MINIMALLY INVASIVE SURGICAL TOWER ACCESS DEVICES AND RELATED METHODS

• US 20120022594A1
• Filed: 07/26/2010
• Published: 01/26/2012
• Est. Priority Date: 07/26/2010
• Status: Active Grant

• Current Assignee: Spinal USA, Inc. (Precision Spine, Inc.)
• Original Assignee: Spinal LLC
• Inventors: Walker, John Lawrence, Cummins, John Franklin
• Granted Patent: US 8,603,094 B2
• Time in Patent Office: Days
• US Class Current: 606/264
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• 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 17/7001 Screws or hooks combined with longitudinal elements which do not contact vertebrae A61B17/7058 takes precedence
• CPC Class Codes: A61B 17/708 with tubular extensions coaxially mounted on the bone anchors
• 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 17/7086 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 17/86 Pins or screws or threaded wires; nuts therefor A61B17/72 take precedence
• CPC Class Codes: A61B 17/8875 Screwdrivers, spanners or wrenches
• CPC Class Codes: A61B 2017/347 Locking means, e.g. for locking instrument in cannula
• CPC Class Codes: A61B 2017/349 Trocar with thread on outside
• CPC Class Codes: A61B 2017/564 Methods for bone or joint treatment
• CPC Class Codes: A61B 2090/031 torque limiting

Abstract

Devices and methods are provided for assisting in spinal stabilization. An access device is provided that includes an outer sleeve, inner sleeve, spring latch and lock nut. The inner sleeve includes compressible grasping elements. The access device can be coupled to a screw head by sliding the outer sleeve relative to the inner sleeve and compressing the grasping elements. The coupled access device and screw can then be delivered to a target location in a patient. After providing two or more access devices, a rod member can be delivered using a rod insertion device. The rod member can serve as a connection between the two screws, and can provide spinal stabilization. An anti-torque device and a persuading device can be used to help ensure that the rod member is placed and secured in a proper location within a patient.

Claims

1. A system for spinal stabilization, comprising:

a percutaneous access device including;

an outer sleeve (21) having a proximal slot (27) and a distal slot (28);

an inner sleeve (22) having a proximal section (31) and a distal section (33), the proximal section (31) being operably connected to a spring latch (60) having a tab member (86) and including a threaded portion (34), the distal section (33) including a slot (23) and a pair of compressible grasping elements (38), each of the grasping elements (38) including slits (41), an internal tapered surface (47), and an internal protruding member (45) capable of being received in an aperture in a head of a screw member (90), wherein the inner sleeve (22) is configured to be slidably received into the outer sleeve (21) such that the spring latch (60) is located within the proximal slot (27) of the outer sleeve (21) and the slot (23) of the inner sleeve (22) is aligned with the distal slot (28) of the outer sleeve (21); and

a lock nut (80) having an internal engagement surface (83) for engaging the threaded portion of the inner sleeve (22), wherein placement of the lock nut (80) at a bottom section of the threaded portion of the inner sleeve (22) results in compression of the grasping elements (38), and wherein the internal engagement surface (83) is configured to interact with the tab member (86) via depressions (88) to limit counter rotation of the lock nut (80) during use;

a cannulated screw member (90) attachable to the inner sleeve (22) comprising a head portion coupled to a shaft, wherein the head portion includes a seat for receiving a rod implant, one or more apertures for receiving an internal protruding member (45) of the inner sleeve (22), and at least one slot for interacting with the internal tapered surface (47) of the inner sleeve (22);

a screw driver for rotating and driving the screw member (90) into a bone;

a rod insertion device (110) including a handle (130) and a distal gripping end (115) for gripping and delivering a rod member;

an anti-torque device (142) including a handle (143) connected to a cannula (145), wherein the cannula (145) is configured to be placed over the outer sleeve (21), and wherein the cannula (145) includes a side slot (149) for engaging the rod member; and

a persuader device (131) having a hollow interior (136) and internal threads that can interact with the anti-torque device and assist in forcing the rod member into the seat of the screw member.

2. A system for spinal stabilization, comprising:

an outer sleeve having a distal slot; and

an inner sleeve having a proximal section and a distal section, the proximal section including a threaded portion, the distal section including a slot and a pair of compressible grasping elements, each of the grasping elements including an internal protruding member,

wherein the inner sleeve is configured to be slidably received into the outer sleeve such that the slot of the inner sleeve is aligned with the distal slot of the outer sleeve, and wherein sliding the outer sleeve relative to the inner sleeve actuates compression of the grasping elements of the inner sleeve.

3. The system of claim 2, further comprising a lock nut having an internal engagement surface for engaging the threaded portion of the inner sleeve.

4. The system of claim 3, wherein placement of the lock nut at a bottom section of the threaded portion of the inner sleeve results in compression of the grasping elements.

5. The system of claim 2, further comprising a cannulated screw member attachable to the inner sleeve including a head portion affixed to a shaft, wherein the head portion includes a pair of apertures for receiving the internal protruding member of each of the grasping elements.

6. The system of claim 2, further comprising a rod insertion device including a handle and a distal gripping end for gripping and delivering a rod member near the outer sleeve.

7. The system of claim 2, further comprising an anti-torque device including a handle connected to a cannula, wherein the cannula is configured to be placed over the outer sleeve.

8. The system of claim 7, wherein the cannula includes a side slot for engaging a rod member.

9. The system of claim 2, further comprising a persuader device including a handle and rod engaging members for forcing a rod member into a desired position.

10. The system of claim 9, wherein the persuader device is configured to be inserted over the threaded portion of the inner sleeve.

11. The system of claim 2, further comprising a spring latch operably connected to the proximal section of the inner sleeve.

12. The system of claim 11, wherein the spring latch is insertable within a proximal slot of the outer sleeve.

13. The system of claim 11, wherein the spring latch includes a marker for identifying a mode of operation of the percutaneous access device.

14. The system of claim 11, wherein the spring latch includes a tab member for interacting with a lock nut to limit loosening of the lock nut.

15. The system of claim 2, wherein the distal slot of the outer sleeve and the slot of the inner sleeve are of substantially the same width.

16. The system of claim 2, wherein the compressible grasping elements include slits.

17. The system of claim 2, wherein the inner sleeve is configured to be received into a hollow interior of the outer sleeve.

18. The system of claim 2, wherein the slot of the inner sleeve is about half the length of a non-threaded portion of the inner sleeve.

19. A method of spinal stabilization, comprising:

providing a first access device including a first outer sleeve and a first inner sleeve, wherein the first inner sleeve includes a first pair of compressible grasping elements actuated by sliding the first inner sleeve relative to the first outer sleeve;

providing a first screw member within the first pair of compressible grasping elements;

compressing the first pair of compressible grasping elements to couple the first access device to the first screw member;

delivering the first access device and first screw member to a first location within a patient;

inserting the first screw member into a first bone member of the patient;

providing a second access device including a second outer sleeve and a second inner sleeve, wherein the second inner sleeve includes a second pair of compressible grasping elements actuated by sliding the second inner sleeve relative to the second outer sleeve;

providing a second screw member within the second pair of compressible grasping elements;

compressing the second pair of compressible grasping elements to couple the second access device to the second screw member;

delivering the coupled second access device and second screw member to a second location within a patient;

inserting the second screw member into a second bone member of the patient; and

delivering a rod member to connect between the first screw member and second screw member.

20. The method of claim 19, further comprising providing a screw driver within the first access device prior to delivering the first access device and first screw member to the first location within the patient.

21. The method of claim, 20, wherein the first access device and first screw member are delivered to the first location within the patient via a k-wire.

22. The method of claim 19, further comprising providing an anti-torque device, the anti-torque device including a handle connected to a cannula configured to be placed over the first outer sleeve.

23. The method of claim 22, further comprising placing the cannula of the anti-torque device over the first outer sleeve.

24. The method of claim 23, further comprising providing a persuader device and inserting the persuader device within an interior of the first inner sleeve to force the rod member into a seat of a head of the first screw member.