System and method for wire-guided pedicle screw stabilization of spinal vertebrae

• US 8,556,940 B2
• Filed: 09/30/2009
• Issued: 10/15/2013
• Est. Priority Date: 10/01/2008
• Status: Active Grant

• Current Assignee: Sherwin Hua
• Original Assignee: Sherwin Hua
• Inventors: Hua, Sherwin
• Primary Examiner(s): Philogene, Pedro
• Application Number:
  US13/122,388
• Publication Number:
  US 20110196429A1
• Time in Patent Office: 1,476 Days
• Field of Search: 606264-267, 606/305, 606/278, 606/279, 606/86.A, 606/104, 606/301, 606/300, 606/246, 606/99, 606/96, 606/190, 606/914, 292/48, 600/201, 600/203, 600/210
• US Class Current: 606/279
• CPC Class Codes: A61B 17/7001 Screws or hooks combined with longitudinal elements which do not contact vertebrae A61B17/7058 takes precedence
• CPC Class Codes: A61B 17/7002 Longitudinal elements, e.g. rods
• 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 17/7053 with parts attached to bones or to each other by flexible wires, straps, sutures or cables
• CPC Class Codes: A61B 17/7083 Tools for guidance or insertion of tethers, rod-to-anchor connectors, rod-to-rod connectors, or longitudinal elements
• CPC Class Codes: A61B 17/8863 Apparatus for shaping or cutting osteosynthesis equipment by medical personnel
• CPC Class Codes: A61B 2090/392 Radioactive markers
• CPC Class Codes: A61B 2090/3937 Visible markers
• CPC Class Codes: A61B 2090/3941 Photoluminescent markers
• CPC Class Codes: A61B 2090/3954 magnetic, e.g. NMR or MRI
• CPC Class Codes: A61B 2090/3966 Radiopaque markers visible in an X-ray image
• CPC Class Codes: A61B 90/92 coded with colour

Abstract

An improved system and method for positioning screws and rods to immobilize bones is provided. Specifically, the system and method is optimal for performing transforaminal lumbar interbody fusion (TLIF) and other interbody fusions in the spine. The system involves pedicle screws detachably connected to wires that guide rods down to the screws. The wires are strong, narrow, flexible, adjustable in tension, and easily disconnected from the screws after rod placement via a process such as cutting, radiating, burning, dissolving, etc. The use of wires to place the rods avoids the conventional bulky tower apparatuses of the prior art while at the same time enhancing the accuracy of placement. One of the preferred methods involves relying upon the natural lordotic curvature of the spine and the narrow diameter of the wires to insert many elements through a single minimally invasive incision.

Claims

1. A method of treating the spine, comprising:

making an incision in the skin of a patient to provide access to a spinal location;

delivering a first screw through the incision and into a first vertebra, the first screw having detachably connected thereto a first guiding element comprising a tower, tube, or partial tube having a height, after implantation of the first screw into the first vertebra, at or below the level of the skin incision;

delivering a second screw through the incision and into a second vertebra;

delivering a spinal stabilization element to the first and second screws; and

locking the spinal stabilization element to the first and second screws.

2. The method of claim 1, wherein the second screw has detachably connected thereto a second guiding element having a height, after implantation of the second screw into the second vertebra, at or below the level of the skin incision.

3. The method of claim 1, wherein the second screw has detachably connected thereto a second guiding element having a height, after implantation of the second screw into the second vertebra, above the level of the skin incision.

4. The method of claim 1, wherein the second screw has detachably connected thereto a second guiding element comprising a tower, tube, or partial tube.

5. The method of claim 1, wherein the second screw has detachably connected thereto a second guiding element comprising a wire.

6. The method of claim 1, wherein the first guiding element has attached thereto an elongated member that, after implantation of the first screw into the first vertebra, extends above the level of the skin incision.

7. The method of claim 6, wherein the elongated member is flexible.

8. The method of claim 6, wherein the elongated member is rigid.

9. A system for bone stabilization, comprising:

a first screw having a first screw head;

a first guiding element detachably connected to the first screw head;

a second screw having a second screw head;

a spinal fixation element; and

a locking mechanism configured to lock the spinal fixation element into the first and second screw heads,

wherein the first guiding element comprises a tower, tube, or partial tube configured to have a height, after implantation of the first screw into a vertebra, at or below a level of a skin incision,

wherein the spinal fixation element is configured to be guided by the first guiding element to the first and second screw heads.

10. The system of claim 9, further comprising at least one elongated member extending from an upper end of the tower, tube, or partial tube.

11. The system of claim 10, wherein the elongated member is flexible.

12. The system of claim 10, wherein the elongated member is rigid.

13. The system of claim 9, further comprising a second guiding element detachably connected to the second screw head, wherein the second guiding element is configured to have a height, after implantation of the second screw into a second vertebra, above the level of the skin incision.

14. The system of claim 9, further comprising a second guiding element detachably connected to the second screw head, wherein the second guiding element is configured to have a height, after implantation of the second screw into a second vertebra, at or below the level of the skin incision.

15. The system of claim 9, wherein the second screw has detachably connected thereto a second guiding element comprising a tower, tube, or partial tube.

16. The system of claim 9, wherein the second screw has detachably connected thereto a second guiding element comprising a wire.

17. The system of claim 9, wherein the first screw, the second screw, the spinal fixation element and the first guiding element are configured to be delivered through the same percutaneous or minimally invasive skin incision.

18. A screw for use in bone stabilization, comprising:

a screw shaft;

a screw head configured to receive a spinal fixation element;

a guiding element extending from the screw head, the guiding element comprising a tower, tube, or partial tube,

wherein the guiding element is configured to have a height, after implantation of the screw through a skin incision and into a vertebra, at or below a level of the skin incision.

19. The screw of claim 18, further comprising an elongated member extending from an upper end of the guiding element.

20. The screw of claim 19, further comprising a locking assembly configured to lock the spinal fixation element to the screw head.