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WO2025202887A1 - Prolongateur de vis, manchon de prolongation de vis et système de prolongation de vis - Google Patents

Prolongateur de vis, manchon de prolongation de vis et système de prolongation de vis

Info

Publication number
WO2025202887A1
WO2025202887A1 PCT/IB2025/053130 IB2025053130W WO2025202887A1 WO 2025202887 A1 WO2025202887 A1 WO 2025202887A1 IB 2025053130 W IB2025053130 W IB 2025053130W WO 2025202887 A1 WO2025202887 A1 WO 2025202887A1
Authority
WO
WIPO (PCT)
Prior art keywords
screw
sleeve
elongated
screw extender
tubular body
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
PCT/IB2025/053130
Other languages
English (en)
Inventor
Morten Beyer
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Neo Medical SA
Original Assignee
Neo Medical SA
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Neo Medical SA filed Critical Neo Medical SA
Publication of WO2025202887A1 publication Critical patent/WO2025202887A1/fr
Pending legal-status Critical Current
Anticipated expiration legal-status Critical

Links

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
    • A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • A61B17/7076—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation
    • A61B17/7077—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation for moving bone anchors attached to vertebrae, thereby displacing the vertebrae
    • A61B17/708—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation for moving bone anchors attached to vertebrae, thereby displacing the vertebrae with tubular extensions coaxially mounted on the bone anchors
    • 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
    • A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • A61B17/7083—Tools for guidance or insertion of tethers, rod-to-anchor connectors, rod-to-rod connectors, or longitudinal elements
    • A61B17/7086—Rod reducers, i.e. devices providing a mechanical advantage to allow a user to force a rod into or onto an anchor head other than by means of a rod-to-bone anchor locking element; rod removers

Definitions

  • the present invention concerns a screw extender and in particular to a spinal screw or pedicle screw extender that can be mounted or pre-mounted to a spinal screw or pedicle screw.
  • the present invention further concerns a screw extender sleeve for receiving or for attachment to the screw extender.
  • the present invention also concerns a screw extender system including the screw extender sleeve and the screw extender.
  • the present invention further concerns a method for assembling the screw extender system, as well as a method for attaching an orthopedic rod to a spinal or pedicle screw using the spinal screw or pedicle screw extender and the screw extender sleeve.
  • Bone screws in association with an orthopedic rod are used to correct spinal deformity or to treat spinal trauma.
  • An orthopedic or connecting rod is placed and held in the heads of a plurality of spinal screws implanted in vertebrae to treat a degenerative spine, correct a spinal deformity or to treat a spinal trauma.
  • a passage or bore for receiving the shaft of the spinal screw is formed in the pedicle or vertebra using a succession of drilling tools such as tap, awl, pedicle finder, and probe.
  • a thin guide wire such as Kirschner-wire (or K-wire) can be placed in each of the passages or bores to guide the spinal screw into the passage or bore for insertion into the pedicle or vertebrae.
  • the spinal screw is attached to an instrument that is a screw extender (also known as a tower or tube).
  • the instrument thus forms an extension of the spinal screw when attached to a head of the spinal screw.
  • the screw extender allows implants and/or instruments, used in association with the spinal screw, to be guided inside and through the screw extender to the spinal screw when the spinal screw is implanted in a vertebrae.
  • the screw extender facilitates, for example, orthopedic rod reduction and setscrew tightening in the spinal screw head when the spinal screw is implanted in the vertebrae. Setscrew tightening in the spinal screw head fixes the orthopedic or connecting rod inside the spinal screw head (see, for example, US10058355B2).
  • a shaft of the spinal screw typically includes a through-bore through which the guide wire is first passed and then passed through the screw extender attached to the spinal screw allowing the screw and the screw extender to be guided to the passage or bore formed in the pedicle or vertebrae.
  • a screwdriver may then, for example, be passed inside the screw extender to engage the spinal screw and rotate the spinal screw into the pedicle or vertebrae.
  • Figure 8 is a perspective view showing elements of the spinal surgery system of Figure 6 in an assembled state.
  • the spinal surgery system can be used for pre-tightening or final tightening of the setscrew in the screw head of the spinal screw.
  • Figure 10 is a perspective view showing the screw extender after a re-attachment of the screw extender sleeve of the present disclosure to the screw extender of the present disclosure and following final tightening of the setscrew and release of the screw extender from the spinal screw.
  • the proximal end 21A of the elongated tubular body 15 includes, or partially or fully defines or delimits a proximal opening 43 (see for example, Figure 5, 7, 12A, 14A, 14B) of the elongated tubular body 15 and/or of the passage 23 of the elongated tubular body 15 for receiving pedicle or spinal screw instruments, such as the setscrew driver 31.
  • the passage 23 extends between the distal and proximal openings and allows an instrument to pass fully through the elongated tubular body 15.
  • the proximal end 21A of the elongated tubular body 15 includes an outer rim or platform 45 defining or including an outer surface 47 (see for example Figures 14A and 14B) of the proximal end 21B of the elongated tubular body 15.
  • the outer rim or platform 45 (and/or the outer surface 47 thereof) may include, define or delimit the proximal opening 43 (or a portion thereof) of the elongated tubular body 15, and/or the proximal opening 43 (or a portion thereof) of the passage 23.
  • the outer surface 47 faces (at least partially) outwards in a direction of elongation of the elongated attachment member 17.
  • the outer surface 47 faces, at least partially, outwards in a direction opposite to the direction of elongation of the spinal screw 7 from the elongated tubular body 15, when the spinal screw 7 is attached to the elongated tubular body 15.
  • the outer surface 47 faces outwards to a side of the screw extender where the proximal end of the elongated attachment member 17 is located.
  • the outer surface 47 includes an outer surface portion or platform surface 49 (see, for example, Figures 14A and 14B) that is separated from the elongated attachment member 17 by the proximal opening 43 and/or by the passage 23 of the elongated tubular body 15.
  • the outer surface portion or platform surface 49 is, for example, located or laterally located on an opposite side of the elongated tubular body 15 to that of the elongated attachment member 17, and separated by the proximal opening 43 and/or by the passage 23.
  • the outer rim or platform 45 and/or the outer surface 47 is located (at least partially) opposite or facing the clearance 19.
  • the distal portion 17b may include or define an outer surface 47b (see, for example, Figure 12A).
  • the distal portion 17b (and/or the outer surface 47b thereof) may, for example, extend to the outer rim or platform 45, and the outer rim or platform 45 or the outer surface 47 thereof may extend to partially define or delimit the proximal opening 43.
  • the distal portion 17b and/or the outer surface 47b thereof may, for example, extend to include, define or delimit a portion of the proximal opening 43 of the elongated tubular body 15, and/or of a portion of the passage 23.
  • the clearance 19 for example is or defines a cut-out region or a partially recessed region.
  • the cut-out region or partially recessed region being a region in which screw extender material is absent, or a region devoid screw extender material that consists solely of an airspace.
  • the clearance 19 is, for example, located directly opposite or directly facing the elongated attachment member 17 and located directly opposite or facing the outer surface 47 of the screw extender 1 defined by the proximal end 21A of the elongated tubular body 15.
  • the clearance 19 is, for example, located directly opposite or directly facing the elongated attachment member 17 and located directly opposite or facing the passage 23 and/or in fluid (air) communication with the passage.
  • the clearance 19 is located above the outer surface 47 and/or the outer rim or platform 45 (see, for example, Figure 1) in a direction extending towards or facing towards the proximal end 5B of the screw extender 1.
  • the clearance 19 may be located above or facing the outer surface 47b and/or the distal portion 17b or at least a portion thereof.
  • the elongated attachment member 17 extends beyond the proximal end 21A of the elongated tubular body 15 to or towards the proximal end 5B of the screw extender 1 (see, for example, Figure 1).
  • the distal end DE of the elongated attachment member 17 is, for example, attached to the proximal end 21A of the elongated tubular body 15.
  • the elongated attachment member 17 may, for example, extend from the first or second arms RMl, RM2 of the elongated tubular body 15.
  • the elongated attachment member 17, for example, defines or delimits the proximal end 5B of the screw extender l.ln an embodiment, the elongated attachment member 17 extends, for example, from the outer rim or platform 45 of the proximal end 21A of the elongated tubular body 15.
  • the elongated attachment member 17 may, for example, be attached to the elongated tubular body 15 at the outer rim or platform 45 of the proximal end 21A of the elongated tubular body 15.
  • the elongated attachment member 17 is configured to be removably coupled to the elongated screw extender sleeve 3.
  • the elongated attachment member 17 is, for example, configured to slidably receive the elongated screw extender sleeve 3 ( Figures 2 to 4) to guide a displacement of the elongated screw extender sleeve 3 relative to and/or along the elongated tubular body 15 of the screw extender 1.
  • the elongated attachment member 17 is, for example, configured to slidably receive and guide a displacement of the elongated screw extender sleeve 3 along the elongated attachment member 17 to the elongated tubular body 15, to receive the elongated tubular body 15 inside the elongated screw extender sleeve 3.
  • the elongated attachment member 17 may, for example, include at least one connection mechanism 51 configured to interact or cooperate with a corresponding or complementarity connection mechanism 53 of the elongated screw extender sleeve 3. This facilitates and quickens assembly of the screw extender to the sleeve 3.
  • the immobilization mechanism 51 may, for example, include a projection or elongated projection 51, for example a ridge (see for example Figures 5 and 14B), configured to be received and guided by a connection mechanism 53 of the screw extender sleeve 3,
  • the connection mechanism 53 may include, for example, a groove or elongated groove 53 (see, for example, Figure 2).
  • the connection mechanisms 51, 53 may, for example, include at least one groove or elongated groove configured to receive and guide a complementary projection or elongated projection of the elongated screw extender sleeve 3.
  • connection mechanism 51 may, for example, be located opposite or facing the clearance 19.
  • the elongated attachment member 17 includes an elongated body 55.
  • the elongated body 55 may have a thickness (in the X-direction and/or (substantially) perpendicular to a direction of elongated extension) and/or be made of a material permitting the elongated body 55 to be flexible and be movable by a user in a direction (X-direction) substantially perpendicular to the longitudinal axis LA of the screw extender 1.
  • the elongated body 55 comprises a first side or face SI and a second side or face S2 located opposite the first side or face SI.
  • the first face SI faces towards, for example, the clearance 19 or the opening 43 defined by the proximal end 21A of the elongated tubular body 15.
  • the first side or face SI (inner side or face) faces, for example, the clearance 19 and/or faces inwards towards the longitudinal axis LA of the screw extender 1.
  • the second side or face S2 (outer side or face) faces, for example, outwards away from the longitudinal axis LA of the screw extender 1.
  • connection mechanism 51 or the projection or elongated projection 51 is, for example, located on the first side or face SI.
  • the elongated attachment member 17 and/or the elongated body 55 may include at least one prehension tab or landing 57 located at the proximal end 5B of the screw extender 1 and at a proximal end PE of the elongated attachment member 17.
  • the prehension tab 57 extends or protrudes from the elongated body 55 or an intermediate member or ridge 59 of the elongated body 55 (see, for example, Figure 1).
  • the intermediate member or ridge 59 may, for example, extend from the distal end of the elongated attachment member 17 to the proximal end thereof.
  • the prehension tab or landing 57 facilitates and quickens assembly and disassembly of the screw extender to the sleeve 3.
  • the elongated attachment member 17 includes at least attachment mechanism (or attachment and guiding mechanism) 61 configured to interact or cooperate with a corresponding or complementary attachment mechanism (or attachment and guiding mechanism) 63 of the elongated screw extender sleeve 3.
  • the attachment mechanism 61 may, for example, be located and/or extend from an outermost extremity of the proximal end of the elongated attachment member 17 and/or the screw extender 1. This facilitates and quickens assembly and disassembly of the screw extender to the sleeve 3.
  • the attachment 61 and corresponding attachment 63 may, for example, be configured to hold the screw extender attached to the sleeve 3 during a sliding displacement of the screw extender relative to the sleeve 3, and/or may, for example, be configured to axially guide the displacement of the screw extender relative to the sleeve 3.
  • the attachment mechanism 61 may include, for example, at least one rail 61 having a complementary shape to that of the attachment mechanism 63 of the elongated screw extender sleeve 3, for example, at least one rail guide 63 or inner passage 63 of the sleeve 3.
  • the rail guide 63 may, for example, include or define the inner passage.
  • the at least one attachment mechanism 61 (or rail 61) can be, for example, located on the second side or face S2 and/or on the first face SI of the elongated attachment member 17.
  • the at least one rail 61 is, for example, configured to be received and guided by the at least one rail guide or inner passage 63 of the elongated screw extender sleeve 3.
  • the elongated attachment member 17 includes a first rail 61A and a second rail 61B (see for example Figure 1).
  • the first rail 61A is, for example, configured to be received and guided by a first rail guide or inner passage 63A of the elongated screw extender sleeve 3
  • the second rail 61B is, for example, configured to be received and guided by a second rail guide or inner passage 63B of the elongated screw extender sleeve 3 (see, for example, Figure 2).
  • connection mechanism 53 of the elongated screw extender sleeve 3 can be, for example, located between the first rail guide or inner passage 63A and the second rail guide or inner passage 63B of the elongated screw extender sleeve 3.
  • the first rail 61A and the second rail 61B may be, for example, separated by the intermediate ridge 59.
  • the intermediate ridge 59 may, for example, include or define, a first elongated guiding surface GF1 that cooperates with a guiding surface of the first guide rail 63A, and a second elongated guiding surface GF2 that cooperates with a guiding surface of the second guide rail 63B to guide and/or centre a relative displacement of the elongated attachment member 17 relative to the sleeve 3.
  • the elongated attachment member 17 may, for example, include at least one immobilization mechanism 65 or elongated screw extender sleeve immobilization mechanism 65A (see, for example, Figure 5).
  • the immobilization mechanism 65A is configured to engage an attachable instrument, for example, the elongated screw extender sleeve 3 to temporarily immobilize a displacement of the screw extender relative to, or along, the instrument or elongated screw extender sleeve 3.
  • the immobilization mechanism 65A may, for example, comprise at least one protrusion or clip (for example, located on the inner surface SI of the elongated attachment member 17) configured to be received and removably held in a complementary depression or groove 65B (see, for example, Figure 2) located on the instrument or on the elongated screw extender sleeve 3.
  • the immobilization mechanism 65A may, for example, comprise at least one depression or groove configured to receive a complementary protrusion or clip.
  • the immobilization mechanism 65A is, for example, located on the elongated attachment member 17 to be displaced and placed into an immobilization position by the sleeve 3 (see for example Figure 2) during the sliding movement of the screw extender relative to the sleeve 3.
  • the sleeve 3 may include for example an activation mechanism 67 configured to act on the elongated attachment member 17 and/or the immobilization mechanism 65A during the relative (axial) sliding movement.
  • Attachment of the immobilization mechanism 65A can, for example, be activated by a ramp 67 (see for example Figure 2) during a sliding movement to displace and/or guide the immobilization mechanism 65A to the complementary immobilization mechanism 65B of the instrument or elongated screw extender sleeve 3.
  • Figure 2 shows one exemplary embodiment of the sleeve 3, or the screw extender sleeve or sheath 3.
  • the sleeve 3 or screw extender sleeve 3 may be, for example, a pedicle screw sleeve 3 or pedicle screw extender sleeve 3.
  • Figure 15 shows another exemplary embodiment of the sleeve 3, or screw extender sleeve or sheath 3.
  • the sleeve 3 of the exemplary embodiment of Figure 15 may, for example, be used with a screw extender 1 that is identical to that previously described herein and whose elongated attachment member 17 or the body 55 thereof is different to that previously described, in that the elongated attachment member 17 and/or the body 55 thereof extends from the elongated tubular body 15 in a non-protruding lateral manner, that is, non-protruding in the lateral direction or X-direction or radial direction of the elongated tubular body 15.
  • the elongated attachment member 17 or body 55 extends, for example, (vertically) level to or in alignment/parallel to the wall 25 (or the outer surface thereof) of the elongated tubular body 15; or the elongated attachment member 17 or body 55 extends (substantially) flush/aplomb to the outer surface of the wall of the elongated tubular body 15 and is non-protruding relative to the outer surface of the wall of the elongated tubular body 15.
  • the prehension tab or landing 57 may be absent or extending in a longitudinal direction.
  • An inner surface of the sleeve 3 may, for example, include or define a coupling and/or guiding mechanism or means such as an (elongated) ridge or groove configured to cooperate with a corresponding or complementary (elongated) ridge or groove located on the elongated attachment member 17.
  • a coupling and/or guiding mechanism or means such as an (elongated) ridge or groove configured to cooperate with a corresponding or complementary (elongated) ridge or groove located on the elongated attachment member 17.
  • the ridge may, for example, be the ridge 59 previously described.
  • the attachment mechanism 61 may, for example, be absent from the elongated attachment member 17.
  • the ridge 59 may, for example, cross-sectionally have or form a dove-tail shape to be received and guided in a complementary shaped elongated groove, the groove being included or defined for example on the inner surface of the sleeve 3 (or on the outer surface of the elongated attachment member 17 in an alternative embodiment for cooperation with a ridge provided on the inner surface of the sleeve 3).
  • the sleeve 3 may thus receive the proximal and distal end of the screw extender inside the sleeve 3 and receive the elongated attachment member 17 inside the proximal end 105B of the sleeve 3.
  • the sleeve 3 or screw extender sleeve 3 includes the elongated tubular body 103 comprising the proximal end 105B and the distal end 105A.
  • the elongated tubular body 103 includes a passage 107 extending through the elongated tubular body 103 from the proximal end 105B and towards or to the distal end 105A to receive at least one pedicle or spinal screw instrument 31.
  • the passage 107 is defined or delimited by, for example, an inner surface of the sleeve 3 or the elongated tubular body 103.
  • the passage 107 allows, for example, an instrument to be inserted through a proximal entrance opening APB of the proximal end 105B and passed through the passage 107 to a distal entrance opening APA of the distal end 105A.
  • the distal end 105A of the elongated tubular body 103 includes a chamber 109 or socket 109 in communication with the passage 107.
  • the passage 107 or the inner surface of the sleeve 3 or the elongated tubular body 103 may, for example, define or delimit the chamber 109.
  • the chamber 109 is, for example, configured to receive the proximal end 21A of the elongated tubular body 15 of the screw extender and/or the proximal end of the pedicle or spinal screw 7 through the distal entrance opening APA of the distal end 105A of the elongated tubular body 103 into the chamber 109 (see, for example, Figure 4).
  • the chamber 109 is, for example, configured to receive the screw-head 11 of the pedicle or spinal screw 7.
  • the distal end 105A of the sleeve 3 is, for example, configured to receive and contact a pedicle or spinal screw connecting rod 37 held in the screw-head 11 to apply a counter-torque or counter force and/or to transfer or propagate a generated force or torque on the connecting rod 37 to the sleeve 3 and/or longitudinally through the sleeve 3.
  • the generated force or torque is, for example, generated during rotation of a setscrew 33 in the screw-head 11 of the pedicle or spinal screw 7.
  • An inner surface 117 defining or delimiting the elongated tubular body 103 or the chamber 109 may, for example, be configured to non-directly couple or non-directly connect to a screw-head 11, or may be configured to indirectly couple or indirectly connect or attach to a screw-head (11) of the pedicle or spinal screw (7).
  • the inner surface 117 defining or delimiting the elongated tubular body 103 or the chamber 109 may alternatively, for example, be configured to contact the screw-head 11 by a non-attaching direct contact or a non-attaching temporarily or permanent direct contact with the screw-head 11.
  • the inner surface 117 defining or delimiting the elongated tubular body 103 or the chamber 109 may, for example, be configured to contact the screw-head 11 by a non-binding/non-gripping direct contact or a non-binding/non-gripping temporarily or permanent direct contact with the screw-head 11.
  • the inner surface 117 defining or delimiting a distal portion of the chamber 109 is, for example, screwhead connection-less or screw-head connection-free, or screw-head direct connection-less or screwhead direct connection-free.
  • the chamber 109 is, for example, configured to receive and hold the pedicle or spinal screw 7 and the pedicle or spinal screw connecting rod 37 held in the screw-head 11 to apply a counter-torque or counter force and/or to transfer or propagate a generated force or torque on the connecting rod 37 to the sleeve 3 and/or longitudinally through the sleeve 3.
  • the elongated tubular body 103 of the sleeve 3 includes, for example, first and second elongated or longitudinal lumens 119A, 119B extending to the distal end 105A of the elongated tubular body 103 to allow a pedicle or spinal screw connecting rod 37 to be simultaneously received by the distal end 105A of the elongated tubular body 103 of the sleeve 3 and in the screw-head 11.
  • the pedicle or spinal screw connecting rod 37 is, for example, simultaneously received, traverse to the longitudinal axis LA of the pedicle or spinal screw 7, by the distal end 105A of the elongated tubular body 103 of the sleeve 3 and in the screw-head 11.
  • the first and second elongated or longitudinal lumens 119A, 119B are, for example, configured to receive and contact the pedicle or spinal screw connecting rod 37 when the spinal screw 7 is located inside the chamber 109 and/or when the elongated tubular body 15 of the screw extender is located inside the chamber 109.
  • the first and second elongated or longitudinal lumens 119A, 119B are, for example, configured to receive and contact the pedicle or spinal screw connecting rod 37 during rotation of a setscrew 33 in a screw-head 11 to apply a counter-torque or counter force and/or to transfer or propagate a generated force or torque on the connecting rod 37 to the sleeve 3 and/or longitudinally through the sleeve 3.
  • the elongated or longitudinal lumens 119A, 119B are, for example, located at the distal end 105A of the elongated tubular body 103.
  • the first and second elongated or longitudinal lumens 119A, 119B are, for example, located opposite or facing one another.
  • the (or each) elongated or longitudinal lumen 119A, 119B extends in an elongated manner to the outermost extremity of the distal end 105A of the elongated tubular body 103 and includes an opening RO into the lumen 119A, 119B at the outermost extremity of the distal end 105A of the elongated tubular body 103, and includes a closed extremity CE located opposite the opening RO, the closed extremity CE being located in the distal end 105A of the elongated tubular body 103.
  • the openings RO allows simultaneous insertion of the elongated rod 37 into the sleeve 3 at two separate locations on the rod 37, and the closed extremities CE hold or maintain the elongated rod 37 located in or at the distal end 105A of the elongated tubular body 103.
  • the closed extremities CE define a surface that can contact the elongated rod 37 located in or at the distal end 105A of the elongated tubular body 103 to couple or retain the elongated rod 37 to the distal end 105A of the elongated tubular body 103.
  • the elongated or longitudinal lumens 119A, 119B are, for example, located only at the distal end 105A of the elongated tubular body 103.
  • the elongated or longitudinal lumens 119A, 119B are, for example, located in the distal half (for example, beyond LNG/2), distal quarter (for example, beyond LNG/4) or distal one-eight (for example, beyond LNG/8) or distal one-tenth (for example, beyond LNG/10) of the sleeve 3, where LNG is, for example, the axial length of the sleeve 3 in the axial direction LA (see, for example, Figure 5).
  • the closed extremities CE or stops SP thereof may, for example, be located at a distance DL from the outermost extremity OME of the distal end 105A of the sleeve 3 (see, for example, Figure 15), where the distance DL is less than or equal to LNG/4, or LNG/8 or LNG/10; or is less than or equal to 2.5cm, 2cm, 1.75cm, 1.5cm, 1.25 cm or 1cm.
  • LNG is, for example, the axial length of the sleeve 3 in the axial direction LA (see, for example, Figure 5).
  • the wall 115 includes or defines a first and second elongated contact surfaces CF1, CF2 located opposite one another that can contact the rod 37 when the rod 37 is in the lumens 119.
  • the first and second elongated contact surfaces CF1, CF2 are, for example, separated by a distance that permits the rod 37 to be releasably positioned therein, and allows the sleeve 3 to seize the rod 37.
  • the separation distance may be such that the rod 7 is receives inside the lumens as a slidably releasable form fit.
  • At least one of the elongated contact surfaces CF1, CF2 may contact, for example, the rod 37 during tightening of the set screw in the head 11 of the spinal screw 7.
  • the first and second elongated or longitudinal lumens 119 are configured to allow the connecting rod 37 (see for example Figure 6) to be received in the distal end 105A (or only the distal end 105A) of the sleeve 3.
  • the first and second elongated or longitudinal lumens 119 extend to define an opening or aperture at the distal end 105A that allows the connecting rod 37 to pass or be displaced between the elongated tubular body 103 and the head 11 of the spinal screw 7.
  • the first and second elongated or longitudinal lumens 119 are, for example, located opposite each other or in diametrically opposed positions on the elongated tubular body 103.
  • the elongated tubular body 103 includes, for example, at least one or first and second (elongated) arms, and the first and second elongated or longitudinal lumens 119 are located between the at least one or the first and second arms.
  • the first and second elongated or longitudinal lumens 119 allows lateral insertion by the surgeon of the connecting rod 37 into the screw extender 1 and/or the first and second elongated or longitudinal lumens 35B of the spinal screw 7 that each have a closed extremity located at a distal end of the screw head 11 of the screw 7.
  • the first and second elongated or longitudinal lumens 119 are, for example, located such that when the screw extender and/or pedicle screw are coupled to the sleeve 3, the coupled elongated or longitudinal lumens form first and second closed elongated openings (see, for example, Figure 6). This, for example, permits traversal guiding of the displacement of the connecting rod 37 through the instrument(s) and implant.
  • the first and second elongated or longitudinal lumens 119 may, for example, form a U-shaped lumen whose opening RO is located at the distal end 105A.
  • the sleeve 3 or screw extender sleeve 3 may, for example, optionally include an attachment or fixation device 131 (see for example Figure 15) located, for example, at a proximal end of the sleeve 3 and/or the elongated tubular body 103.
  • the instrument or tool may alternatively be a counter-torque device or handle 133 (see for example Figure 6) configured to be removably attached to the attachment or fixation device 131 in a traverse manner.
  • the sleeve 3 or screw extender sleeve 3 is, for example, configured to internally receive and/or hold the elongated tubular body 15, and to internally and/externally receive and/or hold the elongated attachment member 17 (see, for example, Figure 4).
  • the sleeve 3 can, for example, be configured to receive the screw extender 1 (or a portion thereof) inside the sleeve 3 as a slidably releasable form fit.
  • the sleeve 3 or screw extender sleeve 3 is, for example, configured to internally receive and/or hold the elongated tubular body 15, and to internally receive and/or hold the elongated attachment member 17.
  • the distal end 105A of the elongated tubular body 103 includes the chamber or socket 109 configured to receive the proximal end of the pedicle or spinal screw 7; and/or the proximal end 21A and/or the distal end 21B of the elongated tubular body 15 of the screw extender device 1 that is holding (or not- holding) the pedicle or spinal screw 7.
  • the screw extender sleeve 3 and/or the elongated tubular body 103 includes a pedicle or spinal screw receiving section 111, at the distal end 105A, that includes, delimits or defines the chamber or socket 109.
  • the pedicle or spinal screw receiving section 111 includes the at least one wall 115, and the inner surface 117 of the wall 115 delimits or defines the chamber or socket 109.
  • the wall 115 includes or defines, for example, the distal entrance aperture or opening APA at the distal end 105A that is configured to allow the elongated tubular body 15 of the screw extender 1 to be introduced into the chamber 109 and sleeve 3.
  • the wall 115 for example, includes, defines or delimits an outer elongated sheath that covers, encloses or surrounds the elongated tubular body 15 of the screw extender 1 (and/or the spinal screw 7) when introduced or present in the chamber 109 and sleeve 3 (see, for example, Figure 4).
  • the wall 115 may further define at least one lateral entrance aperture AL configured to receive and allow the elongated attachment member 17 (of for example the illustrated embodiment of Figure 1) to pass or slide through in a direction of the proximal end 105B of the sleeve 3 and/or to slide through to the proximal end 105B of the sleeve 3 (see, for example, Figure 4).
  • the lateral entrance aperture AL is located between the elongated or longitudinal lumens 119, and/or located between first and second wings WG of the wall 115.
  • connection mechanism 53 extends, for example, from the interconnection interface 121 and/or the surface 123 towards the proximal end of the elongated attachment section 127 and/or the sleeve 3.
  • the interconnection interface 121 may, for example, include a portion of the connection mechanism 53.
  • the attachment mechanism(s) 63 is, for example, located adjacent the connection mechanism 53 to allow both mechanisms to simultaneously cooperate with the corresponding mechanisms of the screw extender 1.
  • the elongated attachment section 127 may for example include the first rail guide or inner passage 63A and the second rail guide or inner passage 63B in an exemplary embodiment, and the at least one groove or elongated groove 53 (for example) may be located between the first and second rail guides or inner passages 63A, 63B in an exemplary embodiment.
  • the rail guide or inner passage 63A, 63B can, for example, be formed, defined or delimited by a surface 143A, 143B of a landing 145A, 145B and an inner surface of an overarching or overhanging extension 149A, 149B overhanging the surface 143A, 143B of the landing 145A, 145B (see, for example, Figure 2).
  • the immobilization mechanism 65B is, for example, located after or at a proximal extremity of the connection mechanism 53, for example, between the connection mechanism 53 and the proximal entrance aperture or opening APB. This allows the screw extender 1 to be fully received by the sleeve
  • the elongated tubular body 3 and/or the elongated attachment section 127 may, for example, include at least one lateral prehension recess 151, or a first and second lateral prehension recess 151A, 151B to facilitate handling of the sleeve 3 and attachment of the screw extender 1.
  • the screw extender 1 is configured to slidably receive the elongated screw extender sleeve 3 (and vice versa) to guide a displacement of the elongated screw extender sleeve 3 relative to and/or along the elongated tubular body 15 of the screw extender to be received and held inside the chamber 109. This can be done while the spinal screw 7 is attached to the distal end of the screw extender, and while the rod 37 is positioned traverse in the head 11 of the screw 7.
  • An assembly method for assembling the screw extender 1 to the above described embodiment of the screw extender sleeve 3 comprises bringing the connection mechanism 51 of the screw extender 1 into connection or contact with the connection mechanism 53 of the screw extender sleeve 3, slidably moving the screw extender 1 relative to the screw extender sleeve 3 to bring the attachment mechanism 61 of the screw extender 1 into cooperation with the corresponding attachment mechanism 63 of the screw extender sleeve 3, slidably moving the screw extender 1 relative to the screw extender sleeve 3 to bring the immobilization mechanism 65A of the screw extender 1 into engagement or cooperation with the immobilization mechanism 65B of the screw extender sleeve 3 (see, for example, Figures 3 and 4).
  • the slidable movement of the screw extender 1 relative to the screw extender sleeve 3 can bring the immobilization mechanism 65A of the screw extender 1 into contact with the ramp 67 to deflect outwards the proximal end of the elongated attachment member 17 and guide of the immobilization mechanism 65A into cooperation with the immobilization mechanism 65B of the screw extender sleeve 3.
  • the elongated attachment member 17 is held by the connection mechanism 53 and the attachment mechanism 63 of the screw extender sleeve 3, and the elongated tubular body 15 is located and held inside the chamber 109.
  • the first and second elongated or longitudinal lumens 35 of the elongated tubular body 15 align with first and second elongated or longitudinal lumens 119A, 119B of the sleeve 3 to form a first and second sets of lumens each comprising two overlapping and aligned lumens in which the connecting rod 37 can pass through and be located.
  • the resulting assembled system 70 is, for example, shown in Figures 4 and 5.
  • the present disclosure also concerns a spinal instrument kit including or consisting solely of one or more screw extenders 1, and/or one or more screw extender sleeves 1.
  • the spinal screw 7 may be included, in the kit, pre-mounted or pre-assembled to the screw extender 1.
  • the sleeve 3 may be included, in the kit, pre-mounted or pre-assembled to the screw extender 1.
  • the Kit may include further instruments and/or implants such as a setscrew driver 31 and a setscrew 33, for example, pre-mounted to the setscrew driver 31.
  • the present disclosure also concerns an orthopaedic method.
  • the method can, for example, include: providing the at least one screw extender 1 disclosed herein with the spinal screw 7 and the screw extender sleeve 3 attached or mounted thereto; boring or creating a passage or elongated passage into at least one pedicle or vertebra; and inserting a screwdriver into the screw extender sleeve 3 and the elongated tubular body 15 of the screw extender 1 to attach the screwdriver to the proximal end of the threaded shaft 9 of the spinal screw 7, rotating the threaded shaft of the spinal screw 7 into the passage or elongated passage of the pedicle or vertebra to attach the spinal screw 7 to the pedicle or vertebra.
  • the orthopaedic method may further include: inserting the connecting rod 37 into the head 11 of the spinal screw 7 or between at least two heads 11 of two spinal screws 7, the further spinal screw 7 being for example attached to a pedicle or vertebra in the same manner set out above, or in a manner where the classic screw extender SE is used with the spinal screw 7, inserting a setscrew driver 31 into the screw extender sleeve 3 and an elongated tubular body 15 of the screw extender 1 to attach the setscrew driver 31 to the setscrew 33 located in the head 11 of the spinal screw 7 (see for example Figure 6), attaching a handle HD to the proximal end of the setscrew driver 31, optionally attaching a torque limitation device TL to the setscrew driver 31 between the handle HD and the setscrew driver 31 (see for example Figure 8), the torque limitation device TL is used, for example, to perform an initial set screw tightening or pre-tightening in the head 11 to a torque level that is less than that of a final tighten
  • the screw extender sleeve 3 is reattached to the screw extender 1.
  • a final-tightening action of the setscrew 33 to the connecting rod 37 can be carried out by further rotation of the setscrew driver 31 in the head 11 of the spinal screw 7 that is attached to the screw extender 1.
  • the screw extender 1 is removed from the spinal screw 7 by a continued rotation in the same rotational direction of the setscrew driver 31 that axially pushes apart the elongated tubular body 15 from the spinal screw 7 along the longitudinal axis LA, for example, pushes the screw extender in the direction of the user.
  • the counter torque device 131 may also be attached and used during this action.
  • the orthopaedic method similarly benefits from the advantages previously evoked in relation to the screw extender 1, sleeve 3 and system 70.

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Neurology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

La présente invention concerne un prolongateur de vis ayant un corps tubulaire allongé comportant une extrémité proximale et une extrémité distale, l'extrémité distale du corps tubulaire allongé étant conçue pour recevoir une vis pédiculaire ou vertébrale ; un élément de fixation allongé fixé au corps tubulaire allongé et se prolongeant au-delà de l'extrémité proximale du corps tubulaire allongé jusqu'à une extrémité proximale du prolongateur de vis, et un dégagement situé directement à l'opposé ou directement en regard de l'élément de fixation allongé et situé directement à l'opposé d'une surface extérieure du prolongateur de vis défini par l'extrémité proximale du corps tubulaire allongé.
PCT/IB2025/053130 2024-03-27 2025-03-25 Prolongateur de vis, manchon de prolongation de vis et système de prolongation de vis Pending WO2025202887A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
IBPCT/IB2024/052978 2024-03-27
IB2024052978 2024-03-27

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WO2025202887A1 true WO2025202887A1 (fr) 2025-10-02

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Application Number Title Priority Date Filing Date
PCT/IB2025/053130 Pending WO2025202887A1 (fr) 2024-03-27 2025-03-25 Prolongateur de vis, manchon de prolongation de vis et système de prolongation de vis

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20110263945A1 (en) * 2010-04-23 2011-10-27 Synthes Usa, Llc Minimally invasive instrument set, devices and related methods
US20170007301A1 (en) * 2006-04-11 2017-01-12 DePuy Synthes Products, Inc. Minimally invasive fixation system
US10058355B2 (en) 2013-05-13 2018-08-28 Neo Medical S.A. Orthopedic implant kit
US20190090979A1 (en) * 2017-09-22 2019-03-28 Medos International Sarl Patient-mounted surgical support

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20170007301A1 (en) * 2006-04-11 2017-01-12 DePuy Synthes Products, Inc. Minimally invasive fixation system
US20110263945A1 (en) * 2010-04-23 2011-10-27 Synthes Usa, Llc Minimally invasive instrument set, devices and related methods
US10058355B2 (en) 2013-05-13 2018-08-28 Neo Medical S.A. Orthopedic implant kit
US20190090979A1 (en) * 2017-09-22 2019-03-28 Medos International Sarl Patient-mounted surgical support

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