Midline occipital vertebral fixation system

• US 20040153070A1
• Filed: 11/10/2003
• Published: 08/05/2004
• Est. Priority Date: 02/03/2003
• Status: Active Grant

• Current Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Original Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Inventors: Heinz, Eric Steven, Barker, B. Thomas, Farey, Ian
• Granted Patent: US 7,575,588 B2
• Time in Patent Office: Days
• US Class Current: 606/61
• CPC Class Codes: A61B 17/7044 also having plates, staples or washers bearing on the vertebrae
• CPC Class Codes: A61B 17/7055 connected to sacrum, pelvis or skull

Abstract

An occipital plating system includes a plate extending along a longitudinal axis. The plate is engageable to the occiput, and includes at least one coupling member laterally offset relative to the longitudinal axis of the plate. The coupling member extends along a portion of the length of the plate. The at least one coupling member includes a passage to receive a connecting element. The coupling member is structured to at least medially and laterally constrain a portion of a length of the connecting element positioned in the passage.

Claims

1. An occipital plating system, comprising:

a plate extending along a longitudinal axis and including a profile adapted for positioning along the medial nuchal line of the occiput, said plate including a length along the longitudinal axis between a cephalad end and a caudal end; and

at least one coupling member extending from said plate and offset laterally of the longitudinal axis of said plate, said at least one coupling member forming a passage extending along a portion of said length of said plate, said at least one coupling member being structured to at least medially and laterally constrain a portion of a length of a connecting element positioned in said passage.

2. The plating system of claim 1, wherein said at least one coupling member includes a second coupling member opposite said at least one coupling member and offset laterally of the longitudinal axis of the plate, said second coupling member extending along a portion of the length of said plate.

3. The plating system of claim 1, wherein said plate includes:

a top surface and an opposite bottom surface positionable along the occiput;

opposite sidewalls extending between said top and bottom surfaces; and

said at least one coupling member extends laterally from an adjacent one of said opposite sidewalls.

4. The plating system of claim 3, wherein said at least one coupling member includes a bottom surface co-planar with said bottom surface of said plate and a height extending from said bottom surface to a top surface of said at least one coupling member, wherein said height of said at least one coupling member is greater than a height of said plate between said top surface and said bottom surface of said plate.

5. The plating system of claim 3, wherein said at least one coupling member includes a second coupling member opposite said at least one coupling member and offset laterally of the longitudinal axis of said plate, said second coupling member extending laterally from the other of said opposite sidewalls along a portion of the length of said plate.

6. The plating system of claim 3, wherein said bottom surface is concavely curved along the longitudinal axis.

7. The plating system of claim 1, wherein said caudal end includes a concavely curved end wall extending between a bottom surface and a top surface of said plate.

8. The plating system of claim 1, wherein said plate includes at least one bore extending between a top surface and a bottom surface thereof, and further comprising a bone engaging fastener positionable in said bore.

9. The plating system of claim 8, further comprising a retaining element engageable to said plate adjacent said at least one bore to retaining said bone engaging fastener in said bore.

10. The plating system of claim 1, wherein said at least one coupling member is elongated and extends generally parallel to the longitudinal axis.

11. The plating system of claim 1, wherein said at least one coupling member protrudes caudally from said caudal end of said plate.

12. The plating system of claim 1, wherein said at least one coupling member includes a length along the longitudinal axis that is at least 5 percent of said length of said plate.

13. The plating system of claim 12, wherein said length of said coupling member is between 5 and 50 percent of said length of said plate.

14. The plating system of claim 12, wherein said length of said coupling member is between 15 and 35 percent of said length of said plate.

15. The plating system of claim 12, wherein said length of said coupling member is about 25 percent of said length of said plate.

16. The plating system of claim 1, wherein said connecting element is axially adjustably positionable in said at least one coupling member.

17. The plating system of claim 1, wherein said at least one coupling member is integrally formed with said plate.

18. The plating system of claim 1, wherein said at least one coupling member includes lateral walls extending therealong and said passage is formed between said lateral walls.

19. The plating system of claim 18, wherein said passage opens at a cephalad end and at a caudal end of said at least one coupling member, said passage further opening along a top surface of said coupling member.

20. The plating system of claim 19, wherein said at least one coupling member includes a pair of receptacles spaced along said coupling member and opening at said top surface thereof in communication with said passage.

21. The plating system of claim 20, further comprising a fastener positionable in each of said pair of receptacles, said fasteners engageable to said connecting element in said passage to radially and axially constrain said connecting element in said passage.

22. The plating system of claim 21, wherein said fasteners are threadingly engageable in said receptacle.

23. The plating system of claim 19, further comprising a second coupling member extending along said plate and offset laterally of said longitudinal axis to a side opposite said at least one coupling member, wherein said second coupling member includes lateral walls extending therealong and a second passage formed between said lateral walls for receiving a cephalad end of a second connecting element, wherein said second passage opens at a cephalad end and at a caudal end of said second coupling member, said second passage further opening along a top surface of said second coupling member, wherein said second coupling member includes a pair of receptacles spaced therealong and opening at said top surface thereof in communication with said second passage.

24. The plating system of claim 1, wherein said at least one coupling member includes a wall extending about said passage, said wall radially constraining said connecting element in said passage.

25. The plating system of claim 24, wherein said passage opens at a caudal end and at a cephalad end of said coupling member.

26. The plating system of claim 24, wherein said passage opens at a caudal end of said coupling member and is closed at a cephalad end of said coupling member by a wall.

27. The plating system of claim 1, wherein said at least one coupling member is structured to radially constrain said connecting element while simultaneously permitting axial adjustment of the position of said connecting element in said at least one coupling member.

28. An occipital plating system, comprising:

a plate extending along a longitudinal axis and including a bottom surface profile adapted for positioning along the medial nuchal line of the occiput and an opposite top surface, said plate including a length along the longitudinal axis between a cephalad end and a caudal end;

at least one coupling member extending from said plate and offset laterally of the longitudinal axis of said plate, said at least one coupling member forming a passage extending along a portion of said length of said plate to receive a cephalad end of an elongated connecting element in said passage, said passage opening along a top surface of said connecting element, said coupling member further including at least one receptacle opening at said top surface of said coupling member in communication with said passage; and

a fastener engageable in said receptacle in contact with said cephalad end of said connecting element to secure said cephalad end of said connecting element between said fastener and said coupling member.

29. The plating system of claim 28, wherein said elongated connecting element is axially adjustable in said passage of said coupling member prior to securement with said fastener.

30. The plating system of claim 28, wherein said fastener and said coupling member radially constrain said elongated connecting element in said passage.

31. The plating system of claim 28, wherein said fastener is a set screw with a threaded distal portion, and said receptacle is internally threaded for engagement with said threaded distal portion.

32. The plating system of claim 31, wherein said set screw includes a proximal portion severable from said distal portion upon application of a predetermined threshold torque thereto.

33. The plating system of claim 28, further comprising:

an implant positionable between cervical vertebrae of the spinal column.

34. The plating system of claim 33, further comprising:

a plate engageable along an anterior side of cervical vertebrae of the spinal column.

35. The plating system of claim 28, further comprising a fixation system positionable along a posterior side of the spinal column from cervical vertebrae to the sacral region.

36. The plating system of claim 35, wherein said fixation system includes multi-axial screws.

37. The plating system of claim 35, wherein said fixation system includes a transverse connector adapted to extend across the spinal mid-line and interconnect a pair of elongated connecting elements extending along the posterior side of the spinal column.

38. The plating system of claim 35, wherein said fixation system includes an offset connector adapted to axially couple a caudal end of said elongated connecting element and a cephalad end of a caudally extending elongated connecting element.

39. The plating system of claim 35, wherein said fixation system includes a sacral plate.

40. The plating system of claim 35, wherein said fixation system include a pair of elongated caudal connecting elements positionable along respective sides of the spinous processes of the thoracic and lumbar vertebrae of the spinal column.

41. The plating system of claim 28, wherein said elongated connecting element includes a pair of elongated connecting elements positionable along respective sides of the spinous processes of the cervical vertebrae, said plate including a second coupling member opposite said at least one coupling member adapted to received a cephalad end of the other of said pair of elongated connecting elements.

42. The system of claim 28, wherein said at least one receptacle includes a pair of receptacles spaced longitudinally along said coupling member.

43. The system of claim 42, wherein said at least one coupling member includes a second coupling member extending from said plate opposite said at least one coupling member, said second coupling member forming a second passage extending along a portion of said length of said plate to receive a cephalad end of a second elongated connecting element in said second passage, said second passage opening along a top surface of said second coupling member, said second coupling member further including a pair of receptacles opening along said top surface thereof and in communication with said second passage for receiving fasteners spaced longitudinally along said second coupling member.

44. An occipital plating system, comprising:

a plate extending along a longitudinal axis and including a profile adapted for positioning along the medial nuchal line of the occiput, said plate including a length along the longitudinal axis between a cephalad end and a caudal end; and

at least one coupling member extending from said plate and offset laterally of the longitudinal axis of said plate, said at least one coupling member forming a passage extending along a portion of said length of said plate, wherein said coupling member is structured to radially constrain a cephalad end of said connecting element in said passage while simultaneously permitting axial adjustment of said connecting element in said passage.

45. The plating system of claim 44, wherein said passage opens at a caudal end of said coupling member and also opens at a cephalad end of said coupling member.

46. The plating system of claim 44, wherein said passage opens at a caudal end of said coupling member and is closed by a wall at a cephalad end of said coupling member.

47. The plating system of claim 44, wherein said coupling member includes threads adjacent a cephalad end of said passage, and a cephalad end of said connecting element is externally threaded and engageable to said internally threaded passage.

48. An occipital plating system, comprising:

a plate extending along a longitudinal axis, said plate including a length along the longitudinal axis between a cephalad end and a concavely curved caudal end, said plate being structured for positioning along the medial nuchal line of the occiput; and

first and second coupling members extending along respective ones of opposite sides of said plate, said coupling members each including a passage to receive a cephalad end portion of an elongated connecting element therein, wherein said plate includes a rectangular shape extending cephaladly from said first and second coupling members.

49. The system of claim 48, wherein said coupling members each extend between a cephalad end and a caudal end, said caudal ends of said coupling members projecting caudally from said caudal end of said plate.

50. The system of claim 48, wherein each of said coupling members includes a bottom wall and a pair of lateral walls extending along said passage thereof, said coupling members further each including a top surface and a receptacle therethrough in communication with said passage.

51. The system of claim 50, further comprising a fastener engageable in said receptacle to secure said connecting element in said passage.

52. The system of claim 51, wherein for each of said coupling members said at least one receptacle includes a pair of receptacles spaced longitudinally along said coupling member.

53. A method for stabilizing the spine comprising:

engaging a plate along a medial-nuchal line of the occiput;

positioning an elongated connecting element along a first side of spinous processes of the cervical region of the spine;

positioning a cephalad end of the connecting element in a passage of the plate, the passage being offset from the medial nuchal line to the first side of the spinous processes;

medially and laterally constraining the connecting element in the passage while simultaneously permitting axial adjustment of the position of the connecting element in the passage; and

axially securing the connecting element in the passage.

54. The method of claim 53, further comprising securing the connecting element posteriorly to at least one vertebra of the spinal column.

55. The method of claim 54, further comprising securing a spinal fixation system along the posterior side of the spinal column between the sacral region and the occiput.

56. The method of claim 55, wherein the fixation system includes at least one transverse connector.

57. The method of claim 56, wherein the fixation system includes at least one offset connector.

58. The method of claim 53, further comprising positioning an implant in a space between vertebrae of the cervical region.

59. The method of claim 53, further comprising bending the connecting element to conform the connecting element to the spinal anatomy.

60. The method of claim 53, further comprising:

positioning a second elongated connecting element along a second side of the spinous processes;

positioning a cephalad end of the second connecting element in a second passage of the plate, the second passage being offset from the medial nuchal line to the second side of the spine;

medially and laterally constraining the second connecting element in the second passage while simultaneously permitting axial adjustment of the position of the second connecting element in the second passage; and

axially securing the second connecting element in the second passage.

61. The method of claim 53, wherein medially and laterally constraining includes radially constraining the connecting element in the passage.

62. The method of claim 53, further comprising contouring the plate to lie along the occiput.