INSTRUMENTS AND METHODS FOR ADJUSTING SEPARATION DISTANCE OF VERTEBRAL BODIES WITH A MINIMALLY INVASIVE SPINAL STABILIZATION PROCEDURE

• US 20100069972A1
• Filed: 11/20/2009
• Published: 03/18/2010
• Est. Priority Date: 12/02/2004
• Status: Active Grant

• Current Assignee: Zimmer Biomet Spine, Inc. (Zimvie Incorporated)
• Original Assignee: Zimmer Spine, Inc. (Zimmer Biomet Holdings, Inc.)
• Inventors: Jones, Robert J., Forton, Charles R.
• Granted Patent: US 8,192,440 B2
• Time in Patent Office: Days
• US Class Current: 606/86.A
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/16 Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans arthroscopic bone cutters A61B17/320016; dental implant drills potentially for other surgical use A61C8/0089; bone grinders A61F2/4644, A22C17/06; A61B17/1662 takes precedence over all other subgroups except A61B17/17
• CPC Class Codes: A61B 17/1655 for tapping
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 17/7002 Longitudinal elements, e.g. rods
• 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 17/7079 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 17/7083 Tools for guidance or insertion of tethers, rod-to-anchor connectors, rod-to-rod connectors, or longitudinal elements
• 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 17/8605 Heads, i.e. proximal ends projecting from bone
• CPC Class Codes: A61B 17/861 specially shaped for gripping driver
• CPC Class Codes: A61B 17/8866 for gripping or pushing bones, e.g. approximators joint distractors A61B17/025
• CPC Class Codes: A61B 17/8875 Screwdrivers, spanners or wrenches
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2090/037 with a frangible part, e.g. by reduced diameter

Abstract

A spinal stabilization system may be formed in a patient. In some embodiments, a minimally invasive procedure may be used to form a spinal stabilization system in a patient. Bone fastener assemblies may be coupled to vertebrae. Each bone fastener assembly may include a bone fastener and a collar. Extenders may be coupled to the collar to allow for formation of the spinal stabilization system through a small skin incision. The extenders may allow for alignment of the collars to facilitate insertion of an elongated member in the collars. An elongated member may be positioned in the collars and a closure member may be used to secure the elongated member to the collars. An adjuster may be used in conjunction with the extenders to change a separation distance between the bone fastener assemblies.

Claims

1. A system for adjusting a distance between vertebral bodies of a human spine, comprising:

a first extender detachably coupled to a first bone fastener assembly that is secured to a first vertebral body, wherein the first bone fastener assembly secures to a rod so as to inhibit movement of the first bone fastener assembly relative to the rod;

a second extender detachably coupled to a second bone fastener assembly that is secured to a second vertebral body, wherein the second bone fastener assembly is movably coupled to the rod to allow the second bone fastener to move along the rod relative to the first bone fastener assembly; and

an adjuster having;

a first handle coupled to a shaft, wherein the shaft detachably engages the adjuster to the first extender; and

a second handle having a driver engager, wherein a driver detachably engages the adjuster to the second extender through the driver engager of the adjuster,

wherein rotation of the first handle and the second handle towards each other about a pivot point forces the second extender to move towards the first extender, whereby the second bone fastener assembly secured to the second vertebral body is forced to move towards the first bone fastener assembly secured to the first vertebral body, causing compression of the first vertebral body and the second vertebral body.

2. The system of claim 1, wherein the pivot point is offset from a shaft of the driver, the shaft of the extender engager, or both.

3. The system of claim 2, wherein the shaft of the driver is longer than the shaft of the extender engager.

4. The system of claim 1, wherein the shaft of the extender engager fits in or over a portion of the first extender.

5. The system of claim 1, wherein the adjuster further comprises an engagement mechanism having a movable member and an opening, wherein the pivot point is adjustable via the engagement mechanism, and wherein the movable member is movable within the opening between a first position and a second position.

7. The system of claim 1 further comprising a locking mechanism coupled to the first handle and the second handle operable to engage so as to prevent relative rotational movement between the first handle and the second handle.

8. An apparatus for adjusting a separation distance between vertebral bodies of a human spine, comprising:

an adjuster, wherein the adjuster comprises;

a first handle coupled to a shaft for detachably engaging the adjuster to a first extender that is coupled to a first bone fastener assembly secured to a first vertebral body; and

a second handle having a driver engager, wherein a driver detachably engages the adjuster through the driver engager to a second extender that is coupled and movable relative to a second bone fastener assembly secured to a second vertebral body, wherein rotation of the first handle and the second-handle towards each other about a pivot point forces the second extender to move towards the first extender, thereby forcing the second bone fastener assembly secured to the second vertebral body to move towards the first bone fastener assembly secured to the first vertebral body, thereby causing compression of the first vertebral body and the second vertebral body.

9. The apparatus of claim 8, wherein the shaft of the extender engager fits in or over the first extender.

10. The apparatus of claim 8, wherein the adjuster further comprises an engagement mechanism having a movable member and an opening, wherein the pivot point is adjustable via the engagement mechanism, and wherein the movable member is movable within the opening between a first position and a second position.

11. The apparatus of claim 10, wherein the second handle further comprises protrusions and wherein the movable member of the engagement mechanism further comprises protrusions to mate with protrusions in the second handle.

12. The apparatus of claim 10, wherein the engagement mechanism allows a separation distance to be established between an end surface of the adjuster and the driver, wherein the separation distance allows the driver to be rotated towards the extender engager.

13. The apparatus of claim 8, further comprising a locking mechanism coupled to the first handle and the second handle operable to engage so as to prevent relative rotational movement between the first handle and the second handle.

14. A method of adjusting a distance between vertebral bodies of a human spine, comprising:

securing a first bone fastener assembly to a rod to inhibit movement of the first bone fastener assembly relative to the rod, wherein the first bone fastener assembly is coupled to a first extender and secured to a first vertebra;

coupling the rod to a second bone fastener assembly, wherein the second bone fastener assembly is movable along the rod, wherein the second fastener assembly is coupled to a second extender and secured to a second vertebra;

coupling an adjuster to the first extender via a shaft of the adjuster, wherein the shaft is attached to a first handle of the adjuster through a pivot point;

inserting a driver through a second handle of the adjuster into the second extender;

rotating the first handle and the second handle about the pivot point, wherein rotation of the first handle and the second handle about the pivot point causes movement of the second extender relative to the first extender, thereby causing the second bone fastener assembly secured to the second vertebra to move relative to the first bone fastener assembly secured to the first vertebra, thereby adjusting a distance between the first vertebra and the second vertebra.

15. The method of claim 14, further comprising engaging a locking mechanism so as to prevent relative rotational movement between the first handle and the second handle.

16. The method of claim 14, further comprising loosening an engagement mechanism of the adjuster, establishing a separation distance between the driver and an end surface of the adjuster, and tightening the engagement mechanism to inhibit translation of the driver relative to the adjuster.

17. The method of claim 14, wherein the adjuster comprises a compressor configured to reduce the distance between the first vertebra and the second vertebra.

18. The method of claim 14, wherein the adjuster comprises a distractor configured to increase the distance between the first vertebra and the second vertebra.

19. A system for adjusting a distance between vertebral bodies of a human spine comprising:

a first extender detachably coupled to a first bone fastener assembly that is secured to a first vertebral body, wherein the first bone fastener assembly secures a rod so as to inhibit movement of the first bone fastener assembly relative to the rod;

a second extender detachably coupled to a second bone fastener assembly that is secured to a second vertebral body, wherein the second bone fastener assembly is movably coupled to the rod to allow the second bone fastener to move along the rod relative to the first bone fastener assembly; and

an adjuster having;

a first handle coupled to a shaft, wherein the shaft detachably engages the adjuster to the first extender; and

a second handle having a driver engager, wherein a driver detachably engages the adjuster to the second extender through the driver engager of the adjuster,

wherein rotation of the first handle and the second handle towards each other about a pivot point forces the second extender to move away from the first extender, thereby forcing the second bone fastener assembly secured to the second vertebral body to move away from the first bone fastener assembly secured to the first vertebral body, thereby causing distraction of the first vertebral body and the second vertebral body.

20. The system of claim 19, wherein the pivot point is offset from a shaft of the driver, the shaft of the extender engager, or both.

21. The system of claim 20, wherein the shaft of the driver is longer than the shaft of the extender engager.

23. The system of claim 19, wherein the adjuster further comprises an engagement mechanism having a movable member and an opening, wherein the pivot point is adjustable via the engagement mechanism, and wherein the movable member is movable within the opening between a first position and a second position.

24. The system of claim 19, further comprising a locking mechanism coupled to the first handle and the second handle operable to engage so as to prevent relative rotational movement between the first handle and the second handle.

22. The system of claim 27, wherein the shaft of the extender engager fits in or over a portion of the first extender.