The spine is subject to various pathologies that compromise its load bearing and support capabilities. Such pathologies of the spine include, for example, degenerative diseases, the effects of tumors and, of course, fractures and dislocations attributable to physical trauma. In the treatment of diseases, malformations or injuries affecting spinal motion segments (which include two or more adjacent vertebrae and the disc tissue or disc space therebetween), and especially those affecting disc tissue, it has long been known to remove some or all of a degenerated, ruptured or otherwise failing disc. It is also known that artificial discs, fusion implants, or other interbody devices can be placed into the disc space after disc material removal. External stabilization of spinal segments alone or in combination with interbody devices also provides advantages. Elongated rigid plates, rods and other external stabilization devices have been helpful in the stabilization and fixation of a spinal motion segment, in correcting abnormal curvatures and alignments of the spinal column, and for treatment of other conditions.
In spinal rod fixation procedures extending to the base of the skull, the surgeon contours the rod to match the angle of the occiput and sub-axial spine. Bending the rod induces stress to the rod and decreases the fatigue strength of the material. In addition, the geometric and dimensional features of these rod systems and patient anatomy constrain the surgeon during surgery and prevent optimal placement and attachment along the spinal column and the occiput. For example, elongated, one-piece rods can be difficult to bend and maneuver into position between the upper end of the cervical spine and the occipital bone of the skull, and also provide the surgeon with only limited options in sizing and selection of the rod system to be placed during surgery.
In one aspect, a spinal rod connection system having a first elongated rod for attachment to the spinal column. The first rod extends along a longitudinal axis between a coupling member at its first end and an opposite second end. The system further includes a second elongated rod for attachment to a skull. Similarly, the second rod also extends along a longitudinal axis between a coupling member at its first end and an opposite second end. The system further includes a coupling mechanism for releasably coupling the coupling member of the first rod and the coupling member of the second rod in an end-to-end fashion where the longitudinal axis of each of the first and second rods is at an angle to one another.
In another aspect, a spinal rod connection system having a first elongated rod for attachment to the spinal column. The first rod extends along a longitudinal axis between a coupling member at its first end and an opposite second end. The system further includes a second elongated rod for attachment to the skull. Similarly, the second rod also extends along a longitudinal axis between a coupling member at its first end and an opposite second end. The system further includes a coupling mechanism for releasably coupling the coupling member of the first rod and the coupling member of the second rod in an end-to-end fashion, wherein an angle between the longitudinal axis of each of the rods can be temporarily varied and thereafter fixed so that the coupling mechanism axially and torsionally constrains the rods relative to one another.
In another aspect, a method for assembling a spinal rod system extending to the skull. The method includes a first rod that extends along a longitudinal axis between a coupling member at its first end and an opposite second end. The method further includes a second elongated rod for attachment to the skull. Similarly, the second rod also extends along a longitudinal axis between a coupling member at its first end and an opposite second end. The method further includes providing a coupling mechanism for releasably coupling said first coupling member and said second coupling member in an end-to-end fashion, wherein said longitudinal axis of each of said first and second rods is at an angle to one another. The method may further include temporarily varying the angle and thereafter fixing it so that the coupling mechanism axially and torsionally constrains the first and second rods relative to one another.
For the purposes of promoting an understanding of the principles of the invention, reference will now be made to the embodiments illustrated in the drawings and specific language will be used to describe the same. It will nevertheless be understood that no limitation of the scope of the invention is hereby intended. Any such alterations and further modifications in the illustrated devices, and any such further applications of the principles of the invention as illustrated herein being contemplated as would normally occur to one skilled in the art to which the invention relates.
In
First rod 12 includes a rod portion 14 and coupling member 16 at one end of rod portion 14. Second rod 30 includes a rod portion 32 and coupling member 16 at one end of rod portion 32. Coupling mechanism 28 includes a rod portion 29 and a coupling body 34 at either end thereof. Rod portion 29 may be of any shape and can be configured in any number of angles or configurations. Rod portions 14, 32 can be secured to vertebrae of the spinal column system or to the occiput of the skull with any one or combination of plates, hooks, screws, bolts, multi-axial screws, staples, cables or wires, sutures, clamps, and/or other attachment devices and systems.
First rod portion 14 can be provided with a characteristic that differs from a characteristic of second rod portion 32. The coupling mechanism 28 allows rods of differing characteristics to be secured to one another in end-to-end fashion to provide a rod system that is adapted for the anatomy, surgical condition, or surgical procedure. In one embodiment, the characteristic includes a cross-sectional dimension of the rod portions 14, 32. Other embodiments contemplate selection criteria for selection and assembly of the rod portion to include any one or combination of characteristics, including length, contouring, flexibility, surface features, shape, section modulus, elasticity, materials and material properties, and coatings, for example.
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Coupling member 16 includes a threaded outer surface extending from rod portion 14 or 32 to an end member 20 lacking threads. Coupling member 16 further includes a contact portion 18 along at least one side thereof, as also shown in
Coupling body 34 can be enlarged relative to rod portion 29 to provide a flange or hub to which coupling member 16 can be releasably engaged. In the illustrated embodiment, coupling body 34 is a cubic block, although other shapes are also contemplated, such as rectangular and cylindrical shapes. Coupling body 34 includes a first bore 36 formed internally therein that opens away from rod portion 29 at an end of coupling body 34. Coupling body 34 further includes a second bore 38 extending therein transversely to first bore 36. As further shown in
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Engaging member 42 is positionable in second bore 38 and engageable to coupling member 16 to prevent rod 12 or 30 from disengaging from coupling mechanism 28. In one embodiment, contact portion 18 of coupling member 16 is oriented toward second bore 38, and engaging member 42 is an externally threaded set screw 44 engageable in second bore 38. A tool engaging recess 46 is provided for engagement with a tool, such as a hex driver, to allow the set screw 44 to be driven into second bore 38. Set screw 44 is driven into second bore 38 so that end 48 is in contact with contact portion 18, preventing coupling member 16 from rotating in coupling body 34 and resisting torsional loading between rods 12, 30.
Other embodiments contemplate other arrangements for coupling mechanism 28. For example, engaging member 42 can be a pin that is received in a hole or recess in coupling member 16. Coupling body 34 can be a nut rotatably captured on the end of rod portion 32. Coupling body 34 can include a bayonet locking type device, or a spring-biased ball plunger in coupling member 16 that is received in a detent in coupling body 34. In another embodiment, coupling body 34 does not include a second bore for an engaging member, and coupling member 16 can be provided completely threaded therearound. To torsionally constrain this type of coupling member 16 in coupling body 34, coupling member 16 can be provided with locking threads. In another embodiment, a simple threaded engagement is provided and relative rotation of rods 12, 30 is resisted by the engagement of rods 12, 30 to the spinal column or the skull.
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Articulating connector 205 further includes a fastener 290 extendable through aligned bores 204, 206. Aligned bore 204 extends through extension portion 270 and its axis is perpendicular to contact surface 202. Aligned bore 206 extends through extension portion 271 and its axis is perpendicular to contact surface 203.
Fastener 290 is positionable through bore 204 and is engageable to bore 206 of extension portion 271 to prevent contact surfaces 202 and 203 from moving relative to one another. In one embodiment, fastener 290 has an externally threaded portion 291 engageable in bore 206, which has internal threads. A tool engaging recess 246 is provided for engagement with a tool, such as a hex driver, to allow the fastener 290 to be driven into bore 206. Fastener 290 is driven into bore 206 so that end 292 is in contact with extension portion 270 and contact surfaces 202 and 203 are in contact with one another and are prevented from moving relative to one another and resisting torsional loading between coupling bodies 34. One or both of contact surfaces 202, 203 may include teeth, splines, cams, roughened portions or any other movement prevention device to help prevent the contact surfaces from moving relative to one another.
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While the invention has been illustrated and described in detail in the drawings and foregoing description, the same is to be considered as illustrative and not restrictive in character. All changes and modifications that come within the spirit of the invention are desired to be protected.