Bone support assembly

• US 6,503,250 B2
• Filed: 04/19/2001
• Issued: 01/07/2003
• Est. Priority Date: 11/28/2000
• Status: Expired due to Fees

• Current Assignee: Kamaljit S. Paul
• Original Assignee: Kamaljit S. Paul
• Inventors: Paul, Kamaljit S.
• Primary Examiner(s): Robert, Eduardo C.
• Application Number:
  US09/838,646
• Publication Number:
  US 20020065517A1
• Time in Patent Office: 628 Days
• Field of Search: 606/60, 606/61, 606/69, 606/70, 606/71
• US Class Current: 606/279
• CPC Class Codes: A61B 17/7059 Cortical plates A61B17/7007, A61B17/7058 take precedence
• CPC Class Codes: A61B 17/8042 the additional component being a cover over the screw head

Abstract

A bone support assembly comprising a support plate, bone fasteners, and a bone fastener cover assembly. The support plate comprises a fixed base portion comprising base apertures, and a slot portion comprising slot-shaped apertures. The bone fasteners are disposed in ones of the base apertures and the slot-shaped apertures, the bone fasteners and the support plate, in combination, being adapted and configured for holding the support plate to bone material. The bone fastener cover assembly comprises a cover plate, and at least one cover plate fastener effective to fasten the cover plate to the support plate. The cover plate and support plate, in combination, accommodate both longitudinal and transverse sliding movement of the cover plate along the top surface of the support plate to thereby cover and uncover ones of the apertures, having bone fasteners therein, while the cover plate is attached to the support plate.

Claims

1. A bone support plate for use in a bone support assembly, said bone support plate comprising:

(a) a top surface;

(b) a bottom surface opposite the top surface and adapted to engage bone structure of a user;

(c) a fixed base portion, having first and second apertures extending therethrough, from the top surface to the bottom surface, for receiving bone fasteners therethrough;

(d) a first base cover plate recess in the top surface at said fixed base portion for receiving a base cover plate thereonto and accommodating sliding movement of such base cover plate to impose and withdraw at least partial obstruction of the first and second apertures;

(e) a slot portion, having at least third and fourth apertures extending therethrough, from the top surface to the bottom surface, for receiving bone fasteners therethrough, said apertures in said bone support plate being shaped to accommodate settling of vertebrae after surgical attachment of said bone support plate to such vertebrae; and

(f) a second settle cover plate recess in the top surface at said slot portion for receiving a settle cover plate thereonto and accommodating sliding movement of such settle cover plate to impose and withdraw at least partial obstruction of the third and fourth apertures.

2. A bone support plate as in claim 1, said at least third and fourth apertures of said slot portion being longitudinally slot-shaped, with respect to a longitudinal axis of said support plate, to enable respective bone fasteners to be inserted into respective said at least third and fourth apertures such that the slot-shaped apertures accommodate movement of the bone support plate with respect to such bone fasteners.

3. A bone support plate as in claim 1, said third and fourth apertures being sized and configured to accommodate vertebral settling of at least about 2 millimeters.

4. A bone support plate as in claim 1, said third and fourth apertures being sized and configured to accommodate vertebral settling of about 5-6 millimeters.

5. A bone support plate as in claim 1, said third and fourth apertures being sized and configured to enable sufficient vertebral settling as a result of axial loading.

6. A bone support assembly for support of bone structure, said bone support assembly comprising:

(a) a support plate comprising a top surface, a bottom surface adapted to engage such bone structure, a fixed base portion, and a slot portion, said fixed base portion comprising base apertures, said slot portion comprising slot-shaped apertures;

(b) bone fasteners disposed in ones of the base apertures and the slot-shaped apertures, said bone fasteners and said support plate, in combination, being adapted and configured for holding said support plate to bone material; and

(c) a bone fastener cover assembly, said bone fastener cover assembly comprising a cover plate, and at least one cover plate fastener effective to fasten said cover plate to said support plate, said at least one cover plate and said support plate, in combination, accommodating both longitudinal and transverse sliding movement of said cover plate with respect to said support plate, to thereby cover and uncover ones of said bone fasteners while said cover plate is attached to said support plate, including uncovering one of a pair of bone fasteners arranged in side-by-side relationship along the longitudinal axis of said support plate, while relatively covering the other of such pair of bone fasteners.

7. A bone support assembly as in claim 6 wherein said cover plate of said bone fastener cover assembly simultaneously covers, at least in part, said bone fasteners in at least 4 slot-shaped apertures of said support plate, where one or both longitudinal and transverse movement of said cover plate tends to simultaneously cover a said bone fastener in at least one aperture while uncovering another said bone fastener in another aperture, whereby at no time are said bone fasteners in all apertures uncovered.

8. A bone support assembly for support of bone structure, said bone support assembly comprising:

(a) a support plate comprising a top surface, a bottom surface adapted to engage such bone structure, a fixed base portion, and a slot portion, said fixed base portion comprising base apertures, said slot portion comprising slot-shaped apertures;

(b) bone fasteners disposed in ones of the base apertures and the slot-shaped apertures, said bone fasteners and said support plate, in combination, being adapted and configured for holding said support plate to bone material, said slot-shaped apertures being adapted to accommodate settling of vertebrae after surgical attachment of said bone support plate to such vertebrae;

(c) a base portion cover assembly disposed at said fixed base portion; and

(d) as a separate and distinct element, a slot portion cover assembly disposed at said slot portion.

9. A bone support assembly as in claim 8, said base portion cover assembly comprising a base cover plate having an upper surface and a lower surface, at least one base cover plate fastener, and at least one base cover plate aperture spanning from the upper surface of said base cover plate toward the lower surface of said base cover plate.

10. A bone support assembly as in claim 9, said at least one base cover plate aperture comprising an aperture wall, wherein an upper portion of said aperture wall comprises an inwardly-tapered frustoconical configuration extending inwardly toward the lower surface of said base cover plate.

11. A bone support assembly as in claim 9, said slot portion cover assembly comprising a settle cover plate having a superior surface and an inferior surface, at least one settle cover plate aperture spanning from said superior surface to said inferior surface of said settle cover plate, and at least one settle cover plate fastener in said at least one settle cover plate aperture.

12. A bone support assembly as in claim 8 wherein said base cover plate and said support plate, in combination, are designed and configured to enable both longitudinal and transverse adjustment of said base cover plate, with respect to said support plate, while maintaining said support plate connected to said base cover plate.

13. A bone support assembly as in claim 8, said at least one settle cover plate aperture comprising an aperture wall, wherein an upper portion of said aperture wall comprises an inwardly-tapered frustoconical configuration adjacent the superior surface of said settle cover plate and extending toward the inferior surface of said settle cover plate.

14. A bone support assembly as in claim 8, said slot portion cover assembly comprising a settle cover plate, said settle cover plate overlapping a portion of at least one said bone fastener in at least one said slot-shaped aperture of said support plate.

15. A bone support assembly as in claim 14 wherein said settle cover plate and said support plate are, in combination, designed and configured to enable both longitudinal and transverse adjustment of said settle cover plate, with respect to said support plate, while maintaining said support plate connected to said settle cover plate.

16. A bone support assembly as in claim 15 wherein said settle cover plate can simultaneously cover, at least in part, said bone fasteners in at least 4 slot-shaped apertures of said slot portion, where one or both longitudinal and transverse movement of said settle cover plate tends to simultaneously cover a said bone fastener in at least one said aperture while uncovering another said bone fastener in another said aperture, whereby at no time are all bone fasteners in all apertures uncovered.

17. A bone support assembly as in claim 8 wherein the slot-shaped apertures are designed and configured to enable respective bone fasteners to be inserted into respective said slot-shaped apertures such that the slot-shaped apertures accommodate movement of the bone support plate with respect to the bone fasteners.

18. A bone support plate as in claim 8, said slot-shaped apertures being sized and configured to accommodate vertebral settling of at least about 2 millimeters.

19. A bone support plate as in claim 8, said slot-shaped apertures being sized and configured to accommodate vertebral settling of about 5-6 millimeters.

20. A bone support plate as in claim 8, said slot-shaped apertures being sized and configured to enable sufficient vertebral settling as a result of axial loading.

21. A bone support assembly for support of bone structure, said bone support assembly comprising:

(a) a support plate comprising a top surface, a bottom surface adapted to engage such bone structure, a fixed base portion, and a slot portion, said fixed base portion comprising base apertures, said slot portion comprising slot-shaped apertures;

(b) bone fasteners disposed in ones of the base apertures and the slot-shaped apertures, said bone fasteners and said support plate, in combination, being adapted and configured for holding said support plate to bone material;

(c) a base portion cover assembly disposed at said fixed base portion; and

(d) a slot portion cover assembly disposed at said slot portion,

said base portion cover assembly comprising a base cover plate having an upper surface and a lower surface, at least one base cover plate fastener, and at least one base cover plate aperture spanning from the upper surface of said base cover plate toward the lower surface of said base cover plate, size of said at least one base cover plate aperture being greater than a corresponding size of said at least one base cover plate fastener by a first dimension greater than or substantially equal to that amount of bidirectional movement of said base cover plate about said base cover plate fastener relative to said support plate necessary to gain fastening access to at least one said bone fastener of said support plate while prohibiting fastening access to at least another said bone fastener, whereby at no time are all bone fasteners accessible for fastening to said bone structure.

22. A bone support plate as in claim 21, said slot-shaped apertures being sized and configured to accommodate vertebral settling of at least about 2 millimeters.

23. A bone support assembly for support of bone structure, said bone support assembly comprising:

(a) a support plate comprising a top surface, a bottom surface adapted to engage such bone structure, a fixed base portion, and a slot portion, said fixed base portion comprising base apertures, said slot portion comprising slot-shaped apertures;

(b) bone fasteners disposed in ones of the base apertures and the slot-shaped apertures, said bone fasteners and said support plate, in combination, being adapted and configured for holding said support plate to bone material;

(c) a base portion cover assembly disposed at said fixed base portion; and

(d) a slot portion cover assembly disposed at said slot portion, said base portion cover assembly comprising a base cover plate, said base cover plate overlapping a portion of at least one said bone fastener in at least one of said base apertures of said support plate, said bone support assembly including a slot in at least one of said base cover plate and said support plate, accommodating sliding of said base cover plate into overlying relationship with first ones of said bone fasteners, and out of overlying relationship with second ones of said bone fasteners.

24. A bone support plate as in claim 23, said slot-shaped apertures being sized and configured to accommodate vertebral settling of at least about 2 millimeters.

25. A bone support assembly for support of bone structure, said bone support assembly comprising:

(a) a support plate comprising a top surface, a bottom surface adapted to engage such bone structure, a fixed base portion, and a slot portion, said fixed base portion comprising base apertures, said slot portion comprising slot-shaped apertures;

(b) bone fasteners disposed in ones of the base apertures and the slot-shaped apertures, said bone fasteners and said support plate, in combination, being adapted and configured for holding said support plate to bone material;

(c) a base portion cover assembly disposed at said fixed base portion; and

(d) a slot portion cover assembly disposed at said slot portion, said slot portion cover assembly comprising a settle cover plate, said settle cover plate overlapping a portion of at least one said bone fastener in at least one said slot-shaped aperture of said support plate,

wherein said settle cover plate can simultaneously cover, at least in part, said bone fasteners in at least 4 slot-shaped apertures of said slot portion, where one or both longitudinal and transverse movement of said settle cover plate tends to simultaneously cover a said bone fastener in at least one said aperture while uncovering another said bone fastener in another said aperture, whereby at no time are all bone fasteners in all apertures uncovered.

26. A bone support plate as in claim 25, said slot-shaped apertures being sized and configured to accommodate vertebral settling of at least about 2 millimeters.

27. A method of mounting a support to bone structure, the method comprising:

(a) providing a bone support assembly comprising

(i) a support plate adapted to support bone structure, the support plate comprising a fixed base portion having base apertures, and a slot portion having slot-shaped apertures,

(ii) bone fasteners in ones of the base apertures and the slot-shaped apertures, and

(iii) a cover plate disposed over a top surface of the support plate;

(b) moving the bone support assembly into position over bone structure to be supported;

(c) sliding the cover plate, as necessary, away from a position over ones but not all of the bone fasteners thus to expose such fasteners for fastening while prohibiting fastening access to at least another of the bone fasteners, and fastening the so- exposed bone fasteners to the bone structure; and

(d) sliding the cover plate at least partially over the bone fasteners so fastened and tightening the cover plate to the support plate thereby to prevent movement of the cover plate with respect to the fastened bone fasteners and correspondingly preventing extraction of the fastened bone fasteners from the bone structure.

28. A method of mounting a support to bone structure as in claim 27, the cover plate being disposed over the base apertures at the fixed base portion, the method further including

(e) providing a settle plate over a second portion of the top surface of the support plate at the slot portion;

(f) sliding the settle plate away from the position over additional respective ones of the bone fasteners disposed in the slot-shaped apertures, and fastening the respective bone fasteners, in the slot-shaped apertures, to the bone structure; and

(f) sliding the settle plate at least partially over the respective fastened bone fasteners and tightening the settle plate to the support plate thereby to prevent movement of the settle plate, and correspondingly preventing extraction of the fastened bone fasteners.

29. A bone support plate as in claim 27, said slot-shaped apertures being sized and configured to accommodate vertebral settling of at least about 2 millimeters.

30. A bone support plate as in claim 27, said slot-shaped apertures being sized and configured to accommodate vertebral settling of about 5-6 millimeters.

31. A bone support plate as in claim 27, said slot-shaped apertures being sized and configured to enable sufficient vertebral settling as a result of axial loading.

32. A method of mounting a support to bone structure, the method comprising:

(a) providing a bone support assembly comprising

(i) a support plate adapted to support bone structure, the support plate comprising a fixed base portion having base apertures, and a slot portion having slot-shaped apertures,

(ii) bone fasteners in ones of the base apertures and the slot-shaped apertures, and

(iii) a cover plate disposed over a top surface of the support plate, the cover plate being disposed over the base apertures at the fixed base portion;

(b) moving the bone support assembly into position over bone structure to be supported;

(c) sliding the cover plate, as necessary, away from a position over ones but not all of the bone fasteners thus to expose such fasteners for fastening, and fastening the bone fasteners to the bone structure; and

(d) sliding the cover plate at least partially over the bone fasteners so fastened and tightening the cover plate to the support plate thereby to prevent movement of the cover plate with respect to the fastened bone fasteners and correspondingly preventing extraction of the fastened bone fasteners from the bone structure;

(e) providing a settle plate over a second portion of the top surface of the support plate at the slot portion;

(f) sliding the settle plate away from the position over additional respective ones of the bone fasteners disposed in the slot-shaped apertures, and fastening the respective bone fasteners, in the slot-shaped apertures, to the bone structure; and

(g) sliding the settle plate at least partially over the respective fastened bone fasteners and tightening the settle plate to the support plate thereby to prevent movement of the settle plate, and correspondingly preventing extraction of the fastened bone fasteners,

the method including using the settle plate to simultaneously cover , at least in part, the bone fasteners in each of at least 4 slot-shaped apertures of the slot portion, where one or both longitudinal and transverse movement of the settle plate tends to simultaneously cover a respective bone fastener in at least one aperture while uncovering another respective bone fastener in another aperture, whereby at no time are all bone fasteners in all apertures uncovered.

33. A method of distributing stress loads carried by bone fasteners used to attach a spinal support plate to first and second vertebrae of a spinal column, the method comprising attaching a bone support plate to vertebrae in the spinal column by a combination of

(i) first bone fasteners extending through base apertures (22) which are not designed to provide for longitudinal movement of the bone fasteners, and

(ii) second bone fasteners extending through slot-shaped apertures (32) which are designed to provide for longitudinal movement of the bone fasteners to accommodate settling of the vertebrae, the combination of the base apertures (22) and the slot-shaped apertures (32), with the respective first and second bone fasteners therein, allowing post-procedural compression between the respective vertebrae, which enables maintaining the first and second vertebrae under post-procedural axial loading.

34. A method as in claim 33 wherein the apertures (32) are sized and configured to accommodate vertebral settling of at least about 2 millimeters.

35. A method as in claim 33 wherein the apertures (32) are sized and configured to accommodate vertebral settling of about 5-6 millimeters.

36. A method as in claim 33 wherein the apertures (32) are sized and configured to enable sufficient vertebral settling as a result of axial loading.

37. A bone support plate comprising a top surface, a bottom surface, a length, and a width, first base apertures (22) which are not designed to provide for longitudinal movement of first bone fasteners, and second apertures (32) which are designed to provide for longitudinal movement of second bone fasteners to accommodate settling of vertebrae when said bone support plate is attached to such vertebrae, the combination of the first (22) and second (32) apertures, with respective such first and second bone fasteners therein, allowing post-procedural compression of the respective said vertebrae, which enables maintaining the first and second vertebrae under post-procedural axial loading.

38. A bone support plate as in claim 37 wherein the apertures (32) are sized and configured to accommodate vertebral settling of at least about 2 millimeters.

39. A bone support plate as in claim 37 wherein the apertures (32) are sized and configured to accommodate vertebral settling of about 5-6 millimeters.

40. A bone support plate as in claim 37 wherein the apertures (32) are sized and configured to enable sufficient vertebral settling as a result of axial loading.