System and method for stabilizing bone segments

• US 5,382,248 A
• Filed: 09/10/1992
• Issued: 01/17/1995
• Est. Priority Date: 09/10/1992
• Status: Expired due to Fees

• Current Assignee: Brian Mirson, Robert E. Jacobson
• Original Assignee: H D Medical Incorporated
• Inventors: Jacobson, Robert E., Mirson, Brian J.
• Primary Examiner(s): Brown, Michael A.
• Application Number:
  US07/944,206
• Time in Patent Office: 859 Days
• Field of Search: 606/60, 606/61, 606/72, 606/73, 606/54-59
• US Class Current: 606/60
• CPC Class Codes: A61B 17/686 Plugs, i.e. elements forming interface between bone hole and implant or fastener, e.g. screw
• CPC Class Codes: A61B 17/7007 Parts of the longitudinal elements, e.g. their ends, being specially adapted to fit around the screw or hook heads
• CPC Class Codes: A61B 17/701 Longitudinal elements with a non-circular, e.g. rectangular, cross-section A61B17/7005, A61B17/7007 take precedence
• CPC Class Codes: A61B 17/7041 with single longitudinal rod offset laterally from single row of screws or hooks A61B17/7044 takes precedence
• CPC Class Codes: A61B 17/7052 of variable angle or length
• CPC Class Codes: A61B 17/7055 connected to sacrum, pelvis or skull

Abstract

An apparatus for stabilizing a plurality of bone segments, such as vertebrae of a spinal column, comprises one or more fixation devices. Each fixation device comprises an elongated rod having a longitudinal slot through its upper and lower surfaces and having threaded lateral surfaces. Slotted or axially threaded block members are slideably or rotatably movable along each rod into predetermined positions corresponding to locations selected for securing the apparatus to the bone. Posts are provided having have threaded distal ends, such that the distal end of each such post is inserted into the bone. The proximal end of each post is passed through the longitudinal slot in the rod and also through a vertical bore in the block member. The locations at which corrective forces are applied by the posts may be changed relative to the rods in three planes. A transverse connector system, included when at least two implant sets are used permits the implant sets to be spaced different distances apart and at different angular orientations.

Claims

1. A device for stabilizing bone segments, said device comprising:

at least one elongated rod member, said member defining at least one slotted opening therethrough and having a threaded exterior portion; and

means for anchoring said at least one rod member to a plurality of bone segments, each said anchoring means comprising

a post member adapted for engaging one of said bone segments, said post member having a proximal end, a distal end and a shoulder portion located between said proximal and said distal ends, wherein said proximal end is configured for passage through said at least one opening in said rod member and thereafter into a block nut member for securing said post member and said rod member, and wherein said distal end is threaded for insertion into and engagement with one of said bone segments, and further wherein said shoulder portion is adapted for spacing said rod member from said bone segments and is provided upon an upper portion thereof with a bevel adapted to facilitate a substantially locking engagement between said post member and said block nut member;

a block nut member mounted upon said rod member for securing said rod member relative to said post member, said block nut member defining a bore extending substantially vertically therethrough, said bore configured and adapted to permit passage of at least a portion of said post member proximal end to create an interlocking fit with said post member; and

at least one spacer member located between said post member shoulder portion and said block nut member, said at least one spacer member configured for controlling the distance between said shoulder portion and a lower surface of said block nut member.

2. A stabilization device according to claim 1 wherein said at least one spacer member is provided with a bevel upon a first and second portion thereof adjacent, respectively, said shoulder and the lower surface of said block nut member, to facilitate a substantially interlocking fit thereamong.

3. A device for stabilizing bone segments, said device comprising:

at least one elongated rod member, said member defining at least one slotted opening therethrough and having a threaded exterior portion; and

means for anchoring said at least one rod member to a plurality of bone segments, each said anchoring means comprising

a post member having a proximal end and a distal end, wherein said proximal end is configured and adapted for insertion through said at least one opening in said rod member and also through a block nut member adapted for securing said elongated rod member relative to said post member, and wherein said post member distal end is threaded for insertion into and engagement with one of said bone segments, and

a block nut member mounted upon said rod member, said block nut member defining an axial bore extending longitudinally therethrough from a first side to a second side thereof configured and adapted for passage of at least a portion of said elongated rod member therethrough to permit adjustable positioning of said block nut member along said rod member, said block nut member further defining a substantially vertical bore configured for receiving the proximal end of said post member to create an interlocking fit with said post member.

4. A stabilization device according to claim 3 wherein said vertical bore intersects with said axial bore within said block nut member and wherein said vertical bore is alignable with said at least one slotted opening in said rod member.

5. A stabilization device according to claim 3 wherein said vertical bore is offset from said axial bore within said block nut member.

6. A stabilization device according to claim 3 wherein said proximal end of said post member is threaded and wherein said engaging means further comprises means for locking said proximal end of said post member within said substantially vertical bore of said block nut member.

7. A stabilization device according to claim 6 wherein said locking means comprises a post nut adapted for threaded engagement with said proximal end of said post member.

8. A stabilization device according to claim 3 further comprising means for securing said elongated rod to a sacrum, said sacrum securing means comprising an end block member positioned upon a terminal portion of said elongated rod member adjacent said sacrum, said end block member defining a first axial bore configured and adapted for receiving said terminal portion of said elongated rod and a second, substantially vertical bore, spaced apart from said first bore, and adapted for receiving a sacrum engaging screw for securing said end block member to said sacrum.

9. A stabilization device according to claim 8, wherein said first aperture defines a first axis and said second aperture defines a second axis intersecting with said first axis, and wherein said first and second axes intersect at an angle of between about 65 and 90 degrees.

10. A stabilization device according to claim 8 which further comprises a bore adjustment member adapted for repairing means for engaging at least one of said bone segments, said engaging means selected from the group consisting of a post member and a bone screw, said bore adjustment member having a proximal end and a distal end, said distal end provided with an augur thread configuration adapted to create, within said bone segment, a new bore having a width greater than that of said engaging means, said proximal end having a threaded inner axial bore portion therein with a pitch and a diameter corresponding to that of the threaded portion of said engaging means, said engaging means thereafter being screwed into the inner axial bore of the bore adjustment member to provide a locking engagement therebetween.

11. A device for stabilizing a plurality of spinal bone segments, said device comprising:

at least one elongated rod member defining at least one slotted opening therethrough and having a threaded exterior portion;

at least one adjustable block nut member, each said adjustable block nut member having an axial bore extending therethrough from a first side to a second side thereof, configured and adapted to permit adjustable positioning of said block nut member along said elongated rod member; and

a substantially vertical bore adapted for engagement with at least a portion of a means for securing said block nut member to a bone segment;

a post member for securing each said adjustable block nut member to a bone segment, each said post member having a proximal and a distal end, said distal end being threaded for insertion into and engagement with a spinal bone segment, said proximal end configured and adapted for insertion through said at least one slotted opening in said elongated rod member and into said substantially vertical bore in a corresponding adjustable block nut member;

a locking member threadably engageable upon a correspondingly threaded portion of the proximal end of each said post member for locking together each said adjustable block nut member with a corresponding post member; and

an end block member upon a terminal portion of each said elongated rod adjacent a sacrum portion of said spinal column for securing said elongated rod member to said sacrum, said end block member defining a first axial bore configured and adapted for receiving said terminal portion of said elongated rod and a second substantially vertical bore, spaced apart from said first bore, adapted for receiving a sacrum engaging screw for securing said end block member to said sacrum.

12. A stabilization device according to claim 11 which further comprises a bore adjustment member adapted for repairing means for engaging at least one of said bone segments, said engaging means selected from the group consisting of a post member and a bone screw, said bore adjustment member having a proximal end and a distal end, said distal end provided with an augur thread configuration adapted to create, within said bone segment, a new bore having a width greater than said engaging means, said proximal end having a threaded inner axial bore portion therein with a pitch and a diameter corresponding to that of the threaded portion of said engaging means, said engaging means thereafter being screwed into the inner axial bore of the bore adjustment member to provide a locking engagement therebetween.

13. A stabilization device according to claim 11 which comprises first and second elongated rod members and at least one means for transversely interconnecting said members and thereby maintaining said rod members in a predetermined spatial relation to each other.

14. A device for stabilizing a plurality of spinal bone segments, said device comprising:

at least one elongated rod member defining at least one slotted opening therethrough and having a threaded exterior portion;

at least one adjustable block nut member, each said adjustable block nut member having an axial bore extending therethrough from a first side to a second side thereof, configured and adapted to permit adjustable positioning of said block nut member along said elongated rod member; and

a substantially vertical bore adapted for engagement with at least a portion of a means for securing said block nut member to a bone segment;

a post member for securing each said adjustable block nut member to a bone segment, each said post member having a proximal and a distal end, said distal end being threaded for insertion into and engagement with a bone segment, said proximal end configured and adapted for insertion through said at least one slotted opening in said elongated rod member and into said substantially vertical bore in a corresponding adjustable block nut member;

a locking member threadably engageable upon a correspondingly threaded portion of the proximal end of each said post member for locking together each said adjustable block nut member with a corresponding post member;

an end block member upon a terminal portion of each said elongated rod adjacent a sacrum portion of said spinal column for securing said elongated rod member to said sacrum, said end block member defining a first axial bore configured and adapted for receiving said terminal portion of said elongated rod and a second substantially vertical bore, spaced apart from said first bore, adapted for receiving a sacrum engaging screw for securing said end block to said sacrum; and

a bore adjustment member interposed between said sacrum engaging screw and said sacrum, said bore adjustment member having a proximal end and a distal end, said distal end provided with an augur thread configuration adapted to permit creation of a new bore in said sacrum having a width greater than that of said sacrum engaging screw, and said proximal end having a threaded inner axial bore portion therein with a pitch and a diameter corresponding to that of a threaded portion of said sacrum engaging screw, said sacrum engaging screw thus being thereafter screwed into said axial bore of said bore adjustment member to provide a locking engagement therebetween.

15. A device for stabilizing bone segments, said device comprising:

(a) first and second fixation assemblies, each said fixation assembly comprising

at least one elongated rod member defining at least one slotted opening therethrough and having a threaded exterior portion;

at least one adjustable block nut member, each said adjustable block nut member having an axial bore extending therethrough from a first side to a second side thereof, configured and adapted to permit adjustable positioning of said block nut member along said elongated rod member; and

a substantially vertical bore adapted for engagement with at least a portion of a means for securing said block nut member to a bone segment;

a post member for use in securing each said adjustable block nut member to a bone segment, each said post member having a proximal end and a distal end, said distal end being threaded for insertion into and engagement with a spinal bone segment, said proximal end configured and adapted for insertion through said at least one slotted opening in said elongated rod member and into said substantially vertical bore in a corresponding adjustable block nut member;

a locking member threadably engageable upon a correspondingly threaded portion of the proximal end of each said post member for locking together each said block nut member with a corresponding post member; and

(b) at least one means for transversely interconnecting said first and second fixation assemblies and thereby maintaining said assemblies in substantially parallel relation to each other.

16. A stabilization device according to claim 15 further comprising means for securing said elongated rod to a sacrum, said sacrum securing means comprising an end block member positioned upon a terminal portion of said elongated rod member adjacent said sacrum, said end block member defining a first axial bore configured and adapted for receiving said terminal portion of said elongated rod and a second, substantially vertical bore, spaced apart from said first bore, and adapted for receiving a sacrum engaging screw for securing said end block to said sacrum.

17. A stabilization device according to claim 16, wherein each said transverse connection means comprises:

an elongate member extendable between said first and said second elongated rod members;

first attachment means for connecting a first terminal portion of said elongate member with said first elongated rod member; and

second attachment means for connecting a second terminal portion of said elongate member with said second elongated rod member.

18. A stabilization device according to claim 17 wherein said elongate member comprising a first axial end portion having a left hand thread and a second axial end portion having a right hand thread.

19. A stabilization device according to claim 18 wherein said elongate member further comprises a drive portion located intermediate to said first and said second axial end portions.

20. A stabilization device according to claim 19 wherein said drive portion comprises a plurality of diametrically opposed flats configured for engagement by wrench means for causing rotation thereof.

21. A stabilization device according to claim 20 wherein at least one of said flats defines an aperture, each said aperture being configured and adapted for engagement with tool means adapted for insertion within said aperture to permit rotation of said drive member.

22. A stabilization device according to claim 19 wherein said first and said second attachment means each comprise:

an inner clamp member comprising a connector portion having a threaded bore extending axially therethrough for threaded engagement with a first one of the threaded end portions, and a body portion formed integral with said connector portion, said body portion having, on an inner aspect thereof, a threaded surface corresponding to the threads on said elongated rod member for securing said inner clamp member thereto; and

an outer clamp member comprising a connector portion having a substantially smooth bore extending therethrough in alignment with said axial threaded bore in said inner clamp member for engagement with said first end portion of said elongate member, and a body portion formed integral with said connector portion of said outer clamp member, said body portion having, on an inner aspect thereof a threaded surface corresponding to the threads on said elongated rod member for securing said outer clamp member thereto,

wherein each said axial end portion is connected, respectively, to both an inner and an outer clamp member through respectively, said threaded and said substantially smooth axial bores thereof such that rotation of said drive portion in a first direction causes said inner and outer clamp members to move toward one another whereas rotation in a second, opposite direction causes them to move apart.

23. A stabilization device according to claim 22 wherein said outer clamp member further includes a set screw for retention of said threaded end portion of said elongate member within said substantially smooth bore.

24. A method for supplying selective angular corrective forces to a plurality of spinal bone segments, said method comprising:

providing a surgical incision on a dorsal surface of a patient adjacent said patient'"'"'s spinal column;

installing, upon said spinal column, a stabilization device comprising

(a) first and second fixation assemblies, each said fixation assembly comprising

at least one elongated rod member defining at least one slotted opening therethrough and having a threaded exterior portion;

at least one adjustable block nut member, each said adjustable block member having an axial bore extending therethrough from a first side to a second side thereof, configured and adapted to permit adjustable positioning of said block nut member along said elongated rod member; and

a substantially vertical bore adapted for engagement with at least a portion of means for securing said block nut member to a bone segment;

a post member for use in securing each said adjustable block nut member to a bone segment, each said post member having a proximal and a distal end, said distal end being threaded for insertion into and engagement with a spinal bone segment, said proximal end configured and adapted for insertion through said at least one slotted opening in said elongated rod member and into said substantially vertical bore in a corresponding adjustable block nut member;

a locking member threadably engageable upon a correspondingly threaded portion of the proximal end of each said post member for locking together each said block nut member with a corresponding post member, and

an end block member located upon a lower terminal portion of each said elongated rod adjacent a sacrum portion of said spinal column for securing said elongated rod member to said sacrum, said end block member defining a first axial bore configured and adapted for receiving said terminal portion of said elongated rod and a second substantially vertical bore, spaced apart from said first bore, adapted for receiving a sacrum engaging screw for securing said end block to said sacrum; and

(b) at least one means for interconnecting said first and second fixation assemblies and thereby maintaining said assemblies in substantially parallel relation to each other; and

adjusting said stabilization device to provide graded angular movement to said spinal bone segments.