Classifications

• • 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
  • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
  • A61B17/7032—Screws or hooks with U-shaped head or back through which longitudinal rods pass
• • 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
  • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
  • A61B17/7041—Screws or hooks combined with longitudinal elements which do not contact vertebrae with single longitudinal rod offset laterally from single row of screws or hooks
• • 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
  • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
  • A61B17/7044—Screws or hooks combined with longitudinal elements which do not contact vertebrae also having plates, staples or washers bearing on the vertebrae
• • 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
  • A61B17/7053—Spinal positioners or stabilisers, e.g. stabilisers comprising fluid filler in an implant with parts attached to bones or to each other by flexible wires, straps, sutures or cables
• • 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
  • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
  • A61B17/8085—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with pliable or malleable elements or having a mesh-like structure, e.g. small strips
• • 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
  • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
  • A61B17/809—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with bone-penetrating elements, e.g. blades or prongs
• • 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
  • A61B17/82—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin for bone cerclage
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
  • A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
  • A61B2017/0446—Means for attaching and blocking the suture in the suture anchor
  • A61B2017/0448—Additional elements on or within the anchor
  • A61B2017/0453—Additional elements on or within the anchor threaded elements, e.g. set screws
• • 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
  • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
  • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
  • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
  • A61F2002/30462—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements retained or tied with a rope, string, thread, wire or cable

Definitions

• This invention relates to spinal appliances and more specifically to a spinal fusion system which is especially applicable to osteoporotic bone.
• the invention is a spinal fusion system for application especially to osteoporotic bone, although its application is not limited as such.
• the system relies on attaching at least two rod anchors on respective adjacent vertebrae.
• the rod anchors have head segments adapted for receiving a fusion rod and a base that sits tightly against the vertebral surface.
• the head segment and base could be one solid piece or could be attached to each other in a rotatable fashion.
• the base could contact the vertebral surface at a plurality of contact points, such as a base having a plurality of individual legs.
• the base could also contact the vertebral surface over a larger surface area, such as with a relatively planar, malleable base which would be appropriately shaped to accommodate complex vertebral anatomy.
• the base is held tightly against the vertebral surface through the use of flexible threadable segments.
• the threadable segments can be made of any flexible material that is nonreactive inside the body. Examples of materials which could comprise the threadable segments could be flexible nonreactive materials such: plastics, nylon, carbon fiber, or metal. Exemplary embodiments illustrated herein employ Mersilene® tape or Dyneema® thread as threadable segments which accommodate the requirements of the invention. In addition a "zip- tie" or sublaminar strap system could operate as a threadable segment, provided that these could be tensioned sufficiently to render the rod anchors stationary against the vertebrae.
• FIG. 1 is a perspective view of a first embodiment rod anchor of the inventive spinal fusion system.
• FIG. 2 is a plan view of the first embodiment of the rod anchor of the inventive spinal fusion system, showing vertical channels extending through the base of the rod anchor for threading Mersilene® tape.
• FIG. 5 is a perspective view of a second embodiment rod anchor of the inventive spinal fusion system.
• FIG. 6 is a side view of the second embodiment rod anchor of FIG. 5, illustrating a channel opening for threading Mersilene® tape suture material.
• FIG. 11 is a cross-section of lumbar vertebra showing the rod anchors attached to the vertebra with Mersilene® tape.
• FIG. 13 is a front view of a fourth embodiment of the rod anchor having a cavity in the base of the rod anchor for inserting a compression member.
• FIG. 14 is a partially exploded front view of the rod anchor introduced in FIG, 13 being positioned on the vertebra and showing the compression member, fusion rod and locknut
• FIG. 22 is a front view of an eighth embodiment of the rod anchor shown with a base having vertical channels and lock-down screws threaded into the base and intruding into the channels to secure the Mersilene® tape threaded into the channels.
• FIG. 23 is a front view of a ninth embodiment of the rod anchor shown with the base having channels which end in a crimping edge for securing the Mersilene® tape threaded into the channels.
• FIG. 26 is a side view of a tenth embodiment of the rod anchor, this embodiment presenting a base that is malleable.
• FIG. 3 OA is a perspective view of the eleventh embodiment showing the head segment detached from the male coupling member.
• FIG. 34 is a plan view of rod anchors of the eleventh embodiment mounted on a section of vertebra as part of a fusion system including fusion rods loaded into top-loading head segments.
• the second embodiment of the rod anchor 12 is shown.
• the head segment 14 of the rod anchor 12 is positioned atop base 26 which has a flattened bottom surface 28, wherein the base has a horizontal through-channel with opening 36 for inserting the Mersilene® tape 32.
• the base 26 is shown with the head segment 14 pivoting (see arrows in FIG. 5) in relation to the base 26.
• the base 26 includes a channel opening 36 in its side for threading Mersilene® tape 32 which secures the rod anchor 12 to a patient's vertebra 34.
• FIG. 10 is a close-up side view of the assembled system 10.
• the inventive spinal fusion system 10 is shown attached to a section of lumbar vertebrae 40.
• the rod anchors 12 (as represented by the second embodiment shown in FIGS. 5-9) are positioned on the lamina, which offers a relatively flattened surface for placing the flat bottom surface 28 of the base 26.
• the Mersilene® tape 32 is looped through the rod anchor 12 in the manner previously described and then looped around the lamina and through the spinal foramen and tied off, thus securing the rod anchor 12 to the lumbar vertebrae 40.
• FIG. 1 1 shows a cross section through a lumbar vertebra 40 showing the Mersilene® tape 32 looping around the lamina 44 and through the spinal foramen 46 to ultimately secure the rod anchors 12 to the lumbar vertebra.
• FIG. 16 an exploded view of the system employing a fifth embodiment of the rod anchor 12 is shown, this embodiment employing a central cavity 70 with threaded side walls; the cavity 70 extending into the base 26 and aligning with the hollow vertical core 52 of the head segment 14.
• the threaded cavity 70 receives a secondary lock nut 72 which is threaded into the cavity 70 until it contacts the Mersilene® tape 32 lying on the bottom of cavity 70.
• the Mersilene® tape 32 extends through horizontal channels 56 in base 26 and across the bottom of cavity 70. By bottoming the secondary lock nut tightly against Mersilene® tape 32, the tape can be held immovably. Therefore the Mersilene® tape 32 can be wrapped around the vertebra and then tightened with a tensioning tool and held fast in the cavity 70 by the secondary lock nut 72.
• FIG. 26 illustrates a tenth embodiment of the rod anchor 12 incorporating a malleable base 26; the malleable base 26 being formable to the irregular surface 98 of a vertebra 34.
• the malleable base 26 retains the channel and channel opening 36 for threading the Mersilene® tape, as described in prior embodiments.
• the form fitting function is achieved by the surgeon using tools to form the base 26, as needed, to better fit upon the various surface anomalies encountered on the surface 98 of the vertebra 34.
• FIG. 27 shows a plan view of the system 10 applying the rod anchor embodiments introduced in FIG. 26 and mounted on a vertebra 34.
• the various shapings 100 of the malleable bases 26 as determined by the surgeon are readily apparent to best mate to the changing surfaces 98 of the vertebra 34.
• the base can be malleable in quality so it can easily be worked into a preferred shape by a surgeon using pliers and other tools know in the art.
• the male coupling member 106 protrudes upward from the top surface 112 of the base 26, the coupling member 106 here shown as being centered on the base; however it can be arranged in an off-set location on the base, if desired.
• FIG. 29 shows how male coupling member 106 has a threaded center 114 which engages a threaded lock screw 116, here being represented by a hex screw.
• the lock screw 116 protrudingly engages into a channel 118 extending transversely through the body of male coupling member 106, the channel 118 having two opposite openings 120, 122.
• a threadable segment 32 comprised of Mersilene® tape or Dyneema® thread (an additional example of a threadable segment).
• the end 124 of the lock screw 116 protrudes into the channel 118 a length sufficient to compress the threadable segment 32 against the walls of the channel 118 and hold it fast.
• FIGS. 30A and 30B show a head segment 14 being coupled to the male coupling member 106 and base 26 of the eleventh embodiment.
• the head segment 14 has a cavity 126, (female portion) into which is inserted the male coupling member 106.
• the head segment 14 is then depressed down upon the male coupling member 106 until it snaps into place upon the male coupling member 106.
• the "snap" engagement is accomplished by the male coupling member 106 engaging with an expandable ring.
• the male coupling member 106 comprises a wide shoulder section 128 relative to a narrowed circumference beneath the shoulder section.
• FIG. 35 shows the bottom surface 136 of the base of the eleventh embodiment.
• the bottom surface preferably has a roughened texture 138 to enhance grip when placed upon the laminar surface.
• a tensioning device (not shown) can be used to achieve the appropriate tension on the threadable segment to keep the rod anchor 12 immovably attached to the lamina 44.
• Head segment 14 is adjacent to the lockdown member 140 and pivots upon the coupling member 106.
• This embodiment has the advantage of not having to tie knots in through-holes as with the eleventh embodiment, as the threadable segment 32 is completely secured by the lockdown member 140, as both ends of the threadable segment 32 thread through the channel 142 from opposite directions after being threaded around the lamina 44 as shown in FIG. 37. Also, the separate lockdown member 140 is unobstructed by the head segment 14 in this embodiment, which allows for unobstructed threading of the threadable segment 32.
• FIG. 38 represents a thirteenth embodiment of the rod anchor 12, shown with a three-footed base 146, wherein each foot includes a channel with a channel opening 148 defining an entry or exit for securing each leg with a threadable segment.
• the invention has industrial applicability to the medical industry, and more particularly to the field of spinal surgery.
• the invention is especially useful for fusing vertebrae in patients suffering from osteoporosis.

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• Health & Medical Sciences (AREA)
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• Neurology (AREA)
• Heart & Thoracic Surgery (AREA)
• Engineering & Computer Science (AREA)
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• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
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• Surgical Instruments (AREA)

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Cited By (4)

Citations (6)

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• 2013
  • 2013-01-28 EP EP13743994.9A patent/EP2819646A4/fr not_active Withdrawn
  • 2013-01-28 WO PCT/US2013/023425 patent/WO2013116150A1/fr not_active Ceased

Patent Citations (6)

Non-Patent Citations (1)

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