Systems and methods for spinal fixation

• US 20090171391A1
• Filed: 10/23/2008
• Published: 07/02/2009
• Est. Priority Date: 10/23/2007
• Status: Active Grant

• Current Assignee: Alphatec Spine Incorporated (Alphatec Holdings Incorporated)
• Original Assignee: Alphatec Spine Incorporated (Alphatec Holdings Incorporated)
• Inventors: Hutton, Clark, Smith, Ketchen
• Granted Patent: US 8,469,960 B2
• Time in Patent Office: Days
• US Class Current: 606/246
• CPC Class Codes: A61B 17/7032 Screws or hooks with U-shaped head or back through which longitudinal rods pass
• CPC Class Codes: A61B 17/7076 for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation
• CPC Class Codes: A61B 17/708 with tubular extensions coaxially mounted on the bone anchors
• 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 17/7086 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 17/7091 for applying, tightening or removing longitudinal element-to-bone anchor locking elements, e.g. caps, set screws, nuts or wedges
• CPC Class Codes: A61B 17/88 Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices A61B17/7074 takes precedence
• CPC Class Codes: A61B 17/8861 Apparatus for manipulating flexible wires or straps devices for inserting Kirschner wires A61B17/1697
• CPC Class Codes: A61B 17/8875 Screwdrivers, spanners or wrenches

Abstract

A spinal stabilization system, method, and a surgical kit having a surgical extender apparatus for implanting a surgical screw are disclosed. The extender includes a housing having a distal end and a proximal end, a hollow interior passageway disposed between the distal end and the proximal end, a channel disposed along an exterior surface of the housing at least partially between the distal end and the proximal end and configured to at least partially expose the hollow interior passageway, an interior locking mechanism disposed on an interior surface of the housing and substantially adjacent the proximal end, wherein the interior locking mechanism is configured to allow attachment of at least one surgical tool, and at least one flexible member disposed substantially adjacent the distal end. The housing is configured to accommodate placement of a surgical screw implant. The surgical screw implant is secured to the housing a mating feature in the surgical screw implant. The at least one flexible member is configured to retain the surgical screw implant. The mating feature is configured to control axial movement of the surgical screw implant.

Claims

1. A spinal stabilization system for stabilizing a spine using at least one a surgical screw implant configured to be implanted into the spine, comprising:

a housing configured to accommodate placement of the surgical screw implant;

the surgical screw implant is secured to the housing a first mating feature in the surgical screw implant;

a locking feature contained within the housing and configured to retain the surgical screw implant for implantation;

wherein the a first mating feature is configured to control axial movement of the surgical screw implant.

2. The system according to claim 1, further comprising a remover tool having

a shaft configured to be inserted into the housing

having a tab disposed on a distal end of the shaft and configured to release the housing from the surgical screw implant.

3. The system according to claim 1, further comprising

a wire delivery device configured to be inserted into the housing, wherein the wire delivery device includes:

a substantially cylindrical shaft having an opening at a distal tip of the cylindrical shaft;

a locking mechanism configured to lock the surgical extender apparatus;

a pathway disposed within the cylindrical shaft and configured to guide a wire through the pathway to a distal tip of the housing.

4. The system according to claim 3, further comprising a wire advancement mechanism configured to advance wire along the pathway, upon connection of the wire advancement mechanism to the cylindrical shaft.

5. The system according to claim 3, further comprising a wire capturing device configured to capture the wire and pull the wire from the opening in the cylindrical shaft,

the wire capturing device further comprises:

a tube;

an inner shaft configured to be advanced down the tube and tightened on the wire; and

a wire capturing device locking feature configured to advance the inner shaft along the tube toward the surgical screw implant.

6. The system according to claim 3, further comprising an anti-splay device configured to prevent the housing from splaying, bending and flexing during distraction, compression, torsion, and axial loading.

7. The system according to claim 3, wherein the wire includes a distal tip configured to assist in advancement of the wire and a proximal tip configure to allow attachment of a rod, wherein the rod includes an attachment feature configured to accommodate securing of the wire to the rod.

8. The system according to claim 1, further comprising a distractor/compressor device configured to distract/compress at least two surgical screw implants, wherein the distractor/compressor device includes at least two compression arms configured to change orientation/distance between housings coupled the at least two surgical screw implants using a fulcrum mechanism coupled to the distractor/compressor device.

50. The system according to claim 3, wherein the cylindrical shaft includes a first portion coupled to a second portion and wherein the pathway is disposed between the first portion and the second portion.

9. A method of stabilizing spine of a patient including implanting a surgical screw implant having a housing configured to accommodate placement of a surgical screw implant, the surgical screw implant is secured to the housing a first mating feature in the surgical screw implant, a locking feature contained within the housing and configured to retain the surgical screw implant for implantation, wherein the first mating feature is configured to control axial movement of the surgical screw implant, comprising the steps of:

implanting the surgical screw implant coupled to the housing into a bone;

manipulating the surgical screw implant and the housing to orient the housing in a predetermined manner;

advancing a wire through the housing; and

using the wire, connecting the surgical screw implant with another surgical screw implant.

10. The method according to claim 9, further comprising implanting another surgical screw implant coupled to another housing at another location that is other than the location of implantation of the surgical screw implant and the housing.

11. The method according to claim 10, further comprising

advancing the wire from the housing through the surgical screw implant and toward another screw and through another housing.

12. The method according to claim 11, further comprising removing the housing from the surgical screw implant using a remover tool having

a shaft configured to be inserted into the housing and a tab disposed on a distal end of the shaft and configured to release the housing from the surgical screw implant.

13. The method according to claim 11, wherein the wire is configured to be advanced using a wire delivery device configured to be inserted into the housing, wherein the wire delivery device includes:

a substantially cylindrical shaft having an opening at a distal tip of the cylindrical shaft;

a locking mechanism configured to lock the surgical extender apparatus;

a pathway disposed within the cylindrical shaft and configured to guide a wire through the pathway to a distal tip of the housing.

14. The method according to claim 13, wherein the wire is advanced through the wire delivery device using a wire advancement mechanism configured to advance the wire along the pathway, upon connection of the wire advancement mechanism to the cylindrical shaft.

15. The method according to claim 13, further comprising capturing the wire using a wire delivery system that further includes a wire capturing device configured to capture the wire and pull the wire from the opening in the cylindrical shaft,

the wire capturing device further comprises:

a tube;

an inner shaft configured to be advanced down the tube and tightened on the wire; and

a wire capturing locking feature configured to advance the inner shaft along the tube toward the surgical screw implant.

16. The method according to claim 13, further comprising using an anti-splay device prevent the housing from splaying, bending and flexing during distraction, compression, torsion, and axial loading.

17. The method according to claim 13, wherein the wire includes a distal tip configured to assist in advancement of the wire and a proximal tip configure to allow attachment of a rod, wherein the rod includes an attachment feature configured to accommodate securing of the wire to the rod.

18. The system according to claim 11, further comprising adjusting the distance between distal ends of the housing and another housing a distractor/compressor device configured to distract/compress at least two surgical screw implants, wherein the distractor/compressor device includes at least two compression arms configured to change orientation/distance between housings coupled the at least two surgical screw implants using a fulcrum mechanism coupled to the distractor/compressor device.

19. A surgical stabilization system using at least one screw implanted into a bone of a patient, wherein the screw includes a head, wherein the head is configured to include a second mating feature that can be configured to include a plurality of openings and a plurality of recessed edges, the system comprising:

a hollow housing having

a wall surrounding an interior of the hollow housing,

an open proximal end; and

an open distal end,

wherein the wall is disposed between the proximal end and the distal end;

wherein the distal end is secured to the surgical screw and the surgical screw is delivered via the proximal end;

the housing includes a flexible portion having a first mating feature disposed along the wall of the housing and adjacent the distal end;

the flexible indenting portion is configured to retain the surgical screw within the housing.

20. The system according to claim 19, wherein the flexible portion having the first mating feature can be configured to include a protrusion further configured to protrude into the interior of the housing;

the first mating feature is configured to mate with the second mating feature, whereby the protrusion of the flexible portion having the first mating feature is configured to contact at least one of the plurality of the openings and secure the screw to the housing at the distal end.

21. The system according to claim 20, wherein the housing further includes at least one of first mating feature disposed adjacent the distal end and configured to mate with the recessed edges of the screw.

22. The system according to claim 21, wherein the housing is configured to control axial movement of the screw.

23. The system according to claim 22, further comprising a remover device having:

a handle;

a shaft having a distal end and a proximal end, the shaft being coupled to the handle at the proximal end of the shaft;

a tip coupled to the shaft at the distal end of the shaft and having a ramp disposed on an exterior surface of the tip;

wherein the remover device is configured to remove the housing from the screw.

24. The system according to claim 23, wherein the remover device is configured to be inserted into the interior space of the housing for removal of the housing from the screw;

upon insertion of the remover device, the remover device is configured to be rotated using the handle;

upon rotation of the remover device, the ramp is configured to contact and force the flexible portion having the first mating feature away from the interior of the housing.

25. The system according to claim 24, wherein the ramp is further configured to remove the first mating feature of the flexible portion from at least one opening of the housing.

26. The system according to claim 25, wherein upon removal of the first mating feature of the flexible portion from at least one opening of the housing, the housing is removed from the screw.

27. The system according to claim 26, wherein the remover device includes a stopper device configured to prevent further insertion of the remover device inside the housing;

wherein the housing is configured to include a stopping mechanism configured to limit rotation of the remover device.

28. The system according to claim 19, wherein the screw is a bone screw.

29. A surgical extender apparatus for implanting a surgical screw, comprising:

a housing having a distal end and a proximal end;

a hollow interior passageway disposed between the distal end and the proximal end;

a channel disposed along an exterior surface of the housing at least partially between the distal end and the proximal end and configured to at least partially expose the hollow interior passageway;

an interior locking mechanism disposed on an interior surface of the housing and substantially adjacent the proximal end, wherein the interior locking mechanism is configured to allow attachment of at least one surgical tool; and

at least one flexible member disposed substantially adjacent the distal end;

the housing is configured to accommodate placement of a surgical screw implant;

the surgical screw implant is secured to the housing a mating feature in the surgical screw implant;

the at least one flexible member is configured to retain the surgical screw implant;

wherein the mating feature is configured to control axial movement of the surgical screw implant.

30. The apparatus according to claim 29, wherein the flexible members are configured to interact with at least one opening in the surgical screw implant and create a snap fit securing arrangement.

31. The apparatus according to claim 29, wherein the channel is configured to be partially open and configured to be partially disposed along the exterior surface of the housing.

32. The apparatus according to claim 29, wherein the channel is configured to be fully open and configured to connect the distal end and the proximal end of the housing.

33. The apparatus according to claim 29, wherein the housing includes at least one partially open channel and at least one fully open channel;

wherein the partially open channel is configured to be partially disposed along the exterior surface of the housing;

wherein the fully open channel is configured to connect the distal end and the proximal end of the housing.

34. The apparatus according to claim 29, wherein the housing includes at least two partially open channels wherein the partially open channels are configured to be partially disposed along the exterior surface of the housing.

35. The apparatus according to claim 29, further comprising a second housing configured to be coupled to a second surgical screw implant.

36. The apparatus according to claim 35, wherein the surgical screw implant coupled to the housing and second surgical screw implant coupled to the second housing are configured to be connected using a rod;

wherein the rod is configured to be coupled to the surgical screw implant and the second surgical screw implant.

37. The apparatus according to claim 29, further comprising a remover tool having

a shaft configured to be inserted into the housing and further configured to engage the flexible member within the housing;

the shaft including a ramp configured to contact the flexible member and separate the housing from the surgical screw implant.

38. A method of implanting a surgical screw implant into a bone of a patient using a an extender device having a housing configured to accommodate placement of a surgical screw implant, the surgical screw implant being secured to the housing mating feature in the surgical screw implant, wherein the housing includes a flexible member contained within the housing and configured to retain the surgical screw implant, comprising the steps of:

implanting the surgical screw implant into a bone of the patient;

attaching the screw extender device to the surgical screw; and

,

inserting a screw locking device along the long axis of the screw extender.

39. The method according to claim 38, further comprising the step of:

using a screw extender removal tool, removing the screw extender;

wherein the screw extender removal tool includes a shaft and a ramp configured to separate the housing from and the surgical screw implant.

40. A surgical kit for stabilizing the spine of a patient, comprising:

a screw extender configured to be coupled to a surgical screw, wherein the screw extender includes

a housing having a distal end and a proximal end;

a hollow interior passageway disposed between the distal end and the proximal end;

a channel disposed along an exterior surface of the housing at least partially between the distal end and the proximal end and configured to at least partially expose the hollow interior passageway;

an interior locking mechanism disposed on an interior surface of the housing and substantially adjacent the proximal end, wherein the interior locking mechanism is configured to allow attachment of at least one surgical tool; and

at least one flexible member disposed substantially adjacent the distal end;

the housing is configured to accommodate placement of a surgical screw implant;

the surgical screw implant is secured to the housing a mating feature in the surgical screw implant;

the flexible members are configured to retain the surgical screw implant;

wherein the mating feature is configured to control axial movement of the surgical screw implant.

41. The kit according to claim 40, further comprising a surgical screw implant.

42. The kit according to claim 41, further comprising a rod.

43. The kit according to claim 42, further comprising remover tool having

a shaft configured to be inserted into the housing and further configured to engage the flexible member within the housing;

the shaft including a ramp configured to contact the flexible member and separate the housing from the surgical screw implant.

44. The kit according to claim 43, further comprising

a wire delivery device configured to be inserted into the housing, wherein the wire delivery device includes:

a substantially cylindrical shaft having an opening at a distal tip of the cylindrical shaft;

a locking mechanism configured to lock the surgical extender apparatus;

a pathway disposed within the cylindrical shaft and configured to guide a wire through the pathway to a distal tip of the housing.

45. The kit according to claim 44, further comprising a wire advancement mechanism configured to advance wire along the pathway, upon connection of the wire advancement mechanism to the cylindrical shaft.

46. The kit according to claim 45, further comprising a wire capturing device configured to capture the wire and pull the wire from the opening in the cylindrical shaft,

the wire capturing device further comprises:

a tube;

an inner shaft configured to be threaded down the tube and tightened on the wire; and

a wire capturing locking feature configured to advance the inner shaft along the tube toward the surgical screw implant.

47. The kit according to claim 46, further comprising an anti-splay device configured to prevent the housing from splaying, bending and flexing during distraction, compression, torsion, and axial loading.

48. The kit according to claim 47, wherein the wire includes a distal tip configured to assist in advancement of the wire and a proximal tip configure to allow attachment of a rod, wherein the rod includes a hole configured to accommodate securing of the wire to the rod.

49. The kit according to claim 48, further comprising a distractor/compressor device configured to distract/compress at least two surgical screw implants, wherein the distractor/compressor device includes at least two compression arms configured to change orientation/distance between housings coupled to the at least two surgical screw implants using a fulcrum mechanism coupled to the distractor/compressor device.