end region including a first bore 118 formed therethrough and a portion of a first engagement surface (obscured in
The first bore 118 can be configured to selectively receive a surgical tool therein. The first bore's mating element can be configured to matingly engage the surgical tool. Unmating the surgical tool from the first bore 118 can disengage the surgical tool and the first connector 102 so as to allow release of the surgical tool from the first connector 102. For example, the surgical tool can include an installation tool (not shown) configured to engage the first mating element, e.g., threadably engage the first bore's thread, such as with a corresponding thread on a distal end of an elongate shaft of the installation tool. The installation tool engaged with the first connector 102 via the first bore 118 can be configured to be manipulated from outside a patient's body to insert and position the first connector 102 within the patient's body. The installation tool can be configured to be disengaged from the first bore 118, e.g., unthreaded therefrom, so as to allow removal of the installation tool from the patient's body and allow implantation of the first connector 102 within a patient's body without the installation tool connected thereto. For another example, the surgical tool can include a locking member (not shown), e.g., a set screw, a magnetic plug, a snap fit member, etc. The locking member can be configured to engage the second connector 104, e.g., abut against a surface thereof, when the first and second connectors 102, 104 are coupled together so as to lock the first and second connectors 102, 104 in a fixed position relative to one another. The locking member can be configured to be disengaged from the mating element, e.g., unscrewed from the first bore's thread, which can allow for the relative positions of the first and second connectors 102, 104 to be adjusted if the position in which the first and second connectors 102, 104 were locked together using the locking element is desired to be changed. In an exemplary embodiment, the first bore 118 can be configured to selectively receive an installation tool therein and a locking member therein, which can allow the installation tool to install the first connector 102 and then the locking member to lock the first and second connectors 102, 104 together.
The first engagement surface can include an external surface of the first connector 102. The first engagement surface can include a single surface or, as in this illustrated embodiment, can include a plurality of surfaces. The plurality of surfaces forming the first engagement surface in this illustrated embodiment include three surfaces that together define at least a portion of an outer surface of the first connector's top end region and an outer surface of the first connector's intermediate region.
The first seat 110 can include an arcuate member, as in this illustrated embodiment. The arcuate member can have a curved shape generally corresponding to a curved shape of a typical rib's exterior surface. The first seat 110 can thus be configured to securely engage a rib against an interior surface of the first seat 110.
The first mating surface 120 in the intermediate region of the first connector 102 can be configured to movably seat the second connector 104. The first mating surface 120 can have a curved shape configured to movably seat thereon a second mating surface 122 of the second connector 104. The first and second mating surfaces 120, 122 can be configured to be engaged with one another by being in contact with one another so as to mate the first and second connectors 102, 104 together. The first and second connectors 102, 104 do not need any other connection in order to be mated to one another for proper use. The first and second connectors 102, 104 can thus be easily connected together by placing the first and second mating surfaces 120, 122 in contact with one another. The first mating surface 120 can define a pivot point about which the second connector 104 having its second mating surface 122 engaged with the first mating surface 120 can pivot relative to the first connector 102, as discussed further below.
The second connector 104 can have a variety of sizes, shapes, and configurations. As in this illustrated embodiment, the second connector 104 can include a first, top end region including a second engagement surface 128, a second, bottom end region including the second and third seats 112, 114, and an intermediate region between the second connector's first and second end regions including the second mating surface 122. The first, top end region can include a second bore 124 formed therethrough, an opening 126 formed therethrough, the rod seat 108 formed therein that can be configured to seat the rod 106 therein, and a second engagement surface 128 configured to engage the first connector's first engagement surface.
The second bore 124 can include a second mating element 124m (e.g., a thread, a snap fit member, a magnet, etc.) on an internal surface thereof, which can facilitate engagement of the second bore 124 with a surgical tool. The second mating element 124m in this illustrated embodiment is in the form of a thread. The second bore 124 can be positioned adjacent to and be in communication with the rod seat 108, as in this illustrated embodiment, which can allow a surgical tool received in the second bore 124 to engage the rod 106 seated in the rod seat 108. Unmating the surgical tool from the second bore 124, e.g., unthreading the surgical tool from the second mating element 124m, can disengage the surgical tool and the second connector 104 so as to allow release of the surgical tool from the second connector 104. Examples of the surgical tool that can be configured to mate with the second bore 124 include an installation tool (not shown) and a locking member (not shown), similar to that discussed above regarding the first bore 118 of the first connector 102. Namely, an installation tool can be configured to engage the second mating element 124m to facilitate installation of the second connector 104, and a locking member can be configured to engage the second mating element 124m to facilitate a locking action. In the case of a locking member seated in the second bore 124, the locking member can be configured to engage the rod 106 seated in the rod seat 108 so as to lock the rod 106 in a fixed position relative to the second connector 104. When the first and second connectors 102, 104 are fixed in position relative to one another, e.g., by the locking member locking the first and second connectors 102, 104 in a fixed position relative to one another, the locking member seated in the second bore 124 can lock the rod 106 in a fixed position relative to both the first and second connectors 102, 104.
The rod seat 108 can have a C-shape so as to include a curved surface generally corresponding to a curved shape of a typical rod's exterior surface. The C-shape of the rod seat 108 can allow a longitudinal length of the rod 106 to be loaded therein. The opening of the C-shape can be on a side of the second connector 104, as in this illustrated embodiment, so as to allow the rod 106 to be side-loaded into the rod seat 108.
The rod seat 108 can be configured to movably seat the rod 106 therein. As in this illustrated embodiment, the rod 106 seated in the rod seat 108 can be configured to move longitudinally relative to the second connector 104, e.g., slide longitudinally within the rod seat 108, and can be configured to rotate about a longitudinal axis 106A of the rod 106 when seated within the rod seat 108. To effect such movement, the rod 106 can be moved while the second connector 104 is held in a stable position, or the second connector 104 can be moved while the rod 106 is held in a stable position. The longitudinal sliding movement of the rod 106 seated in the rod seat 108 can be in both directions along its longitudinal axis 106A, e.g., in a direction toward the first connector 102 and in an opposite direction away from the first connector 102. The locking member being seated in the second bore 124 and engaging the rod 106 seated in the rod seat 108 can be configured to prevent movement of the rod 106 relative to the second connector 104 so as to lock the rod 106 in position within the rod seat 108.
The opening 126 formed through the second connector 104 can be configured to receive a surgical tool therein. The opening 126 can be configured to align with the first bore 118 formed through the first connector 102 when the first and second connectors 102, 104 are mated together, e.g., when the first and second mating surfaces 120, 122 are mated to one another. In this way, the same surgical tool can be simultaneously received in the opening 126 and the first bore 118. As in the illustrated embodiment, the opening 126 can have an elongate shape that has a width 126w greater than a width 118w (e.g., a diameter) of the first bore 118, which can allow the first bore 118 to be aligned with the opening 126 at a variety of positions along the opening's width 126w.
As in this illustrated embodiment, the opening 126 can include a recessed shelf 126s configured to seat thereon a surgical tool inserted into the opening 126. The recessed shelf 126s can extend around a full perimeter of the opening 126, as in this illustrated embodiment. Alternatively, the recessed shelf 126s can extend around a partial perimeter of the opening 126 and/or can include a plurality of recessed shelves each extending around a partial perimeter of the opening 126. The recessed shelf 126s can be configured to prevent an enlarged portion of the surgical tool from passing entirely through the opening 126, which can help properly position the surgical tool within the opening 126. For example, the recessed shelf 126s can be configured to seat thereon a head of a set screw (not shown) that has a diameter greater than a diameter of a shank extending distally from the head and extending through the opening 126 into the first bore 118 aligned with the opening 126.
The second and third seats 112, 114 can each include an arcuate member, as in this illustrated embodiment. The arcuate members can, similar to the first seat 110, have a curved shape generally corresponding to a curved shape of a typical rib's exterior surface. The second and third seats 112, 114 can thus be configured to securely engage a rib against interior surfaces thereof.
When the first and second connectors 102, 104 are mated together, the first, second, and third seats 110, 112, 114 can be configured to be axially arranged along a bone (e.g., a rib) seated in the first, second, and third seats 110, 112, 114, as shown for example in
The second mating surface 122 in the intermediate region of the second connector 104 can be configured to movably mate to the first mating surface 120 of the first connector 102. The second mating surface 122 can thus have a curved shape complementing the curved shape of the first mating surface 120 to facilitate the mating of the surfaces 120, 122.
As mentioned above, when the first and second connectors 102, 104 are coupled together, the second connector 104 can be configured to be movable relative to the first connector 102 to facilitate positioning of the second connector 104 relative to the first connector 102. This movement can include rotational movement and/or longitudinal sliding movement. In an exemplary embodiment, the second connector 104, when coupled to the first connector 102, can be configured to rotate relative to the first connector 102 and to longitudinally slide relative to the first connector 102 along a longitudinal axis 102A defined by the first connector 102.
The second connector 104 can be configured to rotate relative to the first connector 102 to adjust the second connector's position relative to the first connector 102 when the first and second mating surfaces 120, 122 are mated together by sliding the second mating surface 122 along the first mating surface 120. In other words, the second connector 104 can be rotated about the pivot point defined by the first mating surface 120 when the first and second mating surfaces 120, 122 are mated together to cause rotation of the second connector 104 relative to the first connector 102. The complementary curved shapes of the first and second mating surfaces 120, 122 can facilitate this rotational movement. The rotational movement of the second connector 104 can be in a first direction (e.g., clockwise) toward the first connector 102 so as to move the second and third seats 112, 114 toward the first seat 110, and can be in a second direction (e.g., counterclockwise) opposite to the first direction so as to move the second and third seats 112, 114 away from the first seat 110. The second connector 104 may only need to be rotated in the first direction to seat the bone in the second and third seats 112, 114. However, the second connector 104 can be configured to be alternately rotated in the first and second directions as many times as needed to seat a bone in a desired position in the second and third seats 112, 114. In some embodiments, the rod 106 can be seated and locked in the rod seat 108 prior to the rotation of the second connector 104 relative to the first connector 102 such that the rod 106 also rotates relative to the first connector 102. In other embodiments, the rod seat 108 can be empty of the rod 106 during the second connector's rotation relative to the first connector.
The second connector 104 can be configured to longitudinally slide relative to the first connector 102 to adjust the second connector's position relative to the first connector 102 by sliding the second connector's second engagement surface 128, e.g., an inner surface of the second connector 104, along the first connector's first engagement surface, e.g., an outer surface of the first connector 102.
Optionally, the device 100 can be provided as a kit including a plurality of first connectors and plurality of second connectors. Each of the first connectors can be configured to couple to at least one of the second connectors. Each of the first connectors can have a different size from one another, and each of the second connectors can have a different size from one another. The kit including differently sizes of first and second connectors can facilitate use of the first and second connectors with a variety of different patients having differently sized bones and/or can facilitate use of the first and second connectors with fused ribs that have a larger size than a typical single rib. A medical professional, e.g., a surgeon, can thus use the kit during performance of a surgical procedure on a patient and can choose the most appropriately sized first and second connectors for the patient as observed during the surgical procedure.
In some embodiments, the kit can include a plurality of elongate rods each configured to couple to at least one of second connectors provided in the kit. The elongate rods can each have a different size from one another, e.g., a different longitudinal length and/or a different diameter, which can facilitate selection of an elongate rod during performance of a surgical procedure on a patient based on the patient's observed anatomy and/or on the positioning of devices to which the elongate rod is to be coupled within the patient's body.
As mentioned above, an elongate rod can be anchored using a first device, e.g., the device 100 of
If the device 100 is provided as part of a kit, the kit optionally can include a plurality of first connectors and a plurality of second connectors for the first device, and can include a plurality of first connectors and a plurality of second connectors for the second device.
The surgical devices disclosed herein can be used to perform a surgical procedure in which an elongate rod, such as a spinal rod, is anchored within a patient's body. The surgical procedure can be a minimally invasive procedure or an open surgical procedure. The surgical devices disclosed herein can be used in robotic-assisted minimally invasive or open surgical procedures.
For example, a minimally invasive surgical procedure can begin by preparing the patient for surgery and making one or more appropriately sized incisions at a desired location. This general example is described with respect to the surgical device 100 of
Once the patient is prepared for surgery, the surgical device 100 can be inserted through an incision and/or through an access device to the surgical site. The first and second connectors 102, 104 can be inserted sequentially into the body or can be inserted simultaneously into the body. In an exemplary embodiment, if the first and second connectors 102, 104 are inserted sequentially into the body, the first connector 102 can be inserted into the body before the second connector 104. As mentioned above, an installation tool can be mated to the first connector's first bore 118 to facilitate insertion of the first connector 102 into the body, and the same or a different installation tool can be mated to the second connector's second bore 124 to facilitate insertion of the second connector 104 into the body. In some embodiments, the rod 106 can be mated to the second connector 104 (e.g., locked thereto using a set screw seated in the second bore 124) and used as the installation tool for the second connector 104. Inserting the first and second connectors 102, 104 sequentially can allow the device 100 to be inserted into the body through a smaller incision than if the first and second connectors 102, 104 are inserted simultaneously into the body. In an exemplary embodiment, if the first and second connectors 102, 104 are inserted simultaneously into the body, an installation tool can be used to introduce both of the connectors 102, 104 into the body. For example, the installation tool can extend through the second connector's opening 126 and be mated to the first connector's first bore 118 aligned with the opening 126. For another example, the installation tool can include the rod 106 locked to the second connector 104 by, e.g., a set screw seated in the second bore 124. Inserting the first and second connectors 102, 104 simultaneously can allow the device 100 to be inserted with the first and second connectors 102, 104 coupled together, which can expedite positioning of the first and second connectors 102, 104 relative to a target bone (not shown) in the body. Inserting the first and second connectors 102, 104 simultaneously can provide more space at a surgical site to manipulate the first connector 102 relative to a target bone at the surgical site.
With the first connector 102 in the body, whether or not the second connector 104 is already in the body (e.g., because the second connector 104 was inserted simultaneously with the first connector 104), the first connector 102 can be manipulated to seat a target bone (e.g., a first rib) in the first connector's first seat 110. In some embodiments, seating the target bone in the first seat 110 can include rotating the first connector 102 such that the bottom end region of the first connector rotates around a top part of the target bone to hook the first seat 110 around the target bone. In some embodiments, seating the target bone in the first seat 110 can include moving the first connector 102 laterally relative to the bone so as to side-load the bone into the first seat 110. If the second connector 104 is not already in the body when the first seat 110 is seating the target bone, the second connector 104 can then be inserted into the body.
In an exemplary embodiment, the first and second connectors 102, 104 can be coupled together (e.g., by mating the first and second mating surfaces 120, 122) after the first seat 110 seats the target bone, which can provide more space for manipulating the first connector 102 to seat the target bone and/or can allow for sequential insertion of the first and second connectors 102, 104.
With the first seat 110 seating the target bone and the first and second mating surfaces 120, 122 mated together, as shown in
The second connector 104 can be moved longitudinally relative to the first connector 102 in addition to being rotated relative to the first connector 102 in order to help desirably seat the target bone in the first, second, and third seats 110, 112, 114. In some embodiments, longitudinal movement may be unnecessary because, e.g., the size of the target bone does not require longitudinal sliding movement in order to desirably seat the target bone in the first, second, and third seats 110, 112, 114.
With the first and second connectors 102, 104 in a desired position relative to the target bone, e.g., in the final position of
If the rod 106 has not already been inserted into and locked within the rod seat 108, the rod 106 can be inserted into the rod seat 108 and locked therein by, e.g., inserting a locking member into the second bore 124 until the locking member engages the rod 106 so as to press on and lock the rod 106 in place.
As mentioned above, a second device can be connected to a second target bone (e.g., a second rib), and the rod 106 coupled to the device 100 can be coupled to the second device so as to span between the target bone and the second target bone.
Unlike the C-shaped rod seat 108 of the device 100 of
In the embodiments of
The device 300 can generally be configured and used similar to the device 100 of
The second bore 320 can be positioned adjacent to and be in communication with the rod seat 314, as in this illustrated embodiment. The rod 316 can include a bore 324 formed therein that can be configured to be positioned in the rod seat 314 and aligned with the second bore 320 when the rod 316 is seated in the rod seat 314, as illustrated in
The rod 316 can be pre-loaded into the rod seat 314. Pre-loading of the rod 316 into the rod seat 314 can help speed use of the device 300 and/or can help ensure that a correctly sized rod is inserted into the rod seat 314. Alternatively, the rod 316 can be inserted into the rod seat 314 during performance of a surgical procedure, which can provide medical personnel with flexibility in choosing a particular rod for a particular patient.
The rod's bore 324 can include a mating element 324m (e.g., a thread, a snap fit member, a magnet, etc.) on an internal surface thereof, which can facilitate engagement of the rod's bore 324 with a surgical tool (e.g., an installation tool, a set screw, etc.). In this illustrated embodiment, the rod's mating element 324m includes a thread. In this way, a surgical tool can be mated to the rod's mating element 324m to secure the tool to the rod 316 and to the second connector 304. For example, when the rod 316 is in a desired position relative to the second connector 304, a set screw (not shown) can be inserted into the second connector's second bore 320 and into the rod's bore 324 to mate with the mating element 324m and thereby be secured within the bores 320, 324 so as to lock the rod 316 in position relative to the second connector 304. For another example, an installation tool (not shown) can be inserted into the second connector's second bore 320 and into the rod's bore 324 to mate with the mating element 324m and thereby be secured within the bores 320, 324 so as to allow the installation tool to be manipulated to move the second connector 304 and the rod 316 as a unit. For yet another example, when the rod 316 is not seated in the rod seat 314, an installation tool (not shown) can be inserted into the rod's bore 324 to mate with the mating element 324m and thereby be secured within the bore 324 so as to allow the installation tool to be manipulated to move the rod 316.
When the rod 316 is seated in the rod seat 314 of the device 300, the rod 316 can be configured to be polyaxially pivotable relative to the second connector 304. The rod 316 can be configured to be polyaxially movable about a pivot point defined by a connection point between the rod 316 and the second connector 304, e.g., about a point defined by a coaxial longitudinal axis of the bores 320, 324.
In the embodiments of
The device 400 can generally be configured and used similar to the device 100 of
In general, the second bore 426 formed in the first connector 302 can be configured and used similar to the second bore 320 formed in the second connector 304 of the embodiment in
The opening 418 formed through the second connector 420 in this illustrated embodiment is an open shape, unlike the openings 126, 218, 318 in the embodiments of
One embodiment of movement of the device 400 to seat a bone (e.g., a rib) in the first, second, and third seats 404, 412, 424 is illustrated in
With the first connector 402 in the body, whether or not the second connector 420 is already in the body, the first connector 402 can be manipulated to seat a target bone (e.g., a first rib) in the first connector's first seat 412. With the first seat 404 seating the target bone and the first mating surface 410 mated with the second mating surface, as shown in
The second connector 420 can be moved longitudinally relative to the first connector 402 in addition to being rotated relative to the first connector 402 in order to help desirably seat the target bone in the first, second, and third seats 404, 412, 424.
In general, the rod seat 506 and the second bore 526 of the first connector 502 can be configured and used similar to the rod seat 108 and the second bore 124 of the second connector 104 of
In general, the second connector 520 can be configured to move relative to the first connector 502 similar to the movement of the second connector 420 of
In the embodiments of
The device 700 can generally be configured and used similar to the device 100 of
The rod seat 716 and the rod 718 in this illustrated embodiment can generally be configured and used similar to the rod seat 314 and the rod 316 of the embodiment of
The washer 730 can have a diameter greater than a diameter of the first connector's elongate post 704 and less than a diameter of the head 710. The washer 730 can thus be configured to retain the first connector 702 within the opening 720. The washer 730 has a square shape in this illustrated embodiment, but the washer 730 can have other shapes. The washer 730 has a square shape in this illustrated embodiment, but the washer 730 can have other shapes. In an embodiment in which the washer 730 is not integral with the first connector 702, the washer 730 can include an opening (not shown) formed therethrough and configured to receive the first connector 702 therein. The opening formed through the washer 730 can have a diameter greater than a diameter of the first connector's elongate post 704 and less than a diameter of the head 710. The washer 730 can thus be configured to retain the first connector 702 therein, with the head 710 being unable to pass through the washer's opening. The washer's opening can include a mating element (not shown) configured to facilitate mating of the washer 730 with the first connector 702. The washer's mating element can be configured to secure the first connector 702 in a fixed position relative to the washer 730, which can facilitate simultaneous movement of the washer 730 and the first connector 702 within the opening 730 and/or can help prevent the first connector 702 from becoming unintentionally uncoupled from the second connector 706. The first connector 702 can include a corresponding mating element (not shown) configured to mate with the washer's mating element. For example, the washer's mating element can include a thread on an internal surface of the washer's opening, and the first connector's mating element can include a thread on an external surface thereof.
The second connector's opening 720 in this illustrated embodiment has a closed shape. The closed shape of the opening 720 can be configured to facilitate coupling of the first and second connectors 702, 706, as discussed further below. The opening 720 can include an enlarged diameter portion 720e having a diameter greater than a remaining portion 720r of the opening 720. The diameter of the enlarged diameter portion 720e can be greater than a diameter of the washer 730 such that the washer 730 can be configured to pass freely through the enlarged diameter portion 720e of the opening. The diameter of the remaining portion 720r of the opening 720 can be less than the diameter of the washer 730 such that the washer 730 cannot pass through the opening's remaining portion 720r. The opening 720 can thus be configured to allow passage of the washer 730 through one portion thereof, e.g., the enlarged diameter portion 720e, and to prevent passage of the washer 730 through another portion thereof, e.g., the remaining portion 720r. The washer 730 can thus be configured to be selectively retained within the opening 720, and hence the first connector 702 that includes the washer 730 can be configured to be selectively retained within the opening 720.
The washer 730, and hence the first connector 702, can be configured to be slidably movable within the opening 720. A bottom surface of the washer 730 can be configured to slidingly mate with the bottom surface 722 of the opening 720 when the washer 730 is disposed within the opening 720.
The groove 726 formed in the second connector 706 configured to receive the first connector 702 can be aligned with the remaining portion 720r of the opening, e.g., can be offset from the enlarged portion 720e. In this way, when the washer 730 is disposed in the opening 720 and the first connector 702 is seated in the groove 726, the washer 730 can be retained within the opening 720 by being located at least partially within the remaining portion 720r having a diameter too small to allow the washer 730 seated in the opening 720 to pass therethrough and hence help retain the first connector 702 within the groove 726.
The second connector 706 can include a secondary opening 732 extending therethrough. The secondary opening 732 can be in communication with the opening 720 and can be formed in the bottom surface of the opening 720. The secondary opening 732 can be configured to limit movement of the first connector 702 within the opening 720. The secondary opening 732 can be formed in an area of the second connector 706 aligned with the remaining portion 720r of the opening 720. The secondary opening 732 can thus be configured to prevent the washer 730 from being fully aligned with the opening's enlarged portion 720e, thereby preventing the washer 730 from passing out of the opening 730, and hence preventing the first connector 702 from falling out of the opening 720.
In an embodiment of using the device 700, with the second connector 706 in the body, whether or not the first connector 702 is already in the body, the second connector 706 can be manipulated to seat a target bone (e.g., a first rib) in the second connector's seat 708. In an exemplary embodiment, the first connector 702 is not coupled to the second connector 706 when the second connector 706 seats the target bone, which can facilitate side-loading of the bone into the second connector's seat 708. The first connector 702 can thus be mated to the second connector 706 after the target bone has been seated by the second connector's seat 708. In an embodiment in which the first connector 702 and the washer 730 are not integrally formed, the first connector 702 can be seated in the washer 730 before or after the washer 730 is disposed in the opening 720.
With the second connector's seat 708 seating the target bone and the first connector 702 coupled to the second connector 704, the first connector 702 can be moved relative to the second connector 708, e.g., by sliding laterally within the opening 720 and the secondary opening 732, such that the first connector's seat 704 moves in a direction toward the second connector's seat 708 and hence toward the target bone seated therein. In an exemplary embodiment, the first and second connectors 702, 706 chosen to use with the target bone have a size such that the first connector's post 704 is seated in the groove 726 when the post 704 and the second connector's seat 704 contact the target bone.
The rod 718 can be polyaxially adjusted relative to the second connector 706 and secured in position relative thereto using, e.g., a set screw, inserted into the bores 724, 728 and threadably engaged with the mating element 728m. In an exemplary embodiment, the rod 718 can be adjusted in position relative to second connector 706 after the target bone has been seated by the seats 704, 708, which can help ensure that the rod 718 is angled in a most effective direction for treatment.
The rod seat 1016 and the rod 1018 in this illustrated embodiment can generally be configured and used similar to the rod seat 314 and the rod 316 of the embodiment of
The second connector's opening 1020 in this illustrated embodiment has an open shape. The opening 1020 can be configured to facilitate coupling of the first and second connectors 1002, 1006, as discussed further below. As in this illustrated embodiment, the opening 1020 can extend along a longitudinal length of the second connector 1006. Open ends of the opening 1020 can be located at opposed ends of the second connector 1006, with a first one of the open ends being configured to receive the rod 1018 therein and a second one of the open ends being configured to receive the first connector 1002 therein. The opening 1020 can thus be in communication with the rod seat 1016 and can be aligned therewith so as to be configured similar to the second bore 320 of the embodiment of
The first connector 1002 can be configured to be longitudinally movable relative to the second connector 1006 within the opening 1020. The first connector 1002, e.g., the washer 1010 thereof, can be configured to be advanced into the opening 1020 through the second one of the opening's open ends. In this illustrated embodiment, the first connector 1002 is configured to be manually coupled to the second connector 1002 by being advanced into the opening 1020. In an exemplary embodiment, the first connector 1002 can be inserted into the opening 1020 before the rod 1018 is coupled to the second connector 1006 in order to help provide adequate space for insertion of the first connector 1002 into the opening 1020. In other embodiments, the first connector 1002 can be pre-loaded into the opening 1020 and/or can be non-removable therefrom.
The washer 1010 can be configured to move within the opening 1020 in a channel 1032 defined by the opening's bottom surface 1030 and an interior surface 1034s of a ledge 1034 overhanging either side of the opening 1020. The first connector 1002 can thus be configured to be longitudinally movable relative to the second connector 1006 by sliding in the channel 1032 defined therein.
The first connector 1002 can include a guide portion 1028 configured to facilitate the movement of the first connector 1002 relative to the second connector 1006. The guide portion 1028 can be configured to cooperate with the bottom surface 1030 of the opening 1020 to guide the first connector 1002 within the opening 1020. The guide portion 1028 can be configured to stop longitudinal movement of the first connector 1002 in a first direction R1 relative to the second connector 1006, which can help retain the first connector 1002 within the opening 1020 and/or help prevent the first connector 1002 from moving too far and damaging tissue and/or other material adjacent a target bone.
As in this illustrated embodiment, the guide portion 1028 can include an elongate plate 1028p having a lip 1028L extending therefrom. The elongate plate 1028p can extend from the washer 1010 in a direction away from the elongate post 1004, e.g., in a second direction R2 that is opposite the first direction R1. The elongate plate 1028p can be configured to slide along the bottom surface 1030 of the second connector's opening 1020. The lip 1028L can be configured to abut the bottom surface 1030 when the first connector 1002 is in a first terminal position in which the first connector 1002 is advanced as far as possible in the first direction R1, as shown in
The embodiments in
As mentioned above, a surgical device configured to attach to a bone of a patient to facilitate anchoring of an elongate rod coupled thereto can be configured to allow cross connection. In general, the device can be configured to attach to a bone to facilitate anchoring of a first elongate rod (e.g., a spinal rod) and a second elongate rod (e.g., a cross connection rod) thereto. The first elongate rod can be configured to couple to a second surgical device attached to a second bone, e.g., using a surgical device discussed herein, so as to extend between the first and second surgical devices. The second elongate rod can be configured to couple to a third surgical device attached to a third bone, e.g., using a surgical device discussed herein, so as to extend between the first and third surgical devices. As will be appreciated by a person skilled in the art, cross connection can help provide stability to the system including the first, second, and third devices and the first and second elongate rods, which can facilitate patient treatment.
In some embodiments of surgical devices configured to facilitate spinal rod anchoring and to facilitate cross connection, the surgical device can include a receiver member configured to receive the spinal rod therein. The receiver member can be a discrete element configured to be independently manipulated from a bone connector of the surgical device (e.g., first and second connectors of the device) that the receiver member can be configured to be attached to, which can facilitate manipulation of the spinal rod. The receiver member can include a rod seat configured to seat the spinal rod therein. The rod seat can be side-loading or top-loading. The rod seat can be configured as a monoaxial rod seat that limits the rod seated therein to monoaxial movement relative to the bone connector. Alternatively, the rod seat can be configured as a polyaxial rod seat that allows the rod seated therein to move polyaxially relative to the receiver member.
The first connector 1202 can be configured to couple to a first elongate rod 1214 (e.g., a spinal rod), and can be configured to couple to a second elongate rod 1216 (e.g., a cross connector rod). The first connector 1202 can include a first bore 1218 configured to receive a first locking member therein to facilitate secure attachment of the first and second connectors 1202, 1204 together in a fixed position relative to one another, a second bore 1220 configured to receive the receiver member 20 therein to engage the first rod 1214 to facilitate secure attachment of the first rod 1214 and the first connector 1202 in a fixed position relative to one another, a third bore 1222 configured to receive a third locking member therein to engage the second rod 1216 to facilitate secure attachment of the second rod 1216 and the first connector 1202 in a fixed position relative to one another, and a fourth bore 1224 configured to receive a fourth locking member therein to facilitate secure attachment of the first and third connectors 1202, 1206 together in a fixed position relative to one another. The receiver member 20, and hence also the first rod 1214 seated therein, can be configured to be polyaxially movable within the second bore 1220 relative to the first connector 1202. The first connector 1202 can, as in this illustrated embodiment, include a second third bore 1222, which can allow cross connection via the second rod 1216 in a selected one of two directions and/or allow the second rod 1216 to be secured to the first connector 1202 using two locking members, one in each of the third bores 1222. The second connector 1204 can include a bore 1226 formed therethrough and configured to align with the first bore 1218 and be configured to also receive the first locking member therein to facilitate secure attachment of the first and second connectors 1202, 1204 together in a fixed position relative to one another. The third connector 1206 can include a bore 12268 formed therethrough and configured to align with the fourth bore 1224 and be configured to also receive the fourth locking member therein to facilitate secure attachment of the first and second connectors 1202, 1204 together in a fixed position relative to one another.
As in this illustrated embodiment, the device 1300 can include a first connector 1302, a second connector 1304 configured to couple to the first connector 1302, and a third connector 1306 configured to couple to and extend between the first and second connectors 1302, 1304. The first connector 1302 can include a first seat 1308 configured to seat a bone (e.g., a pedicle) therein. The second connector 1304 can include a second seat 1310 configured to seat the bone therein. The third connector 1306 can be configured to allow polyaxial adjustment of the second connector 1304 relative to the first connector 1302.
The first connector 1302 can be configured to couple to a first elongate rod 1312 (e.g., a spinal rod), and can be configured to couple to a second elongate rod 1314 (e.g., a cross connector rod). The first connector 1302 can include a first bore 1316 configured to receive a first locking member therein to facilitate secure attachment of the first and third connectors 1302, 1306 together in a fixed position relative to one another, a second bore 1318 configured to receive the receiver member 20 therein to engage the first rod 1312 to facilitate secure attachment of the first rod 1312 and the first connector 1302 in a fixed position relative to one another, and a third bore 1320 configured to receive a third locking member therein to engage the second rod 1314 to facilitate secure attachment of the second rod 1314 and the first connector 1302 in a fixed position relative to one another. The third connector 1306 can include a fourth bore 1322 configured to receive a fourth locking member therein to facilitate secure attachment of the first and second connectors 1302, 1304 together in a fixed position relative to one another. The first and fourth bores 1316, 1322 can be configured to cooperate together, along with the first and fourth locking members configured to be respectively received therein, to lock the first and second connectors 1302, 1304 in a fixed position relative to one another. The receiver member 20, and hence also the first rod 1312 seated therein, can be configured to be polyaxially movable within the second bore 1318 relative to the first connector 1302. The second connector 1304 can include an opening 1324 formed therethrough and configured to align with the fourth bore 1322 and be configured to also receive the fourth locking member therein to facilitate secure attachment of the first and second connectors 1302, 1304 together in a fixed position relative to one another. As in the illustrated embodiment, the opening 1324 can have an elongate shape. The elongate shape can allow the third connector 1306 to be positioned any of a plurality of positions relative to second connector 1304 while allowing the fourth bore 1322 to be aligned with the opening 1324, which can facilitate desired positioning of the first and second connectors 1302, 1304 relative to a bone seated thereby.
As in this illustrated embodiment, the device 1400 can include a first connector 1402, a second connector 1404 configured to couple to the first connector 1402, and a third connector 1406 configured to couple to and extend between the first and second connectors 1402, 1404. The first connector 1402 can include a first seat 1408 configured to seat a bone (e.g., a pedicle) therein. The second connector 1404 can include a second seat 1410 configured to seat the bone therein. The third connector 1406 can be configured to allow polyaxial adjustment of the second connector 1404 relative to the first connector 1402. The first, second, and third connectors 1402, 1404, 1406 can generally be configured and used similar to the first, second, and third connectors 1302, 1304, 1306 of
As illustrated in
As in this illustrated embodiment, the device 1500 can include a first connector 1502, a second connector 1504 configured to couple to the first connector 1502, and a third connector 1506 configured to couple to and extend between the first and second connectors 1502, 1504. The first connector 1502 can include a first seat 1508 configured to seat a bone (e.g., a pedicle) therein. The second connector 1504 can include a second seat 1510 configured to seat the bone therein. The third connector 1506 can be configured to allow polyaxial adjustment of the second connector 1504 relative to the first connector 1502. The first, second, and third connectors 1502, 1504, 1506 can generally be configured and used similar to the first, second, and third connectors 1302, 1304, 1306 of
In some embodiments of surgical devices configured to facilitate spinal rod anchoring and to facilitate cross connection, the surgical device can include a single bone connector configured to couple to a first elongate rod (e.g., a spinal rod) and to a second elongate rod (e.g., a cross connector rod). The device can be configured to movably seat a rod seating member therein. The rod seating member can be configured to seat the first elongate rod and be configured to facilitate adjustment of the first elongate rod relative to the bone connector. In some embodiments, the rod seating member can be non-removably coupled to the bone connector, e.g., pre-loaded therein. In other embodiments, the rod seating member can be removably coupled to the bone connector, e.g., selectively insertable into and releasable from the bone connector.
The device 1600 can include a cross connector rod seat 1606 (obscured in
The device 1600 can include a groove 1608 formed therein that can be configured to positioned around a pedicle and around a facet joint. The groove 1608 can thus facilitate attachment of the device 1600 to the pedicle without a screw or any other attachment member having to be inserted into the pedicle. Such insertion into the pedicle can exert a force upon the pedicle that can cause damage to the pedicle.
The device 1600 can include a cavity 1638 formed therein that can be configured to couple the device 1600 to second and third connectors (not shown), such as the second connector 1304 and the third connector 1306 of
The device 1600 can include a rod receiving portion configured to movably seat the rod seating member 1602 therein, and hence to movably seat the first rod 1604 therein when the rod seating member 1602 is seating the first rod 1604, as shown for example in
The rod seating member 1602 can include a top surface 1618 configured to seat the first rod 1604 thereon. The top surface 1618 can have a concave arcuate shape complementing a typical rod's cylindrical shape. The rod seating member 1602 can include a bottom surface 1616 configured to movably engage the bottom surface 1612 of the device 1600. The rod seating member's bottom surface 1616 can have a shape complementing the shape of the device's bottom surface 1612. Thus, as in this illustrated embodiment, the rod seating member's bottom surface 1616 can have a convex spherical shape. Optionally, the rod seating member's bottom surface 1616 and/or the device's bottom surface 1612 can include a frictional feature configured to improve the engagement between the bottom surfaces 1612, 1616 and/or make the bottom surfaces 1612, 1616 less likely to move relative to one another after locking. Examples of the frictional feature include a roughened surface, a textured surface, and a sticky surface.
The device's cavity 1614 can be configured to receive a locking member 1620 therein to engage the first rod 1604 to facilitate secure attachment of the first rod 1604, the rod seating member 1602, and the device 1600 in a fixed position relative to one another. As in this illustrated embodiment, the locking member 1620 can include a set screw. An interior surface of the device 1600 that defines at least a portion of the cavity 1614, e.g., interior surfaces of opposed arms 1628a, 1628b defining sidewalls of the cavity 1614, can include a corresponding locking element 1622 configured to engage the locking member 1620 and lock the locking member 1620 to the device 1600. As in this illustrated embodiment, the locking element 1622 can include a lip protruding radially inward that can be configured to engage the locking member 1620 in the cavity 1614 so as to prevent upward movement of the locking member 1620, e.g., in a direction away from the bottom surface 1612, when the locking member 1620 and the locking element 1622 are engaged. The opposed arms 1628a, 1628b can be configured to be moved apart from one another in response to a force applied to the device 1600. The movement of the opposed arms 1628a, 1628b apart from one another can facilitate insertion of the locking member 1620 into the cavity 1614 and/or can facilitate locked mating engagement of the locking member 1620 and the locking element 1622. The opposed arms 1628a, 1628b can be pried apart by hand and/or using a surgical tool. The device 1600 can include opposed cut-outs 1636 formed therein, e.g., in the second arm 1628b, which can be configured to engage a surgical tool that facilitates temporary expansion of the cavity 1614 by prying apart the arms 1628a, 1628b, the facilitates seating of the rod 1604 in the cavity 1614, and/or that facilitates installation of the device 1600.
The rod seating member 1702 can be configured to seat a first elongate rod 1704 (e.g., a spinal rod) and can be configured to move relative to the bone connector 1700, thereby allowing adjustment of a position of the first rod 1704 relative to the bone connector 1700. In this illustrated embodiment, the rod seating member 1702 is non-removably coupled to the bone connector 1700. The rod seating member 1702 can include an opening 1730 formed therethrough. The opening 1730 can be configured to seat a pin 1732 therein. The pin 1732 and the opening 1730 can cooperate to facilitate movement of the rod seating member 1702 relative to the bone connector 1700, as discussed further below. The device 1700 can have a pin bore 1734 formed therethrough that can be configured to seat the pin 1732 therein. In an exemplary embodiment, the pin 1732 is non-removably fixed in the pin bore 1734, which can help prevent the rod seating member 1702 from being removed from the device 1700.
The device 1700 can include a rod receiving portion configured to movably seat the rod seating member 1702 therein, and hence to movably seat the first rod 1704 therein, as shown for example in
The device's cavity 1714 can be configured to receive a locking member 1720 therein to engage the first rod 1704 to facilitate secure attachment of the first rod 1704, the rod seating member 1702, and the device 1700 in a fixed position relative to one another. The device 1700 can include a corresponding locking element 1722 configured to engage the locking member 1720 and lock the locking member 1720 to the device 1700. The device 1700 can include opposed cut-outs 1736 formed therein, which can be configured to engage a surgical tool that facilitates temporary expansion of the cavity 1714.
As in this illustrated embodiment, the device 1900 can include a first connector 1908 and a second connector 1910 configured to couple to the first connector 1908. The first connector 1908 can be configured to couple to a first elongate rod (not shown), e.g., a spinal rod, via the receiver member 20, and can be configured to couple to a second elongate rod (not shown), e.g., a cross connector rod, via seating in a cross connector seat 1914. The first connector 1908 can include a first bore 1912 configured to receive the receiver member 20 therein, a second bore 1916 configured to receive a locking member therein to engage the second rod to facilitate secure attachment of the second rod and the first connector 1908 in a fixed position relative to one another, a third bore (obscured in
As in this illustrated embodiment, the device 2000 can include a first connector 2008 and a second connector 2010 configured to couple to the first connector 2008. The first connector 2008 can include a rod seat 2012 configured to couple to a first elongate rod (not shown), e.g., a spinal rod, which can be polyaxially seated therein similar to the third connector 1812 being polyaxially seated in a cavity 1814 of the device 1800 of
For comparison purposes with the embodiments of the devices 2000, 2100 of
The devices discussed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. In either case, however, the device can be reconditioned for reuse after at least one use. Reconditioning can include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular pieces, and subsequent reassembly. In particular, the device can be disassembled, and any number of the particular pieces or parts of the device can be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular parts, the device can be reassembled for subsequent use either at a reconditioning facility, or by a surgical team immediately prior to a surgical procedure. Those skilled in the art will appreciate that reconditioning of a device can utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.
Preferably, the invention described herein will be processed before use. First, a new or used instrument is obtained and if necessary cleaned. The instrument can then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and instrument are then placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons. The radiation kills bacteria on the instrument and in the container. The sterilized instrument can then be stored in the sterile container. The sealed container keeps the instrument sterile until it is opened in the medical facility.
It is preferred that device is sterilized. This can be done by any number of ways known to those skilled in the art including beta or gamma radiation, ethylene oxide, steam, and a liquid bath (e.g., cold soak).
One skilled 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.
| Number | Date | Country | |
|---|---|---|---|
| Parent | 62097217 | Dec 2014 | US |
| Child | 14975428 | US |
