Method of implanting a bone plate

• US 10,159,514 B2
• Filed: 11/30/2015
• Issued: 12/25/2018
• Est. Priority Date: 12/23/2011
• Status: Active Grant

• Current Assignee: Xtant Medical Holdings, Inc. (OrbiMed Advisors LLC (China))
• Original Assignee: Pioneer Surgical Technology Incorporated (Surgalign Holdings, Inc.)
• Inventors: Perrow, Scott J., Robie, Reuben J.
• Primary Examiner(s): Hanna, Samuel
• Application Number:
  US14/954,179
• Publication Number:
  US 20160081723A1
• Time in Patent Office: 1,121 Days
• Field of Search: None
• CPC Class Codes: A61B 17/7059 Cortical plates A61B17/7007, A61B17/7058 take precedence
• CPC Class Codes: A61B 17/8014 the extension or compression force being caused by interaction of the plate hole and the screws
• CPC Class Codes: A61B 17/8038 the additional component being inserted in the screw head
• CPC Class Codes: A61B 17/8042 the additional component being a cover over the screw head
• CPC Class Codes: A61B 17/8047 wherein the additional element surrounds the screw head in the plate hole A61B17/8052 takes precedence
• CPC Class Codes: A61B 17/808 Instruments for holding or positioning bone plates, or for adjusting screw-to-plate locking mechanisms
• CPC Class Codes: A61B 17/861 specially shaped for gripping driver
• CPC Class Codes: A61B 17/8888 at its central region
• CPC Class Codes: A61F 2/442 Intervertebral or spinal discs, e.g. resilient non-disc-shaped intervertebral inflatable pockets A61F2/441; non-disc-shaped intervertebral fusion implants A61F2/4455

Abstract

In one aspect, a bone anchor assembly is provided having a bone anchor with a head, a resilient locking cap extending about a portion of the bone anchor head, and a cap drive member having a depending annular wall. The annular wall and locking cap have engagement surfaces configured to engage and expand the locking cap as the cap drive member is shifted from an unlocked to a locked position. In another form, a bone plate system is provided including a bone plate having an elongated throughbore and a resilient support member received therein. The support member has an opening sized to receive a bone anchor head and an actuator device carried thereon. The bone plate and support member have interfering portions configured to be shifted to a locked orientation to lock the support member and the bone anchor head at an axial position in the throughbore.

Claims

1. A method of implanting a bone plate in a patient, the method comprising:

advancing distal, spaced-apart gripping members of an inserter tool into an opening of the bone plate, each of the gripping members including a proximal portion and a distal portion, the gripping members including a pivotal gripping member that is pivotal relative to a pivot body of the inserter tool and a fixed gripping member that is fixed relative to the pivot body, the proximal portion of the pivotal gripping member being pivotally coupled to the pivot body by a pivot pin and supported thereon and the proximal portion of the fixed gripping member being fixedly coupled to the pivot body and supported thereon;

shifting a grip control shaft of the inserter tool coupled to the pivot body in a first direction along a longitudinal axis of an elongated shaft of the inserter tool to pivot the pivotal gripping member relative to the pivot body of the inserter tool and away from the fixed gripping member to grip the bone plate with the distal portions of the gripping members and connect the bone plate to the pivot body of the inserter tool in a first orientation relative to the inserter tool;

advancing the bone plate in the first orientation through a surgical channel formed in tissue toward at least one bone of the patient;

pivoting a gripping portion of a proximal pivot lever of the inserter tool, the pivot lever being pivotally connected to a fixed distal handle of the inserter tool and pivotal about a first pivot axis defined by the connection between the pivot lever and the fixed distal handle, the pivot lever being connected to the pivot body by an elongated pivot member, the pivot body being pivotally connected to the elongated shaft of the inserter tool and pivotal about a second pivot axis defined by the connection between the pivot body and the elongated shaft of the inserter tool;

wherein pivoting the gripping portion includes pivoting the gripping portion distally toward the fixed distal handle of the inserter tool about the first pivot axis extending perpendicular to the longitudinal axis of the elongated shaft of the inserter tool which causes the pivot body, the pivotal gripping member, and the fixed gripping member to pivot together about the second pivot axis extending perpendicular to the longitudinal axis of the elongated shaft of the inserter tool and pivots the bone plate connected to the pivot body from the first orientation to a second orientation relative to the inserter tool, the second orientation being different than the first orientation;

positioning the bone plate in the second orientation in contact with the at least one bone;

securing the bone plate to the at least one bone, wherein securing the bone plate to the at least one bone includes driving a shank of at least one bone anchor through at least one opening of the bone plate and into the at least one bone; and

shifting the grip control shaft of the inserter tool in a second direction opposite to the first direction along the longitudinal axis to pivot the pivotal gripping member relative to the pivot body and toward the fixed gripping member to release the gripping members and disconnect the pivot body of the inserter tool from the bone plate secured to the at least one bone.

2. The method of claim 1, wherein the bone plate is elongated and connecting the bone plate to the pivot body of the inserter tool in the first orientation includes connecting the bone plate to the pivot body of the inserter tool so that a longitudinal axis of the bone plate extends substantially parallel to the longitudinal axis of the inserter tool shaft.

3. The method of claim 2, wherein pivoting the gripping portion of the proximal pivot lever to pivot the bone plate to the second orientation relative to the inserter tool includes pivoting the bone plate so that the longitudinal axis of the bone plate extends substantially perpendicular to the longitudinal axis of the inserter tool shaft.

4. The method of claim 1, wherein pivoting the gripping portion of the proximal pivot lever to pivot the bone plate to the second orientation includes pivoting the bone plate from the first orientation wherein the bone plate is substantially parallel to the shaft of the inserter tool to the second orientation wherein the bone plate is transverse to the inserter tool shaft.

5. The method of claim 1, wherein the at least one bone includes a pair of vertebrae and the method further includes inserting an implant through the surgical channel and into an intervertebral space between the vertebrae.

6. The method of claim 1, wherein

pivoting the gripping portion of the proximal pivot lever to pivot the bone plate to the second orientation relative to the inserter tool includes pivoting the gripping portion of the proximal pivot lever outside of the surgical channel.

7. The method of claim 1, wherein shifting the grip control shaft in the first direction along the longitudinal axis includes turning a knob of the inserter tool.

8. The method of claim 1, wherein the at least one bone includes first and second bones and driving the shank of the at least one bone anchor includes driving a shank of a first bone anchor through a first opening of the bone plate and into the first bone and driving a shank of a second bone anchor through a second opening of the bone plate and into the second bone to secure the bone plate to the first and second bones.

9. The method of claim 1, further comprising locking the bone plate in the second orientation relative to the inserter tool.

10. The method of claim 1, further comprising retracting the tissue using a plurality of blades of a retractor to form the surgical channel.

11. The method of claim 10, further comprising pivoting distal ends of the blades apart to retract the tissue adjacent the at least one bone.

12. The method of claim 10, wherein advancing the bone plate through the surgical channel toward the at least one bone includes advancing the bone plate through the channel while the bone plate extends substantially parallel to the blades of the retractor.

13. The method of claim 10, wherein pivoting the gripping portion of the proximal pivot lever to pivot the bone plate to the second orientation relative to the inserter tool includes pivoting the bone plate to extend generally perpendicular to the blades of the retractor.

14. The method of claim 1, wherein securing the bone plate to the at least one bone includes:

advancing a pin through an opening of the bone plate and into engagement with a first bone; and

advancing a bone anchor through another opening of the bone plate and into engagement with a second bone.

15. The method of claim 1, further comprising moving a resilient support member along an elongated throughbore of the bone plate and securing the bone plate to the at least one bone includes advancing a shank of a bone anchor into a through opening of the support member and into the at least one bone.

16. The method of claim 1, wherein pivoting the gripping portion of the proximal pivot lever includes pivoting the gripping portion of the lever distally and pivoting a transmission portion of the proximal pivot lever on an opposite side of the pivot connection proximally about the pivot connection with the fixed distal handle to shift proximally the elongated pivot member of the inserter tool connecting the transmission portion and the pivot body.

17. The method of claim 16, wherein shifting proximally the elongated pivot member of the inserter tool causes pivoting of the pivot body of the inserter tool which supports the bone plate.

18. The method of claim 1, wherein pivoting the gripping portion of the proximal pivot lever distally toward the fixed distal handle of the inserter tool includes loading a spring disposed between the gripping portion of the proximal pivot lever and the fixed distal handle.

19. The method of claim 1, wherein securing the bone plate to the at least one bone further includes:

advancing a shank of a bone anchor assembly into an opening of a resilient support member that is disposed in an elongated throughbore of the bone plate and into the at least one bone;

seating a head portion of the bone anchor assembly in the opening of the resilient support member; and

driving a locking member of the seated head portion of the bone anchor between unlocked and locked positions to radially expand the resilient support member and engage portions of the resilient support member and the bone plate which fixes the resilient support member along the elongated throughbore relative to the bone plate.

20. The method of claim 19, wherein driving the locking member of the seated head portion of the bone anchor between unlocked and locked positions includes driving the locking member along the bone anchor and radially expanding a locking cap of the bone anchor assembly to radially expand the resilient support member.

21. The method of claim 19, wherein advancing the shank of the bone anchor assembly into the opening of the resilient support member includes connecting the bone anchor to a first tool and advancing the bone anchor using the first tool;

and

driving the locking member of the seated head portion includes driving the locking member using a second tool.