Single-lock skeletal plating system

• US 6,383,186 B1
• Filed: 09/26/2000
• Issued: 05/07/2002
• Est. Priority Date: 02/11/1997
• Status: Expired due to Term

• Current Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Original Assignee: Gary K. Michelson
• Inventors: Michelson, Gary K.
• Primary Examiner(s): REIP, DAVID OWEN
• Application Number:
  US09/669,912
• Time in Patent Office: 588 Days
• Field of Search: 606/60, 606/61, 606/69, 606/70, 606/71, 606/72, 606/73
• US Class Current: 606/70
• CPC Class Codes: A61B 17/1604 Chisels; Rongeurs; Punches; Stamps
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/1728 for holes for bone plates or plate screws
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 17/7059 Cortical plates A61B17/7007, A61B17/7058 take precedence
• CPC Class Codes: A61B 17/80 Cortical plates , i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
• CPC Class Codes: A61B 17/8019 where the means are a separate tool rather than being part of the plate
• CPC Class Codes: A61B 17/8033 having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers
• CPC Class Codes: A61B 17/8042 the additional component being a cover over the screw head
• CPC Class Codes: A61B 17/8052 immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded
• CPC Class Codes: A61B 17/8085 with pliable or malleable elements or having a mesh-like structure, e.g. small strips A61B17/8071, A61B17/8076 take precedence
• CPC Class Codes: A61B 17/861 specially shaped for gripping driver
• CPC Class Codes: A61B 17/8625 Shanks, i.e. parts contacting bone tissue
• CPC Class Codes: A61B 17/863 with thread interrupted or changing its form along shank, other than constant taper
• CPC Class Codes: A61B 17/8695 Washers surrounding screw head in plate hole A61B17/8047, between bone plate and bone A61B17/8028
• CPC Class Codes: A61B 17/8875 Screwdrivers, spanners or wrenches
• CPC Class Codes: A61B 2017/0046 with a releasable handle; with handle and operating part separable for prosthetic joint-implanting tools A61F2/4603
• CPC Class Codes: A61B 2017/8655 with special features for locking in the bone
• CPC Class Codes: A61F 2/0077 Special surfaces of prostheses, e.g. for improving ingrowth A61F2/30767 takes precedence
• CPC Class Codes: Y10S 606/909 Bone

Abstract

The present invention is directed to (1) a plating system having multiple and single locking mechanisms for general skeletal use other than in the anterior cervical spine; (2) an orthopedic plating system that permits a pair of bone screws to be inserted into a bone in a crossed over orientation and locked to the plate; (3) a segmentable plating system which can be made to a selected length by the surgeon; and (4) a combination screw-lock-plating system for allowing and/or causing intersegmental compression of bone portions.

Claims

1. A skeletal plating system for aligning and maintaining bone portions of the same bone or of different bones in a selected spatial relationship for healing or fusion of the bone portions, said skeletal plating system comprising:

a plate having a longitudinal axis and a length sufficient to span at least two bone portions, said plate having an upper surface and a lower surface for placement against the bone portions, said lower surface being selected from one of flat and convex along a substantial portion of the longitudinal axis of said plate;

at least two bone screws each having a central longitudinal axis and being adapted to engage each of the at least two bone portions, respectively, each of said bone screws having a leading end for insertion into the bone portions and a trailing end opposite said leading end;

at least two bone screw receiving holes extending through said plate from said upper surface to said lower surface, each of said bone screw receiving holes having a central longitudinal axis and being adapted to receive one of said bone screws to attach said plate to the bone portions, each of said bone screw receiving holes and said bone screws being configured to cooperate with each other to fixedly align the central longitudinal axis of one of said bone screws with the central longitudinal axis of one of said bone screw receiving holes, at least a first of said bone screw receiving holes adapted to overlie a first of the bone portions and at least a second of said bone screw receiving holes adapted to overlie a second of the bone portions; and

at least one locking element associated with only one of said bone screw receiving holes and adapted to lock to said plate only one of said bone screws inserted into one of said bone screw receiving holes, said at least one locking element having a central longitudinal axis being substantially aligned with both the central longitudinal axis of said bone screw receiving hole and the central longitudinal axis of said bone screw when inserted in said bone screw receiving hole to retain said bone screw to said plate.

2. The plate of claim 1, wherein said at least one locking element is generally circular and said central longitudinal axis of said at least one locking element is the rotational axis of said at least one locking element, said rotational axis being coaxial to the central longitudinal axis of one of said bone screw receiving holes when said at least one locking element is inserted in said bone screw receiving hole.

3. The plate of claim 1, wherein said lower surface is concave along an axis transverse to the longitudinal axis of said plate.

4. The plate of claim 1, wherein said lower surface is flat along an axis transverse to the longitudinal axis of said plate.

5. The plate of claim 1, wherein said at least one locking element is pre-installed to said plate prior to insertion of bone screws into said bone screw receiving holes.

6. The plate of claim 1, wherein said at least one locking element is at least in part circular.

7. The plate of claim 1, further comprising a threaded recess associated with one of said bone screw receiving holes.

8. The plate of claim 1, wherein said at least one locking element has at least one wedged surface.

9. The plate of claim 1, wherein at least a portion of said lower surface comprises a bone ingrowth material.

10. The plate of claim 1, wherein at least two of said bone screw receiving holes are paired, at least a first bone screw receiving hole in said paired bone screw receiving holes being staggered from a second bone screw receiving hole in said pair, and the center points of said first and second paired bone screw receiving holes being on different transverse lines along the transverse axis of said plate such that the central longitudinal axes of said first paired bone screw receiving holes form an included angle to each other greater than 25 degrees and less than 90 degrees.

11. The system of claim 1, wherein at least one of said bone screw receiving holes is threaded.

12. The plate system of claim 1, wherein at least a portion of said lower surface of said plate includes a bone ingrowth surface.

13. The plate system of claim 1, in combination with a bone growth promoting material.

14. The plate system of claim 13, wherein said bone growth promoting material is at least in part other than bone.

15. The plate system of claim 13, wherein said bone growth promoting material is at least in part bone.

16. The plate system of claim 13, wherein said bone growth promoting material comprises bone morphogenetic protein.

18. The system of claim 7, wherein said lower surface is concave along an axis transverse to the longitudinal axis of said plate.

17. A skeletal plating system for aligning and maintaining bone portions of the same bone or of different bones in a selected spatial relationship for healing or fusion of the bone portions, said skeletal plating system comprising:

a plate having a longitudinal axis and a length sufficient to span at least two bone portions, said plate having an upper surface and a lower surface for placement against the bone portions, said lower surface of said plate being selected from one of flat and convex along a substantial portion of the longitudinal axis of said plate;

at least two bone screws each having a central longitudinal axis and being adapted to engage each of the at least two bone portions, respectively, each of said bone screws having a leading end for insertion into the bone portions and a trailing end opposite said leading end, said trailing end having a top surface oriented toward said upper surface of said plate and a bottom surface opposite said top surface oriented toward said lower surface of said plate;

at least two bone screw receiving holes extending through said plate from said upper surface to said lower surface, at least a first of said bone screw receiving holes adapted to overlie a first of the bone portions and at least a second of said bone screw receiving holes adapted to overlie a second of the bone portions, each of said bone screw receiving holes being configured to prevent said bottom surface of said trailing end of said bone screw from protruding below said lower surface of said plate; and

at least one locking element for locking to said plate a bone screw insertable into a single one of said bone screw receiving holes, said at least one locking element being coaxially engageable to only one of said bone screw receiving holes to retain said one of said bone screws to said plate.

19. The system of claim 17, wherein said lower surface is flat along an axis transverse to the longitudinal axis of said plate.

20. The system of claim 17, further comprising a threaded recess associated with one of said bone screw receiving holes.

21. The system of claim 17, wherein said at least one locking element has at least one wedged surface.

22. The system of claim 17, wherein at least a portion of said lower surface comprises a bone ingrowth material.

23. The system of claim 17, wherein at least two of said bone screw receiving holes are paired, at least a first bone screw receiving hole in said paired bone screw receiving holes being staggered from a second bone screw receiving hole in said pair, and the center points of said first and second paired bone screw receiving holes being on different transverse lines along the transverse axis of said plate such that the central longitudinal axes of said first paired bone screw receiving holes form an included angle to each other greater than 25 degrees and less than 90 degrees.

24. The system of claim 17, wherein at least one of said bone screw receiving holes is threaded.

25. The system of claim 17, wherein said at least one locking element is generally circular and said central longitudinal axis of said at least one locking element is the rotational axis of said at least one locking element, said rotational axis being coaxial to the central longitudinal axis of one of said bone screw receiving holes when said at least one locking element is inserted in said bone screw receiving hole.

26. The plate system of claim 17, wherein at least a portion of said lower surface of said plate includes a bone ingrowth surface.

27. The plate system of claim 17, in combination with a bone growth promoting material.

28. The plate system of claim 27, wherein said bone growth promoting material is at least in part other than bone.

29. The plate system of claim 27, wherein said bone growth promoting material is at least in part bone.

30. The plate system of claim 27, wherein said bone growth promoting material comprises bone morphogenetic protein.

31. A skeletal plating system for aligning and maintaining bone portions of the same bone or of different bones in a selected spatial relationship for healing or fusion of the bone portions, said skeletal plating system comprising:

a plate having a longitudinal axis and a length sufficient to span at least two bone portions, said plate having an upper surface and a lower surface for placement against the bone portions, said lower surface being selected from one of flat and convex along a substantial portion of the longitudinal axis of said plate;

at least two bone screws each having a central longitudinal axis and being adapted to engage each of -the at least two bone portions, respectively, each of said bone screws having a leading end for insertion into the bone portions and a trailing end opposite said leading end, said bone screw proximate said trailing end having an upper surface oriented toward said upper surface of said plate and a bottom surface opposite said upper surface of said bone screw oriented toward said lower surface of said plate;

at least two bone screw receiving holes extending through said plate from said upper to said lower surface, at least a first of said bone screw receiving holes adapted to overlie a first of the bone portions and at least a second of said bone screw receiving holes adapted to overlie a second of the bone portions; and

at least one locking element for locking to said plate one of said bone screws inserted into a single one of said plurality of bone screw receiving holes, each of said bone screw receiving holes;

having an offset recess associated with only that one of said bone screw receiving holes adapted to receive said at least one locking element, said at least one locking element configured to overlap at least a portion of said upper surface of said bone screw inserted in one of said bone screw receiving holes.

32. The system of claim 31, wherein said at least one locking element is movable from a first position to a second position, said at least one locking element being configured so as to permit insertion of a bone screw into one of said bone screw receiving holes associated with said offset when in said first position.

33. The system of claim 31, wherein said lower surface is concave along an axis transverse to the longitudinal axis of said plate.

34. The system of claim 31, wherein said at least one locking element is pre-installed to said plate prior to the insertion of bone screws into said bone screw receiving holes.

35. The system of claim 31, wherein said at least one locking element is a rivet.

36. The system of claim 31, further comprising a threaded recess associated with one of said bone screw receiving holes.

37. The system of claim 31, wherein said at least one locking element has at least one wedged surface.

38. The system of claim 31, wherein at least a portion of said lower surface comprises a bone ingrowth material.

39. The system of claim 31, wherein at least two of said bone screw receiving holes are paired, at least a first bone screw receiving hole in said paired bone screw receiving holes being staggered from a second bone screw receiving hole in said pair, and the center points of said first and second paired bone screw receiving holes being on different transverse lines along the transverse axis of said plate such that the central longitudinal axes of said first paired bone screw receiving holes form an included angle to each other greater than 25 degrees and less than 90 degrees.

40. The system of claim 31, wherein said at least one locking element is permanently attached to said plate.

41. The plate system of claim 31, wherein at least a portion of said lower surface of said plate includes a bone ingrowth surface.

42. The plate system of claim 31, in combination with a bone growth promoting material.

43. The plate system of claim 42, wherein said bone growth promoting material is at least in part other than bone.

44. The plate system of claim 42, wherein said bone growth promoting material is at least in part bone.

45. The plate system of claim 42, wherein said bone growth promoting material comprises bone morphogenetic protein.

46. A skeletal plating system for aligning and maintaining bone portions of the same bone or of different bones in a selected spatial relationship for healing or fusion of the bone portions, said skeletal plating system comprising:

a plate having a longitudinal axis and a length sufficient to span at least two bone portions, said plate having an upper surface and a lower surface for placement against the bone portions, said lower surface being selected from one of flat and convex along a substantial portion of the longitudinal axis of said plate;

at least two bone screw receiving holes extending through said plate from said upper to lower surface, at least a first of said bone screw receiving holes adapted to overlie a first of the bone portions and at least a second of said bone screw receiving holes adapted to overlie a second of the bone portions; and

at least one locking element for locking to said plate a bone screw insertable into a single one of said bone screw receiving holes, each of said bone screw receiving holes having an offset recess associated with only that one of said bone screw receiving holes adapted to receive a locking element, at least one of said recesses being threaded.

47. The system of claim 46, wherein said at least one locking element is movable from a first position to a second position, said at least one locking element being configured so as to permit insertion of a bone screw into one of said bone screw receiving holes associated with said offset recess when in said first position.

48. The system of claim 46, wherein said lower surface is concave along an axis transverse to the longitudinal axis of said plate.

49. The system of claim 46, wherein said lower surface is flat along an axis transverse to the longitudinal said plate.

50. The system of claim 46, wherein said at least one locking element is pre-installed to said plate prior to the insertion of bone screws into said bone screw receiving holes.

51. The system of claim 46, wherein said at least one locking element has at least one wedged surface.

52. The system of claim 46, wherein at least a portion of said lower surface comprises a bone ingrowth material.

53. The system of claim 46, wherein said at least one locking element is permanently attached to said plate.

54. The plate system of claim 46, wherein at least a portion of said lower surface of said plate includes a bone ingrowth surface.

55. The plate system of claim 46, in combination with a bone growth promoting material.

56. The plate system of claim 55, wherein said bone growth promoting material is at least in part other than bone.

57. The plate system of claim 55, wherein said bone growth promoting material is at least in part bone.

58. The plate system of claim 55, wherein said bone growth promoting material comprises bone morphogenetic protein.

59. A skeletal plating system for aligning and maintaining bone portions of the same bone or of different bones in a selected spatial relationship for healing or fusion of the bore portions, said skeletal plating system comprising:

a plate having a lower surface for contacting the bone portions and an upper surface opposite said lower surface, said lower surface being selected from one of flat and convex along a substantial portion of the longitudinal axis of said plate;

at least two bone screws each having a central longitudinal axis and being adapted to engage each of the at least two bone portions, respectively, each of said bone screws having a leading end for insertion into the bone portion and a trailing end opposite said leading end, at least one of said bone screws including proximate said trailing end a maximum cross sectional dimension transverse to the central longitudinal axis of said bone screw, said bone screw having a contact surface area at the maximum cross sectional dimension;

at least two bone screw receiving holes extending through said plate from said upper surface through said lower surface, each of said bone screw receiving holes having a central longitudinal axis and being adapted to receive one of said bone screws to attach said plate to the bone portions; and

at least one locking element adapted to lock to said plate only one of said bone screws inserted in one of said bone screw receiving holes, said at least one locking element adapted to coaxially engage a respective one of said bone screw receiving holes and to contact said contact surface area of a respective one of said bone screws so as to retain said respective one of said bone screws to said plate.

60. The plate of claim 59, wherein said lower surface is concave along an axis transverse to the longitudinal axis of said plate.

61. The plate of claim 59, wherein said lower surface is flat along an axis transverse to the longitudinal axis of said plate.

62. The plate of claim 59, wherein said at least one locking element is pre-installed to said plate prior to insertion of bone screws into said bone screw receiving holes.

63. The plate of claim 59, wherein said at least one locking element is at least in part circular.

64. The system of claim 59, wherein said at least one locking element is generally circular and said central longitudinal axis of said at least one locking element is the rotational axis of said at least one locking element, said rotational axis being coaxial to the central longitudinal axis of one of said bone screw receiving holes when said at least one locking element is inserted in said bone screw receiving hole.

65. The plate of claim 59, wherein said at least one locking element has at least one wedged surface.

66. The plate of claim 59, further comprising a threaded recess associated with one of said bone screw receiving holes.

67. The system of claim 59, wherein at lease one of said bone screw receiving holes is threaded.

68. The plate of claim 59, wherein at least a portion of said lower surface comprises a bone ingrowth material.

69. The plate system of claim 59, wherein at least a portion of said lower surface of said plate includes a bone ingrowth surface.

70. The plate system of claim 59, in combination with a bone growth promoting material.

71. The plate system of claim 70, wherein said bone growth promoting material is at least in part other than bone.

72. The plate system of claim 70, wherein said bone growth promoting material is at least in part bone.

73. The plate system of claim 70, wherein said bone growth promoting material comprises bone morphogenetic protein.

74. A skeletal plating system for aligning and maintaining bone portions of the same bone or of different bones in a selected spatial relationship for healing or fusion of the bone portions, said skeletal plating system comprising:

a plate having a lower surface for contacting the bone portions and an upper surface opposite said lower surface, said lower surface being one of flat or convex along a substantial portion of the longitudinal axis of said plate;

at least two bone screws each having a central longitudinal axis and being adapted to engage each of the at least two bone portions, respectively, each of said bone screws having a leading end for insertion into the bone portions and a trailing end opposite said leading end, said trailing end including a lower surface generally transverse to the central longitudinal axis of said screw;

at least two bone screw receiving holes extending through said plate from said upper surface through said lower surface, each of said bone screw receiving holes having a reduced dimension proximate said lower surface of said plate to form a seat, said seat having a surface being at least in part flat and adapted to contact said lower surface of one of said bone screws; and

at least one locking element adapted to lock to said plate only one of said bone screws inserted in one of said at least two bone screw receiving holes, said at least one locking element adapted to coaxially engage one of said bone screws receiving holes and to at least a portion of said bone screw so as to retain a respective one of said bone screws to said plate.

75. The plate of claim 74, wherein said lower surface is concave along an axis transverse to the longitudinal axis of said plate.

76. The plate of claim 74, wherein said lower surface is flat along an axis transverse to the longitudinal axis of said plate.

77. The plate of claim 74, wherein said at least one locking element is pre-installed to said plate prior to insertion of bone screws into said bone screw receiving holes.

78. The plate of claim 74, wherein said at least one locking element is at least in part circular.

79. The system of claim 74, wherein said at least one locking element is generally circular and said central longitudinal axis of said at least one locking element is the rotational axis of said at least one locking element, said rotational axis being coaxial to the central longitudinal axis of one of said bone screw receiving holes when said at least one locking element is inserted in said bone screw receiving hole.

80. The plate of claim 74, wherein said at least one locking element has at least one wedged surface.

81. The plate of claim 74, further comprising a threaded recess associated with one of said bone screw receiving holes.

82. The system of claim 74, wherein at lease one of said bone screw receiving holes is threaded.

83. The plate of claim 74, wherein at least a portion of said lower surface comprises a bone ingrowth material.

84. The plate system of claim 74, wherein at least a portion of said lower surface of said plate includes a bone ingrowth surface.

85. The plate system of claim 74, in combination with a bone growth promoting material.

86. The plate system of claim 85, wherein said bone growth promoting material is at least in part other than bone.

87. The plate system of claim 85, wherein said bone growth promoting material is at least in part bone.

88. The plate system of claim 85, wherein said bone growth promoting material comprises bone morphogenetic protein.