Instrument for the positioning of an implant in the human spine

• US 6,296,647 B1
• Filed: 08/06/1999
• Issued: 10/02/2001
• Est. Priority Date: 08/07/1998
• Status: Expired due to Term

• Current Assignee: Stryker European Operations Holdings, LLC (Stryker Corporation)
• Original Assignee: Stryker Trauma GmbH (Stryker Corporation)
• Inventors: Windhager, Reinhard, Wuisman, Paul, Vlasak, Richard, Kotz, Rainer, Lutz, Christian, Robioneck, Bernd
• Primary Examiner(s): Mancene, Gene
• Assistant Examiner(s): Priddy, Michael B.
• Application Number:
  US09/369,477
• Time in Patent Office: 788 Days
• Field of Search: 606/61, 606/90, 606/105, 623/17.11, 623/17.12, 623/17.13, 623/17.14, 623/17.15, 623/17.16, 600/231, 600/232, 600/233, 600/235
• US Class Current: 606/105
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/70 Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
• CPC Class Codes: A61B 17/7059 Cortical plates A61B17/7007, A61B17/7058 take precedence
• CPC Class Codes: A61B 17/809 with bone-penetrating elements, e.g. blades or prongs bone staples A61B17/0642; intramedullary nails with a plate at an end A61B17/7233
• CPC Class Codes: A61B 17/86 Pins or screws or threaded wires; nuts therefor A61B17/72 take precedence
• CPC Class Codes: A61F 2/44 for the spine, e.g. vertebrae, spinal discs
• CPC Class Codes: A61F 2/4611 of spinal prostheses
• CPC Class Codes: A61F 2002/30125 elliptical or oval
• CPC Class Codes: A61F 2002/30131 horseshoe- or crescent- or C-shaped or U-shaped
• CPC Class Codes: A61F 2002/30228 Cylinders of elliptical or oval basis
• CPC Class Codes: A61F 2002/30235 tubular, e.g. sleeves
• CPC Class Codes: A61F 2002/30237 partial tubes
• CPC Class Codes: A61F 2002/30329 Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2002/30383 made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
• CPC Class Codes: A61F 2002/30387 Dovetail connection
• CPC Class Codes: A61F 2002/30428 made by inserting a protrusion into a slot
• CPC Class Codes: A61F 2002/30494 Cooperating protrusions and recesses, e.g. radial serrations, located on abutting end surfaces of a longitudinal connection
• CPC Class Codes: A61F 2002/30507 using a threaded locking member, e.g. a locking screw or a set screw
• CPC Class Codes: A61F 2002/30517 using a locking plate
• CPC Class Codes: A61F 2002/3055 for adjusting length
• CPC Class Codes: A61F 2002/30553 : for adjusting a position by translation along an axis
• CPC Class Codes: A61F 2002/30578 : having apertures, e.g. for receiving fixation screws
• CPC Class Codes: A61F 2002/30593 : hollow
• CPC Class Codes: A61F 2002/30599 : stackable
• CPC Class Codes: A61F 2002/30601 : telescopic
• CPC Class Codes: A61F 2002/30604 : modular
• CPC Class Codes: A61F 2002/30774 : internally-threaded
• CPC Class Codes: A61F 2002/30777 : Oblong apertures
• CPC Class Codes: A61F 2002/30785 : parallel
• CPC Class Codes: A61F 2002/30787 : inclined obliquely with respect to each other
• CPC Class Codes: A61F 2002/30841 : Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
• CPC Class Codes: A61F 2002/30975 : made of two halves
• CPC Class Codes: A61F 2220/0025 : Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2230/0008 : elliptical or oval
• CPC Class Codes: A61F 2230/0013 : Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped
• CPC Class Codes: A61F 2230/0069 : cylindrical
• CPC Class Codes: A61F 2250/0008 : for adjusting a position by translation along an axis or two perpendicular axes
• CPC Class Codes: A61F 2250/0063 : Nested prosthetic parts

Abstract

An instrument for the positioning of an implant into the human spine, as a replacement for one or more diseased vertebra bodies has vertebra body plates attachable to the healthy vertebra bodies. Distraction rods are provided which at one end are attachable to a vertebra body plate. Two U-shaped parts having limbs which telescopically cooperate and form a tubular housing around the attached distraction rods. The U-shaped parts comprise inner sections which are supported on the distraction rods. A distraction instrument which is connectable to the other ends of the distraction rods is used for exerting a force onto the rods transversely to their longitudinal direction.

Claims

1. An instrument for the positioning of an implant in the human spine, as a replacement for one or more vertebra bodies located between two healthy vertebra bodies, comprising:

a pair of vertebra body plates each attachable to a healthy vertebra body;

a pair of distraction rods, which at one end are attachable to one of said vertebra body plates;

two U-shaped parts, each having a pair of limbs forming the legs of the U, said limbs of each U-shaped part telescopically cooperate and form a tubular housing around the attached distraction rods, wherein the U-shaped parts comprise inner sections which are supported on the distractions rods; and

a distraction instrument which is connected to the distraction rods for exerting a force onto the rods transversely to their longitudinal extension.

2. The instrument according to claim 1, wherein the vertebra plates have a first limb for bearing against an end surface of a healthy vertebra body and with a second limb which bears on the circumferential surface of said healthy vertebra body, wherein the second limb comprises a threaded hole for a connection to the distraction rod.

3. The instrument according to claim 2 for use with an implant having a side which faces a vertebra body and includes a receiving section for receiving said first limb and the receiving section being formed such that said implant may be inserted in a space from which said vertebra bodies have been removed while the vertebra plates are bearing against said healthy vertebra bodies.

4. The instrument according to claim 1, wherein the U-shaped parts have a wall which is curved outwardly in a circular arc shaped manner.

5. The instrument according to claim 4, wherein the walls have an inner side on which is mounted an attachment extending between the limbs of the U-shaped parts, said attachment having an opening to at least partly accommodate one of the distraction rods.

6. The instrument according to claim 1, wherein on one of said limbs of one of said U-shaped parts there is formed a row of recesses and on one of said limbs of the other of said U-shaped part there is a bar with a lateral peg which can be lockingly introduced into one of the recesses.

7. The instrument according to claim 6, wherein the recesses comprise a narrow section and the lateral peg comprises a non-circular elongate cross section rotatably mounted in the bar in a manner such that it may be inserted into and through a narrow section of one of the recesses only in a first rotational position and in a second wider rotational position can be locked in the recess.

8. The instrument according to claim 7, wherein the bar has two ends and at both ends comprises a rotatable non-circular locking peg and the lateral edges of the other U-shaped part likewise comprise at least one recess with a narrow section.

9. The instrument according to claim 1, wherein said U-shaped parts are formed such that they can be telescopically inserted into one another.

10. The instrument according to claim 1, wherein an introduction rod connectable to one of the vertebra plates serves as a distraction rods.

11. The instrument according to claim 10, wherein said distraction rod which can be releasably attached laterally on the implant.

12. The instrument according to claim 11, wherein the rods are connectable to a releasable handle.

13. The instrument according to claim 1, wherein the said implant comprises a stack of a least three cage-like annular bodies joined by a compression plate and an adjusting screw which is screwed into a middle body of said at least three bodies, said adjusting screw having an end screwed to the compression plate, wherein a threaded section of the adjusting screw extends through an elongate hole in the compression plate and an introduction rod can be brought into rotational engagement with said end of the threaded section and there is provided a hollow rod with a drive at one end for a nut which can be screwed onto the threaded section of said adjusting screw.

14. The instrument according to claim 1, wherein a distraction frame is provided with two jaws of which one is rigidly attached to a connection piece and the other jaw is moveable in steps with respect thereto, on the jaws there are attached receiving openings for the receiving of said distraction rods, wherein the one receiving opening on the moveable jaw is adjustable with respect to the rigid jaw.

15. The instrument according to claim 1, wherein said one of distraction rods has an inner end comprising an L-shaped plate formed by a pair of limbs with one limb of said L-shaped plate bearing against the end surface of the vertebra body and the other limb of the L-shaped plate bearing against the lateral wall of the vertebra body.

16. A method for replacing diseased vertebra located between two healthy vertebra with an implant, comprising:

attaching one of a pair of generally L-shaped guide elements to each of the two healthy vertebra, a first leg of the L-shaped guide element including a guide surface extending into a space between the healthy vertebra and the diseased vertebra;

attaching a rod to a second leg of each of the L-shaped guide elements, which leg extends along an outer surface of the healthy vertebra;

distracting said healthy vertebra by distracting said rods;

removing said diseased vertebra, creating a space between the healthy vertebra; and

inserting an implant having guide surfaces into said space by using the guide surfaces on said L-shaped guide element to guide corresponding guide surfaces on said implant.

17. The method as set forth in claim 16 further including placing an expandable cover over said rods prior to distracting.

18. The method as set forth in claim 16, wherein said guide surfaces on said first leg of said L-shaped guide element and said implant are mating male and female guide tracks.

19. The method as set forth in claim 18, wherein said guide tracks are slideable rods having a dovetail shape.

20. A method for replacing diseased vertebra located between two healthy vertebra with an implant comprising:

attaching a rod to each healthy vertebra via an L-shaped plate, said L-shaped plate having a first leg including a guide surface extending into a space between a healthy vertebra and a diseased vertebra and a second leg fixed to an outer surface of said healthy vertebra;

distracting said healthy vertebra by distracting said rods;

removing said diseased vertebra creating a space between the healthy vertebra; and

inserting an implant having a guide surface formed thereon into said space by using the guide surface on said first leg of said L-shaped plate to guide a corresponding guide surface formed on said implant.

21. The method as set forth in claim 20 further including placing an expandable cover over said rods prior to distracting.

22. The method as set forth in claim 21 wherein said cover is composed of two U-shaped parts that can be telescopically inserted into one another.

23. The method as set forth in claim 20, wherein said guide surfaces on said first leg of said L and said implant are mating male and female guide tracks.

24. The method as set forth in claim 23, wherein said guide tracks are slideable rods having a dovetail shape.

25. A system for replacing a diseased vertebra located between two healthy vertebra with an implant comprising:

a generally L-shaped plate coupled to each of the two healthy vertebra, said plate having a first leg, including a guide surface extending into a space between the healthy vertebra and the diseased vertebra and a second leg fixed to said healthy vertebra;

a rod coupled to said second leg of each of said generally L-shaped plates and extending outwardly from said healthy vertebra;

a distraction tool engageable with said rod coupled to each healthy vertebra for distracting said healthy vertebra to allow removal of the diseased vertebra;

an implant having guide surfaces formed thereon engageable with the guide surfaces on said first leg of said L-shaped plate to guide the implant into a space created by the removal of the diseased vertebral; and

an expandable hollow cover sized to fit over said rods and surround said diseased vertebra.

26. The system as set forth in claim 25, wherein said expandable cover comprises two U-shaped parts that can be telescopically inserted into one other.

27. The instrument according to claim 26, wherein the U-shaped parts have walls, the walls have an inner side on which is mounted an attachment extending between the limbs of the U-shaped parts, said attachment having an opening to at least partly accommodate the rod.

28. The instrument according to claim 25, wherein said U-shaped parts have a limb on which there is formed a row of recesses and on the other U-shaped part there is a bar with a lateral peg which can be lockingly introduced into one of the recesses.

29. The instrument according to claim 28, wherein the recesses comprise a narrow section and the locking peg comprises a non-circular elongate cross section rotatably mounted in the bar in a manner such that it may be inserted into and through a narrow section of one of the recesses only in a first rotational position and in a second wider rotational position can be locked in the recess.