Spinal fixation tool set and method

• US 8,273,089 B2
• Filed: 09/29/2006
• Issued: 09/25/2012
• Est. Priority Date: 11/23/2004
• Status: Active Grant

• Current Assignee: Nuvasive Incorporated
• Original Assignee: Roger P. Jackson
• Inventors: Jackson, Roger P.
• Primary Examiner(s): WOODALL, NICHOLAS W
• Application Number:
  US11/541,321
• Publication Number:
  US 20070032162A1
• Time in Patent Office: 2,188 Days
• Field of Search: 606/86.A, 606/246, 606264-278
• US Class Current: 606/86.A
• 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 17/7037 wherein pivoting is blocked when the rod is clamped
• 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 17/7085 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 17/7086 Rod reducers, i.e. devices providing a mechanical advantage to allow a user to force a rod into or onto an anchor head other than by means of a rod-to-bone anchor locking element; rod removers
• CPC Class Codes: A61B 17/7088 wherein the rod is moved transverse to the axis of the bone anchor
• 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: Y10T 29/49826 Assembling or joining

Abstract

A tool set for implanting a rod in a human spine in conjunction with bone screws includes a pair of end guide tools that receive opposite ends of the rod in channels and under manipulation by a surgeon facilitate transport of the rod toward the bone screws attached to the guide tools. Each end guide tool includes a laterally extending, rigid, rod holding structure located near a bottom surface thereof. Intermediate guide tools having pass-through slots are utilized to guide the rod to the bone screws at intermediate locations.

Claims

1. An apparatus for implanting a rod in a spinal bone anchor located in a patient, the apparatus comprising:

a) a first tool portion having;

i) an elongate body having a longitudinal axis, a central bore extending along the longitudinal axis an entire length of the body, an outer surface and a first channel with a lateral opening extending through the outer surface from a bottom of the body along a substantial length of the body, the first channel and the lateral opening being sized and shaped to receive a rod therein,

ii) a spinal bone anchor engaging structure near a bottom of the body that is adapted for removably attaching the first tool portion to a bone anchor such that the central bore is centered over a rod-receiving second channel in a head of the bone anchor and the central bore and the first channel and the channel lateral opening become aligned with the rod-receiving second channel; and

iii) an elongate narrow slot disposed opposite the lateral opening and extending upward from the bottom of the body to an intermediate portion of the body, the narrow slot and lateral opening cooperating to allow manual flexing of the elongate body so as to enlarge the bone anchor engaging structure and thereby enable a snap-on relation of the bone anchor to the bone anchor engaging structure; and

b) a second tool portion cooperating with the first tool portion to reduce the rod relative to the bone anchor rod-receiving second channel so as to seat the rod in the rod-receiving second channel and thereafter the first and second tool portions cooperating to facilitate insertion of a fastener for locking the rod within the bone anchor rod-receiving second channel, and thereafter the apparatus is removed from the patient.

2. The apparatus of claim 1 further including:

a) a rigid holding structure disposed opposite the lateral opening and near the bottom of the body and projecting laterally outwardly from the elongate body outer surface, the holding structure sized and shaped to closely receive and abut against an end of the rod;

wherein

b) the rigid holding structure is sized and shaped to hold the rod end at a location outside of the bone anchor.

3. The apparatus of claim 2 wherein the rigid holding structure includes a pair of spaced arms extending about the body, the body having an opening disposed adjacent the arms, the opening sized and shaped to receive the rod therethrough.

4. The apparatus of claim 1 wherein the bone anchor engaging structure includes first and second opposed pins projecting into the central bore, the pins sized and shaped to be received in cooperating apertures in the bone anchor for releasable attachment thereto.

5. The apparatus of claim 4 wherein each pin has an upwardly projecting lip sized and shaped to be received in an upwardly projecting inner recess of the bone anchor apertures.

6. The apparatus of claim 4 wherein flexing of the elongate body increases a distance between the first and second pins during insertion of the first tool portion on the bone anchor, the pins being in inwardly biasing snap-on relation to the bone anchor at the bone anchor apertures.

7. The apparatus of claim 1 further comprising a driving tool separately attachable to the first tool portion, the driving tool receivable in the central bore and operably attachable to the bone anchor for rotating and driving the bone anchor into bone.

8. The apparatus of claim 7 wherein first tool portion has an outer guide and advancement structure and the driving tool has a fastener, a stem and a driving structure disposed at a lower end of the stem, the driving structure for rotating and driving the bone anchor into bone, the fastener having an inner guide and advancement structure, the fastener being freely rotatable with respect to the stem and the inner guide and advancement structure and rotatingly mateable with the outer guide and advancement structure.

9. The apparatus of claim 8 wherein the driving structure is an internal surface forming a socket for receiving an upper portion of the bone anchor.

10. The apparatus of claim 1 further comprising a rod pusher separately attachable to the first tool portion, the rod pusher having a sleeve and a driving end, the sleeve receivable over the first tool portion elongate body and operably attachable to the elongate body for rotating thereabout, with the rotational movement of the sleeve also translating the driving end along the elongate body.

11. The apparatus of claim 10 wherein the first tool portion has an outer guide and advancement structure and the rod pusher has an inner guide and advancement structure mateable to the outer guide and advancement structure.

12. The apparatus of claim 1 further comprising

a) an elongate torquing tool having a handle and a stem receivable in the central bore of the first tool portion and attachable to a bone anchor fastener;

and

b) an elongate anti-torque tool having a handle and a sleeve receivable over the elongate body of the first tool portion, the sleeve sized and shaped to seat upon and abut against a rod at either side of the first tool portion elongate body, precluding any rotational movement of the anti-torque tool relative to the first tool portion.

13. The apparatus of claim 1 further comprising at least one intermediate guide tool having first and second elongate legs defining an elongate through-slot sized and shaped for receiving a rod therethrough, and a second opposed bone anchor engaging structure disposed near a bottom of the legs.

14. The apparatus of claim 13 wherein the second bone anchor engaging structure includes third and fourth opposed pins, the third pin disposed on the first leg and the fourth pin disposed on the second leg, the third and fourth pins projecting inwardly from the respective legs and sized and shaped to be received in cooperating apertures in a bone anchor for releasable attachment thereto.

15. The apparatus of claim 14 wherein the through-slot is sized and shaped to allow for manual flexing of the intermediate guide tool legs to increase a distance between the third and fourth pins during insertion of the intermediate guide tool on the bone anchor, the third and fourth pins being in inwardly biasing snap-on relation to the bone anchor at the bone anchor apertures.

16. The apparatus of claim 15 wherein the third and fourth pins each have an upwardly projecting lip sized and shaped to be received in an upwardly projecting inner recess of the bone anchor apertures.

17. The apparatus of claim 13 further comprising a driving tool attachable to the intermediate guide tool, the driving tool receivable in the through-slot and operably attachable to the bone anchor for rotating and driving the bone anchor into bone.

18. The apparatus of claim 13 further comprising a rod pusher attachable to the intermediate guide tool, the rod pusher having a sleeve and a driving end, the sleeve receivable over the first and second legs and operably attachable at an upper end of the intermediate guide tool for rotating thereabout, with the rotational movement of the sleeve also translating the driving end along the first and second legs.

19. The apparatus of claim 13 further comprising

a) an elongate torquing tool having a handle and a stem receivable in the through-slot of the intermediate guide tool and attachable to an implant fastener;

and

b) an elongate anti-torque tool having a handle and a sleeve receivable over the first and second legs of the intermediate guide tool, the sleeve sized and shaped to seat upon and abut against a rod at either side of the intermediate guide tool body, precluding any rotational movement of the anti-torque tool relative to the intermediate guide tool.

20. A tool set for implanting a rod in a spinal bone anchor located in a patient, the tool set comprising:

a) a first tool portion having;

i) an elongate body having a longitudinal axis, a central bore extending along the longitudinal axis an entire length of the body, an outer surface and a channel with a lateral opening and a narrow rear slot extending through the outer surface from a bottom of the body along a substantial length of the body, the channel and the lateral opening being sized and shaped to receive a rod therein, the slot and the lateral opening cooperate to allow manual flexing of the body; and

ii) a spinal bone anchor engaging structure near a bottom of the body that is adapted for removably attaching the first tool portion to a bone anchor such that the central bore becomes aligned with a rod-receiving channel in the bone anchor;

wherein

iii) the manual flexing of the body enlarges the bone anchor engaging structure, so as to allow the bone anchor engaging structure to snap on to the bone anchor; and

b) a second tool portion cooperating with the first tool portion to reduce the rod relative to the bone anchor rod-receiving channel so as to seat the rod in the rod-receiving channel and thereafter the first and second tool portions cooperating to facilitate insertion of a fastener for locking the rod within the bone anchor rod-receiving channel, and thereafter the first and second tool portions are removed from the patient.

21. An apparatus for implanting a rod in a spinal bone anchor located in a patient, the apparatus comprising:

a) a first tool portion having;

i) an elongate body having a longitudinal axis, a central bore extending along the longitudinal axis an entire length of the body, an outer surface and a channel, the channel having a lateral opening and an opposed narrow slot, each of the lateral opening and the slot extending through the outer surface from a bottom of the body along a length of the body, the channel and the lateral opening being sized and shaped to receive a rod therein; and

ii) a spinal bone anchor engaging structure near a bottom of the body that is adapted for removably attaching the first tool portion to a head of the bone anchor such that the tool body central bore is centered over a rod-receiving channel in the head of the bone anchor and the central bore and a central bore in the head of the bone anchor become axially aligned and the lateral opening in the tool body becomes aligned with the rod-receiving channel in the bone anchor head;

the slot and the elongate channel cooperating to enlarge the bone anchor engaging structure by manual flexing of the body, whereby the bone anchor engaging structure snaps on to the bone anchor head; and

b) a second tool portion cooperating with the first tool portion to reduce the rod relative to the bone anchor head rod-receiving channel so as to seat the head rod in the rod-receiving channel and thereafter the first and second tool portions cooperating to facilitate insertion of a fastener for locking the rod within the bone anchor head rod-receiving channel, and thereafter the apparatus is removed from the patient.

22. A tool set for implanting a rod in a spinal bone anchor located in a patient, the tool set comprising:

a) a first tool portion having;

i) an elongate body having a longitudinal axis, a central bore extending along the longitudinal axis an entire length of the body, an outer surface and a body channel with both a lateral opening an opposed narrow slot extending through the outer surface from a bottom of the body along a length of the body, the body channel and lateral opening being sized and shaped to receive a rod therein, the lateral opening and the narrow slot cooperating to enable manual flexing of the body and a snap-on relation of the body with a bone anchor; and

ii) a spinal bone anchor engaging structure near a bottom of the body that is adapted for removably attaching the first tool portion to the bone anchor such that the central bore becomes axially aligned with a central bore in a head of the bone anchor and the body channel becomes aligned with a rod-receiving channel in the head of the bone anchor;

b) a second tool portion cooperating with the first tool portion to reduce a rod relative to the bone anchor rod-receiving channel so as to seat the rod in the rod-receiving channel of the head of the bone anchor and thereafter cooperating with at least the first tool portion to facilitate insertion of a fastener for locking the rod within the bone anchor rod-receiving channel, and thereafter the first tool portion being detached from the bone anchor and removed from the patient.