ARTICULATING CRANIAL BOLT

• US 20130072876A1
• Filed: 03/21/2012
• Published: 03/21/2013
• Est. Priority Date: 05/19/2011
• Status: Active Grant

• Current Assignee: Depuy Synthes Products Incorporated (Johnson & Johnson)
• Original Assignee: Jens Richter, Samuel Leuenberger, Urs Hulliger
• Inventors: PRETRE, Isabelle, LEUENBERGER, Samuel, RICHTER, Jens, HULLIGER, Urs
• Granted Patent: US 9,226,735 B2
• Time in Patent Office: Days
• US Class Current: 604/175
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 2090/103 Cranial plugs for access to brain
• CPC Class Codes: A61B 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61M 25/04 in the body, e.g. expansible A61M25/10, A61M16/0488 take precedence

Abstract

A catheter guiding device includes a bolt including a shaft configured to be inserted within a hole drilled in a bone and a passageway extending longitudinally therethrough along a bolt axis and a guide member received within the passageway of the bolt and extending longitudinally along a guide axis. The guide member includes a guide channel extending therethrough along the guide axis, wherein, in a first configuration, the guide member is arrangeable to a desired position relative to the bolt to align the guide axis with a target area and, in a second configuration, the guide member is fixed in the desired position relative to the bolt such that the guide axis is at a desired angle relative to the bolt axis within a permitted range of angulations.

Claims

1. A catheter guiding device, comprising:

a bolt including a shaft configured to be inserted within a hole drilled in a bone and a passageway extending longitudinally therethrough along a bolt axis; and

a guide member received within the passageway of the bolt and extending longitudinally along a guide axis, the guide member including a guide channel extending therethrough along the guide axis, wherein, in a first configuration, the guide member is arrangeable to a desired position relative to the bolt to align the guide axis with a target area and, in a second configuration, the guide member is fixed in the desired position relative to the bolt such that the guide axis is at a desired angle relative to the bolt axis within a permitted range of angulations.

2. The device according to claim 1, the shaft of the bolt including a threading therealong to engage the hole drilled in the bone.

3. The device according to claim 1, the bolt including a head portion at a proximal end thereof sized and shaped to be engaged by a driving tool.

4. The device according to claim 1, wherein the passageway of the bolt includes a proximal portion which tapers radially inward from a proximal end thereof towards a distal end thereof and a distal portion which flares radially outward from a proximal end thereof toward a distal end thereof to accommodate the guide member within the permitted range of angulations.

5. The device according to claim 1, further comprising a coupling element coupling the guide member to the bolt, the coupling element movably received within the passageway and receiving a distal portion of the guide member therein.

6. The device according to claim 5, wherein the coupling element is a slotted bushing, the distal portion of the guide member received within the bushing along a central axis thereof such that the guide axis and the central axis are substantially coaxial.

7. The device according to claim 6, wherein the slotted bushing is movable relative to the bolt in a first configuration and locked relative to the bolt in a second configuration.

8. The device according to claim 7, wherein, in the first configuration, the slotted bushing is biased in a non-expanded configuration and, in the second configuration, the slotted bushing is in an expanded configuration such that the central axis of the bushing is fixed at the desired angle with respect to the bolt.

9. The device according to claim 8, wherein the slotted bushing includes a threaded inner surface tapering from a proximal end to a distal end and a distal portion of the guide member includes a correspondingly threaded exterior surface tapering to the distal end thereof, the guide member being rotatable relative to the bushing to move the bushing between the non-expanded and the expanded configuration.

10. The device according to claim 6, wherein an outer surface of the bushing is at least partially spherical and is received within a correspondingly spherically shaped portion of the passageway such that the bushing is movable with respect to the bolt.

11. The device according to claim 6, wherein an outer surface of the bushing includes a protrusion extending therefrom and received within a corresponding recess of the passageway such that the bushing is prevented from rotating with respect to the bolt.

12. The device according to claim 1, wherein the bolt includes a plurality of probe channels extending therethrough circumferentially about the passageway, the channels sized and shaped to receive a probe therethrough.

13. The device according to claim 12, wherein the probe channels are spaced equidistantly from one another.

14. The device according to claim 12, wherein the probe channels extend along probe axes which are angled with respect to the bolt axis such that the probe channels are prevented from intersecting with the guide axis at the desired angle.

15. The device according to claim 1, further comprising:

a ring sized and shaped to be mounted over a proximal end of the bolt, the ring including a first surface which, in an operative position, faces toward the bolt and a second surface which, when in the operative position faces away from the bolt, the first and second surfaces being angled with respect to one another;

a compression nut threadedly movable along a length of the guide member such that moving the compression nut distally therealong to abut the ring fixed the guide member in the desired position relative to the bolt.

16. The device according to claim 1, further comprising a compressible member received within the passageway of the bolt and including an opening extending therethrough to receive a portion of the guide member therein, the compressible member being movable between a non-compressed configuration in which the compressible member is movable with respect to the bolt and a compressed configuration in which the compressible member extends radially outward to engage a surface of the passageway and radially inward to engage the guide member to fix the guide member in the desired position with respect to the bolt.

17. The device according to claim 1, wherein the passageway includes a locking structure engagable with a corresponding structure of the guide member to fix the guide member therein at the desired position.

18. The device according to claim 17, wherein the locking structure of the passageway includes a plurality of columns extending along a length of an inner surface thereof, the plurality of columns separated from one another about a circumference of the passageway via recesses extending therebetween, the plurality of columns including a plurality of protrusions extending radially inward to engage threads along a spherical distal portion of the guide member to fix the guide member at the desired position relative to the bolt.

19. The device according to claim 1, further comprising a slotted disc mountable over a head portion of the bolt, the guide member slidable within a slot thereof to align the guide axis with the target area.

20. The device according to claim 1, wherein the passageway includes a membrane extending radially inward to engage a distal end of the guide member, the membrane being plastically deformable such that the guide member is movable to the desired position relative to the bolt.

21. The device according to claim 1, wherein the passageway includes cushion filled with a material which transforms the cushion from an insertion configuration in which the guide member is therethrough to locked configuration in which the guide member is fixed therein in the desired position relative to the bolt.

22. The device according to claim 21, wherein the material is one of (i) a liquid that is transformable to a hardened state in the locked configuration, (ii) air which inflates the cushion to the locked configuration, and (iii) granules and air movable relative to one another in the insertion configuration and immovable relative to one another when a vacuum is applied in the locked configuration.

23. The device according to claim 1, wherein the guide channel is sized and shaped to receive a catheter therethrough.

24. The device according to claim 1, wherein the guide member is a catheter.

25. A system for draining cerebrospinal fluid, comprising:

a bolt including a shaft configured to be inserted within a hole drilled in a bone and a passageway extending longitudinally therethrough along a bolt axis;

a guide member received within the passageway of the bolt and extending longitudinally along a guide axis, the guide member including a guide channel extending therethrough along the guide axis, wherein, in a first configuration, the guide member is movable to a desired position relative to the bolt to align the guide axis with a target area and, in a second configuration, the guide member is fixed in the desired position relative to the bolt such that the guide axis is at a desired angle relative to the bolt axis within a permitted range of angulations; and

a catheter insertable through the guide channel to the target area.

26. The system according to claim 25, further comprising:

a guiding tool including a base and a plurality of legs extending therefrom, the base including an opening extending therethrough so that when the guiding tool is slid along a length of the guide member such that the legs abut the bone, a central axis of the opening is one of substantially perpendicular to a surface of the bone and coaxial with the bolt axis.

27. The system according to claim 26, wherein the base of the guiding tool includes a recess extending through a portion thereof, the recess sized and shaped to engage a proximal end of the bolt such that rotation of the guiding tool correspondingly rotates the bolt to engage the hole in the bone.

28. The system according to claim 25, further comprising a driving tool sized and shaped to engage a proximal end of the guide member such that rotation of the driving tool correspondingly rotates the guide member relative to the bolt.

29. A method for treating intracranial pressure, comprising:

drilling a hole in a skull at a point corresponding to a predicted location of ventricles housing cerebrospinal fluid;

inserting a guide member through the hole, the guide member including a guide channel extending therethrough along a guide axis;

moving the guide member to a desired position relative to the hole such that the guide axis is aligned with an observed location of the ventricles; and

fixing the guide member at the desired position relative to the hole.

30. The method according to claim 29, wherein the hole drilled in the skull tapers from a proximal end to a distal end, the guide member movable such that the guide axis is angled with respect to a central axis of the hole.

31. The method according to claim 30, further comprising sliding a cap over the guide member and mounting the cap to the skull, the cap including a sealing ring housed therein to fix the guide member at the desired position relative to the hole.

32. The method according to claim 29, further comprising inserting a bolt into the hole drilled in the skull such that a shaft of the bolt engages an inner surface of the hole and the guide member is inserted into a passageway thereof.

33. The method according to claim 29, wherein, in the desired position, the guide axis is coaxial with a central axis of the hole in the desired position.

34. The method according to claim 32, wherein, in the desired position, the guide axis is angled with respect to a bolt axis.

35. The method according to claim 29, further comprising inserting a catheter through the guide member along the guide axis.

36. The method according to claim 29, further comprising inserting a probe through a probe channel which extends through the bolt such that the probe is prevented from intersecting with the guide axis.

37. A guiding device, comprising:

a guide member configured to be inserted within a hole drilled in a bone, the guide member extending longitudinally along a guide axis and including a guide channel extending therethrough along the guide axis, wherein, in a first configuration, the guide member is arrangeable to a desired position relative to the hole to align the guide axis with a target area and, in a second configuration, the guide member is fixed in a desired position relative to the bolt such that the guide axis is at a desired angle relative to a hole axis within a permitted range of angulations; and

a cap including an opening extending therethrough and a compressible ring within the opening such that the cap is slidable over a proximal end of the guide member to fix the guide member in the second configuration.

38. The device according to claim 37, wherein the guide member is a catheter.

39. The device according claim 37, further comprising a fixation element for fixing the cap to the bone.