US20220000635A9 - Spinal fixation systems and methods - Google Patents
Spinal fixation systems and methods Download PDFInfo
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- US20220000635A9 US20220000635A9 US17/026,791 US202017026791A US2022000635A9 US 20220000635 A9 US20220000635 A9 US 20220000635A9 US 202017026791 A US202017026791 A US 202017026791A US 2022000635 A9 US2022000635 A9 US 2022000635A9
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- plate
- aperture
- spinal fixation
- fixation system
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Images
Classifications
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- H—ELECTRICITY
- H10—SEMICONDUCTOR DEVICES; ELECTRIC SOLID-STATE DEVICES NOT OTHERWISE PROVIDED FOR
- H10D—INORGANIC ELECTRIC SEMICONDUCTOR DEVICES
- H10D84/00—Integrated devices formed in or on semiconductor substrates that comprise only semiconducting layers, e.g. on Si wafers or on GaAs-on-Si wafers
- H10D84/80—Integrated devices formed in or on semiconductor substrates that comprise only semiconducting layers, e.g. on Si wafers or on GaAs-on-Si wafers characterised by the integration of at least one component covered by groups H10D12/00 or H10D30/00, e.g. integration of IGFETs
- H10D84/82—Integrated devices formed in or on semiconductor substrates that comprise only semiconducting layers, e.g. on Si wafers or on GaAs-on-Si wafers characterised by the integration of at least one component covered by groups H10D12/00 or H10D30/00, e.g. integration of IGFETs of only field-effect components
- H10D84/83—Integrated devices formed in or on semiconductor substrates that comprise only semiconducting layers, e.g. on Si wafers or on GaAs-on-Si wafers characterised by the integration of at least one component covered by groups H10D12/00 or H10D30/00, e.g. integration of IGFETs of only field-effect components of only insulated-gate FETs [IGFET]
- H10D84/834—Integrated devices formed in or on semiconductor substrates that comprise only semiconducting layers, e.g. on Si wafers or on GaAs-on-Si wafers characterised by the integration of at least one component covered by groups H10D12/00 or H10D30/00, e.g. integration of IGFETs of only field-effect components of only insulated-gate FETs [IGFET] comprising FinFETs
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers, e.g. stabilisers comprising fluid filler in an implant
- A61B17/7059—Cortical plates
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools for implanting artificial joints
- A61F2/4684—Trial or dummy prostheses
Definitions
- the field of the invention relates to devices, systems, and processes for spinal surgeries, and, in particular, to spinal fixation systems.
- Spinal fusion is a surgical technique used to join two or more vertebrae for the correction of various conditions such as back pain caused by degenerative conditions, misalignment, scoliosis, injury causing misalignment, or abnormal intervertebral motion.
- Spinal fusion may be indicated for the cervical region or, (more rarely), the thoracic or lumbar regions.
- Intervertebral (or interbody) fusion is accomplished by immobilizing vertebrae relative to one another with one or more surgical implants, removing a portion of material between the vertebrae, and providing graft material between the vertebrae.
- the material removed typically includes the intervertebral disk, but may often include part(s) of one or both of the adjacent vertebrae.
- Graft material typically includes supplementary bone material, which may be obtained from the recipient, a donor, a synthetic substitute, or any suitable combination of the above.
- a spinal fixation system includes an interbody and a plate.
- the interbody defines a locking aperture
- the plate includes a front surface, a back surface, a locking projection extending from the back surface, and at least one bone screw aperture extending from the front surface to the back surface.
- the locking projection is removably engaged with the locking aperture such that the plate is removably coupled to the interbody.
- a spinal fixation system includes an interbody that defines a locking aperture.
- the spinal fixation system also includes a plate that includes a locking projection and defines a locking cam aperture.
- the spinal fixation system includes a locking cam that has a stem and a tab. The locking projection is removably engaged with the locking aperture, and the stem of the locking cam is at least partially positioned within the locking cam aperture.
- a plate for a spinal fixation system includes a body having a front surface and a back surface.
- the plate also includes a locking projection extending outwardly from the back surface of the body.
- the plate further includes a locking cam aperture extending through the body from the front surface to the back surface.
- the plate additionally includes a bone screw aperture extending through the body from the front surface to the back surface.
- FIG. 1 is a perspective view of a spinal fixation system according to aspects of the current disclosure.
- FIG. 2 is a front view of the spinal fixation system of FIG. 1 .
- FIG. 3 is a back view of the spinal fixation system of FIG. 1 .
- FIG. 4 is a side view of the spinal fixation system of FIG. 1 .
- FIG. 5 is a top view of the spinal fixation system of FIG. 1 .
- FIG. 6 is a sectional view of the spinal fixation system of FIG. 1 taken along line 6 - 6 in FIG. 5 .
- FIG. 7 is a sectional view of the spinal fixation system of FIG. 1 taken along line 7 - 7 in FIG. 4 .
- FIG. 8 is an exploded assembly view of the spinal fixation system of FIG. 1 .
- FIG. 9 is a perspective view of an interbody of the spinal fixation system of FIG. 1 .
- FIG. 10 is an exploded assembly view of a plate and locking collars of the spinal fixation system of FIG. 1 .
- FIG. 11 is a front view of the plate of the spinal fixation system of FIG. 1 .
- FIG. 12 is a back view of the plate of the spinal fixation system of FIG. 1 .
- FIG. 13 is a side view of the plate of the spinal fixation system of FIG. 1 .
- FIG. 14 is another side view of the plate of the spinal fixation system of FIG. 1 .
- FIG. 15 is a perspective view of a locking cam of the spinal fixation system of FIG. 1 .
- FIG. 16 is a bottom view of the locking cam of the spinal fixation system of FIG. 1 .
- FIG. 17 is a top view of a locking collar of the spinal fixation system of FIG. 1 .
- FIG. 18 is a perspective view of the locking collar on the locking cam.
- FIG. 19 is a side view of the locking collar on the locking cam.
- FIG. 20 is a bottom view of the locking collar on the locking cam.
- FIG. 21 illustrates a view of the spinal fixation system of FIG. 1 being implanted in a spine with a tool according to aspects of the current disclosure.
- FIG. 22 illustrates another view of the spinal fixation system of FIG. 1 being implanted in a spine with the tool.
- FIG. 23 is a perspective view of the tool of FIG. 21 .
- FIG. 24 is a sectional view of the tool of FIG. 21 .
- FIG. 25 is a perspective view of a trial system according to aspects of the current disclosure.
- FIG. 26 is an exploded perspective view of the trial system of FIG. 25 .
- FIG. 27 is a perspective view of a trial plate and a trial body of the trial system of FIG. 25 .
- FIG. 28 is a side view of a plate of a spinal fixation system according to aspects of the current disclosure.
- Embodiments of the present disclosure are directed towards spinal fixation systems and associated methods, systems, devices, and apparatuses.
- the disclosed spinal fixation systems are described in but a few exemplary aspects among many.
- FIGS. 1-20 illustrate an example of a spinal fixation system 100 that includes an interbody 102 and a plate 104 .
- the spinal fixation system 100 may also include a locking cam 106 and a locking collar 108 ( FIG. 6 ).
- the components of the spinal fixation system 100 may be constructed from various suitable biocompatible materials such that the implant can be provided within a patient's body.
- the interbody 102 may be constructed from polyetheretherketone (“PEEK”), hydroxyapatite polyetheretherketone (“HA PEEK”), or other suitable materials
- the plate 104 may be constructed from a metal, such as titanium or others.
- one or more components of the spinal fixation system 100 may be coated, surface-altered, and/or impregnated with various materials using various known techniques.
- the interbody 102 includes a front surface 110 , a back surface 112 , an upper surface 114 , and a lower surface 116 .
- the shape and profile of the interbody 102 illustrated in FIGS. 1-20 should not be considered limiting on the current disclosure, as in other examples, the interbody 102 may have various suitable shapes and profiles as desired.
- gripping portions 118 may be provided on the upper surface 114 and/or the lower surface 116 to engage the vertebrae of the patient.
- the interbody 102 defines a central opening 120 that is configured for receiving graft material that helps the interbody 102 fuse with the vertebrae of the patient when the spinal fixation system 100 is positioned within an intervertebral disc space of the patient's body.
- the shape of the central opening 120 should not be considered limiting on the current disclosure.
- Various other openings or apertures may be provided on the interbody 102 as desired.
- the interbody 102 defines one or more locking apertures 122 (see FIG. 8 , for example).
- each locking aperture 122 extends from the front surface 110 to the central opening 120 .
- a central axis of one of the locking apertures 122 is substantially parallel with a central axis of another locking aperture 122 , although it need not be in other examples.
- the interbody 102 may include any number of locking apertures as desired such as one locking aperture, three locking apertures, etc.
- the locking apertures 122 may receive locking projections of the plate 104 such that the plate 104 is selectively coupled to the interbody 102 .
- the plate 104 includes a front surface 124 , a back surface 125 , and a perimeter surface 128 between the front surface 124 and the back surface 125 .
- the back surface 125 of the plate 104 may be positioned adjacent to the front surface 110 of the interbody 102 .
- a shape or profile of the back surface 125 is complimentary to a shape or profile of the front surface 110 , although it need not be in other examples.
- the front surface 124 and the back surface 125 may have a non-linear curvature in at least one direction, although in other examples, the front surface 124 and/or the back surface 125 may have various suitable profiles as desired.
- the plate 104 defines one or more bone screw apertures 126 for receiving bone screws (not illustrated) that engage the vertebrae of the patient and secure the spinal fixation system 100 within the patient's body.
- the plate 104 includes four bone screw apertures 126 , although in other examples, any number of bone screw apertures may be utilized.
- Each bone screw aperture 126 extends from the front surface 124 to the back surface 125 .
- the bone screw apertures 126 may extend through the plate 104 at an oblique angle relative to a plane of the front surface 124 and/or the back surface 125 , although they need not in other examples.
- a central axis of one of the bone screw apertures 126 may be non-parallel to a central axis of another one of the bone screw apertures 126 .
- the plate 104 defines one or more locking cam apertures 130 .
- the number of locking cam apertures 130 should not be considered limiting on the current disclosure.
- the number of locking cam apertures 130 corresponds with the number of locking cams 106 .
- the plate 104 includes two locking cam apertures 130 .
- Each locking cam aperture 130 extends from the front surface 124 to the back surface 125 of the plate 104 .
- a portion of a locking cam 106 may be positioned within each locking cam aperture 130 such that the locking cam 106 is selectively movable between an unlocked position and a locked position. In the unlocked position (best illustrated in FIGS.
- the locking cam 106 may allow for the positioning of bone screws in the bone screw apertures 126 .
- a portion of the locking cam 106 overlaps a portion of the bone screw aperture 126 and thus bone screws within the bone screw aperture 126 to prevent the bone screws from backing out of the bone screw apertures 126 .
- the plate 104 defines a locking collar recess 132 that selectively receives a locking collar 108 when assembled.
- the locking collar recess 132 includes one or more alignment ribs 134 ( FIG. 11 ), which may aid in the positioning and retention of the locking collar 108 within a particular locking collar recess 132 .
- the locking collar 108 may aid in the positioning and retention of the locking cam 106 on the plate 104 .
- each locking cam aperture 130 extends through a corresponding locking collar recess 132 .
- the plate 104 includes a locking cam recess 136 that at least partially surrounds a corresponding locking cam aperture 130 .
- the locking cam recess 136 may facilitate movement of the locking cam 106 within a particular locking cam recess 136 by minimizing interference between the locking cam 106 and the plate 104 as the locking cam 106 is rotated between the locked and unlocked positions.
- the perimeter surface 128 defines one or more tool pockets 138 that selectively receive a portion of an implanting tool during installation of the spinal fixation system 100 .
- the perimeter surface 128 includes two tool pockets 138 , although any number of tool pockets may be utilized as desired.
- the back surface 125 of the plate 104 includes one or more locking projections 140 that are insertable into the locking apertures 122 of the interbody 102 to selectively secure the plate 104 relative to the interbody 102 .
- the plate 104 includes two locking projections 140 , although in other examples, any desired number of locking projections may be utilized.
- each locking projection 140 includes a stem portion 142 and locking ribs 146 . The stem portion 142 is insertable into the corresponding locking aperture 122 , and the locking ribs 146 selectively engage the interbody 102 .
- the locking ribs 146 selectively engage the interbody 102 within the central opening 120 , although they need not in other examples.
- the stem portion 142 includes one or more flex members 144 that bias the locking ribs 146 outwardly such that the locking ribs 146 engage the interbody 102 and the interbody 102 and plate 104 are retained together.
- each locking cam 106 includes a tab portion 148 , a collar 150 , and a stem portion 152 .
- the locking cam 106 defines a tool recess 154 in the tab portion 148 that can receive a tool that rotates the locking cam 106 between the locked and unlocked positions.
- the collar 150 is positionable within the locking cam recess 136 of the plate 104 and may include one or more collar ribs 156 that selectively engages the locking collar 108 within the locking cam recess 136 . Engagement of the collar ribs 156 within the locking cam recess 136 may selectively maintain the locking cam 106 in the unlocked configuration or the locked configuration.
- each locking cam 106 is insertable into a corresponding one of the locking cam apertures 130 of the plate 104 .
- the stem portion 152 includes one or more flex members and/or locking ribs similar those of the locking projections 140 , although it need not in other examples.
- the locking cam 106 is rotatable while the collar 150 is within the locking cam recess 136 such that the locking cam 106 can rotate between the locked configuration (where the tab portions 148 partially overlap the bone screw apertures 126 ) and the unlocked configuration (where the tab portions 148 do not overlap the bone screw apertures 126 ).
- FIGS. 1 and 2 illustrate the locking cams 106 in the unlocked configuration.
- each locking collar 108 includes locking arms 158 and/or locking notches 160 that engage with the alignment ribs 134 of the plate 104 such that a position and orientation of the locking collar 108 relative to the plate 104 can be maintained.
- each locking collar 108 also defines cam-locking notches 162 that selectively engage the collar ribs 156 of the corresponding locking cam 106 to maintain the locking cam 106 in the unlocked configuration or the locked configuration.
- the locking collars 108 may be integrally or monolithically formed with the plate 104 as a unitary component, but in other examples, the locking collars 108 are separate components that are assembled with the plate 104 .
- FIGS. 21 and 22 illustrate the spinal fixation system 100 being implanted into vertebrae 2100 .
- an implanting tool 2102 may selectively engage the tool pockets 138 of the plate 104 during implantation to insert the spinal fixation system 100 into the vertebrae 2100 .
- FIGS. 23 and 24 illustrate the implanting tool 2102 in greater detail.
- the implanting tool 2102 generally includes a body 2304 and an engagement feature 2306 .
- the engagement feature 2306 is a body with a pair of hooks 2308 A-B.
- the body 2304 is hollow, and the engagement feature 2306 is at least partially positioned within the body 2304 .
- the engagement feature 2306 is removable from the body 2304 such that another type of engagement feature may be used with the implanting tool 2102 .
- the implanting tool 2102 may include a knob 2309 or other suitable device that is engaged with the engagement feature 2306 to control at least one aspect of the engagement feature 2306 .
- the knob 2309 is rotatably supported on the body 2304 and threadably engaged with the engagement feature 2306 to move the engagement feature 2306 in a linear direction (represented by arrow 2401 ) and thereby control how much of the engagement feature 2306 is retained within the body 1204 .
- FIGS. 2309 or other suitable device that is engaged with the engagement feature 2306 to control at least one aspect of the engagement feature 2306 .
- the knob 2309 is rotatably supported on the body 2304 and threadably engaged with the engagement feature 2306 to move the engagement feature 2306 in a linear direction (represented by arrow 2401 ) and thereby control how much of the engagement feature 2306 is retained within the body 1204 .
- a distance 2403 between the hooks 2308 A-B may be controlled and adjusted as desired (e.g., to be increased or decreased compared to that illustrated in FIG. 24 ).
- FIGS. 25-27 illustrate an example of a trial system 2500 according to aspects of the current disclosure.
- the trial system 2500 may be utilized to determine a correct size of a spinal fixation system for a patient before the final spinal fixation system is implanted.
- the trial system 2500 generally includes a template tool 2502 , a trial plate 2504 , and a trial body 2506 .
- the template tool 2502 includes a handle 2508 and an engaging portion 2510 .
- the engaging portion 2510 is removably attached to the handle 2508 through various suitable mechanisms such as threading, hooks, pins, snaps, locks, etc. as desired.
- the engaging portion 2510 and the handle 2508 are a single component.
- the trial plate 2504 may generally have a shape and size that corresponds to a particular size of a plate of the spinal fixation system.
- the trial body 2506 may have a shape and size that corresponds to a particular size of an interbody of the spinal fixation system.
- the trial plate 2504 may include alignment ribs 2512 that assist with positioning the trial plate 2504 relative to the trial body 2506 .
- An end 2514 of the engaging portion 2510 may engage the trial plate 2504 and/or the trial body 2506 to give an approximation of the spinal fixation system and/or the inserter tool during implantation.
- the end 2514 includes threading
- the trial plate 2504 and trial body 2506 include apertures configured to engage the end 2514 (with or without threading).
- various other suitable engagement mechanisms may be utilized to engage the engaging portion 2510 with the trial plate 2504 and/or the trial body 2506 .
- the trial system 2500 may be used to simulate an implantation procedure, and based on the simulation (or other measurements), a doctor or other professional may determine the appropriate sized spinal fixation system. For example, the doctor may determine that a larger or smaller plate 104 and/or interbody 102 during an actual implant procedure for a patient based on the trial system 2500 . In other words, the trial system 2500 may be used to verify or determine what size implants need to be used.
- FIG. 28 illustrates another example of a plate 2804 for a spinal fixation system according to aspects of the current disclosure.
- the plate 2804 is substantially similar to the plate 104 except that locking projections 2840 of the plate 2804 (only one locking projection 2840 is visible in FIG. 28 ) do not include locking ribs 146 and the stem portion 142 does not include flex members 144 .
- the locking projections 2840 of the plate 2804 are tapered as they extend away from the back surface 125 , and an end 2811 of each locking projection 2840 has a width that is less than a width of a portion of each locking projection 2840 that is closer to the back surface 125 .
- the tapered locking projections 2840 are configured to form a press fit or friction fit with an interbody of the spinal fixation system (e.g., the interbody 102 ) such that the interbody and plate 2804 are retained together.
- the method includes assembling the plate 104 with the interbody 102 such that a position and orientation of the plate 104 relative to the interbody 102 is maintained.
- assembling the plate 104 with the interbody 102 includes positioning the back surface 125 of the plate 104 adjacent to the front surface 110 of the interbody 102 .
- Assembling the plate 104 with the interbody 102 also includes positioning the locking projections 140 of the plate 104 within the locking apertures 122 of the interbody 102 .
- positioning the locking projections 140 within the corresponding locking apertures 122 includes inserting the stem portion 142 within the locking aperture 122 such that the locking ribs 146 engage the interbody 102 and the interbody 102 and the plate 104 are retained together. Assembling the plate 104 with the interbody 102 may also include positioning the locking collars 108 in the corresponding locking collar recesses 132 . In some cases, each locking collar 108 is assembled by engaging the locking arms 158 and/or locking notches 160 with the alignment ribs 134 of the plate 104 .
- the method includes assembling the locking cams 106 with the assembled interbody 102 and the plate 104 .
- assembling each locking cam 106 includes inserting the stem portion 152 into the corresponding locking cam aperture 130 and the collar 150 within the locking cam recess 136 .
- Assembling each locking cam 106 may include engaging collar ribs 156 with corresponding cam-locking notches 162 of the locking collar 108 .
- the method may include implanting the assembled spinal fixation system 100 into vertebrae 2100 of the patient.
- Implanting the spinal fixation system 100 may include engaging an implanting tool 2102 with tool pockets 138 of the plate 104 .
- Bone screws may be inserted through the bone screw apertures 126 . Inserting the bone screws may include initially rotating the locking cam 106 such that the tab portion 148 is in the unlocked configuration.
- the bone screws are then inserted through the bone screw apertures 126 to engage the vertebrae 2100 of the patient and secure the spinal fixation system within the patient's body. After the bone screws are inserted and engaged with the vertebrae, the tab portion 148 may be rotated to the locked configuration.
- the trial plate 2504 corresponds to a particular sized plate of the spinal fixation system
- the trial body 2506 corresponds to a particular sized interbody of the spinal fixation system.
- the method includes simulating at least a portion of an implant procedure with the trial system 2500 .
- the method includes determining a proper size of the plate 104 and/or the interbody 102 based on and relative to the size of the trial plate 2504 and the trial body 2506 .
- a desired plate 104 and/or interbody 102 are provided to the doctor or professional.
- the desired plate 104 and interbody 102 may be attached together, connected to an inserter tool (e.g., via engagement features 2306 ), and implanted into a disc space.
- the spinal fixation system described herein has many advantageous features.
- the spinal fixation system may be configured so that it directs the screw angle trajectory of the bone screws and at anterior corners of the patient's vertebrae to facilitate maximum purchase of the screws into the patient's cortical shell.
- the design of the spinal fixation system maximizes the utilization of PEEK (or other biocompatible material) of the interbody while still providing titanium on titanium fixation.
- the spinal fixation system with the titanium plate and bone screws and HA PEEK interbody reduces the amount of titanium in the spinal fixation system as compared to conventional spinal fixation systems. This is advantageous because PEEK more closely resembles cortical bone and is therefore more biomechanically acceptable.
- the interbody may promote surface area contact as compared to conventional spinal fixation systems. This in turn may promote an increase in fusion velocity as compared to conventional spinal fixation systems. This increased surface area also helps the interbody resist subsidence.
- a reduced amount of titanium allows for better imaging of the spinal fixation system and the portion of the patient's body with the spinal fixation system.
- the spinal fixation system design also eliminates the need to snap the spinal fixation system into place and then insert a metal ring to retain it in position, which may otherwise introduce imaging issues.
- the configuration of the spinal fixation system facilitates proper anterior-posterior placement of the spinal fixation system within a patient and/or increases torsional stability of the spinal fixation system.
- the spinal fixation system has superior attachment capabilities, which results in a stronger overall fixation of the spinal fixation system to the vertebrae.
- the design of the interbody is such that it can be used in isolation if needed (i.e., without the plate). This is possible because the plate can be omitted while allowing for a front surface with structural integrity.
- the spinal fixation system is designed to facilitate ease of installation in that the plate can be snapped into place on the front surface of the interbody into the predefined configuration rather than requiring other alignment of the plate relative to the interbody.
- a spinal fixation system comprising: an interbody defining a locking aperture; and a plate comprising a front surface, a back surface, a locking projection extending from the back surface, and at least one bone screw aperture extending from the front surface to the back surface, wherein the locking projection is removably engaged with the locking aperture such that the plate is removably coupled to the interbody.
- EC 2 The spinal fixation system of any of the preceding or subsequent example combinations, wherein the interbody comprises a front surface and a central opening, wherein the locking aperture extends from the front surface to the central opening, and wherein the locking projection is removably engaged with the locking aperture such that a locking rib of the locking projection engages the interbody within the central opening.
- EC 3 The spinal fixation system of any of the preceding or subsequent example combinations, wherein the locking aperture is a first locking aperture, wherein the locking projection is a first locking projection, wherein the interbody further comprises a second locking aperture, and wherein the plate further comprises a second locking projection that is removably engaged with the second locking aperture.
- EC 4 The spinal fixation system of any of the preceding or subsequent example combinations, wherein the plate further defines a locking cam aperture extending from the front surface to the back surface of the plate, wherein the spinal fixation system further comprises a locking cam comprising a tab and a stem, and wherein the stem of the locking cam is removably positioned within the locking cam aperture.
- EC 5 The spinal fixation system of any of the preceding or subsequent example combinations, wherein the front surface of the plate comprises a locking collar recess surrounding the locking cam aperture, wherein the locking cam further comprises a collar, and wherein the collar of the locking cam is positioned within the locking collar recess.
- EC 6 The spinal fixation system of any of the preceding or subsequent example combinations, further comprising a locking collar, wherein the locking collar is positioned within the locking collar recess and is configured to selectively engage the collar of the locking cam.
- EC 7 The spinal fixation system of any of the preceding or subsequent example combinations, wherein the at least one bone screw aperture comprises a plurality of bone screw apertures.
- a spinal fixation system comprising: an interbody defining a locking aperture; a plate comprising a locking projection and defining a locking cam aperture; and a locking cam comprising a stem and a tab, wherein the locking projection is removably engaged with the locking aperture, and wherein the stem of the locking cam is at least partially positioned within the locking cam aperture.
- EC 9 The spinal fixation system of any of the preceding or subsequent example combinations, wherein the plate further defines at least one bone screw aperture extending through the plate from a front surface of the plate to a back surface of the plate, wherein the locking projection extends outwardly from the back surface of the plate, and wherein the locking cam aperture extends from the front surface of the plate to the back surface of the plate.
- EC 10 The spinal fixation system of any of the preceding or subsequent example combinations, wherein the interbody comprises a front surface and a central opening, wherein the locking aperture extends from the front surface to the central opening, and wherein the locking projection is removably engaged with the locking aperture such that a locking rib of the locking projection engages the interbody within the central opening.
- EC 11 The spinal fixation system of any of the preceding or subsequent example combinations, wherein the locking projection comprises a stem, wherein the stem comprises a flex member, and wherein the flex member comprises a locking rib.
- EC 12 The spinal fixation system of any of the preceding or subsequent example combinations, wherein a front surface of the plate comprises a locking collar recess surrounding the locking cam aperture, wherein the locking cam further comprises a collar, and wherein the collar of the locking cam is positioned within the locking collar recess.
- EC 13 The spinal fixation system of any of the preceding or subsequent example combinations, further comprising a locking collar, wherein the locking collar is positioned within the locking collar recess and is configured to selectively engage the collar of the locking cam.
- EC 14 The spinal fixation system of any of the preceding or subsequent example combinations, wherein the front surface of the plate further comprises a locking cam recess at least partially surrounding the locking collar recess, and wherein tab of the locking cam is movable within the locking cam recess.
- a plate for a spinal fixation system comprising: a body comprising a front surface and a back surface; a locking projection extending outwardly from the back surface of the body; a locking cam aperture extending through the body from the front surface to the back surface; and a bone screw aperture extending through the body from the front surface to the back surface.
- EC 16 The plate of any of the preceding or subsequent example combinations, wherein the body further comprises a perimeter surface between the front surface and the back surface, and wherein the perimeter surface defines at least one tool pocket.
- EC 17 The plate of any of the preceding or subsequent example combinations, further comprising a locking collar recess in the front surface of the body and surrounding the locking cam aperture.
- EC 18 The plate of any of the preceding or subsequent example combinations, wherein the locking collar recess further comprises at least one locking rib.
- EC 19 The plate of any of the preceding or subsequent example combinations, further comprising a locking cam recess in the front surface of the body at least partially surrounding the locking collar recess.
- EC 20 The plate of any of the preceding or subsequent example combinations, wherein the locking projection is a first locking projection, and wherein the plate further comprises a plurality of locking projections extending outwardly from the back surface.
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Abstract
Description
- This application claims the benefit of U.S. Provisional Patent Application No. 62/905,280, filed on Sep. 24, 2019and entitled SPINAL FIXATION SYSTEMS AND METHODS, the content of which is hereby incorporated by reference in its entirety.
- The field of the invention relates to devices, systems, and processes for spinal surgeries, and, in particular, to spinal fixation systems.
- Spinal fusion is a surgical technique used to join two or more vertebrae for the correction of various conditions such as back pain caused by degenerative conditions, misalignment, scoliosis, injury causing misalignment, or abnormal intervertebral motion. Spinal fusion may be indicated for the cervical region or, (more rarely), the thoracic or lumbar regions.
- Spinal fusion, and particularly intervertebral (or interbody) fusion, is accomplished by immobilizing vertebrae relative to one another with one or more surgical implants, removing a portion of material between the vertebrae, and providing graft material between the vertebrae.. The material removed typically includes the intervertebral disk, but may often include part(s) of one or both of the adjacent vertebrae. Graft material typically includes supplementary bone material, which may be obtained from the recipient, a donor, a synthetic substitute, or any suitable combination of the above.
- Successful fusion requires that the relative orientation of the fused vertebrae be maintained, as well as the spacing between them. Although the vertebrae may be fixed by mechanical implants, such as rods, plates, or cages connected to the vertebrae by screws, or by exterior support in the form of orthotic bracing, these approaches are limited and are susceptible to various problems such as the backing out of bone screws, misalignment, etc.
- The terms “invention,” “the invention,” “this invention” and “the present invention” used in this patent are intended to refer broadly to all of the subject matter of this patent and the patent claims below. Statements containing these terms should be understood not to limit the subject matter described herein or to limit the meaning or scope of the patent claims below. Embodiments of the invention covered by this patent are defined by the claims below, not this summary. This summary is a high-level overview of various embodiments of the invention and introduces some of the concepts that are further described in the Detailed Description section below. This summary is not intended to identify key or essential features of the claimed subject matter, nor is it intended to be used in isolation to determine the scope of the claimed subject matter. The subject matter should be understood by reference to appropriate portions of the entire specification of this patent, any or all drawings, and each claim.
- According to certain examples, a spinal fixation system includes an interbody and a plate. The interbody defines a locking aperture, and the plate includes a front surface, a back surface, a locking projection extending from the back surface, and at least one bone screw aperture extending from the front surface to the back surface. The locking projection is removably engaged with the locking aperture such that the plate is removably coupled to the interbody.
- According to various examples, a spinal fixation system includes an interbody that defines a locking aperture. The spinal fixation system also includes a plate that includes a locking projection and defines a locking cam aperture. The spinal fixation system includes a locking cam that has a stem and a tab. The locking projection is removably engaged with the locking aperture, and the stem of the locking cam is at least partially positioned within the locking cam aperture.
- According to some examples, a plate for a spinal fixation system includes a body having a front surface and a back surface. The plate also includes a locking projection extending outwardly from the back surface of the body. The plate further includes a locking cam aperture extending through the body from the front surface to the back surface. The plate additionally includes a bone screw aperture extending through the body from the front surface to the back surface.
- Various implementations described in the present disclosure can include additional systems, methods, features, and advantages, which cannot necessarily be expressly disclosed herein but will be apparent to one of ordinary skill in the art upon examination of the following detailed description and accompanying drawings. It is intended that all such systems, methods, features, and advantages be included within the present disclosure and protected by the accompanying claims.
- The features and components of the following figures are illustrated to emphasize the general principles of the present disclosure. Corresponding features and components throughout the figures can be designated by matching reference characters for the sake of consistency and clarity.
-
FIG. 1 is a perspective view of a spinal fixation system according to aspects of the current disclosure. -
FIG. 2 is a front view of the spinal fixation system ofFIG. 1 . -
FIG. 3 is a back view of the spinal fixation system ofFIG. 1 . -
FIG. 4 is a side view of the spinal fixation system ofFIG. 1 . -
FIG. 5 is a top view of the spinal fixation system ofFIG. 1 . -
FIG. 6 is a sectional view of the spinal fixation system ofFIG. 1 taken along line 6-6 inFIG. 5 . -
FIG. 7 is a sectional view of the spinal fixation system ofFIG. 1 taken along line 7-7 inFIG. 4 . -
FIG. 8 is an exploded assembly view of the spinal fixation system ofFIG. 1 . -
FIG. 9 is a perspective view of an interbody of the spinal fixation system ofFIG. 1 . -
FIG. 10 is an exploded assembly view of a plate and locking collars of the spinal fixation system ofFIG. 1 . -
FIG. 11 is a front view of the plate of the spinal fixation system ofFIG. 1 . -
FIG. 12 is a back view of the plate of the spinal fixation system ofFIG. 1 . -
FIG. 13 is a side view of the plate of the spinal fixation system ofFIG. 1 . -
FIG. 14 is another side view of the plate of the spinal fixation system ofFIG. 1 . -
FIG. 15 is a perspective view of a locking cam of the spinal fixation system ofFIG. 1 . -
FIG. 16 is a bottom view of the locking cam of the spinal fixation system ofFIG. 1 . -
FIG. 17 is a top view of a locking collar of the spinal fixation system ofFIG. 1 . -
FIG. 18 is a perspective view of the locking collar on the locking cam. -
FIG. 19 is a side view of the locking collar on the locking cam. -
FIG. 20 is a bottom view of the locking collar on the locking cam. -
FIG. 21 illustrates a view of the spinal fixation system ofFIG. 1 being implanted in a spine with a tool according to aspects of the current disclosure. -
FIG. 22 illustrates another view of the spinal fixation system ofFIG. 1 being implanted in a spine with the tool. -
FIG. 23 is a perspective view of the tool ofFIG. 21 . -
FIG. 24 is a sectional view of the tool ofFIG. 21 . -
FIG. 25 is a perspective view of a trial system according to aspects of the current disclosure. -
FIG. 26 is an exploded perspective view of the trial system ofFIG. 25 . -
FIG. 27 is a perspective view of a trial plate and a trial body of the trial system ofFIG. 25 . -
FIG. 28 is a side view of a plate of a spinal fixation system according to aspects of the current disclosure. - The subject matter of embodiments of the present invention is described here with specificity to meet statutory requirements, but this description is not necessarily intended to limit the scope of the claims. The claimed subject matter may be embodied in other ways, may include different elements or steps, and may be used in conjunction with other existing or future technologies. This description should not be interpreted as implying any particular order or arrangement among or between various steps or elements except when the order of individual steps or arrangement of elements is explicitly described. Directional references such as “up,” “down,” “top,” “bottom,” “left,” “right,” “front,” and “back,” among others, are intended to refer to the orientation as illustrated and described in the figure (or figures) to which the components and directions are referencing.
- Embodiments of the present disclosure are directed towards spinal fixation systems and associated methods, systems, devices, and apparatuses. The disclosed spinal fixation systems are described in but a few exemplary aspects among many.
-
FIGS. 1-20 illustrate an example of aspinal fixation system 100 that includes an interbody 102 and aplate 104. As discussed in detail below, thespinal fixation system 100 may also include alocking cam 106 and a locking collar 108 (FIG. 6 ). The components of thespinal fixation system 100 may be constructed from various suitable biocompatible materials such that the implant can be provided within a patient's body. As one example, the interbody 102 may be constructed from polyetheretherketone (“PEEK”), hydroxyapatite polyetheretherketone (“HA PEEK”), or other suitable materials, and theplate 104 may be constructed from a metal, such as titanium or others. In some examples, one or more components of thespinal fixation system 100 may be coated, surface-altered, and/or impregnated with various materials using various known techniques. - The interbody 102 includes a
front surface 110, aback surface 112, anupper surface 114, and alower surface 116. The shape and profile of the interbody 102 illustrated inFIGS. 1-20 should not be considered limiting on the current disclosure, as in other examples, the interbody 102 may have various suitable shapes and profiles as desired. In some cases, grippingportions 118 may be provided on theupper surface 114 and/or thelower surface 116 to engage the vertebrae of the patient. In various examples, theinterbody 102 defines acentral opening 120 that is configured for receiving graft material that helps the interbody 102 fuse with the vertebrae of the patient when thespinal fixation system 100 is positioned within an intervertebral disc space of the patient's body. The shape of thecentral opening 120 should not be considered limiting on the current disclosure. Various other openings or apertures may be provided on the interbody 102 as desired. - In various examples, the
interbody 102 defines one or more locking apertures 122 (seeFIG. 8 , for example). In various aspects, each lockingaperture 122 extends from thefront surface 110 to thecentral opening 120. In some examples, a central axis of one of the lockingapertures 122 is substantially parallel with a central axis of another lockingaperture 122, although it need not be in other examples. While two lockingapertures 122 are shown, in other examples, the interbody 102 may include any number of locking apertures as desired such as one locking aperture, three locking apertures, etc. As discussed in detail below, the lockingapertures 122 may receive locking projections of theplate 104 such that theplate 104 is selectively coupled to theinterbody 102. - The
plate 104 includes afront surface 124, aback surface 125, and aperimeter surface 128 between thefront surface 124 and theback surface 125. When theplate 104 is assembled with the interbody 102, theback surface 125 of theplate 104 may be positioned adjacent to thefront surface 110 of theinterbody 102. In certain examples, a shape or profile of theback surface 125 is complimentary to a shape or profile of thefront surface 110, although it need not be in other examples. In some non-limiting examples, thefront surface 124 and theback surface 125 may have a non-linear curvature in at least one direction, although in other examples, thefront surface 124 and/or theback surface 125 may have various suitable profiles as desired. - The
plate 104 defines one or morebone screw apertures 126 for receiving bone screws (not illustrated) that engage the vertebrae of the patient and secure thespinal fixation system 100 within the patient's body. In the example ofFIGS. 1-20 , theplate 104 includes fourbone screw apertures 126, although in other examples, any number of bone screw apertures may be utilized. Eachbone screw aperture 126 extends from thefront surface 124 to theback surface 125. In some examples, thebone screw apertures 126 may extend through theplate 104 at an oblique angle relative to a plane of thefront surface 124 and/or theback surface 125, although they need not in other examples. In certain cases, a central axis of one of thebone screw apertures 126 may be non-parallel to a central axis of another one of thebone screw apertures 126. - In various examples, the
plate 104 defines one or morelocking cam apertures 130. The number oflocking cam apertures 130 should not be considered limiting on the current disclosure. In various examples, the number oflocking cam apertures 130 corresponds with the number oflocking cams 106. In the example ofFIGS. 1-20 , theplate 104 includes two lockingcam apertures 130. Each lockingcam aperture 130 extends from thefront surface 124 to theback surface 125 of theplate 104. When thespinal fixation system 100 is assembled, a portion of alocking cam 106 may be positioned within each lockingcam aperture 130 such that thelocking cam 106 is selectively movable between an unlocked position and a locked position. In the unlocked position (best illustrated inFIGS. 1 and 2 ), the lockingcam 106 may allow for the positioning of bone screws in thebone screw apertures 126. In the locked position, a portion of thelocking cam 106 overlaps a portion of thebone screw aperture 126 and thus bone screws within thebone screw aperture 126 to prevent the bone screws from backing out of thebone screw apertures 126. - As best illustrated in
FIGS. 10 and 11 , in various examples, theplate 104 defines alocking collar recess 132 that selectively receives alocking collar 108 when assembled. In some cases, thelocking collar recess 132 includes one or more alignment ribs 134 (FIG. 11 ), which may aid in the positioning and retention of thelocking collar 108 within a particularlocking collar recess 132. As described in detail below, thelocking collar 108 may aid in the positioning and retention of thelocking cam 106 on theplate 104. In various cases, each lockingcam aperture 130 extends through a correspondinglocking collar recess 132. - In some aspects, the
plate 104 includes alocking cam recess 136 that at least partially surrounds a correspondinglocking cam aperture 130. The lockingcam recess 136 may facilitate movement of thelocking cam 106 within a particularlocking cam recess 136 by minimizing interference between the lockingcam 106 and theplate 104 as thelocking cam 106 is rotated between the locked and unlocked positions. - As best illustrated in
FIGS. 1, 4, 8, 10, and 14 , in some cases, theperimeter surface 128 defines one or more tool pockets 138 that selectively receive a portion of an implanting tool during installation of thespinal fixation system 100. In the example ofFIGS. 1-20 , theperimeter surface 128 includes twotool pockets 138, although any number of tool pockets may be utilized as desired. - In various examples, the
back surface 125 of theplate 104 includes one ormore locking projections 140 that are insertable into the lockingapertures 122 of the interbody 102 to selectively secure theplate 104 relative to theinterbody 102. In the example ofFIGS. 1-20 , theplate 104 includes two lockingprojections 140, although in other examples, any desired number of locking projections may be utilized. As shown inFIGS. 13-14 , each lockingprojection 140 includes astem portion 142 and lockingribs 146. Thestem portion 142 is insertable into thecorresponding locking aperture 122, and the lockingribs 146 selectively engage theinterbody 102. In various examples, the lockingribs 146 selectively engage the interbody 102 within thecentral opening 120, although they need not in other examples. Optionally, thestem portion 142 includes one ormore flex members 144 that bias the lockingribs 146 outwardly such that the lockingribs 146 engage the interbody 102 and the interbody 102 andplate 104 are retained together. - As best illustrated in
FIGS. 15 and 16 , each lockingcam 106 includes atab portion 148, acollar 150, and astem portion 152. In various examples, the lockingcam 106 defines atool recess 154 in thetab portion 148 that can receive a tool that rotates thelocking cam 106 between the locked and unlocked positions. Thecollar 150 is positionable within the lockingcam recess 136 of theplate 104 and may include one ormore collar ribs 156 that selectively engages thelocking collar 108 within the lockingcam recess 136. Engagement of thecollar ribs 156 within the lockingcam recess 136 may selectively maintain thelocking cam 106 in the unlocked configuration or the locked configuration. Thestem portion 152 of each lockingcam 106 is insertable into a corresponding one of thelocking cam apertures 130 of theplate 104. Optionally, thestem portion 152 includes one or more flex members and/or locking ribs similar those of the lockingprojections 140, although it need not in other examples. - In certain aspects, the locking
cam 106 is rotatable while thecollar 150 is within the lockingcam recess 136 such that thelocking cam 106 can rotate between the locked configuration (where thetab portions 148 partially overlap the bone screw apertures 126) and the unlocked configuration (where thetab portions 148 do not overlap the bone screw apertures 126). As mentioned,FIGS. 1 and 2 illustrate the lockingcams 106 in the unlocked configuration. - As best illustrated in
FIG. 17 , each lockingcollar 108 includes lockingarms 158 and/or lockingnotches 160 that engage with thealignment ribs 134 of theplate 104 such that a position and orientation of thelocking collar 108 relative to theplate 104 can be maintained. In some cases, each lockingcollar 108 also defines cam-lockingnotches 162 that selectively engage thecollar ribs 156 of thecorresponding locking cam 106 to maintain thelocking cam 106 in the unlocked configuration or the locked configuration. In some cases, the lockingcollars 108 may be integrally or monolithically formed with theplate 104 as a unitary component, but in other examples, the lockingcollars 108 are separate components that are assembled with theplate 104. -
FIGS. 21 and 22 illustrate thespinal fixation system 100 being implanted intovertebrae 2100. As illustrated inFIGS. 21 and 22 , an implantingtool 2102 may selectively engage the tool pockets 138 of theplate 104 during implantation to insert thespinal fixation system 100 into thevertebrae 2100. -
FIGS. 23 and 24 illustrate the implantingtool 2102 in greater detail. As illustrated inFIGS. 23 and 24 , the implantingtool 2102 generally includes abody 2304 and anengagement feature 2306. In the example ofFIGS. 23 and 24 , theengagement feature 2306 is a body with a pair ofhooks 2308A-B. In some examples, thebody 2304 is hollow, and theengagement feature 2306 is at least partially positioned within thebody 2304. In various examples, theengagement feature 2306 is removable from thebody 2304 such that another type of engagement feature may be used with the implantingtool 2102. - As best illustrated in
FIG. 24 , in some examples the implantingtool 2102 may include aknob 2309 or other suitable device that is engaged with theengagement feature 2306 to control at least one aspect of theengagement feature 2306. In the example ofFIGS. 23 and 24 , theknob 2309 is rotatably supported on thebody 2304 and threadably engaged with theengagement feature 2306 to move theengagement feature 2306 in a linear direction (represented by arrow 2401) and thereby control how much of theengagement feature 2306 is retained within the body 1204. In the example ofFIGS. 23 and 24 , by controlling how much of theengagement feature 2306 is within thebody 2304, and because thehooks 2308A-B havenon-planar surfaces 2310, adistance 2403 between thehooks 2308A-B may be controlled and adjusted as desired (e.g., to be increased or decreased compared to that illustrated inFIG. 24 ). -
FIGS. 25-27 illustrate an example of atrial system 2500 according to aspects of the current disclosure. In some examples, and as explained in detail below, thetrial system 2500 may be utilized to determine a correct size of a spinal fixation system for a patient before the final spinal fixation system is implanted. - As illustrated in
FIGS. 25-27 , thetrial system 2500 generally includes atemplate tool 2502, atrial plate 2504, and atrial body 2506. Thetemplate tool 2502 includes ahandle 2508 and an engagingportion 2510. In some examples, as illustrated inFIG. 26 , the engagingportion 2510 is removably attached to thehandle 2508 through various suitable mechanisms such as threading, hooks, pins, snaps, locks, etc. as desired. In other examples, the engagingportion 2510 and thehandle 2508 are a single component. - The
trial plate 2504 may generally have a shape and size that corresponds to a particular size of a plate of the spinal fixation system. Similarly, thetrial body 2506 may have a shape and size that corresponds to a particular size of an interbody of the spinal fixation system. Thetrial plate 2504 may includealignment ribs 2512 that assist with positioning thetrial plate 2504 relative to thetrial body 2506. Anend 2514 of the engagingportion 2510 may engage thetrial plate 2504 and/or thetrial body 2506 to give an approximation of the spinal fixation system and/or the inserter tool during implantation. In some cases, theend 2514 includes threading, and thetrial plate 2504 andtrial body 2506 include apertures configured to engage the end 2514 (with or without threading). In other examples, various other suitable engagement mechanisms may be utilized to engage the engagingportion 2510 with thetrial plate 2504 and/or thetrial body 2506. - In some cases, the
trial system 2500 may be used to simulate an implantation procedure, and based on the simulation (or other measurements), a doctor or other professional may determine the appropriate sized spinal fixation system. For example, the doctor may determine that a larger orsmaller plate 104 and/orinterbody 102 during an actual implant procedure for a patient based on thetrial system 2500. In other words, thetrial system 2500 may be used to verify or determine what size implants need to be used. -
FIG. 28 illustrates another example of aplate 2804 for a spinal fixation system according to aspects of the current disclosure. Theplate 2804 is substantially similar to theplate 104 except that lockingprojections 2840 of the plate 2804 (only onelocking projection 2840 is visible inFIG. 28 ) do not include lockingribs 146 and thestem portion 142 does not includeflex members 144. Instead, the lockingprojections 2840 of theplate 2804 are tapered as they extend away from theback surface 125, and anend 2811 of each lockingprojection 2840 has a width that is less than a width of a portion of each lockingprojection 2840 that is closer to theback surface 125. In certain embodiments, thetapered locking projections 2840 are configured to form a press fit or friction fit with an interbody of the spinal fixation system (e.g., the interbody 102) such that the interbody andplate 2804 are retained together. - Referring to
FIGS. 1-8 , a method of assembling thespinal fixation system 100 is also disclosed. In various aspects, the method includes assembling theplate 104 with the interbody 102 such that a position and orientation of theplate 104 relative to the interbody 102 is maintained. In some cases, assembling theplate 104 with the interbody 102 includes positioning theback surface 125 of theplate 104 adjacent to thefront surface 110 of theinterbody 102. Assembling theplate 104 with the interbody 102 also includes positioning the lockingprojections 140 of theplate 104 within the lockingapertures 122 of theinterbody 102. In certain cases, positioning the lockingprojections 140 within the corresponding lockingapertures 122 includes inserting thestem portion 142 within the lockingaperture 122 such that the lockingribs 146 engage the interbody 102 and the interbody 102 and theplate 104 are retained together. Assembling theplate 104 with the interbody 102 may also include positioning the lockingcollars 108 in the corresponding locking collar recesses 132. In some cases, each lockingcollar 108 is assembled by engaging the lockingarms 158 and/or lockingnotches 160 with thealignment ribs 134 of theplate 104. - The method includes assembling the locking
cams 106 with the assembledinterbody 102 and theplate 104. In various aspects, assembling each lockingcam 106 includes inserting thestem portion 152 into the correspondinglocking cam aperture 130 and thecollar 150 within the lockingcam recess 136. Assembling each lockingcam 106 may include engagingcollar ribs 156 with corresponding cam-lockingnotches 162 of thelocking collar 108. - The method may include implanting the assembled
spinal fixation system 100 intovertebrae 2100 of the patient. Implanting thespinal fixation system 100 may include engaging an implantingtool 2102 withtool pockets 138 of theplate 104. Bone screws may be inserted through thebone screw apertures 126. Inserting the bone screws may include initially rotating thelocking cam 106 such that thetab portion 148 is in the unlocked configuration. The bone screws are then inserted through thebone screw apertures 126 to engage thevertebrae 2100 of the patient and secure the spinal fixation system within the patient's body. After the bone screws are inserted and engaged with the vertebrae, thetab portion 148 may be rotated to the locked configuration. - In some examples, prior to assembling the spinal fixation system, the method may include determining a spinal fixation system size using the
trial system 2500. Determining the size of the spinal fixation system may include assembling thetrial system 2500 with thetrial plate 2504 and thetrial body 2506. Thetrial plate 2504 corresponds to a particular sized plate of the spinal fixation system, and thetrial body 2506 corresponds to a particular sized interbody of the spinal fixation system. In some examples, the method includes simulating at least a portion of an implant procedure with thetrial system 2500. In various examples, the method includes determining a proper size of theplate 104 and/or the interbody 102 based on and relative to the size of thetrial plate 2504 and thetrial body 2506. Based on thetrial system 2500, a desiredplate 104 and/orinterbody 102 are provided to the doctor or professional. For example, the desiredplate 104 andinterbody 102 may be attached together, connected to an inserter tool (e.g., via engagement features 2306), and implanted into a disc space. - The spinal fixation system described herein has many advantageous features. For example, the spinal fixation system may be configured so that it directs the screw angle trajectory of the bone screws and at anterior corners of the patient's vertebrae to facilitate maximum purchase of the screws into the patient's cortical shell.
- As another example, the design of the spinal fixation system maximizes the utilization of PEEK (or other biocompatible material) of the interbody while still providing titanium on titanium fixation. For example, the spinal fixation system with the titanium plate and bone screws and HA PEEK interbody reduces the amount of titanium in the spinal fixation system as compared to conventional spinal fixation systems. This is advantageous because PEEK more closely resembles cortical bone and is therefore more biomechanically acceptable. As a further example, because more biomechanically acceptable material is available for contact (through the increase in the PEEK material on the upper surface and lower surface), the interbody may promote surface area contact as compared to conventional spinal fixation systems. This in turn may promote an increase in fusion velocity as compared to conventional spinal fixation systems. This increased surface area also helps the interbody resist subsidence.
- In addition, a reduced amount of titanium allows for better imaging of the spinal fixation system and the portion of the patient's body with the spinal fixation system. The spinal fixation system design also eliminates the need to snap the spinal fixation system into place and then insert a metal ring to retain it in position, which may otherwise introduce imaging issues.
- Moreover, in some cases, the configuration of the spinal fixation system facilitates proper anterior-posterior placement of the spinal fixation system within a patient and/or increases torsional stability of the spinal fixation system. As yet another advantage, the spinal fixation system has superior attachment capabilities, which results in a stronger overall fixation of the spinal fixation system to the vertebrae.
- In some cases, the design of the interbody is such that it can be used in isolation if needed (i.e., without the plate). This is possible because the plate can be omitted while allowing for a front surface with structural integrity. Moreover, the spinal fixation system is designed to facilitate ease of installation in that the plate can be snapped into place on the front surface of the interbody into the predefined configuration rather than requiring other alignment of the plate relative to the interbody.
- A collection of exemplary examples, including at least some explicitly enumerated as “ECs” (Example Combinations), providing additional description of a variety of example types in accordance with the concepts described herein are provided below. These examples are not meant to be mutually exclusive, exhaustive, or restrictive; and the invention is not limited to these example examples but rather encompasses all possible modifications and variations within the scope of the issued claims and their equivalents.
- EC 1. A spinal fixation system comprising: an interbody defining a locking aperture; and a plate comprising a front surface, a back surface, a locking projection extending from the back surface, and at least one bone screw aperture extending from the front surface to the back surface, wherein the locking projection is removably engaged with the locking aperture such that the plate is removably coupled to the interbody.
- EC 2. The spinal fixation system of any of the preceding or subsequent example combinations, wherein the interbody comprises a front surface and a central opening, wherein the locking aperture extends from the front surface to the central opening, and wherein the locking projection is removably engaged with the locking aperture such that a locking rib of the locking projection engages the interbody within the central opening.
- EC 3. The spinal fixation system of any of the preceding or subsequent example combinations, wherein the locking aperture is a first locking aperture, wherein the locking projection is a first locking projection, wherein the interbody further comprises a second locking aperture, and wherein the plate further comprises a second locking projection that is removably engaged with the second locking aperture.
- EC 4. The spinal fixation system of any of the preceding or subsequent example combinations, wherein the plate further defines a locking cam aperture extending from the front surface to the back surface of the plate, wherein the spinal fixation system further comprises a locking cam comprising a tab and a stem, and wherein the stem of the locking cam is removably positioned within the locking cam aperture.
- EC 5. The spinal fixation system of any of the preceding or subsequent example combinations, wherein the front surface of the plate comprises a locking collar recess surrounding the locking cam aperture, wherein the locking cam further comprises a collar, and wherein the collar of the locking cam is positioned within the locking collar recess.
-
EC 6. The spinal fixation system of any of the preceding or subsequent example combinations, further comprising a locking collar, wherein the locking collar is positioned within the locking collar recess and is configured to selectively engage the collar of the locking cam. - EC 7. The spinal fixation system of any of the preceding or subsequent example combinations, wherein the at least one bone screw aperture comprises a plurality of bone screw apertures.
- EC 8. A spinal fixation system comprising: an interbody defining a locking aperture; a plate comprising a locking projection and defining a locking cam aperture; and a locking cam comprising a stem and a tab, wherein the locking projection is removably engaged with the locking aperture, and wherein the stem of the locking cam is at least partially positioned within the locking cam aperture.
- EC 9. The spinal fixation system of any of the preceding or subsequent example combinations, wherein the plate further defines at least one bone screw aperture extending through the plate from a front surface of the plate to a back surface of the plate, wherein the locking projection extends outwardly from the back surface of the plate, and wherein the locking cam aperture extends from the front surface of the plate to the back surface of the plate.
- EC 10. The spinal fixation system of any of the preceding or subsequent example combinations, wherein the interbody comprises a front surface and a central opening, wherein the locking aperture extends from the front surface to the central opening, and wherein the locking projection is removably engaged with the locking aperture such that a locking rib of the locking projection engages the interbody within the central opening.
- EC 11. The spinal fixation system of any of the preceding or subsequent example combinations, wherein the locking projection comprises a stem, wherein the stem comprises a flex member, and wherein the flex member comprises a locking rib.
- EC 12. The spinal fixation system of any of the preceding or subsequent example combinations, wherein a front surface of the plate comprises a locking collar recess surrounding the locking cam aperture, wherein the locking cam further comprises a collar, and wherein the collar of the locking cam is positioned within the locking collar recess.
- EC 13. The spinal fixation system of any of the preceding or subsequent example combinations, further comprising a locking collar, wherein the locking collar is positioned within the locking collar recess and is configured to selectively engage the collar of the locking cam.
- EC 14. The spinal fixation system of any of the preceding or subsequent example combinations, wherein the front surface of the plate further comprises a locking cam recess at least partially surrounding the locking collar recess, and wherein tab of the locking cam is movable within the locking cam recess.
- EC 15. A plate for a spinal fixation system, the plate comprising: a body comprising a front surface and a back surface; a locking projection extending outwardly from the back surface of the body; a locking cam aperture extending through the body from the front surface to the back surface; and a bone screw aperture extending through the body from the front surface to the back surface.
- EC 16. The plate of any of the preceding or subsequent example combinations, wherein the body further comprises a perimeter surface between the front surface and the back surface, and wherein the perimeter surface defines at least one tool pocket.
- EC 17. The plate of any of the preceding or subsequent example combinations, further comprising a locking collar recess in the front surface of the body and surrounding the locking cam aperture.
- EC 18. The plate of any of the preceding or subsequent example combinations, wherein the locking collar recess further comprises at least one locking rib.
- EC 19. The plate of any of the preceding or subsequent example combinations, further comprising a locking cam recess in the front surface of the body at least partially surrounding the locking collar recess.
- EC 20. The plate of any of the preceding or subsequent example combinations, wherein the locking projection is a first locking projection, and wherein the plate further comprises a plurality of locking projections extending outwardly from the back surface.
- Different arrangements of the components depicted in the drawings or described above, as well as components and steps not shown or described are possible. Similarly, some features and sub-combinations are useful and may be employed without reference to other features and sub-combinations. Embodiments of the invention have been described for illustrative and not restrictive purposes, and alternative embodiments will become apparent to readers of this patent. Accordingly, the present invention is not limited to the embodiments described above or depicted in the drawings, and various embodiments and modifications may be made without departing from the scope of the claims below.
Claims (20)
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US17/026,791 US11728339B2 (en) | 2019-09-24 | 2020-09-21 | Spinal fixation systems and methods |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US201962905270P | 2019-09-24 | 2019-09-24 | |
| US17/026,791 US11728339B2 (en) | 2019-09-24 | 2020-09-21 | Spinal fixation systems and methods |
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| US20210085482A1 US20210085482A1 (en) | 2021-03-25 |
| US20220000635A9 true US20220000635A9 (en) | 2022-01-06 |
| US11728339B2 US11728339B2 (en) | 2023-08-15 |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US11439514B2 (en) | 2018-04-16 | 2022-09-13 | Carlsmed, Inc. | Systems and methods for orthopedic implant fixation |
| US11457957B2 (en) * | 2020-04-11 | 2022-10-04 | Life Spine, Inc. | Spine implant with an expandable cage and expandable vertebral attachment plate providing uniform rate movement |
| US12232980B2 (en) | 2021-06-08 | 2025-02-25 | Carlsmed, Inc. | Patient-specific expandable spinal implants and associated systems and methods |
| US12324753B2 (en) | 2022-10-05 | 2025-06-10 | Warsaw Orthopedic, Inc. | Interbody trial instrument with screw trajectory indicators |
| EP4646173A2 (en) * | 2023-01-03 | 2025-11-12 | Carlsmed, Inc. | Patient-specific spinal fusion devices and associated systems and methods |
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| US20160095714A1 (en) * | 2011-09-16 | 2016-04-07 | Globus Medical, Inc. | Low profile plate |
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| FR2784571B1 (en) * | 1998-10-19 | 2001-02-02 | Scient X | ANTERIOR OSTEOSYNTHESIS PLATE FOR LUMBAR OR LUMBAR / SACRED VERTEBRES AND INSTRUMENT FOR POSITIONING SUCH A PLATE |
| FR2822674B1 (en) * | 2001-04-03 | 2003-06-27 | Scient X | STABILIZED INTERSOMATIC MELTING SYSTEM FOR VERTEBERS |
| FR2823096B1 (en) * | 2001-04-06 | 2004-03-19 | Materiel Orthopedique En Abreg | PLATE FOR LTE AND LTE VERTEBRATE OSTEOSYNTHESIS DEVICE, OSTEOSYNTHESIS DEVICE INCLUDING SUCH A PLATE, AND INSTRUMENT FOR LAYING SUCH A PLATE |
| US7819903B2 (en) * | 2003-03-31 | 2010-10-26 | Depuy Spine, Inc. | Spinal fixation plate |
| FR2894130B1 (en) * | 2005-12-05 | 2012-07-13 | Spineart Sa | CAGES OF CONTENTION AND INTERSOMATIC FUSION OF VERTEBRATES |
| US8100975B2 (en) * | 2006-08-11 | 2012-01-24 | Warsaw Orthopedic, Inc. | Intervertebral implants with attachable flanges and methods of use |
| US9730804B2 (en) * | 2009-09-06 | 2017-08-15 | Warsaw Orthopedic, Inc. | Locking spinal fusion device |
| US8932335B2 (en) * | 2012-08-31 | 2015-01-13 | Warsaw Orthopedic, Inc. | Retaining mechanism |
| US10603187B2 (en) * | 2013-07-17 | 2020-03-31 | Aesculap Implant Systems, Llc | Spinal interbody device, system and method |
| US10064666B2 (en) * | 2014-11-10 | 2018-09-04 | Meditech Spine, Llc | Polyaxial bone plate and locking assembly |
| US10376385B2 (en) * | 2017-04-05 | 2019-08-13 | Globus Medical, Inc. | Decoupled spacer and plate and method of installing the same |
| US10849763B2 (en) * | 2017-04-20 | 2020-12-01 | Life Spine, Inc. | Lateral spine plate with collapsible vertebral attachment arms |
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| US20160095714A1 (en) * | 2011-09-16 | 2016-04-07 | Globus Medical, Inc. | Low profile plate |
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| US20210085482A1 (en) | 2021-03-25 |
| US11728339B2 (en) | 2023-08-15 |
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