Instruments and methods for stabilization of bony structures

• US 20060229614A1
• Filed: 01/24/2006
• Published: 10/12/2006
• Est. Priority Date: 10/20/1999
• Status: Active Grant

• Current Assignee: Jeff R. Justis, Kevin T. Foley, Michael C. Sherman
• Original Assignee: Jeff R. Justis, Kevin T. Foley, Michael C. Sherman
• Inventors: Foley, Kevin T., Sherman, Michael C., Justis, Jeff R.
• Granted Patent: US 8,721,685 B2
• Time in Patent Office: Days
• US Class Current: 606/86.A
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/7038 to a different extent in different directions, e.g. within one plane only
• CPC Class Codes: A61B 17/7086 Rod reducers, i.e. devices providing a mechanical advantage to allow a user to force a rod into or onto an anchor head other than by means of a rod-to-bone anchor locking element; rod removers
• CPC Class Codes: A61B 17/7089 wherein insertion is along an arcuate path
• CPC Class Codes: A61B 17/88 Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices A61B17/7074 takes precedence
• CPC Class Codes: A61B 17/8872 Instruments for putting said fixation devices against or away from the bone A61B17/7074, A61B17/808 take precedence
• CPC Class Codes: A61B 17/8897 Guide wires or guide pins
• CPC Class Codes: A61B 17/90 Guides therefor
• CPC Class Codes: A61B 2017/681 Alignment, compression, or distraction mechanisms

Abstract

The present invention relates to a brace installation instrument placement that is mounted to anchors secured in an animal subject. The installation instrument includes anchor extensions coupled to the anchors. The instrument is movable with respect to the anchors to position a brace in a position more proximate the anchors. The brace can be indexed for insertion at a predetermined orientation with respect to the installation instrument. Methods and techniques for using the installation instrument are also provided.

Claims

1-39. -39. (canceled)

40. A device for use in a surgical procedure on an animal subject, comprising:

an installation instrument coupled to a brace, said brace having an indexed portion coupling said brace in a predetermined orientation with respect to said installation instrument.

41. The device of claim 40, wherein said brace is connectable to at least one anchor securable to the animal subject.

42. The device of claim 40, wherein said brace is immovable with respect to said installation instrument when coupled to said installation instrument.

43. The device of claim 40, wherein said installation instrument includes a brace inserter having a distal end, said brace indexed portion being coupled at said distal end of said brace inserter.

50. The device of claim 40, wherein said indexed portion is at a first end of said brace, said brace including an opposite second end adapted for percutaneous insertion.

51. The device of claim 40, wherein said installation instrument is movable along a predetermined path and said brace is indexed for orientation along said path.

52. The device of claim 51, wherein said path is an arc having a radius determined by a pivot axis of said installation instrument.

44-49. -49. (canceled)

53-57. -57. (canceled)

58. A device for use in a surgical procedure on an animal subject, comprising:

at least one anchor securable to the animal subject, said anchor including a set screw having a break-off portion; and

an instrument mounted on said anchor movable to position a brace relative to said anchor, said instrument being released from said anchor when said break-off portion is severed from said set screw.

59. The device of claim 58, wherein said instrument includes a tool bore providing access to said set screw break-off portion.

60. The device of claim 58, wherein said at least one anchor includes a bone screw engageable to the animal subject pivotably mounted in a connector, said set screw being threadingly received in said connector.

61. The device of claim 60, wherein said anchor includes a passageway through said connector between said bone screw and said set screw, said instrument movable to position said brace in said passageway.

62. The device of claim 61, wherein said set screw is threaded into said connector passageway to secure said brace to said anchor before said break-off portion is severed.

63. The device of claim 61, wherein said instrument is rotated about a pivot axis to position said brace in said passageway.

64. The device of claim 58, further comprising:

a second anchor securable to the animal subject, said second anchor including a second set screw having a break-off portion; and

said instrument also mounted on said second anchor and moveable to position said brace relative to said anchor and said second anchor, said instrument being released from said second anchor when said break-off portion is severed from said second set screw.

65. The device of claim 64, wherein said anchor and said second anchor each include a bone screw engageable to the animal subject pivotably mounted in a connector, said set screw of said anchor being threadingly received in said connector.

66. The device of claim 65, wherein said anchor and said second anchor each include a passageway through said connector between said bone screw and said set screw, said instrument movable to position said brace in said passageways of said connectors.

67. The device of claim 66, wherein said instrument is rotated about a pivot axis to position said brace in said passageways of said anchor and said second anchor.

68. The device of claim 67, wherein said set screws are threaded into said passageways of said connectors to secure said brace to said anchors before said break-off portions are severed.

69-98. -98. (canceled)

99. A minimally invasive surgical system, comprising:

a connecting element having a predetermined geometry comprising at least a first connector point and a second connector point; and

an instrument having a coupling mechanism for holding the connecting element in a predetermined relationship with the instrument, and wherein the instrument is operable to guide the connecting element along a predetermined path, the predetermined path comprising at least a first path point, a second path point and a third path point, the first path point and the second path point respectively positioned in a predetermined orientation within a body of a patient, the third path point positioned external to the body, wherein the predetermined path comprises a percutaneous insertion path.

100. A minimally invasive surgical device, comprising:

at least a pair of anchors positionable within a body of a patient;

a connecting element positionable within the body; and

an instrument associated with the connecting element, the instrument being operable to percutaneously place the connecting element relative to the pair of anchors.

101. The system of claim 100, wherein the instrument is operable place the connecting element in a predetermined location relative to the pair of anchors.

102. The system of claim 100, wherein the pair of anchors each include a screw portion sized to engage a pedicle of a vertebral body.

103. A minimally invasive surgical system, comprising:

a connecting element having a longitudinal axis; and

an inserter releasably coupled to the connecting element along the longitudinal axis thereof, said inserter being adapted to percutaneously place the connecting element.

104. The minimally invasive surgical system of claim 103, wherein the connecting element extends longitudinally from an end of the inserter.

105. The minimally invasive surgical system of claim 103, wherein the connecting element has a predetermined geometry and is movable with the inserter between a first position corresponding to a percutaneous insertion position of the connecting element with respect to a patient'"'"'s body, and a second subcutaneous position within the body, the second position having a predetermined relationship relative to at least a pair of reference points positioned within the body.

106. The minimally invasive surgical system of claim 103, wherein the inserter has a known relationship with respect to the pair of reference points, the inserter being releasably coupled to the connecting element and operable to guide the connecting element along a predetermined path between the first percutaneous position and the second subcutaneous position.

107. The minimally invasive surgical system of claim 103, wherein the connecting element has a leading end adapted for percutaneous insertion.

108. The minimally invasive surgical system of claim 103, wherein the connecting element is flexible.

109. The minimally invasive surgical system of claim 103, further comprising a pair of anchors each including a screw portion sized to engage a pedicle of a vertebral body, said inserter being mountable to said pair of anchors.

110. A device for use in a surgical procedure on an animal subject, comprising:

at least one anchor securable to the animal subject, said anchor including a bone engaging portion and a receiver extending proximally from said bone engaging portion, said anchor further comprising a set screw engaged with said receiver; and

an instrument mounted on said anchor and extending proximally therefrom, said instrument being movable to position said receiver in a desired position to receive a brace relative to said anchor with said instrument releasably engaged to said set screw.

111. The device of claim 110, wherein said set screw includes a distal portion engageable with said receiver of said at least one anchor and a proximal break-off portion, said extension being released from said anchor when said break-off portion is severed from said distal portion.

112. The device of claim 110, wherein said instrument includes a longitudinal bore and said set screw is accessible in said bore.

113. The device of claim 110, wherein said receiver is pivotal and rotatable relative to said bone engaging portion.

114. The device of claim 110, wherein said anchor includes a passageway through said receiver located between said anchor portion and said set screw, said instrument further being movable relative to said anchor to position said brace in said passageway.

115. The device of claim 110, further comprising:

a second anchor securable to the animal subject, said second anchor including a second bone engaging portion and a second receiver extending proximally from said second bone engaging portion, said second anchor further comprising a second set screw engaged with said second receiver; and

a second instrument mounted on said second anchor and extending proximally therefrom, said second instrument being movable to position said second receiver in a desired position to receive said brace relative to said second anchor with said second instrument releasably engaged to said second set screw.

116. The device of claim 115, further comprising an installation instrument pivotally mounted to proximal ends of said instruments.

117. A device for use in a surgical procedure on an animal subject, comprising:

at least one anchor;

a receiver member including a passageway therethrough, said receiver member attached to said at least one anchor; and

a releasable coupled attachment to said receiver member for controlling a position of said receiver member for connection of a brace.