1. Technical Field
The present disclosure relates to orthopedic surgical devices and, more particularly, to a spinal stabilization system and a method of use therefor.
2. Background of Related Art
The spinal column is a complex system of bones and connective tissues that provide support for the human body and protection for the spinal cord and nerves. The adult spine is comprised of an upper and lower portion. The upper portion contains twenty-four discrete bones, which are subdivided into three areas including seven cervical vertebrae, twelve thoracic vertebrae, and five lumbar vertebrae. The lower portion is comprised of the sacral and coccygeal bones. The cylindrical shaped bones, called vertebral bodies, progressively increase in size from the upper portion downwards to the lower portion.
An intervertebral disc along with two posterior facet joints cushion and dampen the various translational and rotational forces exerted upon the spinal column. The intervertebral disc is a spacer located between two vertebral bodies. The facets provide stability to the posterior portion of adjacent vertebrae. The spinal cord is housed in the canal of the vertebral bodies. It is protected posteriorly by the lamina. The lamina is a curved surface with three main protrusions. Two transverse processes extend laterally from the lamina, while the spinous process extends caudally and posteriorly. The vertebral bodies and lamina are connected by a bone bridge called the pedicle.
The spine is a flexible structure capable of a large range of motion. There are various disorders, diseases and types of injury, which restrict the range of motion of the spine or interfere with important elements of the nervous system. The problems include, for example, scoliosis, kyphosis, excessive lordosis, spondylolisthesis, slipped or ruptured discs, degenerative disc disease, vertebral body fracture, and tumors. Persons suffering from any of the above conditions typically experience extreme or debilitating pain and often times diminished nerve function. These conditions and their treatments can be further complicated if the patient is suffering from osteoporosis, or bone tissue thinning and loss of bone density.
Spinal fixation apparatuses are widely employed in surgical processes for correcting spinal injuries and diseases. When the disc has degenerated to the point of requiring removal, there are a variety of interbody implants that are utilized to take the place of the disc. These include interbody spacers, metal cages and cadaver and human bone implants. In order to facilitate stabilizing the spine and keeping the interbody in position, other implants are commonly employed, such as bone screws and connecting rods. Depending on the pathology and treatment, a surgeon will select the appropriate spinal rod material and size, specifically, the cross-sectional diameter.
To meet the problem of providing a rigid pedicle screw and rod construct, especially for addressing the demands of stiff deformity corrections, larger rod constructs have been made to improve the strength of the screw and rod construct. Spinal rods are typically made of a titanium alloy. However when large deformity corrections need to be made, these rods are not always strong enough. Larger diameter stainless steel rods have been made for these applications, but a larger rod requires a larger mating screw head to contain the rod which in turn increases the profile of the construct. In addition, in order to reduce the likelihood of material incompatibility in vivo, the screw assembly also needs to be made of stainless steel to match the rod material, which is not a cost effective alternative.
Therefore, a need exists for a cost effective, rigid screw and rod construct that can still maintain a low profile, while maintaining the surgical correction.
In accordance with an embodiment of the present disclosure, there is provided a spinal stabilization system including a connecting rod and a bone screw. The connecting rod includes an elongate rounded section, a pair of elongate rail portions, and a pair of neck portions connecting the elongate rounded section with the respective pair of elongate rail portions. Each elongate rail portion extends radially outward from the elongate rounded section and diametrically opposes the other rail portion. The bone screw includes a head portion defining a slot, a shank extending longitudinally from the head portion, and a set screw configured to secure the connecting rod in the slot. The slot includes a leading end portion configured to receive one of the pair of elongate rail portions and a trailing end portion configured to engage the set screw, wherein the connecting rod is pivotable about the elongate rounded section in the slot.
In another embodiment, at least one of the pair of elongate rail portions may include a non-circular cross-section. In particular, the non-circular cross-section may be rectangular. The elongate rounded section may have a substantially circular cross-section. In addition, at least one of the pair of elongate rail portions may include an arcuate surface. Furthermore, the arcuate surface of the at least one of the elongate rail portions may conform to a contour of the leading end portion of the slot defined in the bone screw. Alternatively, at least one of the pair of elongate rail portions may include a planar surface configured to be in a surface contact with the set screw.
In still another embodiment, the width of at least one of the pair of elongate rail portions may be smaller than the diameter of the elongate rounded section. In addition, the neck portion of the connecting rod may be narrower than the elongate rounded section of the connecting rod. Each neck portion may include a pair of concave sides joining the elongate rail portion with the elongate rounded section.
In yet another embodiment, the connecting rod may be monolithically formed. Additionally, the connecting rod may be made of titanium or titanium alloy. The bone screw and the connecting rod may be made of the same material.
The foregoing and other features of the present disclosure will become apparent to one skilled in the art to which the present disclosure relates upon consideration of the following description of the disclosure with reference to the accompanying drawings, wherein:
Embodiments of the present disclosure will now be described in detail with reference to the drawings, in which like reference numerals designate identical or corresponding elements in each of the several views. As used herein, the term “distal,” as is conventional, will refer to that portion of the instrument, apparatus, device or component thereof which is farther from the user while, the term “proximal,” will refer to that portion of the instrument, apparatus, device or component thereof which is closer to the user. In addition, the term “cephalad” is used in this application to indicate a direction toward a patient's head, while the term “caudad” indicates a direction toward the patient's feet. Further still, for the purposes of this application, the term “medial” indicates a direction toward the middle of the body of the patient, while the term “lateral” indicates a direction toward a side of the body of the patient, i.e., away from the middle of the body of the patient. The term “posterior” indicates a direction toward the patient's back, while the term “anterior” indicates a direction toward the patient's front. In the following description, well-known functions or constructions are not described in detail to avoid obscuring the present disclosure in unnecessary detail.
With reference to
With reference to
With reference to
Moreover, the width of each elongate rail portion 14a, 14b is smaller than the diameter of elongate rounded section 12. Such a configuration facilitates pivoting of connecting rod 10 about elongate rounded section 12 within a slot 53 defined in a head portion 52 of bone screw 50, as will be described hereinbelow. The pair of elongate rail portions 14a, 14b is substantially identical to each other. As such, either one of the pair of elongate rail portions 14a, 14b may be placed in leading end portion 53a of slot 53. In addition, the pair of elongate rail portions 14a, 14b is adapted to be placed in contact with set screw 60.
With continued referenced to
Moreover, such a configuration facilitates securement of connecting rod 10 within slot 53 at a desired orientation. When set screw 60 partially locks connecting rod 10 within slot 53, the surgeon may, e.g., pivot connecting rod 10 about elongate rounded section 12 to place connecting rod 10 in a desired orientation. However, an elongate rail portion defining, e.g., a planar surface, will tend to orient elongate rail portion towards a central orientation upon tightening of set screw 60. However, arcuate surfaces 15a, 15b being in contact with set screw 60 enables the surgeon to maintain the desired orientation of connecting rod 10 during tightening of set screw 60.
With particular reference to
With reference back to
With reference back to
As discussed hereinabove, elongate rail portions 14a, 14b each have a smaller width than the diameter of elongate rounded section 12. In this manner, slot 53 provides a slight gap 59 (
Specifically, since connecting rod 10 is pivotable within slot 53 when connecting rod 10 is partially locked within slot 53, connecting rod 10 can be secured to one of a plurality of angular orientations by fully locking connecting rod 10 within slot 53 by fully tightening set screw 60, whereby a longitudinal axis “Y-Y” (
With continued reference to
With reference now to
However, in contrast to connecting rod 10, elongate rail portion 214a includes a planar surface 215a adapted to be in, e.g., a surface contact, with set screw 60. As discussed hereinabove, an elongate rail portion having a planar surface 215a will tend to orient elongate rail portion towards a central orientation upon tightening of set screw 60. Thus, connecting rod 210 may be utilized in surgical procedures in which it is desirable to orient connecting rod 210 to the central orientation upon tightening of set screw 60.
Moreover, trailing end portion 53b of slot 53 defines a substantially planar surface such that set screw 60 threadably inserted in slot 53 is substantially flush with trailing end portions 56b of the respective walls 56 when connecting rod 210 is positioned within slot 53 and secured by set screw 60 therein. However, elongate rail portion 214b may include an arcuate surface 215b to facilitate pivoting of connecting rod 210 within slot 53 of bone screw 50, as discussed hereinabove.
With reference now to
Engaging portion 86 defines at least one aperture 88 adapted and dimensioned to receive therethrough connecting rods 10, 210. In particular, inner walls that define aperture 88 are configured to permit insertion of connecting rod 10 through aperture 88 in a single orientation with respect to such aperture.
With particular reference to
The length of elongate body 84 may be tailored to meet the needs of the surgical application to provide a suitable long moment arm necessary to provide the user a mechanical advantage to bend connecting rod 10. In addition, it is also envisioned that elongate body 84 may be a hollow tubular member and/or define lightening holes to reduce the weight of device 80.
It is also envisioned that spinal stabilization system 100 may be used with other surgical instruments such as, e.g., a rod reduction device, configured to reduce a rod into position in a rod receiving slot in a head of a bone screw with a controlled, measured action. Reference may be made to U.S. Patent Application Publication Nos. 2009-0018593 and 2011-0087298, the entire contents of each of which are incorporated herein by reference, for a detailed discussion of the construction and operation of a rod reduction device.
In use, the user implants a plurality of bone screws 50 in vertebral bodies of a patient. Threaded shank 54 can be driven into the desired vertebral body by providing torsional force via a driving tool (not shown) configured to mate with and grip bone screw 50. After shank 54 is positioned within the vertebral body and the driving tool is removed from bone screw 50, connecting rod 10 is positioned within slot 53 of head portion 52.
In particular, spinal stabilization system 100 can be utilized to correct spinal deformity. Prior to securing connecting rod 10 with bone screw 50, the surgeon can manipulate and correct the curve of the spinal column, i.e., to manually manipulate and reduce the “rib hump.” After placing the spine in proper position, the surgeon can bend connecting rod 10 prior to securing connecting rod 10 to the first two points of the spinal column where the construct is to be attached.
The surgeon can bend connecting rod 10 by utilizing the pair of rod bender devices 80. In use, connecting rod 10 is inserted through apertures 88 of rod bender devices 80 and force is applied at handle members 82 of rod bender devices 80 to appropriately contour and shape connecting rod 10 to a desired curve.
At this time, connecting rod 10 is positioned in respective slots 53 of bone screws 50 implanted in vertebral bodies. Set screws 60 can now be threadably inserted into head portion 52 of bone screw 50. Prior to fully securing connecting rod 10 to bone screws 50, the surgeon may once again utilize rod bender devices 80 to position connecting rod 10 to a desired orientation. As discussed hereinabove, slight gap 59 (
Although the illustrative embodiments of the present disclosure have been described herein with reference to the accompanying drawings, the above description, disclosure, and figures should not be construed as limiting, but merely as exemplifications of particular embodiments. It is contemplated that the amount of gap 59 may be tailored to the procedure being performed. For example, the width of elongate rail portions 14a, 14b may be tailored to meet the needs of a particular surgical procedure that requires a particular degree of freedom to adjust orientation of connecting rod 10 in slot 53. One skilled in the art will recognize that the present disclosure is not limited to use in spine surgery, and that the instrument and methods can be adapted for use with any suitable surgical device. It is to be understood, therefore, that the disclosure is not limited to those precise embodiments, and that various other changes and modifications may be effected therein by one skilled in the art without departing from the scope or spirit of the disclosure.
Number | Name | Date | Kind |
---|---|---|---|
5113685 | Asher et al. | May 1992 | A |
5217497 | Mehdian | Jun 1993 | A |
5261912 | Frigg | Nov 1993 | A |
5658286 | Sava | Aug 1997 | A |
5667508 | Errico et al. | Sep 1997 | A |
5899904 | Errico et al. | May 1999 | A |
5910142 | Tatar | Jun 1999 | A |
5947969 | Errico et al. | Sep 1999 | A |
6102912 | Cazin et al. | Aug 2000 | A |
6451021 | Ralph et al. | Sep 2002 | B1 |
6482207 | Errico | Nov 2002 | B1 |
6540749 | Schafer et al. | Apr 2003 | B2 |
6582434 | Kawakami et al. | Jun 2003 | B2 |
6644087 | Ralph et al. | Nov 2003 | B1 |
7503918 | Baccelli et al. | Mar 2009 | B2 |
7520879 | Justis et al. | Apr 2009 | B2 |
7563274 | Justis et al. | Jul 2009 | B2 |
7569061 | Colleran | Aug 2009 | B2 |
7588575 | Colleran et al. | Sep 2009 | B2 |
7588588 | Spitler et al. | Sep 2009 | B2 |
7604653 | Kitchen | Oct 2009 | B2 |
7618442 | Spitler et al. | Nov 2009 | B2 |
7766942 | Patterson et al. | Aug 2010 | B2 |
7931676 | Veldman et al. | Apr 2011 | B2 |
20020161368 | Foley et al. | Oct 2002 | A1 |
20050065515 | Jahng | Mar 2005 | A1 |
20080027432 | Strauss et al. | Jan 2008 | A1 |
20080086130 | Lake et al. | Apr 2008 | A1 |
20080262546 | Calvosa et al. | Oct 2008 | A1 |
20090018593 | Barrus et al. | Jan 2009 | A1 |
20110087298 | Jones | Apr 2011 | A1 |
20110190823 | Bergeron et al. | Aug 2011 | A1 |
Number | Date | Country | |
---|---|---|---|
20140135841 A1 | May 2014 | US |