SCREW INSERTION INSTRUMENT AND METHODS OF USE

• US 20180353224A1
• Filed: 06/12/2018
• Published: 12/13/2018
• Est. Priority Date: 06/12/2017
• Status: Active Grant

• Current Assignee: K2M, Inc (Stryker Corporation)
• Original Assignee: K2M, Inc (Stryker Corporation)
• Inventors: Kam, Andrew, Rubin, Josh, Angus, Olivia, Hayles, Mary
• Granted Patent: US 10,973,558 B2
• Time in Patent Office: Days
• CPC Class Codes: A61B 17/7032 Screws or hooks with U-shaped head or back through which longitudinal rods pass
• CPC Class Codes: A61B 17/7082 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 17/7085 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 17/864 hollow, e.g. with socket or cannulated
• CPC Class Codes: A61B 17/8897 Guide wires or guide pins
• CPC Class Codes: A61B 2017/564 Methods for bone or joint treatment

Abstract

A screw insertion instrument includes a handle, a driving assembly, and a stylet. The driving assembly extends distally from the handle and includes a knob, a tubular body extending distally from the knob, and a driver including an elongated body extending through the knob and the tubular body. The elongated body has a proximal region operably coupled to the handle and a distal region extending distally beyond the tubular body and engageable with a pedicle screw. The stylet includes an elongated body positionable through first and second longitudinal bores defined through the handle and the driver, respectively. A proximal portion of the stylet is positionable adjacent the handle and a distal portion of the stylet extends distally beyond the driver and is positionable through a third longitudinal bore defined through the pedicle screw such that the distal portion of the stylet extends distally beyond the pedicle screw.

Claims

1. A screw insertion instrument comprising:

a handle defining a first longitudinal bore therethrough;

a driving assembly extending distally from the handle, the driving assembly including;

a knob;

a tubular body extending distally from the knob; and

a driver including an elongated body extending through the knob and the tubular body, the elongated body having a proximal region operably coupled to the handle and a distal region extending distally beyond the tubular body and engageable with a pedicle screw, the driver defining a second longitudinal bore therethrough; and

a stylet including an elongated body positionable through the first and second longitudinal bores of the handle and the driver, a proximal portion of the stylet positionable adjacent the handle and a distal portion of the stylet extending distally beyond the driver and positionable through a third longitudinal bore defined through the pedicle screw such that the distal portion of the stylet extends distally beyond the pedicle screw.

2. The screw insertion instrument according to claim 1, further including:

an extension assembly including an elongated body extending distally from the knob of the driving assembly and adapted to receive the tubular body of the driving assembly therethrough, the elongated body of the extension assembly having a distal portion configured to selectively engage the pedicle screw.

3. The screw insertion instrument according to claim 2, wherein the elongated body of the extension assembly includes an internal threaded surface configured to threadably engage a threaded portion of the tubular body of the driving assembly.

4. The screw insertion instrument according to claim 1, wherein the handle includes a gripping portion and a mounting sleeve, the mounting sleeve having an internal housing configured to receive the proximal region of the driver of the driving assembly therein.

5. The screw insertion instrument according to claim 1, wherein the distal region of the driver includes a driving bit extending distally therefrom, the driving bit configured to engage a head of the pedicle screw.

6. The screw insertion instrument according to claim 1, wherein the knob of the driving assembly is movable relative to the tubular body between a first position, in which the driver is movably supported within the knob and the tubular body, and a second position, in which the driver is fixedly supported within the knob and the tubular body.

7. The screw insertion instrument according to claim 1, wherein the stylet includes a head at the proximal portion thereof and a tissue engaging member at the distal portion thereof.

8. The screw insertion instrument according to claim 7, wherein the head of the stylet includes a flange having a diameter greater than a diameter of the first longitudinal bore of the handle such that when the stylet is advanced distally therethrough, the flange abuts a proximal portion of the handle.

9. The screw insertion instrument according to claim 7, further including:

a clamping member configured to engage a proximal portion of the handle and the head of the stylet to selectively fix the stylet within the handle.

10. The screw insertion instrument according to claim 7, wherein the first longitudinal bore of the handle includes a threaded inner surface at a proximal end portion thereof, and wherein the head of the stylet includes a threaded portion configured to threadably engage the threaded inner surface of the first longitudinal bore to selectively fix the stylet within the handle.

11. The screw insertion instrument according to claim 7, further including:

a spacer configured for passage of the elongated body of the stylet therethrough, and positionable between the head of the stylet and the handle.

12. A screw insertion system comprising:

a pedicle screw including a head and threaded shank, and defining a longitudinal channel therethrough; and

a screw insertion instrument including;

a handle defining a first longitudinal bore therethrough;

a driving assembly extending distally from the handle, the driving assembly including;

a knob;

a tubular body extending distally from the knob; and

a driver including an elongated body extending through the knob and the tubular body, the elongated body having a proximal region operably coupled to the handle and a distal region extending distally beyond the tubular body and engageable with the head of the pedicle screw, the driver defining a second longitudinal bore therethrough; and

a stylet including an elongated body positionable through the first and second longitudinal bores of the handle and the driver, a proximal portion of the stylet positionable adjacent the handle and a distal portion of the stylet extending distally beyond the driver and positionable through the longitudinal channel defined through the pedicle screw such that the distal portion of the stylet extends distally beyond the pedicle screw.

13. The screw insertion system according to claim 12, wherein the pedicle screw further includes a tulip disposed around the head, and the screw insertion instrument further includes an extension assembly including an elongated body extending distally from the knob of the driving assembly and adapted to receive the tubular body of the driving assembly therethrough, the elongated body of the extension assembly having a distal portion configured to selectively engage the tulip of the pedicle screw.

14. The screw insertion system according to claim 12, wherein the stylet includes a head at the proximal portion thereof, and the screw insertion instrument further includes a clamping member configured to engage a proximal portion of the handle and the head of the stylet to selectively fix the stylet within the handle.

15. The screw insertion system according to claim 12, wherein the stylet includes a head at the proximal portion thereof, and the screw insertion instrument further includes a spacer configured for passage of the elongated body of the stylet therethrough, and positionable between the head of the stylet and the handle.

16. A method for inserting a screw into vertebral bone, the method comprising:

advancing a driving assembly through an extension assembly that is coupled to a pedicle screw such that a knob of the driving assembly abuts a proximal portion of the extension assembly, a tubular body of the driving assembly is disposed within the extension assembly, and a driving bit of a driver of the driving assembly engages a head of the pedicle screw;

advancing a stylet through a handle that is coupled to the driver of the driving assembly such that an elongated body of the stylet is positioned through the handle, the driver, and the pedicle screw, a proximal portion of the stylet is positioned adjacent a proximal portion of the handle, and a distal portion of the stylet extends distally beyond a distal end of the pedicle screw;

penetrating vertebral bone with the distal portion of the stylet to create a pilot hole; and

introducing the pedicle screw into the vertebral bone through the pilot hole.

17. The method according to claim 16, further including:

rotating the knob of the driving assembly to secure the extension assembly to the driving assembly; and

actuating the knob of the driving assembly to rotatably fix the driver to the knob.

18. The method according to claim 16, further including:

positioning a clamping member over the proximal portion of the handle to secure the proximal portion of the stylet to the handle.

19. The method according to claim 16, further including:

threadably securing the proximal portion of the stylet into the proximal portion of the handle to secure the stylet to the handle.

20. The method according to claim 16, further including:

positioning a spacer between the proximal portion of the stylet and the proximal portion of the handle such that a predetermined length of the distal portion of the stylet extends distally beyond the distal end of the pedicle screw.