Systems and methods for compressing and distracting vertebrae of the spinal column

• US 7,686,814 B2
• Filed: 07/06/2004
• Issued: 03/30/2010
• Est. Priority Date: 07/06/2004
• Status: Active Grant

• Current Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Original Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Inventors: Conley, Arthur, Melkent, Anthony J., Lim, Roy
• Primary Examiner(s): Barrett; Thomas C
• Assistant Examiner(s): Yang; Andrew
• Application Number:
  US10/885,265
• Publication Number:
  US 20060009777A1
• Time in Patent Office: 2,093 Days
• Field of Search: 606/61, 606/86, 606/105, 606246-279, 606/86.A, 606/86.R, 813/00, 813/43, 814/11, 814/13, 814/86
• US Class Current: 606/105
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/7079 Tools requiring anchors to be already mounted on an implanted longitudinal or transverse element, e.g. where said element guides the anchor motion
• CPC Class Codes: A61B 17/8019 where the means are a separate tool rather than being part of the plate
• CPC Class Codes: A61B 17/8866 for gripping or pushing bones, e.g. approximators joint distractors A61B17/025
• CPC Class Codes: A61B 2017/0256 for the spine

Abstract

Spinal surgical systems include a compressor mountable to a first vertebra and positionable relative to a fulcrum mountable to a second vertebra. The compressor and fulcrum are manipulated relative to one another to compress the first and second vertebrae. The systems further include a distractor mountable to a first vertebra and positionable relative to a fulcrum mountable to a second vertebra. The distractor and fulcrum are manipulated relative to one another to distract the first and second vertebrae.

Claims

1. A compressor, comprising:

an elongated body extending between a proximal end and a distal leverage surface, said elongated body including a channel extending at least partially between said proximal end and distal leverage surface;

a pair of arms extending distally of said distal leverage surface of said body, said pair of arms defining an elongated opening therebetween for receiving a fulcrum therethrough; and

an engaging member extending between distal ends of said pair of arms, said engaging member being mountable to an anchor engaged to a bony portion of a patient'"'"'s body, said engaging member includes a pair of extensions extending transversely to respective ones of said pair of arms and an end member extending between said pair of extensions, said end member and said pair of extensions being arranged to accommodate a bone anchor therebetween and said end member including a distally oriented recess extending therein to receive a connecting element extending from the bone anchor when the bone anchor is positioned between said pair of extensions, wherein said opening extends between said engaging member and said distal leverage surface of said elongated body.

2. The compressor of claim 1, wherein said engaging member defines a circular receptacle.

3. The compressor of claim 1, wherein said engaging member defines a rectangular receptacle.

4. The system of claim 1, wherein said channel is defined by a concavely curved surface extending between opposite sides of said elongated body.

5. A spinal surgical system, comprising:

a compressor engageable to a first vertebra, said compressor including an elongated body extending between a proximal end and a distal leverage surface, a pair of arms extending distally of said distal leverage surface of said body and defining an opening therebetween, and an engaging member at a distal end of said arms extending from one of said pair of arms to the other of said pair of arms; and

a fulcrum including an elongated shaft extending between a proximal end and a distal end, said distal end being engageable to a second vertebra, said distal end of said fulcrum being sized for positioning through said opening between said arms of said compressor and said opening of said compressor is arranged to receive an anchor engaged to the first vertebra to position said engaging member in engagement with the anchor while said distal end of said fulcrum extends through said opening and is engaged to an anchor engaged to the second vertebra, wherein said compressor is movable along a length of said elongated shaft between said proximal and distal ends of said elongated shaft to proximally and distally vary a location in which said distal leverage pivots against said elongated shaft in accordance with a relative positioning between said distal ends of said compressor and said fulcrum, said compressor and said fulcrum having a first configuration wherein said distal leverage surface contacts said elongated shaft of said fulcrum with said distal end of said fulcrum positioned to a first side of said engaging member of said compressor and said proximal end of said fulcrum positioned to a second side of said proximal end of said compressor, said second side being opposite said first side, wherein movement of said proximal ends of said compressor and said fulcrum toward one another when said engaging member is engaged to the first vertebra and said distal end of said fulcrum is engaged to the second vertebra moves said engaging member of said compressor and said distal end of said fulcrum toward one another about said distal leverage surface to compress the first and second vertebrae.

6. The system of claim 5, wherein said elongated body of said compressor and said elongated shaft of said fulcrum cross one another in said first configuration to form an X shape.

7. The system of claim 5, wherein said elongated body of said fulcrum extends along a longitudinal axis and said fulcrum includes a handle extending from said proximal end transversely to said longitudinal axis.

8. The system of claim 7, wherein said handle is orthogonal to said longitudinal axis.

9. The system of claim 5, wherein said fulcrum includes a passage extending through said elongated shaft, said passage opening at said distal and proximal ends of said fulcrum.

10. The system of claim 5, wherein said elongated body of said compressor includes a channel between said proximal end and said distal leverage surface, said channel being oriented toward said elongated shaft of said fulcrum in said first configuration.

11. The system of claim 10, wherein said channel is formed by a concave surface extending between opposite sides of said elongated body of said compressor.

12. The system of claim 10, wherein in said first configuration said elongated shaft is positioned in a portion of said channel in contact with said distal leverage surface of said elongated body of said compressor.

13. The system of claim 12, wherein in use at least one of said compressor and said fulcrum are moveable relative to the other from said first configuration to a second configuration to deliver a compression force between the first and second vertebrae by pivoting said at least one of said fulcrum and said compressor about said distal leverage surface.

14. The system of claim 13, wherein said pivoting of said at least one of said compressor and said fulcrum includes positioning said elongated shaft of said fulcrum in said channel of said compressor.

15. A spinal surgical system, comprising:

a compressor engageable to a first vertebra, said compressor including an elongated body extending between a proximal end and a distal leverage surface, a pair of arms extending distally of said distal leverage surface of said body and defining an opening therebetween, and an engaging member at a distal end of said arms extending between said arms; and

a fulcrum including an elongated shaft extending between a proximal end and a distal end, said distal end being engageable to a second vertebra, said distal end of said fulcrum being sized for positioning through said opening between said arms of said compressor and said opening of said compressor is arranged to receive an anchor engaged to the first vertebra to position said engaging member in engagement with the anchor while said distal end of said fulcrum extends through said opening and is engaged to an anchor engaged to the second vertebra, wherein said compressor is movable along a length of said elongated shaft between said proximal and distal ends of said elongated shaft to proximally and distally vary a location in which said distal leverage pivots against said elongated shaft in accordance with a relative positioning between said distal ends of said compressor and said fulcrum, said compressor and said fulcrum having a first configuration wherein said distal leverage surface contacts said elongated shaft of said fulcrum with said distal end of said fulcrum positioned to a first side of said engaging member of said compressor and said proximal end of said fulcrum positioned to a second side of said proximal end of said compressor, said second side being opposite said first side, wherein movement of said proximal ends of said compressor and said fulcrum toward one another when said engaging member is engaged to the first vertebra and said distal end of said fulcrum is engaged to the second vertebra moves said engaging member of said compressor and said distal end of said fulcrum toward one another about said distal leverage surface to compress the first and second vertebrae, wherein said engaging member of said compressor includes a pair of extensions extending transversely to respective ones of said pair of arms and an end member extending between said pair of extensions.

16. The system of claim 15, wherein said engaging member defines a circular receptacle.

17. The system of claim 15, wherein said engaging member defines a rectangular receptacle.

18. The system of claim 15, wherein said engaging member includes a distally oriented recess therein.

19. A spinal surgical system, comprising:

a compressor engageable to a first vertebra, said compressor including an elongated body extending between a proximal end and a distal leverage surface, a pair of arms extending distally of said distal leverage surface of said body and defining an opening therebetween, and an engaging member at a distal end of said arms extending between said arms; and

a fulcrum including an elongated shaft extending between a proximal end and a distal end, said distal end being engageable to a second vertebra, said distal end of said fulcrum being sized for positioning through said opening between said arms of said compressor and said opening of said compressor is arranged to receive an anchor engaged to the first vertebra to position said engaging member in engagement with the anchor while said distal end of said fulcrum extends through said opening and is engaged to an anchor engaged to the second vertebra, wherein said compressor is movable along a length of said elongated shaft between said proximal and distal ends of said elongated shaft to proximally and distally vary a location in which said distal leverage pivots against said elongated shaft in accordance with a relative positioning between said distal ends of said compressor and said fulcrum, said compressor and said fulcrum having a first configuration wherein said distal leverage surface contacts said elongated shaft of said fulcrum with said distal end of said fulcrum positioned to a first side of said engaging member of said compressor and said proximal end of said fulcrum positioned to a second side of said proximal end of said compressor, said second side being opposite said first side, wherein movement of said proximal ends of said compressor and said fulcrum toward one another when said engaging member is engaged to the first vertebra and said distal end of said fulcrum is engaged to the second vertebra moves said engaging member of said compressor and said distal end of said fulcrum toward one another about said distal leverage surface to compress the first and second vertebrae, and further comprising;

a construct including an elongated connecting member extending between the first and second vertebrae and the first and second anchors for engaging the connecting member to respective ones of the first and second vertebrae, wherein said compressor and said fulcrum are mountable to respective ones of the first and second anchors.

20. The system of claim 19, wherein said connecting member is a plate, said first anchor and said second anchor each include a first portion engageable to respective ones of the first and second vertebrae and a second portion engaged to said first portion to secure said plate to said respective anchor, said engaging member of said compressor being positionable about said second portion of said first anchor and said fulcrum including an engaging member at said distal end thereof positionable about said second portion of said second anchor.

21. The system of claim 20, wherein said plate includes a central slot for receiving said first portions of said first and second anchors therethrough, at least one of said first and second anchors being movable along said central slot of said plate as said engaging members of said compressor and said fulcrum are moved toward one another about said distal leverage surface.

22. The system of claim 19, wherein said connecting member is a rod, said first anchor and said second anchor each include a first portion engageable to respective ones of the first and second vertebrae and a second portion extending proximally from said first portion to receive said rod and a plug for engaging said rod to said second portion, said compressor being positionable about said second portion of said first anchor and said fulcrum including an engaging member at a distal end thereof positionable about said second portion of said second anchor.

23. The system of claim 22, wherein at least one of said first and second anchors is movable along said rod as said engaging members of said compressor and said fulcrum are moved toward one another to compress the first and second vertebrae.

24. A spinal surgical system, comprising:

a compressor including an elongated body extending between a proximal end and a leverage surface, said compressor further including an engaging member spaced distally of said leverage surface and an opening between said leverage surface and said engaging member, said opening being arranged to receive an anchor engageable to a first vertebra; and

a fulcrum including an elongated shaft extending between a proximal end and a distal end, said distal end being engageable to a second vertebra, said distal end of said fulcrum being sized for positioning through said opening while said opening of said compressor receives the anchor engaged to the first vertebra to position said engaging member in engagement with the anchor and said fulcrum being removably and nestably received relative to said compressor when said distal end of said fulcrum extends through said opening and is engaged to the second vertebra, wherein said compressor is movable along a length of said elongated shaft between said proximal and distal ends of said elongated shaft to proximally and distally vary a location in which said leverage surface pivots against said elongated shaft in accordance with a relative positioning of said distal end of said fulcrum relative to said engaging member of said compressor, said compressor and said fulcrum having a first configuration wherein said leverage surface contacts said elongated shaft and said distal end of said fulcrum is positioned to a first side of said engaging member of said compressor and said proximal end of said fulcrum is positioned to a second side of said proximal end of said compressor, said second side being opposite said first side, wherein movement of said proximal ends of said compressor and said fulcrum toward one another moves said engaging member of said compressor and said distal end of said fulcrum toward one another to compress the first and second vertebrae; and

a construct including an elongated connecting member extending between the first and second vertebrae and first and second anchors for engaging the connecting member to respective ones of the first and second vertebrae, wherein said compressor and said fulcrum are mountable to respective ones of the first and second anchors, said elongated connecting member being movable along at least one of said anchors when said proximal ends of said fulcrum and said compressor are moved toward one another to move said engaging member of said compressor and said distal end of said fulcrum toward one another to compress the first and second vertebrae.

25. The system of claim 24, further comprising a pair of arms extending from said leverage surface of said body and defining said opening therebetween, said engaging member extending between said pair of arms at a distal end of said arms and said leverage surface extending between said pair of arms at a proximal end of said pair of arms.

26. The system of claim 25, wherein said fulcrum is received through said opening between said pair of arms.

27. The system of claim 24, wherein said elongated body of said compressor and said elongated shaft of said fulcrum cross one another in said first configuration to form an X shape.

28. The system of claim 24, wherein said elongated shaft of said fulcrum extends along a longitudinal axis and said fulcrum includes a handle extending from said proximal end transversely to said axis.

29. The system of claim 24, wherein said elongated body of said compressor includes a channel extending at least partially between said proximal end distal ends thereof oriented toward said elongated shaft of said fulcrum in said first configuration.

30. A method for compressing vertebrae, comprising:

positioning a compressor through a portal to the vertebrae;

positioning a distal end of a fulcrum through an opening of the compressor with the compressor positioned through the portal;

mounting an engaging member of the compressor to a first vertebra, the compressor extending from the engaging member to an opposite proximal end;

mounting the distal end of the fulcrum to a second vertebra, the fulcrum extending from the distal end to an opposite proximal end;

positioning the fulcrum against a leverage surface of the compressor after mounting the distal end of the fulcrum to the second vertebra, wherein the leverage surface contacts the fulcrum with the distal end of the fulcrum positioned to a first side of the engaging member of the compressor and the proximal end of the fulcrum is positioned to a second side of the proximal end of the compressor, the second side being opposite the first side; and

pivoting the compressor and fulcrum relative to one another about the leverage surface by moving proximal ends of the compressor and fulcrum toward one another to move distal ends of the compressor and fulcrum toward one another, thereby compressing the vertebrae.

31. The method of claim 30, wherein the leverage surface is positionable at any one of a number of locations along the fulcrum.

32. The method of claim 30, wherein positioning the fulcrum against the leverage surface of the compressor includes positioning the fulcrum in the opening between a pair of arms extending distally from the leverage surface with the fulcrum and compressor crossing one another to form an X shape.

33. The method of claim 30, wherein pivoting the compressor and fulcrum relative to one another includes positioning the fulcrum in a channel extending along the compressor from the leverage surface to the proximal end of the compressor.

34. The method of claim 30, wherein mounting the compressor and mounting the fulcrum each include mounting the compressor and mounting the fulcrum to an anchor engaged to respective ones of the first and second vertebrae with the fulcrum and compressor crossing one another to form an X shape, wherein the anchor mounted to the compressor is received in the opening of the compressor.

35. The method of claim 30, further comprising engaging a connecting member between the first and second anchors when a desired compression between the first and second vertebrae is obtained.