Anchor Extenders for Minimally Invasive Surgical Procedures

• US 20110125192A1
• Filed: 01/31/2011
• Published: 05/26/2011
• Est. Priority Date: 06/21/2007
• Status: Active Grant

• Current Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Original Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Inventors: Justis, Jeff R., McBride, Larry T. JR., Pond, John D. JR.
• Granted Patent: US 8,657,825 B2
• Time in Patent Office: Days
• US Class Current: 606/279
• 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

Abstract

Systems for positioning a connecting element adjacent the spinal column in minimally invasive surgical procedures include one or more extenders removably engaged to one or more anchors engaged to a bony segment. The anchor extenders provide a reference to the respective anchor locations within the patient even when the anchor is obstructed by skin and/or tissue of the patient. An inserter can be movably mounted to the one or more anchor extenders, or an inserter can be employed without mounting to the one or more anchor extenders. In either form, the inserter is operable to position a stabilization element relative to the anchors for engagement to the anchors to stabilize the bony segment to which the anchors are engaged. At least one of the one or more anchor extenders includes a reduction assembly that is operable to move one or more portions of the bony segment while maintaining the minimally invasive character of the procedure.

Claims

1-18. -18. (canceled)

19. A surgical instrument assembly, comprising:

a first anchor including a bone engaging portion and a proximal receiving portion;

a second anchor including a bone engaging portion and a proximal receiving portion;

a first extender including an inner member received within an outer member, said inner and outer members extending along a longitudinal axis and being axially movable relative to one another, said inner member being releasably engaged to said proximal receiving portion of said first anchor, wherein said outer member of said first extender includes a proximal hub portion, said proximal hub portion including a laterally extending portion along one side thereof and an abutment surface along an opposite side thereof, said abutment surface including an extension member extending transversely to said longitudinal axis and outwardly from said abutment surface;

a second extender including an inner member received within an outer member, said inner and outer members extending along a longitudinal axis and being axially movable relative to one another, said inner member being releasably engaged to said proximal receiving portion of said second anchor, said outer member of said second extender includes a proximal hub portion, said proximal hub portion including a laterally extending portion along one side thereof and an abutment surface along an opposite side thereof, said abutment surface including a receptacle extending transversely to said longitudinal axis, wherein said extension member of said first extender is received in said receptacle of said second extender; and

an installation instrument pivotally mounted to said laterally extending portions of said first and second extenders.

20. The assembly of claim 19, wherein said laterally extending portions each include a mounting surface facing opposite said abutment surface and said installation instrument is pivotally mounted to each of said first and second extenders along said mounting surfaces.

21. The assembly of claim 20, wherein for each of said first and second extenders said abutment surface is parallel to said mounting surface.

22. The assembly of claim 21, wherein said abutment surface and said mounting surface of each of said first and second extenders are each angled about 4 degrees relative to said longitudinal axis.

23. The assembly of claim 20, wherein said laterally extending portions each include a wall portion extending around said mounting surface that is tapered toward said mounting surface.

24-25. -25. (canceled)

26. A method for stabilizing bony structures comprising:

attaching a first bone anchor with a first extender extending therefrom and having a receiving portion to a first vertebra;

attaching a second bone anchor with a second extender extending therefrom and having a receiving portion to a second vertebra;

positioning a connecting element into a desired position relative to the first bone anchor and the second bone anchor and into a pathway defined in the second extender;

delivering a securing member through a passage in the first extender;

securing the connecting element in the receiving portion of the first bone anchor with the securing member;

manipulating the second extender so that the second extender contacts the connecting element;

moving the second vertebra toward the connecting element while the second extender is contacting the connecting element until the connecting element is seated in the receiving portion of the second bone anchor;

securing the connecting element in the receiving portion of the second bone anchor; and

disengaging the first extender from the first bone anchor and the second extender from the second bone anchor.

27. The method of claim 26, wherein moving the second vertebra comprises correcting alignment of the second vertebra relative to the first vertebra.

28. The method of claim 26, wherein the second extender comprises a reduction assembly.

29. The method of claim 28, wherein the reduction assembly comprises an outer member configured to contact the connecting element and an inner member configured to move the second vertebra.

30. The method of claim 29, wherein the outer member and the inner member are axially displaceable relative to each other.

31. The method of claim 29, further comprising axially displacing the inner member relative to the outer member to move the second vertebra toward the connecting element.

32. The method of claim 26 wherein the connecting element is a rod.

33. The method of claim 26 wherein positioning a connecting element comprises positioning the connecting element with a minimally invasive procedure.

34. The method of claim 33, wherein the minimally invasive procedure comprises mounting an installation instrument to at least one of the first extender and the second extender.

35. The method of claim 33, wherein the minimally invasive procedure comprises mounting an installation instrument to both the first extender and the second extender.

36. The method of claim 26, further comprising attaching a third bone anchor with a third extender extending therefrom and having a receiving portion to a third vertebra.

37. The method of claim 36, further comprising

moving the third vertebra toward the connecting element until the connecting element is seated in the receiving portion of the third bone anchor;

securing the connecting element in the receiving portion of the third bone anchor; and

disengaging the third extender from the third bone anchor.

38. The method of claim 26, wherein positioning a connecting element comprises at least one of:

guiding the connecting element with an instrument pivotally mounted to at least one of the first extender and second extender;

guiding the connecting element with an instrument non-pivotally mounted to at least one of the first extender and second extender;

guiding the connecting element with an instrument guided via freehand techniques; and

guiding the connecting element under visualization by an imaging system.

39. The method of claim 26, wherein the connecting element is non-rigid.

40. The method of claim 26, further comprising determining the position of the second vertebra relative to the first vertebra by reference to indicia on the second extender.