Translatable carriage fixation system

• US 9,414,870 B2
• Filed: 07/13/2012
• Issued: 08/16/2016
• Est. Priority Date: 09/03/2003
• Status: Expired due to Term

• Current Assignee: Depuy Synthes Products Incorporated (Johnson & Johnson)
• Original Assignee: Depuy Synthes Products Incorporated (Johnson & Johnson)
• Inventors: Ryan, Christopher J., Suh, Sean S., Rathbun, David S., Roth, Christoph A., Koch, David
• Primary Examiner(s): Philogene, Pedro
• Assistant Examiner(s): Comstock, David C
• Application Number:
  US13/548,820
• Publication Number:
  US 20120283782A1
• Time in Patent Office: 1,495 Days
• Field of Search: 606/71, 606/280, 606/282, 606/289, 606/290
• US Class Current: 1/1
• CPC Class Codes: A61B 17/1728 for holes for bone plates or plate screws
• CPC Class Codes: A61B 17/7059 Cortical plates A61B17/7007, A61B17/7058 take precedence
• CPC Class Codes: A61B 17/8004 with means for distracting or compressing the bone or bones
• CPC Class Codes: A61B 17/8009 the plate having a ratchet
• CPC Class Codes: A61B 17/8023 Variable length plates adjustable in both directions
• CPC Class Codes: A61B 17/8047 wherein the additional element surrounds the screw head in the plate hole A61B17/8052 takes precedence

Abstract

Translational bone fixation assemblies, kits containing such assemblies, and methods of use are described herein. The described assemblies may be used in spinal fusion procedures in which a damaged or diseased disc (or part of a disc) is removed from between a pair of vertebrae and a spinal fusion spacer is placed between the vertebrae. The assemblies may be applied to an anterior portion of the affected vertebrae to span the affected disc space, and may be fixed to the vertebrae using bone screws. The assemblies may function to maintain the vertebrae aligned during the initial period following fixation in which fusion of the spacer to the adjacent vertebrae occurs. The assemblies may also function to share some of the axial spinal load applied to the fusion spacer to prevent extreme subsidence of the spacer into the vertebral body, such as where the patient has poor bone quality.

Claims

1. A fixation assembly comprising:

a plate assembly including;

a first plate that extends along a first direction, and at least one fixation hole that is configured to receive a first fixation element to thereby couple the first plate to a first bone, the first plate including a first engagement portion that extends from a first stop surface;

a second plate that includes a second stop surface, and a second engagement portion that is mated with the first engagement portion to thereby couple the second plate to the first plate such that the second stop surface faces the first stop surface so as to define a gap therebetween, wherein the second plate is moveable relative to the first plate along the first direction between an expanded position and a compressed position, and the second plate defines at least one fixation hole that is configured to receive a second fixation element to thereby couple the second plate to a second bone; and

a removable tab having a length in a second direction that is perpendicular to the first direction and a width in the first direction where the length is greater than the width, the removable tab being removably positioned in the gap such that the removable tab removably attaches to the plate assembly at a location in the gap and at no other location of the plate assembly, such that the location in the gap is disposed between the first and second stop surfaces with respect to the first direction, and the removable tab is separate from any structure that attaches to the plate assembly at a location outside the gap with respect to the first direction, wherein (i) the tab abuts the second stop surface to fix the second plate relative to the first plate with respect to movement from the expanded position toward the compressed position, and (ii) the second plate is movable from the expanded position toward the compressed position when the removable tab is removed from the gap.

2. The fixation assembly of claim 1, wherein the first plate includes a third engagement portion, and the fixation assembly further comprises a third plate that includes a fourth engagement portion that is configured to mate with the third engagement portion to thereby couple the third plate to the first plate such that the third plate is moveable relative to the first plate along the first direction between an expanded position and a compressed position between the first and third plates.

3. The fixation assembly of claim 2, further comprising a second removable tab removably positioned between the first and third plates.

4. The fixation assembly of claim 2, wherein the third plate defines at least one fixation hole that is configured to receive a third fixation element to thereby couple the third plate to a third bone.

5. The fixation assembly of claim 1, wherein the second plate is fixed in the expanded position when the removable tab is positioned between the first and second plates.

6. The fixation assembly of claim 1, wherein the second plate is moveable relative to the first plate along the first direction from the expanded position to the compressed position.

7. The fixation assembly of claim 1, wherein the first plate at least partially defines a visualization window that extends through the first plate so as to provide visual access through the first plate when the first and second plates are coupled to the first and second bones.

8. The fixation assembly of claim 7, wherein the visualization window extends through the first plate so as to provide visual access of a graft that is disposed between the first and second bones when the first and second plates are coupled to the first and second bones.

9. The fixation assembly of claim 1, wherein the first plate further defines at least one drill guide key that is configured to receive at least a portion of a drill guide to thereby align the drill guide with the at least one fixation hole of the first plate.

10. The fixation assembly of claim 1, wherein the second engagement portion is a contoured opening that receives the first engagement portion.

11. The fixation assembly of claim 10, wherein the first engagement portion projects out from the first stop surface along the first direction, and the removable tab removably attaches to the first engagement portion in the gap.

12. The fixation assembly of claim 1, wherein the removable tab has a thickness measured along the first direction that is substantially equal to the gap when the second plate is in the expanded position.

13. The fixation assembly of claim 12, wherein the first engagement portion includes a first interference member and the second engagement portion includes a second interference member that abuts the first interference member when the second plate is in the expanded position to thereby prevent the second plate from moving beyond the expanded position.

14. The fixation assembly of claim 1, wherein the removable tab is removable after the first plate and the second plate have been coupled to the first and second bones respectively.

15. The fixation assembly of claim 1, further comprising a clip that is at least partially disposed within the at least one fixation hole of the first plate.

16. The fixation assembly of claim 15, further comprising at least one fastener that includes a head and a threaded shaft that extends from the head along a central axis, the head of the fastener having a side surface and a lower surface that extends from the side surface and flares away from the central axis as it extends along a direction from the head toward the threaded shaft, the side surface and the lower surface at least partially defining a notch that is disposed above the lower surface and is configured to at least partially receive the clip such that engagement between the clip and the lower surface prevents the fastener from backing out of the at least one fixation hole of the first plate along a direction from the threaded shaft toward the head.

17. The fixation assembly of claim 16, wherein the notch is sized greater than the clip so as to permit the fastener to angulate relative to the clip when the fastener is received within the at least one fixation hole.

18. The fixation assembly of claim 17, wherein the first engagement portion includes a first interference member and the second engagement portion includes a second interference member that abuts the first interference member when the second plate is in the expanded position to thereby prevent the second plate from moving beyond the expanded position.

19. The fixation assembly as recited in claim 1, wherein an entirety of the removable tab is disposed between the first and second stop surfaces with respect to the first direction.

20. The fixation assembly as recited in claim 19, wherein the removable tab is separate from any structure that is disposed outside the gap with respect to the first direction.

21. A fixation assembly comprising:

a first plate that extends along a first direction, and includes a first tapered engaging portion, the first plate further having at least one fixation hole that is configured to receive a first fixation element to thereby couple the first plate to a first vertebra, the first tapered engaging portion defining a width along a second direction that is perpendicular to the first direction, wherein

     1) the fixation hole extends through the first plate along a third direction that is perpendicular to each of the first and second directions,

     2), the first tapered engaging portion defines upper and lower surfaces spaced from each other along the third direction, and

     3) the first tapered engaging portion defines a pair of flat, tapered side surfaces spaced from each other along the second direction, each of the tapered side surfaces oriented along a respective plane that intersects a plane defined by the first and second directions;

a second plate that includes a second engagement portion defining a contoured opening, the contoured opening being configured to receive and mate with the first tapered engaging portion of the first plate such that each of the tapered side surfaces, the upper surface, and a portion of the lower surface of the first tapered engaging portion face at least one complementary mating surface of the contoured opening, thereby coupling the second plate to the first plate such that the second plate is moveable relative to the first plate along the first direction between an expanded position and a compressed position, wherein the second plate defines at least one fixation hole that is configured to receive a second fixation element to thereby couple the second plate to a second vertebra; and

a removable locking device configured to be positioned in a gap defined by a space disposed in between the first and second plates as measured along the first direction so as to fix the second plate in the expanded position such that the fixation holes of the first and second plates are spaced apart a distance that corresponds to a distance that the first vertebra is spaced from the second vertebrae so that the fixation hole of the first plate is configured to overlie the first vertebra and the fixation hole of the second plate is configured to overlie the second vertebra, wherein when the removable locking device is positioned in the gap, the removable locking device removably attaches to the fixation assembly at the gap and is separate from any structure that attaches to the fixation assembly outside the gap, as measured along the first direction, wherein the removable locking device is configured to overlie an entirety of the width of the first tapered engaging portion, wherein the removable locking device is configured to be removed after the first and second plates are coupled to the first and second vertebrae such that when the removable locking device is removed the second plate can move from the expanded position toward the compressed position.

22. The fixation assembly of claim 21, wherein when the second plate is in the expanded position, the second plate is incapable of further expansion relative to the first plate.

23. The fixation assembly of claim 21, wherein the removable locking device is positioned between the first and second plates to thereby fix the second plate relative to the first plate.

24. The fixation assembly of claim 21, wherein the first plate at least partially defines a visualization window that extends through the first plate so as to provide visual access through the first plate when the first and second plates are coupled to the first and second vertebrae.

25. The fixation assembly of claim 21, wherein the first plate further defines at least one drill guide key that is configured to receive at least a portion of a drill guide to thereby align the drill guide with the at least one fixation hole of the first plate.

26. The fixation assembly of claim 21, further comprising a clip that is at least partially disposed within the at least one fixation hole of the first plate.

27. The fixation assembly of claim 26, further comprising at least one fastener that includes a head and a threaded shaft that extends from the head along a central axis, the head of the fastener having a side surface and a lower surface that extends from the side surface and flares away from the central axis as it extends along a direction from the head toward the threaded shaft, the side surface and the lower surface at least partially defining a notch that is disposed above the lower surface and is configured to at least partially receive the clip such that engagement between the clip and the lower surface prevents the fastener from backing out of the at least one fixation hole of the first plate along a direction from the threaded shaft toward the head.

28. The fixation assembly of claim 27, wherein the notch is sized greater than the clip so as to permit the fastener to angulate relative to the clip when the fastener is received within the at least one fixation hole.