Spinal fixation tool set and method for rod reduction and fastener insertion

• US 20060074418A1
• Filed: 09/24/2004
• Published: 04/06/2006
• Est. Priority Date: 09/24/2004
• Status: Active Grant

• Current Assignee: Roger P. Jackson
• Original Assignee: Roger P. Jackson
• Inventors: Jackson, Roger P.
• Granted Patent: US 7,651,502 B2
• Time in Patent Office: Days
• US Class Current: 606/914
• 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 17/7091 for applying, tightening or removing longitudinal element-to-bone anchor locking elements, e.g. caps, set screws, nuts or wedges
• CPC Class Codes: A61B 2090/037 with a frangible part, e.g. by reduced diameter

Abstract

A tool for implantation of a rod into a bone screw implanted in a human spine includes a guide member having a laterally opening channel disposed along an entire length thereof for side loading and receiving an implant fastener. A rod pushing member and a handle with a laterally opening channel are coaxial with the guide member, with the rod pushing member being rotatingly mateable to the guide member and the handle having a spring attachment mechanism for attaching the handle to the guide member. The guide member includes spring tabs for attachment to a bone screw, the tabs biased away from the bone screw. The rod pushing member includes a sleeve that extends substantially about the guide member, pressing the spring tabs toward the bone screw and into apertures on the bone screw arms. The rod pushing member sleeve also operatively functions as a rod pusher that abuts a rod as the sleeve is translated along the guide member and toward the bone screw. The handle lateral opening receives and supports a manipulation tool for inserting and installing an implant fastener for attaching the rod to the bone screw.

Claims

1. An elongate guide tool having a handle structure at an end thereof and opposed implant engaging structure at an opposite end thereof, the guide tool having a channel with a lateral opening that extends an entire length of the guide tool, the channel sized and shaped for side loading and receiving of an implant fastener into at least one loading location intermittently positioned along the length of the channel.

2. The guide tool of claim 1 wherein the at least one loading location is at the handle structure.

3. The guide tool of claim 1 further comprising a rod pushing member attachable to the guide tool.

4. The guide tool of claim 1 having an external guide and advancement structure.

5. The guide tool of claim 4 wherein the guide and advancement structure is a thread.

6. The guide tool of claim 4 wherein the guide and advancement structure is a first guide and advancement structure, and further comprising a rod pushing member having a second guide and advancement structure mateable to the first guide and advancement structure.

7. The guide tool of claim 1 wherein the implant engaging members are flexible and have radially inwardly extending protrusions.

8. The guide tool of claim 1 wherein the implant engaging members have spring tabs biasing radially outwardly from the guide tool.

9. The guide tool of claim 1 wherein the handle structure is detachable.

10. The guide tool of claim 1 wherein the lateral opening has a varying width.

11. A spinal rod implantation tool assembly comprising:

a) an elongate guide member having an end configured for releaseable attachment to a spinal implant and a first channel having a first lateral opening along an entire length of the guide member;

b) an elongate installation tool having a translation nut and an attached sleeve, the translation nut coaxial and being freely rotatable with respect to the sleeve, the nut configured for rotatable attachment to the guide member, the sleeve having a rod pushing end, the rod pushing end translatable along the guide member and configured for pressing the guide member end into engagement with the spinal implant and for contact with and translation of a rod toward the spinal implant; and

c) a handle configured for releaseable attachment to the guide member, the handle having a second channel configured for coaxial alignment with the first channel, and a second lateral opening configured for coaxial alignment with the first lateral opening, the second lateral opening configured for receiving a manipulation tool.

12. The assembly of claim 11 wherein the guide member end has first and second opposed spring tabs disposed on either side of the first lateral opening, each spring tab having a protrusion configured for attachment to a spinal implant, the spring tabs biasing radially outwardly and away from the guide member end, the installation tool sleeve configured for pressing the spring tabs inwardly radially and toward the spinal implant.

13. The assembly of claim 11 further comprising a manipulation tool having a holder and a stem, the stem having an end configured for rotatable engagement with a closure member of a spinal implant, the stem configured to be in coaxial relationship with both the first and second channels, the stem laterally insertable into the handle second channel.

14. The assembly of claim 11 wherein:

a) the guide member has an outer surface having a first guide and advancement structure thereon; and

b) the translation nut has an inner surface having a second guide and advancement structure thereon, mateable with the first guide and advancement structure, and wherein rotation of the translation nut when the first and second guide and advancement structures are mated causes non-rotating axial translation of the sleeve along the guide member.

15. The assembly of claim 11 wherein the guide member has an aperture and the handle has a spring-loaded pin configured to project into the aperture when the handle is received on the guide member with the first and second channels in coaxial alignment.

16. The assembly of claim 15 having a first implant receiving configuration and a second implant holding and rod reducing configuration, the first configuration wherein the installation tool is received on the guide member, the nut rotatably attached to the guide member, the handle received on the guide member with the spring-loaded pin disposed in the aperture and the handle in contact with the translation nut, the second position wherein the translation nut is spaced from the handle, with the sleeve pressing the guide tool into engagement with the spinal implant.

17. The assembly of claim 16 wherein the guide member end has first and second opposed spring tabs disposed on either side of the first lateral opening, each spring tab having a protrusion configured for attachment to a spinal implant, the spring tabs biasing radially outwardly and away from the guide member end, the installation tool sleeve pressing against the spring tabs and urging the protrusions inwardly radially toward the spinal implant when the assembly is in the second implant holding and rod reducing configuration.

18. A guide member for use with a spinal implant bone screw and an associated rod, the guide member comprising:

a) an elongate body having an inner surface defining an elongate channel, the body further defining a first elongate lateral opening communicating with the channel; and

b) a bone screw attachment end having

i) first and second legs defining in part the first lateral opening and defining a second lateral opening opposed to the first lateral opening, the first leg defining a first slot and the second leg defining a second slot; and

ii) first and second opposed spring tabs, the first tab attached to the first leg and the second tab attached to the second leg, each spring tab having a protrusion configured for projecting through one of the slots, and into an aperture of a bone screw, the first and second spring tabs biasing the protrusions away from the first and second slots.

19. The guide member of claim 18 further comprising an abutment surface at the bone screw attachment end, the abutment surface disposed perpendicular to an axis of rotation of the guide member and configured for abutment with a top of a bone screw.

20. The guide member of claim 18 further comprising an outer surface having a first guide and advancement structure thereon adapted to rotatably and matingly receive a second guide and advancement structure disposed on a nut attachment of a rod pusher wherein rotation of the nut results in axial translation of the rod pusher with respect to the end guide member.

21. The guide member of claim 18 having an upper portion defining an aperture for receiving a spring-loaded pin of a handle.

22. A spinal rod implantation tool assembly comprising:

a) a guide member having an elongate body, a bone screw attachment end, and an outer surface having a first guide and advancement structure thereon, the body defining an elongate channel, the body further defining a first elongate lateral opening communicating with the channel, the bone screw attachment end having

i) first and second legs defining in part the first lateral opening and defining a second lateral opening opposed to the first lateral opening, the first leg defining a first slot and the second leg defining a second slot; and

ii) first and second opposed spring tabs, the first tab attached to the first leg and the second tab attached to the second leg, each spring tab having a protrusion configured for projecting through one of the slots, and into an aperture of a spinal implant, the first and second spring tabs biasing the protrusions away from the first and second slots;

b) an elongate installation tool having a translation nut and an attached sleeve, the translation nut coaxial and being freely rotatable with respect to the sleeve, the nut having an inner surface with a second guide and advancement structure thereon, mateable with the first guide and advancement structure, the sleeve having a rod pushing end, the rod pushing end configured for pressing radially inwardly against the spring tabs and thereby projecting the protrusions through the slots and into apertures of a spinal implant, the rod pressing end also configured for contact with and translation of a rod toward the spinal implant; and

c) a handle configured for releaseable attachment to the guide member, the handle having a second channel configured for coaxial alignment with the first channel, and a second lateral opening configured for coaxial alignment with the first lateral opening, the second lateral opening configured for receiving a manipulation tool.

23. The assembly of claim 22 further comprising a manipulation tool having a holder and a stem, the stem having an end configured for rotatable engagement with a closure member of a spinal implant, the stem configured to be in coaxial relationship with both the first and second channels, the stem insertable into the handle second channel through the second lateral opening.

24. A vertebral support rod implantation kit adapted for use with a plurality of vertebrae, the kit comprising:

a) at least one bone implant adapted for implantation in a vertebra;

b) an elongate rod sized and shaped to be received by the at least one bone implant;

c) at least one implant fastener sized and shape to mate with the at least one bone implant and retain the elongate rod within a cavity defined by the bone implant; and

d) an elongate guide tool having a handle structure at an end thereof and opposed implant engaging structure at an opposite end thereof, the guide tool having a channel with a lateral opening that extends an entire length of the guide tool, the channel sized and shaped for side loading and receiving the at least one implant fastener into at least one loading location intermittently positioned along the length of the channel.

25. The kit of claim 24 wherein the at least one loading location is at the handle structure.

26. The kit of claim 24 further comprising an elongate installation tool having a translation nut and an attached sleeve, the translation nut coaxial and being freely rotatable with respect to the sleeve, the nut configured for rotatable attachment to the guide tool, the sleeve having a rod pushing end, the rod pushing end configured for contact with and translation of the rod into the at least one bone implant.

27. The kit of claim 24 further comprising a manipulation tool having a holder and a stem, the stem having an end configured for rotatable engagement with the at least one implant fastener, the stem configured to be in coaxial relationship with the guide tool channel, the stem insertable into the at least one loading location.

28. In a guide member having an elongate body with attachment structure at a lower end thereof adapted to be secured to a bone screw implant;

the improvement comprising;

a) the body having a first laterally opening channel extending into an interior of the body and extending from a top end of the body to the bottom end thereof; and

b) a handle configured for releaseable attachment to the guide member, the handle having a second laterally opening channel configured for coaxial alignment with the first laterally opening channel, the second laterally opening channel configured for receiving a manipulation tool and bone screw implant components.

29. In the combination of a bone screw having a head and a guide member having attachment structure at a lower end thereof that is operably mateable with the bone screw head;

the improvement comprising;

a) the bone screw head having first and second opposed apertures; and

b) the guide member lower end having first and second opposed spring tabs, each tab having a top portion and a bottom portion, the tabs attached to the guide member at the top portions thereof and the bottom portions each having a radially inwardly extending projection sized, shaped and positioned for insertion into one of the first and second opposed apertures, the spring tabs biased radially outwardly.

30. The combination according to claim 29 wherein:

a) the projections extend radially inwardly into the apertures upon application of a force on the spring tab top portions.

31. The combination according to claim 29 further comprising:

a) an elongate installation tool having a translation nut and an attached sleeve, the translation nut coaxial and being freely rotatable with respect to the sleeve, the nut configured for rotatable attachment to the guide member, the sleeve having a rod pushing end, the rod pushing end translatable along the guide member and onto the spring tab top portions, pressing the guide member projections into the bone screw apertures.

32. A method of fastening a longitudinal member of a spinal fixation apparatus to a bone implant in an open surgery procedure comprising the steps of:

a) providing a guide tool having a body with a laterally opening channel extending into an interior of the body and extending from a top end of the body to a bottom end thereof so as to provide side access to the interior of the body along an entire length thereof;

b) attaching the guide tool to the bone implant that has already been implanted in a bone;

c) side loading a fastener into the channel opening; and

d) connecting the fastener to the implant to securely attach the longitudinal member to the implant.

33. A method of rod reduction in an open surgery procedure comprising the steps of:

a) providing an elongate guide tool having a handle structure at a top end thereof and a body with a laterally opening channel extending into an interior of the body and extending from a top of the handle to a bottom of the body;

b) attaching the guide tool to a bone implant that has already been implanted in a bone, thereby capturing a rod that had already been placed in a vicinity of the bone implant between the guide tool and the bone implant;

c) advancing the rod toward the bone implant with a rod pushing member axially aligned with the guide tool;

d) side loading a fastener into the handle; and

e) connecting the fastener to the implant to securely attach the longitudinal member to the implant.