Vertebrae fastener placement guide

• US 6,669,698 B1
• Filed: 10/24/2000
• Issued: 12/30/2003
• Est. Priority Date: 10/24/2000
• Status: Expired due to Term

• Current Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Original Assignee: SDGI Holdings Incorporated (Medtronic Plc)
• Inventors: Tromanhauser, Scott G., Lange, Eric C., Berry, Bret M., Ray, Eddie F. III
• Primary Examiner(s): GIBSON, ROY DEAN
• Application Number:
  US09/695,004
• Time in Patent Office: 1,162 Days
• Field of Search: 606/61, 606/96, 606/104
• US Class Current: 606/86.00A
• CPC Class Codes: A61B 17/1615 Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
• CPC Class Codes: A61B 17/1655 for tapping
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 17/8891 at its periphery
• 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 2090/062 penetration depth

Abstract

A screw placement guide includes a first member having a first guide adapted to contact a first vertebral bone portion and a second member having a second guide adapted to contact a second vertebral bone portion. A clamping mechanism provided on one of the members clamps the first guide and the second guide to the vertebral bone portions. The first guide and the second guide are aligned in order to indicate how a fastener will be aligned when fastened between adjacent vertebrae. A driver engages clamping mechanism to clamp the two members together.

Claims

1. An apparatus for guiding a fastener that fastens a first vertebral bone portion with a second vertebral bone portion, comprising:

a first member having first guide adapted to contact the first vertebral bone portion;

a second member having a second guide aligned with said first guide and adapted to contact the second vertebral bone portion;

a clamping mechanism provided between said first and second members to clamp said first guide to said first bone portion and said second guide to second bone portion, wherein said first guide and said second guide are aligned to indicate fastener alignment;

wherein one of said first and second members includes a handle receiving member and a handle removably coupled to said handle receiving member; and

wherein said handle is oriented at an angle with respect to a longitudinal axis extending through said first guide and said second guide.

2. An apparatus for guiding a fastener that fastens a first vertebral bone portion with a second vertebral bone portion, comprising:

a first member having first guide adapted to contact the first vertebral bone portion;

a second member having a second guide aligned with said first guide and adapted to contact the second vertebral bone portion;

a clamping mechanism provided between said first and second members to clamp said first guide to said first bone portion and said second guide to second bone portion, wherein said first guide and said second guide are aligned to indicate fastener alignment;

a locking mechanism to lock relative position between said first and second members; and

wherein said locking mechanism includes a lever coupled between said first and second members, said locking mechanism further including a spring coupled to said lever to bias said lever into locking position.

3. An apparatus for guiding a fastener that fastens a first vertebral bone portion with a second vertebral bone portion, comprising:

a first member having first guide adapted to contact the first vertebral bone portion;

a second member having a second guide aligned with said first guide and adapted to contact the second vertebral bone portion;

a clamping mechanism provided between said first and second members to clamp said first guide to said first bone portion and said second guide to second bone portion, wherein said first guide and said second guide are aligned to indicate fastener alignment; and

wherein said first guide has a hollow cylindrical shape and a serrated contact surface for contacting the first bone portion.

4. An apparatus for guiding a fastener that fastens a first vertebral bone portion with a second vertebral bone portion, comprising:

a first member having first guide adapted to contact the first vertebral bone portion;

a second member having a second guide aligned with said first guide and adapted to contact the second vertebral bone portion,

a clamping mechanism provided between said first and second members to clamp said first guide to said first bone portion and said second guide to second bone portion, wherein said first guide and said second guide are aligned to indicate fastener alignment; and

wherein said second member includes a support arm coupled to said second guide and a rack coupled to said support arm for engaging said clamping mechanism.

5. The apparatus of claim 4, wherein said first member includes a rack receiver cavity provided therein for receiving said rack.

6. The apparatus of claim 5, wherein said first member has a pinion provided therein to engage said rack.

7. An apparatus for guiding a fastener that fastens a first vertebral bone portion with a second vertebral bone portion, comprising:

a first member having first guide adapted to contact the first vertebral bone portion;

a second member having a second guide aligned with said first guide and adapted to contact the second vertebral bone portion;

a clamping mechanism provided between said first and second members to clamp said first guide to said first bone portion and said second guide to second bone portion, wherein said first guide and said second guide are aligned to indicate fastener alignment; and

wherein said clamping mechanism includes a pinion.

8. The apparatus of claim 7, further comprising a driver coupled to said pinion.

9. An apparatus for guiding a fastener that fastens a first vertebral bone portion with a second vertebral bone portion, comprising:

a first member having first guide adapted to contact the first vertebral bone portion;

a second member having a second guide aligned with said first guide and adapted to contact the second vertebral bone portion;

a clamping mechanism provided between said first and second members to clamp said first guide to said first bone portion and said second guide to second bone portion, wherein said first guide and said second guide are aligned to indicate fastener alignment; and

a screw length indicator provided on said second member to indicate a length of screw required to join the first and second bone portions together.

10. A method, comprising:

providing a fastener placement guide having a first member with a first guide, a second member with a second guide aligned with said first guide, and a clamping mechanism to clamp the first and second members;

aligning the first and second guides along two vertebral bone portions;

clamping the two vertebral bone portions together with the first and second members; and

fastening the two vertebral bone portions together with a fastener in alignment with the first and second guides.

11. The method of claim 10, further comprising:

making a first incision over the two bone portions;

making a second incision in alignment with the first and second guides away from the first incision;

feeding a guide tube with a trocar through the second incision; and

coupling the guide tube to the first guide.

12. The method of claim 11, further comprising:

removing the trocar from the guide tube;

inserting an awl into the guide tube; and

cutting bone with the awl.

13. The method of claim 12, further comprising:

removing the awl from the guide tube;

inserting a drill bit into the guide tube; and

drilling a hole in the bone portions with the drill bit.

14. The method of claim 13, further comprising:

determining drill depth and fastener length by reading length markings on the fastener placement guide; and

confirming the drill depth by reading depth markings on the drill bit.

15. The method of claim 14, further comprising:

removing the drill bit from the guide tube;

threading the hole in the bone portions with a tap; and

wherein said fastening includes screwing a screw in the hole.

16. The method of claim 10, wherein said fastening includes screwing the two bone portions together.

17. The method of claim 10, wherein said clamping includes tightening the clamping mechanism.

18. The method of claim 10, wherein the two bone portions are separate vertebrae.

19. The method of claim 10, wherein said aligning includes:

positioning the first guide at a desired exit point for the fastener; and

positioning the second guide at a desired entry point for the fastener.

20. An apparatus for guiding a fastener that fastens a first vertebral bone portion with a second vertebral bone portion, comprising:

a first member having first guide adapted to contact the first vertebral bone portion;

a second member having a second guide aligned with said first guide to indicate fastener alignment, said second guide being adapted to contact the second vertebral bone portion;

a clamping mechanism provided between said first and second members, said clamping mechanism being adapted to move said first guide and said second guide towards one another to a clamped position in which the first vertebral bone portion and the second vertebral bone portion are clamped together;

a locking mechanism locking said first guide and said second guide in said clamped position to provide hands free guidance during surgery; and

wherein said locking mechanism includes a lever coupled between said first and second members.

21. The apparatus of claim 20, wherein said clamping mechanism includes a rack and pinion mechanism.

22. An apparatus for guiding a fastener that fastens a first vertebral bone portion with a second vertebral bone portion, comprising:

a first member having first guide adapted to contact the first vertebral bone portion;

a second member having a second guide aligned with said first guide to indicate fastener alignment, said second guide being adapted to contact the second vertebral bone portion;

a clamping mechanism provided between said first and second members, said clamping mechanism being adapted to move said first guide and said second guide towards one another to a clamped position in which the first vertebral bone portion and the second vertebral bone portion are clamped together;

a locking mechanism locking said first guide and said second guide in said clamped position to provide hands free guidance during surgery; and

wherein one of said first and second members includes a handle receiving member and a handle removably coupled to said handle receiving member.

23. An apparatus for guiding a fastener that fastens a first vertebral bone portion with a second vertebral bone portion, comprising:

a first member having first guide adapted to contact the first vertebral bone portion;

a second member having a second guide aligned with said first guide to indicate fastener alignment, said second guide being adapted to contact the second vertebral bone portion;

a clamping mechanism provided between said first and second members, said clamping mechanism being adapted to move said first guide and said second guide towards one another to a clamped position in which the first vertebral bone portion and the second vertebral bone portion are clamped together;

a locking mechanism locking said first guide and said second guide in said clamped position to provide hands free guidance during surgery; and

wherein said second guide has a semi-cylindrical shape to allow engagement of said second guide to the second vertebral portion in a narrow space.

24. The apparatus of claim 23, wherein said first guide has a cylindrical shape to receive a guide tube.

25. The apparatus of claim 23, wherein said second guide includes a pair of pointed bone engagement portions.

26. An apparatus for guiding a fastener that fastens a first vertebral bone portion with a second vertebral bone portion, comprising:

a first member having first guide adapted to contact the first vertebral bone portion;

a second member having a second guide aligned with said first guide to indicate fastener alignment, said second guide being adapted to contact the second vertebral bone portion;

a clamping mechanism provided between said first and second members, said clamping mechanism being adapted to move said first guide and said second guide towards one another to a clamped position in which the first vertebral bone portion and the second vertebral bone portion are clamped together;

a locking mechanism locking said first guide and said second guide in said clamped position to provide hands free guidance during surgery; and

a handle provided on said first member and said locking mechanism being provided on said first member.

27. The apparatus of claim 26, further comprising a guide tube coupled to said second guide.

28. The apparatus of claim 27, further comprising a trocar provided in said guide tube.

29. The apparatus of claim 27, further comprising an awl provided in said guide tube for cutting bone.

30. The apparatus of claim 27, further comprising a tap provided in said guide tube.

31. An apparatus for guiding a fastener that fastens a vertebral bone together, comprising:

a first member having first guide adapted to receive a guide tube;

a second member having a second guide aligned with said first guide to indicate fastener alignment, said second guide having a semi-cylindrical shape to allow engagement of said second guide to the vertebral bone in a narrow space; and

a clamping mechanism provided between said first and second members to clamp said first guide and said second guide to the vertebral bone.

32. The apparatus of claim 31, wherein said first guide has a cylindrical shape to receive the guide tube.

33. The apparatus of claim 32, wherein said second guide includes a pair of pointed bone engagement portions.

34. The apparatus of claim 33, wherein said first guide has a first curved bone engaging portion and a second curved bone engaging portion that together define a second pair of pointed bone engagement portions for improving contact between said first guide and the vertebral bone.

35. The apparatus of claim 31, wherein said first guide has a first curved bone engaging portion and a second curved bone engaging portion that together define a pair of pointed bone engagement portions.

36. The apparatus of claim 31, wherein said first guide has a serrated contact surface for engaging the vertebral bone.