STABILIZATION SYSTEM AND METHOD

• US 20090005814A1
• Filed: 06/28/2007
• Published: 01/01/2009
• Est. Priority Date: 06/28/2007
• Status: Active Grant

• Current Assignee: Zimmer Biomet Spine, Inc. (Zimvie Incorporated)
• Original Assignee: Zimmer Spine, Inc. (Zimmer Biomet Holdings, Inc.)
• Inventors: BERGERON, BRIAN J., MILLER, PETER THOMAS
• Granted Patent: US 8,043,343 B2
• Time in Patent Office: Days
• US Class Current: 606/246
• CPC Class Codes: A61B 17/1604 Chisels; Rongeurs; Punches; Stamps
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/3423 Access ports, e.g. toroid shape introducers for instruments or hands access sites for liquids A61M39/0247
• CPC Class Codes: A61B 17/3472 for bones, e.g. intraosseus injections
• CPC Class Codes: A61B 17/7011 Longitudinal element being non-straight, e.g. curved, angled or branched adjustable length longitudinal elements A61B17/7014; A61B17/7019 takes precedence, e.g. coil springs
• CPC Class Codes: A61B 17/7032 Screws or hooks with U-shaped head or back through which longitudinal rods pass
• CPC Class Codes: A61B 17/7037 wherein pivoting is blocked when the rod is clamped
• CPC Class Codes: A61B 17/7038 to a different extent in different directions, e.g. within one plane only
• 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
• CPC Class Codes: A61B 17/848 Kirschner wires, i.e. thin, long nails
• CPC Class Codes: A61B 2090/061 for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/062 penetration depth
• CPC Class Codes: Y10S 606/914 Toolkit for installing or removing spinal positioner or stabilizer

Abstract

The disclosure relates generally to embodiments of systems and methods of spinal stabilization. Embodiments include methods that use a dilator to displace tissue proximate to a sleeve. An embodiment of a surgical system can comprise a dilator that may define a working channel from a first opening to a second opening. The dilator can be positioned to displace tissue proximate to the sleeve. The dilator may be shaped to allow a first end of an elongated member to enter the working channel through the first opening and exit the dilator through the second opening to be percutaneously moved to another assembly.

Claims

1. A spinal stabilization surgical method comprising:

forming a first assembly, the first assembly comprising;

a first bone fastener;

a first collar; and

a first sleeve;

wherein the first bone fastener is fastened to a first vertebra;

forming a second assembly, the second assembly comprising;

a second bone fastener;

a second collar; and

a second sleeve;

positioning a dilator in an incision through which the first assembly enters a patient to displace tissue proximate to the first sleeve, wherein the dilator comprises;

a first opening;

a second opening; and

a working channel running from the first opening to the second opening;

moving at least a first portion of an elongated member into the working channel;

moving the first portion of the elongated member to the second assembly;

seating the first portion of the elongated member in the second collar; and

seating a second portion of the elongated member in the first collar.

2. The method of claim 1, wherein the elongated member enters the working channel through the first opening and exterior to the first sleeve.

3. The method of claim 1, wherein the positioning the dilator further comprises positioning the dilator so that at least a majority of the tissue displaced is on the opposite side of the first sleeve from the second sleeve.

4. The method of claim 1, further comprising moving the first portion of the elongated member into the dilator through the first opening, through the first assembly and out the dilator through the second opening prior to moving the first portion of the elongated member to the second assembly.

5. The method of claim 4, wherein the first portion of the elongated member passes through the first assembly prior to exiting the dilator.

6. The method of claim 4, wherein the first portion of the elongated member exits the dilator prior to passing through the first assembly.

7. The method of claim 1, further comprising guiding the dilator through a third assembly coupled to a third vertebra between the first and second vertebrae.

8. The method of claim 1, wherein guiding the first portion of the elongated member to the second assembly further comprises percutaneously moving the first portion of the elongated member to the second assembly.

9. The method of claim 1, further comprising moving the first portion of the elongated member through a portion of the first sleeve prior to the first portion of the elongated member entering the dilator.

10. The method of claim 1, wherein positioning the dilator further comprises positioning the dilator such that at least a portion of the first sleeve passes through the dilator.

11. The method of claim 1, wherein the dilator further comprises:

a first wall approximately parallel to the sleeve;

a second wall at an angle of approximately 30-45 degrees from the first wall, wherein the first wall and the second wall at least partially define the working channel.

12. The method of claim 11, wherein the dilator further comprises a sleeve receiving section shaped to receive the sleeve and form a frictional fit with the sleeve.

13. The method of claim 12, wherein the sleeve receiving section has an approximately constant cross section.

14. The method of claim 1, wherein the second opening comprises a section approximately parallel to the first opening.

15. The method of claim 11, wherein the dilator is positioned such that the first opening is exterior to the patient and the second opening is proximate to the first collar.

16. The method of claim 11, wherein the second opening comprises a section approximately perpendicular to the first opening.

17. The method of claim 16, wherein positioning further comprises positioning the dilator so that the section of the second opening at least partially overlaps an opening in the first assembly.

18. The method of claim 17, wherein the second opening comprises a second section perpendicular to the first opening and wherein the elongated member overhangs the first collar through the second section when the second portion of the elongated member is seated in the first collar.

19. The method of claim 11, wherein the first opening has a smaller radius of curvature proximate to the first wall than the second wall.

20. A tissue dilator comprising;

a first wall configured to be approximately parallel to a sleeve of a spinal stabilization system during use;

a second wall disposed at an angle to the first wall;

wherein the tissue dilator defines a working channel from a first opening to a second opening; and

wherein the tissue dilator is shaped so that when the dilator is in position proximate to a first sleeve-collar assembly, a portion of an elongated member can enter the working channel through the first opening and exit the dilator through the second opening to be percutaneously moved to a second sleeve-collar assembly.

21. The tissue dilator of claim 20, wherein the first wall is a concave wall shaped to contact the sleeve.

22. The tissue dilator of claim 20, wherein the dilator further comprises a sleeve receiving section shaped to receive the sleeve and form a frictional fit with the sleeve.

23. The tissue dilator of claim 22, wherein the sleeve receiving section has an approximately constant cross section.

24. The tissue dilator of claim 20, wherein the angle is between the first wall and second wall is approximately 30-45 degrees.

25. The tissue dilator of claim 24, wherein the second opening comprises a section approximately parallel to the first opening.

26. The tissue dilator of claim 25, wherein the dilator is shaped such that the first opening is exterior to a patient during use and the second opening is proximate to the first collar.

27. The tissue dilator of claim 25, wherein the second opening comprises a second section approximately perpendicular to the first opening.

28. The tissue dilator of claim 27, wherein the second section of the second opening is positioned to at least partially overlap with an opening in the first sleeve-collar so that the elongated member can enter the first sleeve-collar assembly from the working channel through the second opening.

29. The tissue dilator of claim 28, wherein the second opening comprises a third section perpendicular to the first opening to allow the elongated member to overhang a collar of the first sleeve-collar assembly.

30. The tissue dilator of claim 20, wherein the second opening is positioned to at least partially overlap with an opening in the first sleeve-collar assembly so that the elongated member can enter the first sleeve-collar assembly from the working channel.

31. The tissue dilator of claim 20, wherein the first opening has a smaller radius of curvature proximate to the first wall than the second wall.

32. A spinal stabilization system comprising:

a first assembly comprising;

a bone fastener coupled to a vertebra;

a collar coupled to the bone fastener, said collar comprising a slot for seating an elongated member; and

a sleeve coupled to the collar; and

a dilator defining a working channel from a first opening to a second opening, the dilator positioned to displace tissue proximate to the sleeve, wherein the dilator is shaped to allow a first end of the elongated member to enter the working channel through the first opening and exit the dilator through the second opening to be percutaneously moved to another assembly.

33. The spinal stabilization system of claim 32, wherein the dilator further comprises a sleeve receiving section shaped to receive the sleeve and form a frictional fit with the sleeve.

34. The spinal stabilization system of claim 33, wherein the sleeve receiving section has an approximately constant cross section.

35. The spinal stabilization system of claim 32, wherein the dilator comprises a wall at an angle to the sleeve, wherein the angle is between approximately 30-45 degrees.

36. The spinal stabilization system of claim 35, wherein the second opening comprises a section approximately parallel to the first opening.

37. The spinal stabilization system of claim 36, wherein the dilator is shaped such that the first opening is exterior to a patient during use and the second opening is proximate to the collar.

38. The spinal stabilization system of claim 36, wherein the second opening comprises a second section approximately perpendicular to the first opening.

39. The spinal stabilization system of claim 38, wherein the second section of the second opening is positioned to at least partially overlap with an opening in a first assembly to allow the elongated member can enter the first assembly from the working channel.

40. The spinal stabilization system of claim 39, wherein the second opening comprises a third section perpendicular to the first opening to allow the elongated member to overhang the collar.

41. The spinal stabilization system of claim 32, wherein the second opening is positioned to at least partially overlap with an opening in the first assembly so that the elongated member can enter the first assembly from the working channel.

42. The spinal stabilization system of claim 32, wherein the first opening has a smaller radius of curvature proximate to the first wall than the second wall.