Spinal stabilization systems and methods

• US 7,563,264 B2
• Filed: 05/22/2007
• Issued: 07/21/2009
• Est. Priority Date: 10/30/2002
• Status: Expired due to Term

• Current Assignee: Zimmer Biomet Spine, Inc. (Zimvie Incorporated)
• Original Assignee: Zimmer Spine Austin, Inc.
• Inventors: Landry, Michael E., Jones, Robert J., Wagner, Erik J., Forton, Charles R., Khoo, Larry T.
• Primary Examiner(s): Barrett; Thomas C
• Assistant Examiner(s): SWIGER III, JAMES L
• Application Number:
  US11/752,167
• Publication Number:
  US 20070219554A1
• Time in Patent Office: 791 Days
• Field of Search: 606/61, 606/72, 606/73, 606/60, 606/246, 606250-266, 606/270, 606/272, 606278-279, 606300-301, 606/304, 606/308, 606/319, 606/99, 606/104, 606/86.A, 606/914, 623/17.16
• US Class Current: 606/86.00A
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/1604 Chisels; Rongeurs; Punches; Stamps
• CPC Class Codes: A61B 17/1655 for tapping
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/1703 using imaging means, e.g. by X-rays
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 17/701 Longitudinal elements with a non-circular, e.g. rectangular, cross-section A61B17/7005, A61B17/7007 take precedence
• CPC Class Codes: A61B 17/7011 Longitudinal element being non-straight, e.g. curved, angled or branched adjustable length longitudinal elements A61B17/7014; A61B17/7019 takes precedence, e.g. coil springs
• CPC Class Codes: A61B 17/7032 Screws or hooks with U-shaped head or back through which longitudinal rods pass
• CPC Class Codes: A61B 17/7035 Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
• CPC Class Codes: A61B 17/7037 wherein pivoting is blocked when the rod is clamped
• CPC Class Codes: A61B 17/708 with tubular extensions coaxially mounted on the bone anchors
• CPC Class Codes: A61B 17/7082 for driving, i.e. rotating, screws or screw parts specially adapted for spinal fixation, e.g. for driving polyaxial or tulip-headed screws driving other bone screws A61B17/8875
• CPC Class Codes: A61B 17/7083 Tools for guidance or insertion of tethers, rod-to-anchor connectors, rod-to-rod connectors, or longitudinal elements
• CPC Class Codes: A61B 17/7085 for insertion of a longitudinal element down one or more hollow screw or hook extensions, i.e. at least a part of the element within an extension has a component of movement parallel to the extension's axis
• CPC Class Codes: A61B 17/7091 for applying, tightening or removing longitudinal element-to-bone anchor locking elements, e.g. caps, set screws, nuts or wedges
• CPC Class Codes: A61B 17/8605 Heads, i.e. proximal ends projecting from bone
• CPC Class Codes: A61B 17/861 specially shaped for gripping driver
• CPC Class Codes: A61B 17/8863 Apparatus for shaping or cutting osteosynthesis equipment by medical personnel
• CPC Class Codes: A61B 17/8866 for gripping or pushing bones, e.g. approximators joint distractors A61B17/025
• CPC Class Codes: A61B 17/8875 : Screwdrivers, spanners or wrenches
• CPC Class Codes: A61B 17/8897 : Guide wires or guide pins
• CPC Class Codes: A61B 2017/0256 : for the spine
• CPC Class Codes: A61B 2090/031 : torque limiting
• CPC Class Codes: A61B 2090/037 : with a frangible part, e.g. by reduced diameter
• CPC Class Codes: A61B 2090/061 : for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/062 : penetration depth
• CPC Class Codes: Y10S 606/914 : Toolkit for installing or removing spinal positioner or stabilizer

Abstract

A spinal stabilization system may be formed in a patient. In some embodiments, a minimally invasive procedure may be used to form a spinal stabilization system in a patient. Bone fastener assemblies may be coupled to vertebrae. Each bone fastener assembly may include a bone fastener and a collar. The collar may be rotated and/or angulated relative to the bone fastener. Detachable members may be coupled to the collar to allow for formation of the spinal stabilization system through a small skin incision. The detachable members may allow for alignment of the collars to facilitate insertion of an elongated member in the collars. An elongated member may be positioned in the collars and a closure member may be used to secure the elongated member to the collars.

Claims

1. A system for performing spine surgery, said system comprising:

a first bone screw configured to be screwed into a first vertebra;

a first collar rotatably coupled to the first bone screw, said first collar comprising a first slot;

a second bone screw configured to be screwed into a second vertebra;

a second collar rotatably coupled to the second bone screw, said second collar comprising a second slot;

a rod, said rod having a width necessary to fit within the first slot and the second slot;

a first sleeve comprising a first passage, said first passage extending longitudinally from a first end of the first sleeve to a second end of the first sleeve;

a first closure member configured to be secured to the first collar for securing the rod within the first slot;

a second sleeve comprising a second passage, said second passage extending longitudinally from a first end of the second sleeve to a second end of the second sleeve;

a second closure member configured to be secured to the second collar for securing the rod within the second slot,

wherein the first sleeve and the first collar comprise a first coupling system for coupling the first collar to the first sleeve, said first coupling system configured to provide a detachable mechanical coupling between an outer surface of the first collar and an inner surface of the first sleeve,

wherein when the first collar is detachably coupled to the first sleeve, the first coupling system inhibits translational movement of the first sleeve relative to the first collar,

wherein the second sleeve and the second collar comprise a second coupling system for coupling the second collar to the second sleeve, said second coupling system configured to provide a detachable mechanical coupling between an outer surface of the second collar and an inner surface of the second sleeve,

wherein when the second collar is detachably coupled to the second sleeve, the coupling system inhibits translational movement of the second sleeve relative to the second collar,

wherein the first passage is sized to permit the passage of a tool for securing the first closure member to the first collar, and

wherein the second passage is sized to permit the passage of a tool for securing the second closure member to the second collar.

2. The system of claim 1, wherein the first coupling system comprises a protrusion on the outer surface of the first collar.

3. The system of claim 2, wherein the first coupling system further comprises a recess in the inner surface of the first sleeve, said recess configured for complimentary engagement with the protrusion.

4. The system of claim 3, wherein the protrusion is a collar flange, and wherein the recess is a sleeve flange.

5. The system of claim 1, wherein the first coupling system comprises a protrusion on the inner surface of the first sleeve.

6. The system of claim 5, wherein the first coupling system further comprises a recess on the outer surface of the first collar, said recess configured for complimentary engagement with the protrusion.

7. The system of claim 6, wherein the protrusion is a sleeve flange, and wherein the recess is a collar flange.

8. The system of claim 1, wherein the first coupling system comprises a male threading on the outer surface of the first collar.

9. The system of claim 8, wherein the first coupling system further comprises a female threading on the inner surface of the first sleeve, said female threading configured for complimentary engagement with the male threading.

10. The system of claim 1, wherein the first coupling system comprises a textured surface on the inner surface of the first sleeve, said textured surface provides for frictional engagement with the outer surface of the first collar.

11. The system of claim 1, wherein the first coupling system comprises an interference fit between the first collar and the first sleeve.

12. The system of claim 1, wherein the first coupling system comprises a frictional fit between the first collar and the first sleeve.

13. The system of claim 1, wherein the first coupling system comprises a keyway connection between the first collar and the first sleeve.

14. The system of claim 1, wherein the first coupling system comprises a notch on the first collar.

15. The system of claim 1, wherein the first coupling system forms a dovetail joint between the first collar and the first sleeve.

16. The system of claim 1, wherein the rod is curved.

17. The system of claim 1, wherein the first sleeve is configured to fit within a minimally-invasive incision.

18. The system of claim 1, wherein the first bone screw is cannulated.

19. The system of claim 1, further comprising:

a third bone screw configured to be screwed into a third vertebra;

a third collar rotatably coupled to the third bone screw, said third collar comprising a third slot, the rod having a width necessary to fit within the third slot;

a third sleeve comprising a third passage, said third passage extending longitudinally from a first end of the third sleeve to a second end of the third sleeve;

a third closure member configured to be secured to the third collar for securing the rod within the third slot;

wherein the third sleeve and the third collar comprise a third coupling system for coupling the third collar to the third sleeve, said third coupling system configured to provide a detachable mechanical coupling between an outer surface of the third collar and an inner surface of the third sleeve;

wherein when the third collar is detachably coupled to the third sleeve, the third coupling system inhibits translational movement of the third sleeve relative to the third collar; and

wherein the third passage is sized to permit the passage of a tool for securing the second closure member to the second collar.

20. A system for performing spine surgery, said system comprising:

a first bone screw configured to be screwed into a first vertebra;

a first collar rotatably coupled to the first bone screw, said first collar comprising a first slot;

a second bone screw configured to be screwed into a second vertebra;

a second collar rotatably coupled to the second bone screw, said second collar comprising a second slot;

a rod, said rod having a width necessary to fit within the first slot and the second slot;

a first sleeve comprising a first passage, said first passage extending longitudinally from a first end of the first sleeve to a second end of the first sleeve;

a first closure member configured to be secured to the first collar for securing the rod within the first slot;

a second sleeve comprising a second passage, said second passage extending longitudinally from a first end of the second sleeve to a second end of the second sleeve;

a second closure member configured to be secured to the second collar for securing the rod within the second slot,

wherein the first sleeve and the first collar comprise a first coupling system for coupling the first collar to the first sleeve, said first coupling system configured to provide a detachable mechanical coupling between a surface of the first collar and a surface of the first sleeve,

wherein when the first collar is detachably coupled to the first sleeve, the first coupling system inhibits translational movement of the first sleeve relative to the first collar,

wherein the second sleeve and the second collar comprise a second coupling system for coupling the second collar to the second sleeve, said second coupling system configured to provide a detachable mechanical coupling between a surface of the second collar and a surface of the second sleeve,

wherein when the second collar is detachably coupled to the second sleeve, the coupling system inhibits translational movement of the second sleeve relative to the second collar,

wherein the first passage is sized to permit the passage of a tool for securing the first closure member to the first collar, and

wherein the second passage is sized to permit the passage of a tool for securing the second closure member to the second collar.

21. The system of claim 20, wherein the first coupling system comprises a protrusion on the surface of the first collar.

22. The system of claim 21, wherein the first coupling system further comprises a recess on the surface of the first sleeve, said recess configured for complimentary engagement with the protrusion.

23. The system of claim 22, wherein the protrusion is a collar flange, and wherein the recess is a sleeve flange.

24. The system of claim 20, wherein the first coupling system comprises a protrusion on the surface of the first sleeve.

25. The system of claim 24, wherein the first coupling system further comprises a recess on the surface of the first collar, said recess configured for complimentary engagement with the protrusion.

26. The system of claim 25, wherein the protrusion is a sleeve flange, and wherein the recess is a collar flange.

27. The system of claim 20, wherein the first coupling system comprises a male threading on the surface of the first collar.

28. The system of claim 27, wherein the first coupling system further comprises a female threading on the surface of the first sleeve, said female threading configured for complimentary engagement with the male threading.

29. The system of claim 20, wherein the first coupling system comprises a textured surface on the surface of the first sleeve, said textured surface provides for frictional engagement with the surface of the first collar.

30. The system of claim 20, wherein the first coupling system comprises an interference fit between the first collar and the first sleeve.

31. The system of claim 20, wherein the first coupling system comprises a frictional fit between the first collar and the first sleeve.

32. The system of claim 20, wherein the first coupling system comprises a keyway connection between the first collar and the first sleeve.

33. The system of claim 20, wherein the first coupling system comprises a notch on the first collar.

34. The system of claim 20, wherein the first coupling system forms a dovetail joint between the first collar and the first sleeve.

35. The system of claim 20, wherein the rod is curved.

36. The system of claim 20, wherein the first sleeve is configured to fit within a minimally-invasive incision.

37. The system of claim 20, wherein the first bone screw is cannulated.

38. The system of claim 20, further comprising:

a third bone screw configured to be screwed into a third vertebra;

a third collar rotatably coupled to the third bone screw, said third collar comprising a third slot, the rod having a width necessary to fit within the third slot;

a third sleeve comprising a third passage, said third passage extending longitudinally from a first end of the third sleeve to a second end of the third sleeve;

a third closure member configured to be secured to the third collar for securing the rod within the third slot;

wherein the third sleeve and the third collar comprise a third coupling system for coupling the third collar to the third sleeve, said third coupling system configured to provide a detachable mechanical coupling between a surface of the third collar and a surface of the third sleeve,

wherein when the third collar is detachably coupled to the third sleeve, the third coupling system inhibits translational movement of the third sleeve relative to the third collar,

wherein the third passage is sized to permit the passage of a tool for securing the third closure member to the third collar.

39. A system for performing spine surgery, said system comprising:

a first bone fastener configured to be fastened into a first vertebra;

a first collar coupled to the first bone fastener, said first collar comprising a first slot;

a second bone fastener configured to be fastened into a second vertebra;

a second collar coupled to the second bone fastener, said second collar comprising a second slot;

a rod, said rod having a width necessary to fit within the first slot and the second slot;

a first sleeve comprising a first passage, said first passage extending longitudinally from a first end of the first sleeve to a second end of the first sleeve;

a first closure member configured to be secured to the first collar for securing the rod within the first slot;

a second sleeve comprising a second passage, said second passage extending longitudinally from a first end of the second sleeve to a second end of the second sleeve;

a second closure member configured to be secured to the second collar for securing the rod within the second slot,

wherein the first sleeve and the first collar couple together to form a dovetail joint, wherein the dovetail joint provides a detachable mechanical coupling between the first collar, and the first sleeve,

wherein the second sleeve and the second collar couple together to form a dovetail joint, wherein the dovetail joint provides a detachable mechanical coupling between the second collar and the second sleeve,

wherein the first passage is sized to permit the passage of a tool for securing the first closure member to the first collar, and

wherein the second passage is sized to permit the passage of a tool for securing the second closure member to the second collar.

40. The system of claim 39, further comprising:

a third bone fastener configured to be fastened into a third vertebra;

a third collar coupled to the third bone fastener, said third collar comprising a third slot, the rod having a width necessary to fit within the third slot;

a third sleeve comprising a third passage, said third passage extending longitudinally from a third end of the third sleeve to a second end of the third sleeve;

a third closure member configured to be secured to the third collar for securing the rod within the third slot;

wherein the third sleeve and the third collar couple together to form a dovetail joint, wherein the dovetail joint provides a detachable mechanical coupling between the third collar, and the third sleeve,

wherein the third passage is sized to permit the passage of a tool for securing the third closure member to the third collar.