Methods and devices for spinal fixation element placement

• US 20050131422A1
• Filed: 12/16/2003
• Published: 06/16/2005
• Est. Priority Date: 12/16/2003
• Status: Active Grant

• Current Assignee: Depuy Synthes Products Incorporated (Johnson & Johnson)
• Original Assignee: Depuy Spine Incorporated (Johnson & Johnson)
• Inventors: Anderson, David Greg, Ross, George Joseph
• Granted Patent: US 7,666,188 B2
• Time in Patent Office: Days
• US Class Current: 606/104
• CPC Class Codes: A61B 17/7002 Longitudinal elements, e.g. rods
• CPC Class Codes: A61B 17/7079 Tools requiring anchors to be already mounted on an implanted longitudinal or transverse element, e.g. where said element guides the anchor motion
• CPC Class Codes: A61B 17/7082 for driving, i.e. rotating, screws or screw parts specially adapted for spinal fixation, e.g. for driving polyaxial or tulip-headed screws driving other bone screws A61B17/8875
• CPC Class Codes: A61B 17/7085 for insertion of a longitudinal element down one or more hollow screw or hook extensions, i.e. at least a part of the element within an extension has a component of movement parallel to the extension's axis
• CPC Class Codes: A61B 17/7091 for applying, tightening or removing longitudinal element-to-bone anchor locking elements, e.g. caps, set screws, nuts or wedges

Abstract

Minimally invasive methods and devices are provided for positioning a spinal fixation element in relation to adjacent spinal anchors. In an exemplary embodiment, the device is a percutaneous access device that can be coupled to a spinal anchor, and the method includes the step of positioning a spinal fixation element through at least one sidewall opening of at least two percutaneous access devices such that the spinal fixation element extends in a lengthwise orientation that is substantially transverse to the longitudinal axis of each percutaneous access device. The spinal fixation element can then be advanced in the lengthwise orientation to seat the spinal fixation element in or adjacent to the receiver heads of at least two adjacent spinal anchors. A fastening element or other closure mechanism can then be applied to each spinal anchor to engage the spinal fixation element within the receiver heads of the adjacent anchors.

Claims

1. A method for introducing a spinal fixation element into a patient'"'"'s spinal column, comprising:

providing at least two percutaneous access devices, each device having

a proximal end positioned outside a patient'"'"'s body,

a distal end coupled to a spinal anchor,

a lumen extending between the proximal and distal ends of the percutaneous access device and defining a longitudinal axis, and

at least one sidewall opening extending from the distal end through at least a portion of the percutaneous access device;

positioning a spinal fixation element through the at least one sidewall opening of at least two percutaneous access devices such that the spinal fixation element extends in an orientation substantially transverse to the longitudinal axis of each percutaneous access device; and

advancing the spinal fixation element in the substantially transverse orientation to seat the spinal fixation element in a receiver head of at least two adjacent spinal anchors.

2. The method of claim 1, wherein each percutaneous access device includes first and second opposed sidewall openings.

3. The method of claim 1, wherein the at least one sidewall opening extends from the distal end and terminates at a position distal to the proximal end.

4. The method of claim 1, wherein each percutaneous access device includes a sleeve disposed therearound and effective to prevent removal of each percutaneous device from the spinal anchor coupled thereto, the sleeve including at least one sidewall opening formed therein that is adapted to align with the at least one sidewall opening in the percutaneous access device.

5. The method of claim 1, wherein each percutaneous access device is threadably coupled to the receiver head of each spinal anchor.

6. The method of claim 1, wherein each percutaneous access device and spinal anchor are mating together by a twist-lock closure mechanism.

7. The method of claim 1, wherein each percutaneous access device is coupled to the receiver head of a spinal anchor, and the at least one opening in the percutaneous access device is adapted to align with a seating portion formed in each receiver head.

8. The method of claim 1, further comprising providing a pusher mechanism adapted to advance the spinal fixation element into the receiver head of adjacent spinal anchors.

9. The method of claim 1, further comprising providing a compression tool, and engaging at least two adjacent percutaneous access devices to compress the devices toward one another while maintaining relative spacing therebetween.

10. The method of claim 9, wherein the compression tool comprises first and second opposed arms that are pivotally mated to one another.

11. The method of claim 1, further comprising delivering a closure mechanism through each percutaneous access device and applying the closure mechanism to each spinal anchor to lock the spinal fixation element in the receiver heads of the anchors.

12. A method for introducing a spinal fixation element into a receiver head of adjacent spinal anchors, comprising:

positioning a spinal fixation element through openings formed in at least two adjacent percutaneous access devices such that the spinal fixation element extends between the at least two adjacent percutaneous access devices in a lengthwise orientation;

advancing the spinal fixation element in a distal direction to seat the spinal fixation element in the receiver heads of the adjacent spinal anchors.

13. The method of claim 12, wherein the spinal fixation element is advanced between muscles.

14. The method of claim 12, wherein the each spinal anchor is coupled to a percutaneous access device.

15. The method of claim 12, wherein each percutaneous access device includes opposed openings formed therethrough and extending along a length thereof.

16. The method of claim 15, wherein the openings comprise slots that extend from a distal end and terminate at a position distal to the proximal end of each percutaneous access device.

17. The method of claim 12, further comprising providing a pusher mechanism adapted to advance the spinal fixation element into the receiver head of adjacent spinal anchors.

18. The method of claim 12, further comprising providing a compression tool, and engaging at least two adjacent percutaneous access devices to compress the devices toward one another.

19. The method of claim 18, wherein the compression tool comprises first and second opposed arms that are pivotally mated to one another.

20. The method of claim 12, further comprising providing and applying a closure mechanism to each spinal anchor to lock the spinal fixation element in the receiver heads of the anchors.

21. A percutaneous access system for introducing a spinal fixation element into a patient'"'"'s body, comprising:

a plurality of spinal anchors that are adapted to be implanted in bone;

a plurality of elongate, generally cylindrical hollow tubes, each tube having a proximal end, a distal end that is adapted to mate to a spinal anchor, and at least one sidewall opening extending from the distal end of the hollow tube and terminating at a position distal to the proximal end; and

a spinal fixation element that is adapted to be positioned in relation to at least two spinal anchors disposed within adjacent vertebra.

22. The percutaneous access device of claim 21, further comprising a driver mechanism adapted to be removably disposed through the hollow tube and including a proximal handle portion, and a distal end adapted to couple to a spinal anchor such that rotation of the driver mechanism is effective to thread the spinal anchor into bone.

23. The percutaneous access device of claim 21, wherein the at least one sidewall opening is sized to accommodate the spinal fixation element.

24. The percutaneous access device of claim 21, wherein the percutaneous access device is adapted to threadably couple to a receiver head of a spinal anchor.

25. The percutaneous access device of claim 21, further comprising a sleeve adapted to be slidably disposed around at least a portion of the hollow tube and including at least one sidewall opening formed therein and adapted to align with the at least one sidewall opening formed in the hollow tube.