Surgical cable system and method

• US 6,682,533 B1
• Filed: 07/23/1999
• Issued: 01/27/2004
• Est. Priority Date: 08/26/1997
• Status: Expired due to Fees

• 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): Woo, Julian W.
• Application Number:
  US09/360,062
• Time in Patent Office: 1,649 Days
• Field of Search: 606/61, 606/74, 606/103, 606/232, 606/69, 606/70, 606/71, 241/34.R, 241/34.KB, 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) are 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 either perpendicular or parallel with respect to each other. In one embodiment, the tensioner is 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. The connector may include a locking portion for engaging a protrusion formed on the pin. The engagement of the protrusion with the locking portion may inhibit rotation of the pin. The connectors may be incorporated into an elongated rigid member to form a spinal fixation device.

Claims

1. A bone fixation system comprising:

an elongated member comprising an internal cavity and a fastener cavity;

a fastener configured to couple the elongated member to a bone, wherein a head of the fastener is positionable in the fastener cavity during use;

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

a pin positionable within the internal cavity during use in a first position for securing a portion of the cable with respect to the elongated member, thereby fixing the size of the loop during use, and wherein the pin is positionable in a second position to place the cable adjacent to a groove in the pin such that the cable is moveable relative to the elongated member to allow the size of the loop to be altered during use.

2. The system of claim 1, wherein the cable further comprises an elongated and substantially flexible main portion, the main portion comprising a stranded metal wire.

3. The system of claim 1, wherein the cable further comprises a leader portion adapted to guide the cable around a portion of the human bone.

4. The system of claim 1, wherein the cable further comprises a leader portion, the leader portion comprising a non-stranded wire, and wherein the leader portion is adapted to guide the cable around a portion of the human bone.

5. The system of claim 1, wherein the cable further comprises a tip located at an end of the cable, and wherein the tip comprises a diameter that is larger than a diameter of the cable.

6. The system of claim 1, wherein the cable further comprises a tip located at an end of the cable, and wherein the tip comprises a diameter that is larger than a portion of the internal cavity.

7. The system of claim 1, wherein the elongated member further comprises a first arm and a second arm extending from the elongated member, and wherein the internal cavity passes longitudinally through the entire elongated member between the first arm and the second arm.

8. The system of claim 7, wherein the pin is configured to rotate within the internal cavity, and wherein the first and second arms are positioned such that rotation of the pin within the internal cavity is hindered during use.

9. The system of claim 7 wherein the pin is configured to rotate in a first direction into the first position, and wherein at least one of the first and second arms comprises a first opening, and wherein the pin comprises a protrusion, and wherein the protrusion is configured to engage the first opening when the pin is in the first position such that rotation of the pin in a direction opposite the first direction is substantially inhibited.

10. The system of claim 7, wherein the pin is configured to rotate in a first direction into the first position, and wherein the first arm comprises a first opening and the second arm comprises a second opening, and wherein the pin comprises a first protrusion and a second protrusion, and wherein the firs t protrusion is configured to engage the first opening and the second protrusion is configured to engage the second opening when the pin is in the first position such that rotation of the pin in a direction opposite the first direction is substantially inhibited.

11. The system of claim 1, wherein the pin further comprises an upper portion and a lower portion, and wherein the upper portion comprises a diameter substantially greater than a diameter of the lower portion.

12. The system of claim 1, wherein the pin further comprises an upper portion and a lower portion, and wherein the upper portion comprises a diameter that is substantially greater than a diameter of the internal cavity, and wherein the lower portion comprises a diameter that is substantially less than a diameter of the internal cavity.

13. The system of claim 1, wherein the pin is adapted to be secured within the internal cavity.

14. The system of claim 1, wherein the pin is adapted to rotate from the first position to the second position to secure a portion of the cable with respect to the elongated member during use.

15. The system of claim 1, wherein the pin is adapted to rotate from the second position to the first position to permit movement of a portion of the cable through the elongated member during use.

16. The system of claim 1, wherein the elongated member further comprises a duct passing through the elongated member, the duct communicating with the internal cavity.

17. The system of claim 16, wherein the duct passes through the elongated member in a substantially perpendicular orientation to a longitudinal axis of the elongated member.

18. The system of claim 16, wherein the duct passes through the elongated member in a substantially perpendicular orientation to the cavity.

19. The system of claim 16, further comprising a connector positioned within the internal cavity, the connector comprising an aperture, and wherein the aperture is positioned such that a portion of the cable extends into the duct and into the aperture of the connector during use.

20. The system of claim 19, wherein the pin is positioned within the connector during use.

21. The system of claim 16, wherein the pin comprises a groove, the groove being positioned to align with the duct when the pin is in the second position during use.

22. The system of claim 16, wherein the pin is configured to compress the cable against the duct such that the cable is secured within the elongated member during use.

23. The system of claim 16, wherein the elongated member further comprises an additional duct, the additional duct communicating with the internal cavity.

24. The system of claim 1, wherein the pin further comprises an opening passing through a longitudinal axis of the pin, the opening being configured to allow a portion of the cable to pass through the opening during use.

25. The system of claim 1, wherein the pin comprises an opening passing through a longitudinal axis of the pin, the opening comprising an upper portion and a lower portion, the upper portion being shaped to receive a tip of the cable.

26. The system of claim 1, wherein the pin comprises an opening passing through a longitudinal axis of the pin, the opening comprising an upper portion and a lower portion, the upper portion being shaped to couple with a torsioning device, the torsioning device being configured to apply a torsional force to the pin.

27. The system of claim 1, wherein the elongated member is substantially U-shaped.

28. The system of claim 1, wherein the elongated member is substantially linear.

29. The system of claim 1, wherein the elongated member further comprises:

a plurality of internal cavities formed within the elongated member; and

a plurality of additional pins, each of the pins being positionable within one of the plurality of internal cavities during use.

30. The system of claim 1, wherein the pin is rotated to move the pin from the first position to the second position.

31. A bone fixation system comprising:

an elongated member; and

a connector coupled to the elongated member, the connector 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, the cable having a first portion;

a pin positionable within the internal cavity during use in a first position for securing a portion of the cable with respect to the elongated member, thereby fixing the size of the loop during use, and wherein the pin is positionable in a second position to place the cable adjacent to a groove in the pin such that the cable is moveable relative to the elongated member to allow the size of the loop to be altered during use; and

an opening passing in a substantially longitudinal direction through the pin, wherein the first portion of the cable has a size that allows the first portion to pass through the opening.

32. The system of claim 31, wherein the cable further comprises an elongated and substantially flexible main portion, the main portion comprising a stranded metal wire.

33. The system of claim 31, wherein the cable further comprises a leader portion adapted to guide the cable around a portion of the human bone.

34. The system of claim 31, wherein the cable further comprises a leader portion, the leader portion comprising a non-stranded wire, and wherein the leader portion is adapted to guide the cable around a portion of the human bone.

35. The system of claim 31, wherein the cable further comprises a tip located at an end of the cable, and wherein the tip comprises a diameter that is larger than a diameter of the cable.

36. The system of claim 31, wherein the cable further comprises a tip located at an end of the cable, and wherein the tip comprises a diameter that is larger than a portion of the internal cavity.

37. The system of claim 31, wherein the connector further comprises a first arm and a second arm extending from the body, and wherein the internal cavity passes longitudinally through the body between the first arm and the second arm.

38. The system of claim 37, wherein the pin is configured to rotate within the internal cavity, and wherein the first and second arms are positioned such that rotation of the pin within the internal cavity is hindered during use.

39. The system of claim 37 wherein the pin is configured to rotate in a first direction into the first position, and wherein at least one of the first and second arms comprises a first opening, and wherein the pin comprises a protrusion, and wherein the protrusion is configured to engage the first opening when the pin is in the first position such that rotation of the pin in a direction opposite the first direction is substantially inhibited.

40. The system of claim 37, wherein the pin is configured to rotate in a first direction into the first position, and wherein the first arm comprises a first opening and the second arm comprises a second opening, and wherein the pin comprises a first protrusion and a second protrusion, and wherein the first protrusion is configured to engage the first opening and the second protrusion is configured to engage the second opening when the pin is in the first position such that rotation of the pin in a direction opposite the first direction is substantially inhibited.

41. The system of claim 31, wherein the pin further comprises an upper portion and a lower portion, and wherein the upper portion comprises a diameter substantially greater than a diameter of the lower portion.

42. The system of claim 31, wherein the pin further comprises an upper portion and a lower portion, and wherein the upper portion comprises a diameter that is substantially greater than a diameter of the internal cavity, and wherein the lower portion comprises a diameter that is substantially less than a diameter of the internal cavity.

43. The system of claim 31, wherein the pin is adapted to be secured within the internal cavity.

44. The system of claim 31, wherein the pin is adapted to rotate from the first position to the second position to secure a portion of the cable with respect to the elongated member during use.

45. The system of claim 31, wherein the pin is adapted to rotate from the second position to the first position to permit movement of a portion of the cable through the elongated member during use.

46. The system of claim 31, wherein the connector further comprises a duct passing through the body, the duct communicating with the internal cavity.

47. The system of claim 46, wherein the duct passes through the body in a substantially perpendicular orientation to the longitudinal axis of the body.

48. The system of claim 46, wherein the duct passes through the body in a substantially perpendicular orientation to the cavity.

49. The system of claim 46, wherein the elongated member further comprises an aperture, and wherein the aperture is positioned such that a portion of the cable extends into the aperture, and into the duct during use.

50. The system of claim 49, wherein the pin is positioned within the connector during use.

51. The system of claim 46, wherein the pin comprises a groove, the groove being oriented substantially perpendicular to the duct when the pin is in the first position during use.

52. The system of claim 46, wherein the pin is configured to compress the cable against the duct such that the cable is secured within the connector during use.

53. The system of claim 46, wherein the connector further comprises an additional duct, the additional duct communicating with the internal cavity.

54. The system of claim 31, wherein the pin comprises a tool junction, the tool junction being shaped to couple with a torsioning device, the torsioning device being configured to apply a torsional force to the pin.

55. The system of claim 31, wherein the elongated member is substantially U-shaped.

56. The system of claim 31, wherein the elongated member is substantially linear.

57. The system of claim 31, wherein the elongated member further comprises:

a plurality of additional connectors coupled to the elongated member, each of the connectors comprising;

an internal cavity; and

a pin, the pin being positionable within the internal cavity during use.

58. The system of claim 57, wherein the elongated member further comprises a plurality of bone screw cavities coupled to the elongated member, wherein each of the bone screw cavities are configured to receive a head of a bone screw.

59. The system of claim 31, wherein the elongated member further comprises a bone screw cavity, and wherein the bone screw cavity is configured to receive a head of a bone screw.

60. The system of claim 59, wherein the elongated member further comprises a plurality of additional b one screw cavities coupled to the elongated member, wherein each of the plurality of additional bone screw cavities are configured to receive a head of a bone screw.

61. The system of claim 31, wherein the pin is rotated to move the pin from the first position to the second position.

62. The system of claim 31, wherein the cable comprises a second portion and wherein a cross sectional area of the second portion inhibits passage of the cable through the opening.

63. A bone fixation system comprising:

an elongated member comprising an internal cavity;

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

a pin comprising a protrusion positionable within the internal cavity during use in a first position for securing a portion of the cable with respect to the elongated member, thereby fixing the size of the loop during use, and wherein the pin is positionable in a second position such that the cable is moveable relative to the elongated member to allow the size of the loops to be altered during use and

a first arm extending from the elongated member adjacent to the internal cavity, the first arm comprising an opening configured to engage the pin protrusion when the pin is in the first position to inhibit movement of the pin.

64. The system of claim 63, wherein the cable further comprises an elongated and substantially flexible main portion, the main portion comprising a stranded metal wire.

65. The system of claim 63, further comprising a second arm extending from the elongated member such that the internal cavity passes between the first arm and the second arm.

66. The system of claim 65, wherein the pin is configured to rotate within the internal cavity, and wherein the first arm and the second arm are positioned such that rotation of the pin within the internal cavity is hindered during use.

67. The system of claim 65 wherein the pin is configured to rotate in a first direction into the first position, and wherein the protrusion is configured to engage the first opening when the pin is in the first position such that rotation of the pin in a direction opposite the first direction is substantially inhibited.

68. The system of claim 63, wherein the pin is adapted to be secured within the internal cavity.

69. The system of claim 63, wherein the pin is adapted to rotate from the first position to the second position to allow adjustment of the cable during use.

70. The system of claim 63, wherein the pin is adapted to rotate from the second position to the first position to secure a portion of the cable with respect to the elongated member during use.

71. The system of claim 63, wherein the elongated member further comprises a duct passing through the elongated member, the duct communicating with the internal cavity.

72. The system of claim 71, wherein the duct passes through the elongated member in a substantially perpendicular orientation to a longitudinal axis of the elongated member.

73. The system of claim 71, wherein the duct passes through the elongated member in a substantially perpendicular orientation to the internal cavity.

74. The system of claim 71, further comprising a connector positioned within the internal cavity, wherein the connector comprises an aperture, and wherein the aperture is positioned such that a portion of the cable extends into the duct and into the aperture of the connector during use.

75. The system of claim 74, wherein the pin is positioned within the connector during use.

76. The system of claim 71, wherein the pin is configured to press the cable against the duct such that the cable is secured within the elongated member during use.

77. The system of claim 63, wherein the pin further comprises an opening passing through a longitudinal axis of the pin, the opening being configured to allow a portion of the cable to pass through the opening during use.

78. The system of claim 63, wherein the elongated member is substantially U-shaped.

79. The system of claim 63, wherein the elongated member is substantially linear.

80. The system of claim 63, wherein the elongated member further comprises a bone screw cavity configured to receive a bone screw.

81. The system of claim 63, further comprising a second internal cavity, a second pin adapted to fit within the second cavity, the second pin adapted to adjustably secure a loop of a second cable to the elongated member.

82. A bone fixation system comprising:

a U shaped elongated member comprising an internal cavity;

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

a pin comprising an upper portion and a lower portion, the upper portion comprising a diameter that is substantially greater than a diameter of the internal cavity, the lower portion comprising a diameter that is substantially less than a diameter of the internal cavity, wherein the pin is positionable within the internal cavity during use in a first position for securing a portion of the cable with respect to the elongated member, thereby fixing the size of the loop during use, and wherein the pin is positionable in a second position to place the cable adjacent to a groove in the pin such that the cable is moveable relative to the elongated member to allow the size of the loops to be altered during use.

83. The system of claim 82, wherein the pin is rotated to move the pin from the first position to the second position.

84. The system of claim 82, further comprising a fastener;

wherein the elongated member comprises a fastener opening; and

wherein the fastener is configured to be driven into a bone during use to couple the elongated member to the bone.

85. The system of claim 82, wherein the pin comprises an opening passing longitudinally through the pin, wherein a portion of the cable is configured to pass through the opening.

86. The system of claim 85, wherein the cable comprises a portion having a cross sectional area that inhibits passage of the portion through the opening during use.

87. The system of claim 82, wherein the pin comprises at least one protrusion;

wherein a wall defining the internal cavity comprises at least one opening; and

wherein the at least one protrusion is configured to engage a portion of the wall defining the at least one opening to resist movement of the pin from the first position to the second position.

88. The system of claim 87, wherein the at least one protrusion has a leading edge that engages a first portion of the wall to resist movement of the pin from the first position to the second position when the pin is rotated in a first direction, and a trailing edge that engages a second portion of the wall to inhibit movement of the pin from the first position to the second position when the pin is rotated in a direction opposite to the first direction.

89. A bone fixation system, comprising:

an elongated member;

a first connector and a second connector coupled to the elongated member, each connector comprising;

an internal cavity;

a pin positionable within the internal cavity during use in a first position for securing a portion of a cable with respect to the elongated member, and wherein the pin is positionable in a second position, such that the cable is moveable relative to the elongated member to allow movement of the cable relative to the elongated member;

a first cable configured to pass through the elongated member and the first connector so that the first cable forms a loop around a first bone portion; and

a second cable configured to pass through the elongated member and the second connector so that the second cable forms a loop around a second bone portion.

90. The system of claim 89, further comprising at least one fastener;

wherein the elongated member comprises at least one fastener opening; and

wherein the at least one fastener is configured to be driven into a bone during use to couple the elongated member to the bone.

91. The system of claim 89, wherein the pin of the first connector comprises an opening passing in a substantially longitudinal direction through the pin;

and wherein a portion of the first cable is configured to pass through the pin during use.

92. The system of claim 89, wherein the pin of the first connector comprises at least one protrusion, wherein a wall defining the internal cavity of the first connector comprises at least one opening, and wherein the at least one protrusion is configured to engage a portion of the wall defining the at least one opening to resist movement of the pin from the first position to the second position.

93. The system of claim 92, wherein the at least one protrusion has a leading edge that engages a first portion of the wall to resist movement of the pin from the first position to the second position when the pin is rotated in a first direction, and a trailing edge that engages a second portion of the wall to inhibit movement of the pin from the first position to the second position when the pin is rotated in a direction opposite to the first direction.

94. A bone fixation system comprising:

an elongated member comprising an internal cavity and a duct in communication with the internal cavity;

a connector positioned within the internal cavity, the connector comprising an aperture, wherein the aperture of the connector aligns with the duct of the elongated member;

a cable adapted to form a loop for engaging a portion of a human bone, and wherein the cable passes through the duct and the aperture; and

a pin positionable within the internal cavity during use in a first position for securing a portion of the cable with respect to the elongated member, thereby fixing the size of the loop during use, and wherein the pin is positionable in a second position to place the cable adjacent to a groove in the pin such that the cable is moveable relative to the elongated member to allow the size of the loop to be altered during use.

95. The system of claim 94, wherein the pin is rotated to move the pin from the first position to the second position.

96. The system of claim 94, further comprising a fastener;

wherein the elongated member comprises a fastener opening; and

wherein the fastener is configured to be driven into a bone during use to couple the elongated member to the bone.

97. The system of claim 94, wherein the pin comprises an opening passing longitudinally through the pin, wherein a portion of the cable is configured to pass through the opening.

98. The system of claim 97, wherein the cable comprises a portion having a cross sectional area that inhibits passage of the portion through the opening during use.

99. The system of claim 94, wherein the pin comprises at least one protrusion;

wherein a wall defining the internal cavity comprises at least one opening; and

wherein the at least one protrusion is configured to engage a portion of the wall defining the at least one opening to resist movement of the pin from the first position to the second position.

100. The system of claim 99, wherein the at least one protrusion has a leading edge that engages a first portion of the wall to resist movement of the pin from the first position to the second position when the pin is rotated in a first direction, and a trailing edge that engages a second portion of the wall to inhibit movement of the pin from the first position to the second position when the pin is rotated in a direction opposite to the first direction.