Method and apparatus for spinal fixation

• US 7,824,429 B2
• Filed: 07/18/2003
• Issued: 11/02/2010
• Est. Priority Date: 07/19/2002
• Status: Active Grant

• Current Assignee: Depuy Synthes Products Incorporated (Johnson & Johnson)
• Original Assignee: Interventional Spine, Inc (Johnson & Johnson)
• Inventors: Culbert, Brad S., Stevens, Bruce E.
• Primary Examiner(s): RAMANA, ANURADHA
• Application Number:
  US10/623,193
• Publication Number:
  US 20040127906A1
• Time in Patent Office: 2,664 Days
• Field of Search: 606/60, 606/61, 606/72, 606/73
• US Class Current: 606/279
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/70 Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
• CPC Class Codes: A61B 17/7007 Parts of the longitudinal elements, e.g. their ends, being specially adapted to fit around the screw or hook heads
• 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 17/7049 Connectors, not bearing on the vertebrae, for linking longitudinal elements together A61B17/7055, A61B17/7053, A61B17/7019 take precedence
• CPC Class Codes: A61B 17/7064 Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor
• CPC Class Codes: A61B 17/8047 wherein the additional element surrounds the screw head in the plate hole A61B17/8052 takes precedence
• CPC Class Codes: A61B 17/86 Pins or screws or threaded wires; nuts therefor A61B17/72 take precedence
• CPC Class Codes: A61B 17/8685 comprising multiple separate parts
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61B 2017/0424 the separate member staying in the anchor after placement
• CPC Class Codes: A61B 2017/0425 the anchor or the separate member comprising threads, e.g. a set screw in the anchor
• CPC Class Codes: A61B 2017/0438 slotted, i.e. having a longitudinal slot for enhancing their elasticity
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/681 Alignment, compression, or distraction mechanisms
• CPC Class Codes: A61B 2090/037 with a frangible part, e.g. by reduced diameter

Abstract

Disclosed is a fixation device for spinal fixation. The fixation device includes an elongated body comprising a bone anchor at a distal end. An axially moveable proximal anchor is carried by the proximal end of the fixation device. In one embodiment, the device is inserted through a first vertebra and the bone anchor is rotated into positioned within a second vertebra. The proximal anchor is distally advanced with respect to the bone anchor to provide compression across the first and second vertebra. In other embodiments, the device is used to secure stabilization devices across two or more vertebra.

Claims

1. A method of providing spinal fixation, comprising the steps of:

providing a fixation device that comprises a body having a first portion that forms a bone anchor and a second portion that forms a proximal end, the first and second portion of the body detachably coupled to each other at a junction;

advancing the bone anchor of the fixation device through a facet of a first vertebra to position a distal tip of the bone anchor within a pedicle of a second vertebra;

advancing a proximal anchor distally over retention structures on the body to reduce the distance between the bone anchor and the proximal anchor, thereby applying compression between the facet on the first vertebra and the second vertebra; and

mechanically decoupling the second portion from the first portion after the proximal anchor is advanced distally along the fixation device.

2. The method of claim 1, wherein the step of advancing the bone anchor of the fixation device into a second vertebra comprises rotating the bone anchor.

3. The method of claim 1, comprising drilling a bore in the first vertebra having a diameter slightly larger than the outside diameter of the proximal anchor.

4. The method of claim 1, further comprising adjusting the angle between a longitudinal axis of the body and the proximal anchor with respect to a longitudinal axis of a flange.

5. The method of claim 1, wherein separating and removing the second portion from the first portion comprises rotating the second portion with respect to the first portion.

6. The method of claim 1, wherein the second portion of the body comprises part of a device used to advance the bone anchor into the pedicle of the second vertebra.

7. The method of claim 1, wherein the first vertebra is the L-5 vertebra and the second vertebra comprises the S-1 portion of the sacrum.

8. The method of claim 1, wherein the first and second vertebra are in a cervical region of a spine.

9. The method of claim 1, further comprising advancing the proximal anchor distally along the fixation device before the body is advanced through the facet of the first vertebra.

10. The method of claim 1, comprising advancing the proximal anchor distally along the fixation device after the bone anchor is advanced into the pedicle of the second vertebra.

11. The method of claim 1, wherein step of advancing the proximal anchor over the retention structures comprises advancing the proximal anchor over at least 10% of the overall length of the fixation device.

12. The method of claim 1, wherein step of advancing the proximal anchor over the retention structures comprises advancing the proximal anchor over at least 20% of the overall length of the fixation device.

13. The method of claim 1, wherein step of advancing the proximal anchor over the retention structures comprises advancing the proximal anchor over at least 50% of the overall length of the fixation device.

14. The method of claim 1, wherein the step of advancing the proximal anchor over the retention structures comprises advancing the proximal anchor over a series of ridges.

15. A method of treating the spine, comprising the steps of:

providing a fixation device that comprises a body having a distal anchor and a proximal anchor;

advancing the distal anchor of the fixation device through a facet of a first vertebra and into a pedicle of a second vertebra;

rotating the fixation device to engage the distal anchor with the pedicle; and

moving the proximal anchor distally over retention structures on the body to reduce the distance between the distal anchor and the proximal anchor, such that a locking element on the proximal anchor engages at least one retention structure on the body thereby applying compression between the first and second vertebra.

16. The method of claim 15, wherein the body comprises distal and proximal portions that are detachably coupled to each other at a junction.

17. The method of claim 15, wherein the first vertebra is the L-5 vertebra and the second vertebra comprises the S-1 portion of the sacrum.

18. The method of claim 15, wherein the first and second vertebra are in a cervical region of a spine.

19. The method of claim 15, further comprising coupling the proximal anchor to the body before the body is advanced through the facet of the first vertebra.

20. The method claim of 15, further comprising coupling the proximal anchor to the body after the distal anchor is advanced into the pedicle of the second vertebra.

21. The method of claim 15, wherein step of moving the proximal anchor distally over the retention structures comprises moving the proximal anchor over at least 10% of the overall length of the fixation device.

22. The method of claim 15, wherein step of moving the proximal anchor over the retention structures comprises moving the proximal anchor over at least 20% of the overall length of the fixation device.

23. The method of claim 15, wherein step of moving the proximal anchor over the retention structures comprises moving the proximal anchor over at least 50% of the overall length of the fixation device.

24. The method of claim 15, wherein the step of moving the proximal anchor over the retention structures comprises moving a slip ring over the retention structures.

25. The method of claim 15, wherein the step of moving the proximal anchor over the retention structures comprises moving the proximal anchor over a series of ridges.

26. A method of treating the spine, comprising the steps of:

providing a fixation device that comprises a body having a distal anchor and a proximal anchor;

advancing the distal anchor of the fixation device through a facet of a first vertebra and into a pedicle of a second vertebra;

rotating the fixation device to engage the distal anchor with the pedicle;

moving the proximal anchor distally over retention structures on the body to reduce the distance between the distal anchor and the proximal anchor, such that a locking element on the proximal anchor engages at least one retention structure on the body thereby applying compression between the first and second vertebra; and

drilling a bore in the first vertebra having a diameter slightly larger than the outside diameter of the proximal anchor.

27. The method of claim 26, further comprising separating and removing the proximal portion from the distal portion.

28. The method of claim 27, wherein separating and removing the proximal portion from the distal portion comprises rotating the proximal portion with respect to the distal portion.

29. The method of claim 28, wherein the proximal portion of the body comprises part of a device used to advance the distal anchor into the pedicle of the second vertebra.

30. A method of facet to pedicle fixation with secondary compression, comprising the steps of:

providing a fixation device that comprises a body having a distal anchor and a proximal anchor;

advancing the distal anchor of the fixation device through a facet of a first vertebra and into a pedicle of a second vertebra;

rotating the fixation device to engage the distal anchor with respect to the second vertebra; and

axially shortening the fixation device thereby reducing the distance between the distal anchor and the proximal anchor, such that a locking element on the proximal anchor engages at least one retention structure on the body thereby applying compression between the first and second vertebra.

31. The method of claim 30, wherein the body comprises distal and proximal portions of the body that are detachably coupled to each other at a junction.

32. The method of claim 31, further comprising separating and removing the proximal portion from the distal portion.

33. The method of claim 32, wherein separating and removing the proximal portion from the distal portion comprises rotating the proximal portion with respect to the distal portion.

34. The method of claim 31, wherein the proximal portion of the body comprises part of a device used to advance the distal anchor into the pedicle of the second vertebra.

35. The method of claim 30, wherein the first vertebra is the L-5 vertebra and the second vertebra comprises the S-1 portion of the sacrum.

36. The method of claim 30, wherein the first and second vertebra are in a cervical region of a spine.

37. The method of claim 30, further comprising coupling the proximal anchor to the body before the body is advanced through the facet of the first vertebra.

38. The method of claim 30, further comprising coupling the proximal anchor to the body after the distal anchor is advanced into the pedicle of the second vertebra.

39. The method of claim 30, wherein step of moving the proximal anchor distally over the retention structures comprises moving the proximal anchor over at least 10% of the overall length of the fixation device.

40. The method of claim 30, wherein step of moving the proximal anchor over the retention structures comprises moving the proximal anchor over at least 20% of the overall length of the fixation device.

41. The method of claim 30, wherein step of moving the proximal anchor over the retention structures comprises moving the proximal anchor over at least 50% of the overall length of the fixation device.

42. The method of claim 30, wherein the step of moving the proximal anchor over the retention structures comprises moving a slip ring over the retention structures.

43. A method of facet to pedicle fixation with secondary compression, comprising the steps of:

providing a fixation device that comprises a body having a distal anchor and a proximal anchor;

advancing the distal anchor of the fixation device through a facet of a first vertebra and into a pedicle of a second vertebra;

rotating the fixation device to engage the distal anchor with respect to the second vertebra;

axially shortening the fixation device thereby reducing the distance between the distal anchor and the proximal anchor, such that a locking element on the proximal anchor engages at least one retention structure on the body thereby applying compression between the first and second vertebra; and

drilling a bore in the first vertebra having a diameter slightly larger than the outside diameter of the proximal anchor.