Surgical cable system and method

• US 6,391,030 B1
• Filed: 12/15/1998
• Issued: 05/21/2002
• Est. Priority Date: 08/26/1997
• Status: Expired due to Term

• Current Assignee: Zimmer Spine, Inc. (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Spinal Concepts Incorporated (Zimmer Biomet Holdings, Inc.)
• Inventors: Wagner, Erik J., Dinsdale, Michael C.
• Primary Examiner(s): Reip, David O.
• Assistant Examiner(s): Woo, Julian W.
• Application Number:
  US09/211,888
• Time in Patent Office: 1,253 Days
• Field of Search: 606/74, 606/61, 606/103, 606/232, 606/139, 606/144, 242/79, 241/15.R, 241/36.R, 241/36.K, 242/83, 241/34.P
• US Class Current: 606/74
• CPC Class Codes: A61B 17/82 for bone cerclage apparatus for manipulating wires or straps A61B17/8861; wires, bands or straps other than cerclage A61B17/842
• CPC Class Codes: A61B 17/842 Flexible wires, bands or straps A61B17/72, A61B17/82, A61B17/86 take precedence
• CPC Class Codes: A61B 17/8861 Apparatus for manipulating flexible wires or straps devices for inserting Kirschner wires A61B17/1697
• CPC Class Codes: A61B 17/8869 Tensioning devices
• CPC Class Codes: Y10S 606/907 Composed of particular material or coated
• CPC Class Codes: Y10T 24/3951 Dual cam

Abstract

A surgical cable system and method for securing surgical cable around a portion of a human element (e.g., bone) is described. The surgical cable system may include a connector and a tensioner. The connector may be adapted to hold a pin, positionable within the connector, such that the pin may secure the cable within the connector. The pin may be repositioned, after securing the cable, to allow the cable to move freely through the connector. The cable may be oriented within the connector such that the ends of the cable are perpendicular or parallel with respect to each other. The tensioner is preferably adapted to vary the tension of the cable. The cable may be passed through the connector, around a portion of a human bone, and back through the connector. The cable may be tensioned by use of the tensioner and secured into position within the connector.

Claims

1. A method of surgically implanting a surgical cable system comprising:

passing a cable through a connector body, around a human bone element, and back through the connector body to form a loop;

coupling a tensioner to the connector body, the cable, and to a pin, wherein a side surface of the pin is positioned in a working relationship relative to the connector body and to the cable;

tensioning the cable with the tensioner; and

rotating the pin with the tensioner to couple together the side surface, the cable and the connector body so that movement of the cable with respect to the connector body is inhibited during use.

2. The method of claim 1 wherein the loop encircles at least two vertebrae of a human spine.

3. The method of claim 1 wherein the loop encircles a spinal fixation device and a vertebra of a human spine.

4. The method of claim 1 wherein passing the cable through the connector body comprises passing the cable into a first face of the connector body and out through a second face of the body, and wherein passing the cable back through the connector body comprises passing the cable into the second face and out through the first face.

5. The method of claim 1 wherein passing the cable through the connector body comprises passing the cable into a first face of the connector body and out through a second face of the body, and wherein passing the cable back through the connector body comprises passing the cable into the first face and out through the second face.

6. The method of claim 1 wherein the loop is formed such that both ends of the cable extend out from the connector body.

7. The method of claim 1 wherein the loop is formed such that both ends of the cable extend out from the connector body, and wherein both ends of the cable are secured to the tensioner prior to tensioning the cable.

8. The method of claim 1 herein the loop is formed such that a first end of the cable is secured by the connector body, and wherein a second end of the cable extends out from the connector body.

9. The method of claim 1 wherein the pin is positioned within the connector body prior to passing the cable through the connector body.

10. The method of claim 1 wherein a first end of the cable is sized to inhibit passage of the cable through a passage in the pin, and wherein the loop is formed by passing a second end of the cable through the passage, around the human bone element, and through the connector body such that a portion of the cable is positioned between a wall of the connector body and an outer surface of the pin.

11. The method of claim 1 wherein tensioning the cable comprises using the tensioner to hold the connector body in place while pulling the cable through the connector body.

12. The method of claim 1 wherein tensioning the cable comprises moving a shaft of the tensioner in a direction opposite to a direction of movement of the cable through the connector body.

13. The method of claim 1 further comprising inserting the pin into the connector body after tensioning the cable.

14. A method of surgically implanting a surgical cable system comprising:

passing a cable through a connector body, around a human bone, and back through the connector body to form a loop;

tensioning the cable;

rotating a pin positioned within the connector body to inhibit movement of the cable with respect to the connector body;

adjusting the position of the human bone to release cable tension;

rotating the pin to allow movement of the cable with respect to the connector body;

coupling a tensioner to the connector body, the cable and to the pin;

tensioning the cable with the tensioner; and

rotating the pin with the tensioner to inhibit movement of the cable with respect to the connector body.

15. The method of claim 14 wherein the human bone is a human spinal vertebra.

16. The method of claim 14 wherein the loop encircles portions of at least two vertebrae of a human spine.

17. The method of claim 14, wherein rotating the pin within the connector body to the first position comprises engaging the pin with a portion of the tensioner and rotating the tensioner portion to rotate the pin.

18. The method of claim 14, wherein the loop encircles a portion of a spinal fixation device and a portion of at least one vertebra of a human spine.

19. The method of claim 14, wherein passing the cable through the connector body comprises passing a portion of the cable through a passage that runs through the pin.

20. The method of claim 14, wherein coupling the tensioner to the pin comprises positioning a tool end of the tensioner in a tool opening of the pin.

21. The method of claim 14, wherein rotating the pin to allow movement of the cable comprises rotating the pin with the tensioner.

22. The method of claim 14, wherein coupling the tensioner to the connector body comprises placing the connector body in a tip of the tensioner, wherein coupling the tensioner to the cable comprises fixing a portion of the cable to the tensioner, and wherein tensioning the cable with the tensioner comprises changing the position of the tip relative to the fixed portion of cable to apply tension to the cable.

23. A surgical cable system comprising:

a body comprising an internal cavity;

a cable adapted to pass through the body to form a loop for engaging a portion of a human bone during use;

a pin rotatable within the internal cavity during use to a first position for coupling a side surface of the pin, a portion of the cable and a portion of the body together to fix a size of the loop during use, and wherein the pin is rotatable to a second position, subsequent to fixing the size of the loop, such that the cable is moveable relative to the body to allow the size of the loop to be altered during use; and

a tensioner configured to couple to the connector body, the cable and the pin, wherein the tensioner is configured to vary the tension of the cable and wherein the tensioner is configured to rotate the pin to the first position during use.

26. The surgical cable system of claim 23 wherein the human bone is a human spinal vertebra.

27. The system of claim 23, wherein the connector body comprises titanium.

28. The system of claim 23, wherein the cable comprises a stranded metal cable.

24. The surgical cable system of 23 wherein the tensioner comprises a recessed opening, the recessed opening comprising a shape complimentary to the connector.

25. The surgical cable system of 23 wherein the tensioner comprises a body, the body comprising a cable clamp, and wherein the cable clamp is adapted to inhibit movement of a portion of the cable with respect to the body.

29. A method of using a connector comprising a connector body and a pin for surgically implanting a surgical cable system comprising:

passing a cable through the connector body, around a human bone element, and back through the connector body to form a loop, wherein a first section of cable and a second section of cable are within the connector body during use, and the pin is between the first section of cable and the second section of cable;

coupling a tensioner to the connector body, a pin, and the cable;

tensioning the cable with the tensioner; and

rotating the pin with the tensioner to secure the first section and the second section of the cable against the pin and against the connector body.

30. The method of claim 29 wherein passing the cable through the connector body comprises passing the cable into a first face of the connector body and out through a second face of the body, and wherein passing the cable back through the connector body comprises passing the cable into the second face and out through the first face.

31. The method of claim 29 wherein passing the cable through the connector body comprises passing the cable into a first face of the connector body and out through a second face of the body, and wherein passing the cable back through the connector body comprises passing the cable into the first face and out through the second face.

32. The method of claim 29 wherein the loop is formed such that both ends of the cable extend out from the connector body.

33. The method of claim 29 wherein the loop is formed such that a first end of the cable is secured by the connector body, and wherein a second end of the cable extends out from the connector body.

34. The method of claim 29 wherein the pin is positioned within the connector body prior to passing the cable through the connector body.

35. The method of claim 29 wherein the loop is formed such that a first end of the cable is contained by a pin positioned within the connector body, and wherein a second end of the cable extends out from the connector body.

36. The method of claim 29 further comprising passing the cable through the pin prior to passing the cable around the human bone element.

37. The method of claim 36 wherein tensioning the cable comprises pulling a first end of the cable such that the cable is secured by the pin, and further comprising pulling a second portion of the cable through the connector body.

38. The method of claim 29 further comprising inserting the pin into the connector body after tensioning the cable.

39. The method of claim 29 wherein the human bone element is a human spinal vertebra.

40. A method of using a tensioner for surgically implanting a surgical cable system comprising:

passing a cable around a human bone element and through a connector to form a loop, the connector comprising a body and a pin;

tensioning the cable with the tensioner such that a first direction of movement of a shaft of the tensioner is opposite to a second direction of movement of the cable through the connector;

coupling the tensioner to the pin; and

using the tensioner to secure the cable within the connector by pressing the cable against the body with a side surface of the pin while maintaining tension in the cable with the tensioner.

41. The method of claim 40 wherein the loop is formed such that two end portions of cable extend out from the connector, and wherein the both end portions of the cable are secured to the tensioner prior to tensioning.

42. The method of claim 40 wherein the loop is formed such that a first end of the cable is secured by the connector, and wherein a second portion of the cable extends out from the connector, and wherein the second portion of the cable is secured to the tensioner prior to tensioning.

43. The method of claim 40 further comprising positioning the connector within a tip of the tensioner prior to tensioning the cable.

44. The method of claim 40 further comprising securing the cable to the tensioner prior to tensioning the cable.

45. The method of claim 40 further comprising securing a portion of the cable underneath a cable clamp lever prior to tensioning the cable.

46. The method of claim 40 further comprising securing a first portion of the cable with a first cable clamp, and further comprising securing a second portion of the cable with a second cable clamp, and wherein both portions of the cable are secured prior to tensioning the cable.

47. The method of claim 40 wherein tensioning the cable comprises the tensioner concurrently holding the connector in place and pulling the cable through the connector until the tension of the cable reaches a predetermined amount.

48. The method of claim 40 wherein the human bone element is a human spinal vertebra.

49. A surgical cable system comprising:

a body comprising an internal cavity;

a pin positioned within the body, wherein the pin comprises a passage;

a cable positioned through the passage and between the body and the pin such that the cable forms a loop, wherein an end of the cable is sized to inhibit the cable from passing through the pin;

a driver configured to couple to the pin, wherein rotating a portion of the driver to a first position rotates the pin to secure the cable to the pin and the body, and wherein rotating the portion of the driver to a second position releases the cable and allows the cable to move relative to the body; and

a tensioner adapted to vary the tension of the cable during use, wherein the driver and the tensioner are configured as portions of an instrument.

50. The system of claim 49, wherein the tensioner and the driver are portions of a single tool.

51. The system of claim 49, wherein the tensioner comprises a cable clamp and a shaft, and wherein a position of a tip of the shaft is movable relative to a position of the cable clamp.

52. The system of claim 49, wherein the cable comprises a leader portion and a main body, and wherein the leader portion has sufficient rigidity to guide the cable through the body.

54. The system of claim 49, wherein the tensioner comprises a recessed opening, the recessed opening comprising a shape complimentary to a portion of the body.

55. The system of claim 49, wherein the cable comprises stranded metal wire.

56. The system of claim 49, wherein the body comprises titanium.

57. The system of claim 49, wherein the pin comprises titanium.

53. The system of 49, wherein the tensioner comprises a tensioner body and a cable clamp, and wherein the cable clamp is adapted to inhibit movement of a portion of the cable with respect to the tensioner body.

58. A method of surgically implanting a surgical cable system comprising:

passing a cable through a connector, around a human bone element, and back through the connector to form a loop, the connector comprising;

a body, the body comprising an internal cavity, a duct, and a projection, the duct

communicating with the internal cavity, the projection comprising an opening;

a cable configured to pass through the duct to form a loop for engaging a portion of a bone during use, wherein a portion of the cable extends into the internal cavity during use; and

a pin comprising a protrusion;

wherein the pin is positionable within the internal cavity during use in a first position for securing the portion of the cable with respect to the body, and

wherein the pin is positionable in a second position during use such that the cable is moveable relative to the body during use;

and wherein the pin is configured to rotate in a first direction into the first position, and wherein the protrusion is configured to engage a first surface of the projection that defines the opening to inhibit rotation of the pin in a second direction that is opposite to the first direction while allowing further rotation in the first direction during use;

tensioning the cable using a tensioner; and

rotating the pin within the connector body to the first position.

59. The method of claim 58 wherein the loop encircles at least two vertebrae of a human spine.

60. The method of claim 58 wherein passing the cable around a human bone element further comprises passing the loop through a passage formed in a bone.

61. The method of claim 58 wherein the loop encircles a spinal fixation device and a vertebra of a human spine.

62. The method of claim 58 wherein the connector further comprises a first duct and a second duct, and wherein passing the cable through the connector comprises passing the cable through a first face, into the first duct, and out through a second face of the body, and wherein passing the cable back through the connector body comprises passing the cable through the first face, into the second duct, and out through the second face.

63. The method of claim 58 wherein the loop is formed such that both ends of the cable extend out from the connector body.

64. The method of claim 58 wherein the loop is formed such that both ends of the cable extend out from the connector body, and wherein the both ends of the cable are secured to the tensioner prior to the tensioning the cable.

65. The method of claim 58 wherein the pin is positioned within the connector prior to passing the cable through the connector.

66. The method of claim 58 further comprising passing the cable through a passage through the pin prior to passing the cable around the human bone element.

67. The method of claim 58 further comprising positioning the connector within a tip of the tensioner prior to tensioning the cable.

68. The method of claim 58 further comprising securing the cable to the tensioner prior to tensioning the cable.

69. The method of claim 58 further comprising using a drive tool to rotate the pin within the connector body.

70. The method of claim 58 further comprising:

varying the position of the pin within the connector to permit the cable to move within the connector body;

retensioning the cable with the tensioner; and

repositioning the pin within the connector body to secure the cable within the connector body.

71. The method of claim 70 wherein varying the position of the pin comprises rotating the pin to the second position.

72. The method of claim 70 wherein varying the position of the pin comprises removing the pin from the connector body.

73. The method of claim 70 wherein repositioning the pin comprises rotating the pin to the first position.

74. The method of claim 70 wherein repositioning the pin comprises inserting the pin into the connector body so that the pin is in the first position.

75. The method of claim 70, wherein the projection includes a second surface defining the opening, wherein rotation of the pin in the first direction past the second surface is deterred, and wherein varying the position of the pin comprises applying enough rotational force to the pin to rotate the pin past the second surface to the second position.

76. The method of claim 70 wherein repositioning the pin comprises rotating the pin in the first direction such that the protrusion passes into the opening.

77. The method of claim 58 wherein rotating the pin comprises rotating the pin in the first direction such that the protrusion passes into the opening.

78. The method of claim 58 wherein the cable comprises a stranded metal cable.

79. A method of surgically implanting a surgical cable system comprising:

passing a portion of a cable through a pin, wherein a first end of the cable is sized to pass through a passage in the pin and wherein a second end of the cable is sized to inhibit passage of the second end through the passage;

passing the first end around a human bone element, and through the connector body to form a loop;

tensioning the cable with a tensioner;

coupling a drive tool to the pin, wherein the tensioner and the drive tool are portions of an instrument; and

rotating the drive tool to couple the connector body, the cable and the pin together so that movement of the cable with respect to the connector body is inhibited during use.

80. The method of claim 79, wherein the cable comprises stranded metal wire.

81. The method of claim 79, wherein the first end of the cable comprises a leader portion that has greater rigidity than a main portion of the cable, wherein the leader portion facilitates passage of the cable through the pin and the connector body.

82. The method of claim 79, wherein the loop encircles portions of at least two vertebrae.

83. The method of claim 79, wherein the loop encircles a portion of at least one vertebrae and a portion of at least one fixation device.

84. The method of claim 79, wherein tensioning the cable comprises fixing a portion of the cable to the tensioner, and moving the fixed portion of cable relative to the connector body to place the cable in tension.

85. The method of claim 79, further comprising releasing tension in the cable;

rotating the pin to allow the cable to move relative to the connector body;

retensioning the cable with the tensioner; and

rotating the pin to inhibit movement of the cable relative to the connector body.

86. A method of using a connector comprising a connector body and a pin for surgically implanting a surgical cable system, comprising:

passing a cable through a passage in the pin, wherein a first end of the cable is sized to inhibit passage of the end through the pin;

placing the cable around a human bone element;

passing a second end of the cable between the connector body and the pin to form a loop;

tensioning the cable with a tensioner;

coupling a portion of the tensioner to the pin and turning the portion, so that the pin is rotated to a first position to inhibit movement of the pin and secure a portion of the cable between the pin and the connector body.

87. The method of claims 86, wherein tensioning the cable comprises coupling a tensioner to the connector body and the cable;

and moving the cable relative to the connector body to tension the cable.

88. The method of claim 86, wherein the cable is a stranded metal wire.

89. The method of claim 86, wherein the cable comprises a leader portion and a main body, wherein the leader portion has greater rigidity than the main body to facilitate passing the cable through the pin, around the human bone element, and through the connector body.

90. The method of claim 86, wherein the pin and connector body are configured to resist rotation of the pin from the first position to a second position where the cable is movable through the connector body.

91. The method of claim 86, further comprising rotating the pin to a second position where the pin is positioned so that the cable may be moved through the connector body, adjusting tension in the cable, and rotating the pin to the first position.

92. The method of claim 86, wherein the loop encircles portions of at least two vertebrae.

93. The method of claim 86, wherein the loop encircles a portion of at least one vertebra and a portion of at least one fixation device.