Multi-functional surgical instrument and method of use for inserting an implant between two bones

• US 8,142,435 B2
• Filed: 02/19/2009
• Issued: 03/27/2012
• Est. Priority Date: 02/19/2009
• Status: Active Grant

• Current Assignee: Aesculap Implant Systems LLC (Sartorius AG)
• Original Assignee: Aesculap Implant Systems LLC (Sartorius AG)
• Inventors: Refai, Daniel, Farris, Jeffrey A.
• Primary Examiner(s): Robert, Eduardo C
• Assistant Examiner(s): Schneider, Lynnsy
• Application Number:
  US12/388,581
• Publication Number:
  US 20100211119A1
• Time in Patent Office: 1,132 Days
• Field of Search: 606/86.A, 606/90, 606/99, 606/279, 623/17.15
• US Class Current: 606/86.A
• CPC Class Codes: A61F 2/44 for the spine, e.g. vertebrae, spinal discs
• CPC Class Codes: A61F 2/4603 for insertion or extraction of endoprosthetic joints or of accessories thereof
• CPC Class Codes: A61F 2/4611 of spinal prostheses
• CPC Class Codes: A61F 2002/30594 slotted, e.g. radial or meridian slot ending in a polar aperture, non-polar slots, horizontal or arcuate slots
• CPC Class Codes: A61F 2002/4627 with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument
• CPC Class Codes: A61F 2002/4629 connected to the endoprosthesis or implant via a threaded connection

Abstract

The surgical instrument includes a handle and a housing member that has a first end that is fixed to the handle and a second end that is configured to receive an engagement member. The surgical instrument also has an implant holding mechanism that is operatively associated with the housing member and the handle. The surgical instrument further includes a length control mechanism that has a knob, a rod member and a toothed member. The toothed member is fixed to one end of the rod member and the knob is attached to the other end. The surgical instrument also has a locking mechanism that includes a knob and a rod member having a proximal end to which the knob is attached and a distal end that is configured to detachably couple to a locking device. A surgical method for using the surgical instrument and a bone spacing kit is also disclosed.

Claims

1. A surgical instrument for inserting an implant between two bones, the surgical instrument comprising:

a holder member;

a housing member having a proximal end, a distal end and a central bore extending there between, the proximal end of the housing member being fixed to a distal end of the holder member;

an implant holding mechanism operatively associated with the housing member and the holder member, wherein the implant holding mechanism comprises an engagement member, a tube member and a knob, the tube member having a proximal end and a distal end with an opening extending between the proximal end and distal end of the tube member, wherein the engagement member is coupled to the distal end of the tube member and the knob of the implant holding mechanism is coupled to the proximal end of the tube member, wherein the distal end of the housing member is configured to receive the engagement member, and wherein the engagement member moves proximally relative to the distal end of the housing member when the knob of the implant holding mechanism is actuated, wherein the implant holding mechanism when actuated relative to the housing member pressingly engages and holds the implant for insertion between the two bones; and

a length control mechanism for adjusting the overall length of the implant, the length control mechanism comprising a knob, a rod member, and a toothed member, the rod member comprising a proximal end and a distal end, the knob coupled to the proximal end of the rod member, and the toothed member fixed to the distal end of the rod member, the toothed member comprising a plurality of teeth extending from the distal end, the plurality of teeth projecting distally beyond the distal end of the housing member when the length control mechanism is inserted into the opening of the tube member.

2. The surgical instrument of claim 1, wherein the engagement member comprises a base with a hole, a pair of arms extending from the base, and a channel collinear with the hole, the channel being defined by the base and the pair of arms, with the pair of arms being configured to flex inwardly and outwardly when the engagement member is moved relative to the distal end of the housing member.

3. The surgical instrument of claim 2, wherein each of the pair of arms further comprise a distal surface, each distal surface being configured to engage a corresponding structure disposed on the implant to hold the implant after actuation of the implant holding mechanism.

4. The surgical instrument of claim 2, wherein an inner surface of the distal end of the housing member is configured to pressingly engage the pair of arms of the engagement member and flex the pair of arms in an inward direction when the engagement member is actuated in the proximal direction relative to the housing member.

5. The surgical instrument of claim 1, wherein the tube member further comprises an anti-rotation portion and the holder member includes at least one hole configured to receive the anti-rotation portion and inhibit rotation of the tube member in the holder member and housing member upon actuation of the knob of the implant holding mechanism.

6. The surgical instrument of claim 1, wherein the central bore of the housing member is sized to receive the tube member of the implant holding mechanism.

7. The surgical instrument of claim 1, wherein the toothed member is configured to mate with a length adjustment assembly in the implant, wherein when the toothed member is inserted into the length adjustment assembly in the implant and is rotated, the overall length of the implant is changed.

8. The surgical instrument of claim 1, wherein when the length control mechanism is inserted into the opening of the tube member, the knob of the length control mechanism is proximate to the knob of the implant holding mechanism and the toothed member extends into the channel of the engagement member.

9. The surgical instrument of claim 8, wherein the opening of the tube member is sized to facilitate rotation and translation of the length control mechanism following insertion into the implant holding mechanism.

10. The surgical instrument of claim 1, further comprising a locking mechanism for securing the overall length of the implant.

11. The surgical instrument of claim 10, wherein the locking mechanism is configured to be inserted into the opening of the tube member and when in an operative position, the knob of the locking mechanism is proximate to the knob of the implant holding mechanism and the distal end of the locking mechanism extends into the channel of the engagement member.

12. The surgical instrument of claim 10, wherein the opening of the tube member is sized to facilitate rotation and translation of the locking mechanism following insertion into the implant holding mechanism.

13. The surgical instrument of claim 10, wherein the locking mechanism comprises a knob and a rod member having a proximal end and a distal end, the knob of the locking mechanism being coupled to the proximal end of the rod member and the distal end of the locking mechanism being configured to detachably couple a locking device, the locking device being sized and configured to be inserted into the implant to secure the overall length of the implant.

14. The surgical instrument of claim 13, wherein the locking device is at least one of a locking pin, a locking screw, and a dowel.

15. The surgical instrument of claim 1, wherein the rod member of the length control mechanism comprises a homogeneous solid shaft.

16. A surgical instrument, the surgical instrument comprising:

a handle;

a housing member having a proximal end, a distal end and a central bore extending there between, the proximal end of the housing member being fixed to a distal end of the handle;

an implant holding mechanism operatively associated with the housing member and the handle, wherein the implant holding mechanism comprises an engagement member, a tube member and a knob, the tube member having a proximal end and a distal end with an opening extending between the proximal end and distal end of the tube member, wherein the engagement member is coupled to the distal end of the tube member and the knob of the implant holding mechanism is coupled to the proximal end of the tube member, wherein the distal end of the housing member is configured to receive the engagement member, and wherein the engagement member moves proximally relative to the distal end of the housing member when the knob of the implant holding mechanism is actuated, wherein the implant holding mechanism when actuated relative to the housing member pressingly engages and holds the implant;

a length control mechanism for adjusting the overall length of the implant, the length control mechanism comprising a knob, a rod member, and a toothed member, the rod member comprising a proximal end and a distal end, the knob coupled to the proximal end of the rod member, and the toothed member fixed to the distal end of the rod member, the toothed member comprising a plurality of teeth extending from the distal end, the plurality of teeth projecting distally beyond the distal end of the housing member when the length control mechanism is inserted into the opening of the tube member; and

a locking mechanism for securing an overall length of the implant comprising a knob and a rod member having a proximal end and a distal end, the knob of the locking mechanism is configured to couple to the proximal end of the rod member and the distal end of the locking mechanism is configured to detachably couple a locking device, the locking device being sized and configured to be inserted into and secure the overall length of the implant after placement between the two bones.

17. The surgical instrument of claim 16, wherein the engagement member comprises a base element with a hole, a pair of arms extending from the base element, and a channel collinear with the hole, the channel being defined by the base element and the pair of arms, with the pair of arms being configured to flex inwardly and outwardly when the engagement member is moved relative to the distal end of the housing member.

18. The surgical instrument of claim 17, wherein each of the pair of arms further comprise a distal surface, each distal surface being configured to engage a corresponding structure disposed on the implant to hold the implant after actuation of the implant holding mechanism.

19. The surgical instrument of claim 17, wherein an inner surface of the distal end of the housing member is configured to pressingly engage the pair of arms of the engagement member and flex the pair of arms in an inwardly direction when the engagement member is actuated in the proximal direction relative to the housing member.

20. The surgical instrument of claim 16, wherein the tube member further comprises an anti-rotation portion and the handle includes at least one hole configured to receive the anti-rotation portion and inhibit rotation of the tube member in the handle and housing member when the knob of the implant holding mechanism is actuated.

21. The surgical instrument of claim 16, wherein the central bore of the housing member is sized to receive the tube member of the implant holding mechanism.

22. The surgical instrument of claim 16, wherein the toothed member is configured to mate with a length adjustment assembly in the implant, wherein when the toothed member is inserted into the length adjustment assembly in the implant and is rotated, the overall length of the implant is changed.

23. The surgical instrument of claim 16, wherein when the length control mechanism is inserted into the opening of the tube member, the knob of the length control mechanism is proximate to the knob of the implant holding mechanism and the toothed member extends into the channel of the engagement member.

24. The surgical instrument of claim 23, wherein the opening of the tube member is sized to facilitate rotation and translation of the length control mechanism following insertion into the implant holding mechanism.

25. The surgical instrument of claim 16, wherein the locking device is at least one of a locking pin, a locking screw and a dowel.

26. The surgical instrument of claim 16, wherein the locking mechanism is configured to be inserted into the opening of the tube member and when in an operable position, the knob of the locking mechanism is proximate to the knob of the implant holding mechanism and the distal end of the locking mechanism extends into the channel of the engagement member.

27. The surgical instrument of claim 26, wherein the opening of the tube member is sized to facilitate rotation and translation of the locking mechanism following insertion into the implant holding mechanism.

28. The surgical instrument of claim 16, wherein the rod member of the length control mechanism comprises a homogeneous solid shaft.

29. A surgical method for inserting an implant between two bones, the method comprising the steps of:

surgically creating an opening on the skin of a patient, wherein the opening is proximate the location of the two bones;

obtaining a surgical instrument comprising;

a handle;

a housing member having a proximal end, a distal end and a central bore extending there between, the proximal end of the housing member being fixed to a distal end of the handle;

an implant holding mechanism operatively associated with the housing member and the handle, wherein the implant holding mechanism comprises an engagement member, a tube member and a knob, the tube member having a proximal end and a distal end with an opening extending between the proximal end and distal end of the tube member, wherein the engagement member is coupled to the distal end of the tube member and the knob of the implant holding mechanism is coupled to the proximal end of the tube member, wherein the distal end of the housing member is configured to receive the engagement member, and wherein the engagement member moves proximally relative to the distal end of the housing member when the knob of the implant holding mechanism is actuated, wherein the implant holding assembly when actuated relative to the housing member pressingly engages and holds the implant;

a length control mechanism for adjusting the overall length of the implant, the length control mechanism comprising a knob, a rod member, and a toothed member, the rod member comprising a proximal end and a distal end, the knob coupled to the proximal end of the rod member, and the toothed member fixed to the distal end of the rod member, the toothed member comprising a plurality of teeth extending from the distal end, the plurality of teeth projecting distally beyond the distal end of the housing member when the length control mechanism is inserted into the opening of the tube member; and

a locking mechanism for securing an overall length of the implant comprising a knob and a rod member having a proximal end and a distal end, the knob of the locking mechanism being coupled to the proximal end of the rod member and the distal end of the locking mechanism being configured to detachably couple a locking device, the locking device being sized and configured to be inserted into and secure the overall length of the implant;

coupling the implant to the implant holding mechanism;

inserting the surgical instrument and coupled implant into the opening;

positioning the implant into a space between the two bones;

changing the length of the implant to cause the implant to contact the two bones; and

securing the length of the inserted implant.

30. The method of claim 29, wherein the step of coupling the implant further comprises actuating the implant holding mechanism to pressingly engage the implant with the engagement member.

31. The method of claim 29, wherein the step of changing the length of the implant further comprises inserting the toothed member into a length adjustment assembly in the implant and actuating the length control mechanism to rotate the toothed member.

32. The method of claim 29, wherein the step of securing the overall length of the inserted implant further comprises employing the locking mechanism and inserting the locking device into the implant, thereby securing the overall length of the implant.

33. The surgical method of claim 29, wherein the rod member of the length control mechanism comprises a homogeneous solid shaft.

34. A bone spacing kit, the kit comprising:

an implant for placement between two bones; and

a surgical instrument comprising;

a handle;

a housing member having a proximal end, a distal end and a central bore extending there between, the proximal end of the housing member being fixed to a distal end of the handle;

an implant holding mechanism operatively associated with the housing member and the handle, wherein the implant holding mechanism comprises an engagement member, a tube member and a knob, the tube member having a proximal end and a distal end with an opening extending between the proximal end and distal end of the tube member, wherein the engagement member is coupled to the distal end of the tube member and the knob of the implant holding mechanism is coupled to the proximal end of the tube member, wherein the distal end of the housing member is configured to receive the engagement member, and wherein the engagement member moves proximally relative to the distal end of the housing member when the knob of the implant holding mechanism is actuated, wherein the implant holding assembly when actuated relative to the housing member pressingly engages the implant;

a length control mechanism for adjusting the overall length of the implant, the length control mechanism comprising a knob, a rod member, and a toothed member, the rod member comprising a proximal end and a distal end, the knob coupled to the proximal end of the rod member, and the toothed member fixed to the distal end of the rod member, the toothed member comprising a plurality of teeth extending from the distal end, the plurality of teeth projecting distally beyond the distal end of the housing member when the length control mechanism is inserted into the opening of the tube member; and

a locking mechanism for securing the overall length of the implant comprising a knob and a rod member having a proximal end and a distal end, the knob of the locking mechanism being coupled to the proximal end of the rod member and the distal end of the locking mechanism being configured to detachably couple a locking device, the locking device being sized and configured to be inserted into and secure the overall length of the implant.

35. The bone spacing kit of claim 34, wherein the rod member of the length control mechanism comprises a homogeneous solid shaft.