The present invention relates to an improved pedicle screw tulip assembly.
Bone anchor screws come in a variety of shapes and sizes. One of the more common styles has a polyaxial head that allows for the screw to enter the bone structure at an ideal or preferred inclination. To achieve this polyaxial inclination, the head has a shape configured to rotate about its lower external surface. This lower surface can be one of a number of shapes like conical or spherical or hemispherical. This ability is often used in devices having a pedicle screw and tulip assembly.
The pedicle screw and tulip assembly generally includes a tulip. A tulip is a body structure having two opposing sides spaced by a slotted opening to receive a spinal rod. The tulip often employs internal threads to receive a rod locking set screw to anchor or fix the rod in the tulip. The lower portion of the tulip has an opening to allow the threaded shank to pass and to receive and hold the pedicle screw head in a base seat. Often, the tulip can have a saddle that supports the rod along an underside of the rod. The saddle typically has an upper recessed curvature into which the rod sits and a lower cup like opening to receive the top of the pedicle screw head. When the saddle and rod and set screw are tightened, the screw angle is fixed against the tulip seat.
In some cases, it is preferred that the pedicle screw is first placed securely in the bone structure leaving the head protruding above the bone surface. In this surgical procedure a modular head tulip assembly must be adapted to fit down onto the projecting screw head. To accomplish this, the surgeon must push the tulip onto and over the screw head without a clear path of vision. Accordingly, the placement must be accomplished without any way of knowing if the tulip or other device is properly secured. Thereafter, the device is tightened to complete the assembly and the only way to insure the assembly is secure requires an upward pulling of the tightened assembly. This is not a good test, as the assembly will be loosened or the screw to bone interface weakened.
More typically, the pedicle screw and tulip come as a pre-assembly with a pedicle screw of a given or particular size thread.
In many cases, the underlying bone structure being screwed into is insufficient in structure to work well with a normal sized pedicle screw. Ideally, a surgeon would like to use a larger sized screw to improve the bone fastening. The prior art tulips unfortunately cannot accommodate larger screws. The present invention permits this in a uniquely novel design. This allows a single tulip assembly design to accommodate a variety of sizes of pedicle screws.
These and other objectives are achieved by the invention as described hereinafter.
The purpose of this invention is to allow a larger diameter screw to be used with a normal sized pedicle tulip through the use of a multi-segmented member placed into a groove inside the tulip to retain the pedicle screw.
Existing technology uses a single split ring or collet to retain the pedicle screw.
In the present invention, the pedicle screw head can be loaded into the bottom of the tulip until it is pushed past an undercut groove or recess inside the tulip. Then segments or pieces of a multi-segmented member are inserted, preferably, from the bottom of the tulip into the recess or groove to form a segmented locking feature. The pedicle screw head is then pulled against the multi-segmented member that is formed from the multiple segments or pieces that were inserted and then the saddle is placed on top of the screw head preventing the segment pieces from being able to come out of the recess or undercut groove. The assembly acts as any normal pedicle screw, however, with a larger screw size if desired.
The undercut groove could be made only partially around the circumference allowing fewer segment pieces to be used. The concept works well with two, three or four segments to form the locking feature.
By using multiple segment pieces instead of a split ring, allows for thicker segmented pieces to be placed in a bottom loading tulip. Normally the ring is limited by the elasticity of the material and the moment of inertia of the section allowing the ring to spring back. With the multi-locking member made in segments it has to undergo no bending stress unlike a normal split ring. This allows for a more robust lock to be installed in the groove as the segment pieces can move expanding in the small gap between segments substantially narrowing or closing the gap circumferentially as the segments are inserted into the groove below the screw head, the segment pieces retain the screw head securely on assembly. The segment pieces can be arcuate segments, straight pieces or “V” shaped pieces any of which can be loaded into the recessed opening or groove to hold the pedicle screw.
A pedicle screw assembly has a bone screw, a tulip, a multi-segmented locking member and a saddle. The multi-segmented locking member is internal of the tulip positioned in a recess or undercut groove of an inner surface of the tulip. The saddle has a proximal end for engaging a rod and a distal end for receiving a head of the bone screw. The saddle has an exterior surface positioned between the ends. The outer surface is sized to move axially inside the tulip.
The recess or undercut groove of the tulip can have a conical surface tapering inward distally or can be rounded or straight. The effective inner diameter or distance of the segment pieces of the multi-segmented locking member is defined as the distance spanning across the opening or recessed groove between segments. The tulip allows the pedicle screw head to enter through the distal opening and then, when past the recess or groove, the segment pieces can be installed to secure the screw in the tulip.
The bone screw has one of the following head shapes; at least partially a hemispherical or spherical head, conical or a radial array or loci of cylindrical surfaces or any other bulbous head. The head has a driving feature for torsionally driving the screw into bone.
A method of assembling a tulip comprises the step of providing a tulip; and positioning a pedicle screw inside the tulip in pre-loaded condition. The method also includes the step of positioning the multi-segmented locking member in the groove or recess inside the tulip to pre-load the segment pieces in the unlocked condition. The method also includes the step of inserting the saddle into the tulip prior to tightening to hold the screw head and segmented locking member in place on assembly.
The invention will be described by way of example and with reference to the accompanying drawings in which:
With reference to the drawings, various embodiments of the present invention are shown. In
With reference to
With reference to
In one preferred embodiment shown in
In an alternative shown in
Accordingly, for this device to be manufactured, it is important that the locking ring or member 50 shown in
Accordingly, during manufacture, the tulip 20, saddle 30, bone screw 40 and locking ring 50 are pre-loaded as an assembly 10. As illustrated, the saddle 30 has an opening through which the pedicle screw 40 has a plurality of driving flats forming a hexagonal opening 41 that can be tightened or torqued down as required. This opening 41 can be formed by flats that are in a recess or can be any means for providing a torsional tightening of a pedicle screw into bone.
As illustrated, the tulip 20 has parallel walls that are opposing, the internal surface of the tulip 20 has threads for engaging a set screw. The tulip 20, as configured, is designed with a slotted opening for receiving a spinal rod or other similar mechanical device that can be positioned onto the upper surface of the saddle 30 which has a complimentary curved concavity for receiving a round or circular rod as illustrated. Once the set screw is put into position on top of the rod, the rod is then securely fastened against the saddle 30. Once this assembly is achieved, the polyaxial feature of the set screw is locked into position at the desired location.
These polyaxial features of the screw 40 are well understood in the art. It is important that the pedicle screw 40 have at least a partially hemispherical, spherical head 42 such that the lower head surface 44 is engaged by the tulip 20 and locking multi-segmented member 50 such that the screw 40 can be rotated in a polyaxial direction. This can be accomplished as indicated by hemispherical, a spherical head, a conical head or a radial array of loci or cylindrical surfaces or any other bulbous head configuration that is adapted to move in a polyaxial direction when inserted inside a tulip 20. Preferably, the screw 40 is made of an implantable metal such as stainless steel or, more preferably, titanium.
With reference again to
The assembly being pre-loaded at the factory with the multi-segmented locking ring 50 pre-positioned with the saddle 30 and bone screw 40 all inside the tulip 20, allows the ring or member 50 to be substantially stronger than otherwise possible because the forces to engage the locking member 50 are far less than those required to stretch it over a pedicle screw head 42, additionally, this design allows much larger pedicle screws to be used in the tulip 20. At least one full size larger screw can be used, for example, a 7.5 mm pedicle screw in a normal tulip 20 can be replaced with an 8.5 mm size.
The exemplary screw 40 was an 8.5 mm screw. The invention can be of any suitable size for the required purpose allowing the tulip to be universally adaptable to any number of thread sized pedicle screws.
Variations in the present invention are possible in light of the description of it provided herein. While certain representative embodiments and details have been shown for the purpose of illustrating the subject invention, it will be apparent to those skilled in this art that various changes and modifications can be made therein without departing from the scope of the subject invention. It is, therefore, to be understood that changes can be made in the particular embodiments described, which will be within the full intended scope of the invention as defined by the following appended claims.
Number | Date | Country | |
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62194601 | Jul 2015 | US |