Instruments for Use During Spine Surgery

• US 20140276896A1
• Filed: 03/14/2014
• Published: 09/18/2014
• Est. Priority Date: 03/14/2013
• Status: Active Grant

• Current Assignee: Globus Medical, Inc.
• Original Assignee: Globus Medical, Inc.
• Inventors: Harper, Mark
• Granted Patent: US 9,532,814 B2
• Time in Patent Office: Days
• US Class Current: 606/104
• CPC Class Codes: A61B 17/56 Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
• CPC Class Codes: A61B 17/7074 Tools specially adapted for spinal fixation operations other than for bone removal or filler handling A61B17/7062, A61B17/808, A61B17/8858 take precedence; for spinal image producing devices A61B90/36, A61B34/20; markers A61B90/39
• 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 17/7082 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 17/7083 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 17/7086 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 17/7088 wherein the rod is moved transverse to the axis of the bone anchor
• 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 17/8872 Instruments for putting said fixation devices against or away from the bone A61B17/7074, A61B17/808 take precedence
• CPC Class Codes: A61B 17/8875 Screwdrivers, spanners or wrenches
• CPC Class Codes: A61B 17/8886 holding the screw head
• CPC Class Codes: A61B 17/8888 at its central region
• CPC Class Codes: A61B 17/8891 at its periphery
• CPC Class Codes: A61B 2017/00407 Ratchet means
• CPC Class Codes: A61B 2017/564 Methods for bone or joint treatment
• CPC Class Codes: B25B 13/46 of the ratchet type, for providing a free return stroke of the handle
• CPC Class Codes: B25B 13/466 the ratchet parts engaging in an axial direction
• CPC Class Codes: B25B 13/468 with possibility of locking the ratchet mechanism

Abstract

Surgical instruments and devices including drivers, inserters, and reducers. The driver includes a ratcheting mechanism configured to provide uni-directional motion when engaged. The inserter includes a rack, pinion, and cam system designed to secure an implant and release an implant in-situ. The reducer includes a geared system for persuading together surgical components and aligning misaligned vertebrae.

Claims

1. A surgical instrument for inserting a surgical device comprising:

a body having an outer housing and a handle, the outer housing having a longitudinal body with a channel extending therethrough and a distal tip configured to engage the surgical device;

a shaft including a release shaft having a distal end configured to contact the surgical device and a second end, the shaft being housed within the channel of the outer housing, the shaft including a rack having a longitudinal body with a plurality of teeth;

a pinion having a wheel-like body with a plurality of teeth radially extending therefrom and configured to mate with the plurality of teeth of the rack, and a cam having a generally circular body with at least one projection which is rotatably attached to the pinion and the body; and

a trigger coupled to the handle and a linkage connecting the trigger to the second end of the shaft,

wherein, when the trigger is initially depressed, the linkage moves the shaft and secures the surgical device to the distal tip.

2. The device of claim 1, wherein, when the trigger is fully depressed, the linkage moves the rack linearly, which rotates the pinion and the cam and thereby moves the release shaft distally and releases the surgical device.

3. The device of claim 1, wherein the release shaft comprises at least one tab which extends past the distal tip of the outer housing when the trigger is fully depressed.

4. The device of claim 1, wherein the trigger is connected to the second end of the shaft with a coupling element which is retained in a longitudinal opening in the handle to provide linear motion to the shaft.

5. The device of claim 1, wherein the distal tip includes at least two spring tabs configured to secure the surgical device.

6. The device of claim 5, wherein the spring tabs each have a ramped surface configured to allow an axial force to couple the surgical device and a ledge configured to retain at least a portion of the surgical device.

7. The device of claim 6, wherein the outer housing includes one or more spring cuts designed to allow the spring tabs to flex when the surgical device is secured or released.

8. The device of claim 1 further comprising a safety lock and a pin, the pin being receivable within an opening in the distal tip to lock the device.

9. The device of claim 8, wherein the safety lock defines a non-linear opening, the safety lock is coupled to the pin with a coupling element, and the coupling element is positioned within the non-linear opening to translate the motion from the safety lock to the pin.

10. A method of using the instrument of claim 8 comprising:

unlocking the instrument by depressing the safety lock;

connecting the surgical device to the distal tip of the instrument by applying an axial force;

locking the surgical device to the instrument by slightly depressing the trigger;

performing the surgical procedure; and

releasing the surgical device from the instrument by fully depressing the trigger.

11. The device of claim 1, wherein the surgical device is a screw, a tulip, a yoke, or a connector.

12. A kit comprising the instrument of claim 1 and a plurality of fixation devices including fasteners, tulips, and rods.

13. A surgical instrument for driving a fastening element, comprising:

an outer housing and a shaft contained within the outer housing, the shaft having a first end configured for engaging a fastener and a second end configured for providing a rotational force,

a locking element connected to the shaft and having an engaging face with a first plurality of ratchet teeth, the locking element configured to move longitudinally along the shaft;

the outer housing comprising a handle having a contacting face with a second plurality of ratchet teeth sized and dimensioned to correspond with the first plurality of ratchet teeth; and

a locking button disposed on the locking element and configured to engage the shaft such that when the locking button is depressed, the first plurality of ratchet teeth on the engaging face are contacting the second plurality of ratchet teeth on the contacting face and a ratcheting mechanism is engaged.

14. The surgical instrument of claim 13, wherein the shaft further comprises a notch, and when the locking button is engaged in the notch, the first plurality of ratchet teeth on the engaging face teeth are separated a distance from the second plurality of ratchet teeth on the contacting face and the ratcheting mechanism is not engaged.

15. The surgical instrument of claim 13, wherein the locking element further comprises a spring and the spring surrounds the shaft, and wherein the spring is configured to keep the ratcheting mechanism engaged.

16. A surgical instrument for reducing a bone fastener toward a rod, comprising:

a reducing member extending between a proximal end and a distal end, a distal portion of the reducing member adapted to receive a portion of the bone fastener, and a proximal portion of the reducing member having a first plurality of gear teeth;

an outer longitudinal member sized and shaped to receive the reducing member, and

a handle comprising at least one trigger element, the at least one trigger element having a second plurality of gear teeth configured to cause translation of the reducing member with respect to the outer longitudinal member when a force is applied to the handle.

17. The instrument of claim 16, wherein the second plurality of gear teeth are configured to directly engage and mate with the first plurality of gear teeth to cause the reducing member to move proximally.

18. The instrument of claim 16 further comprising a pinion gear, wherein the second plurality of gear teeth are configured to contact and rotate the pinion gear, and the pinion gear is configured to contact at least a portion of the first plurality of gear teeth to cause the reducing member to move proximally.