Method and apparatus for spinal fixation

• US 7,993,377 B2
• Filed: 01/15/2007
• Issued: 08/09/2011
• 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: Stevens, Bruce E., Culbert, Brad S.
• Primary Examiner(s): Ramana; Anu
• Application Number:
  US11/623,270
• Publication Number:
  US 20070118132A1
• Time in Patent Office: 1,667 Days
• Field of Search: 606/279, 606/300, 606/301, 606/305, 606/306, 606/310
• 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 that includes an elongated body including 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 advanced through a spinous process of a first vertebra, inserted through the first vertebra and the bone anchor is rotated into position within a second vertebra. The proximal anchor is distally advanced with respect to the bone anchor to provide compression across the first and second vertebrae.

Claims

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

advancing 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, through a portion of a first vertebra;

advancing the bone anchor of the fixation device into a second vertebra;

advancing a proximal anchor distally along retention structures on the fixation device;

proximally retracting the body of the fixation device with respect to the proximal anchor to adjust compression across the first and second vertebrae; and

wherein the step of advancing the fixation device through the first vertebra

includes advancing the fixation device through a spinous process of the first vertebra.

2. The method of claim 1, wherein the step of advancing a fixation device through a portion of a first vertebra comprises advancing the fixation device through a facet of the first vertebra.

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

4. 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.

5. The method of claim 1, wherein the step of advancing the bone anchor of the fixation device into a second vertebra comprises compressing an axial orientation of the distal anchor for distal insertion through the bore and expanding the distal anchor to an incline orientation to resist axial movement through the bore.

6. The method of claim 5, further comprising withdrawing a locking wire into the body to prevent the distal anchor from compressing.

7. 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.

8. 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.

9. The method of claim 1, where the first and second portion of the body are detachably coupled to each other at a junction.

10. The method of claim 9, further comprising separating and removing the second portion from the first portion after the proximal anchor is advanced distally along the fixation device.

11. The method of claim 10, wherein separating and removing the second portion from the first portion comprises rotating the second portion with respect to the first portion.

12. The method of claim 10, wherein the second portion of the body comprises part of a device used to advance the bone anchor into the pedicle of the second vertebrae.

13. 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.

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

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

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

17. 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% the overall length of the fixation device.

18. 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% the overall length of the fixation device.

19. 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% the overall length of the fixation device.

20. The method of claim 1, wherein the step of advancing the proximal anchor over the retention structures comprises advancing a slip ring over the retention structures.

21. 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.