JP2009535090A - Open type back adjustment coupling device - Google Patents

Abstract

In one embodiment, an apparatus for connecting an implant to an elongated holder includes a body, a collet, an annular ring member, a washer, and a nut. The body defines a first channel configured to receive the rod and defines a second channel extending through the body. The collet is positionable within the two channels and defines a hole configured to receive at least a portion of the implant. The ring member is annular in shape, has a gap, and defines a hole sized to allow insertion of at least a portion of the collet. The washer can be positioned adjacent to the second channel and has a concave surface configured to contact the body and allow the collet to pivot relative to the body. The nut can be positioned adjacent to the washer and is operable to be coupled to the collet to move the collet within the second channel. The movement of the collet functions to expand the ring member and contract the collet around at least a portion of the implant to secure the implant in the desired position.
[Selection] Figure 1

Description

  The present invention generally relates to an open dorsal adjustment coupling device used for coupling an implant and a spinal rod. This device may be useful for reducing spinal cord injury or deformation, and more particularly, but not limited to, allowing for a mutually exclusive connection between the implant and the rod and adjusting the height of the back. The present invention relates to a connecting device that makes it possible.

  In the orthopedic field, it is well known to use an implant to fix the position of the bone. Thereby, healing of the fracture can be promoted and malformations or other injuries can be reduced. For example, in the field of spinal surgery, it is well known to place such implants in the vertebrae for a number of reasons. The reasons include: (a) correction of spinal curvature abnormalities, including spinal curvature, (b) maintenance and support of proper spacing of fractured or otherwise damaged vertebrae, and (c) spinal column Other treatment practices are included.

  Conventional implants and coupling devices include several pieces, which are generally useful, but may only be associated with certain other pieces. Bone screws, hooks, and clamps are known as fixation devices, which are connected or adjacent to a particular bone as a connection between the bone and the connection device. The coupling device can include a support and / or stabilization member, such as a spinal rod. In such devices, a series of two or more screws can be inserted into two or more vertebrae to which the instrument is to be attached. The rod is then placed in the screw or coupled to the screw, or placed in a coupling device connecting the rod and the screw, and the coupling is tightened. In this way, a rigid support structure is secured to the vertebra, and the rod provides support that promotes reduction or healing of vertebral malformations or damage by holding the vertebra in place.

  The device of the present invention may be useful in reducing spinal cord injury or deformation, allowing a mutually exclusive connection between the implant and the rod and allowing for adjustment of the back height.

  The present invention is an open back adjustment coupling device used for coupling an implant and a spinal rod.

FIG. 6 is a perspective view of a coupling assembly for a vertebra according to one embodiment of the disclosure. FIG. 2 is a perspective view of a coupling assembly according to the embodiment shown in FIG. 1. FIG. 3 is an exploded perspective view of the coupling assembly according to the embodiment shown in FIG. 2. FIG. 3 is a cross-sectional view of a coupling assembly according to the embodiment shown in FIG. 2. FIG. 3 is a top view of components of a coupling assembly according to the embodiment shown in FIG. 2. FIG. 3 is a top view of components of a coupling assembly according to the embodiment shown in FIG. 2. FIG. 6 is a perspective view of a coupling assembly according to another disclosed embodiment.

  For a better understanding of the principles of the invention, reference will now be made to the embodiments illustrated in the drawings. A specific language is used for the description. However, it will be understood that it is not intended to limit the scope of the invention, and those skilled in the art related to the invention will be able to make changes and further modifications to the apparatus shown in the figures, as well as It is expected that further applications of the principles of the invention shown will normally occur.

  Referring to FIG. 1, one embodiment of a coupling assembly 20 is shown. The coupling assembly 20 is operable to couple an implant 22 such as a Shanz-type screw having a threaded anchor portion and an elongated member 24 such as a spinal rod. In the illustrated embodiment, the implant 22 is inserted into the vertebra 26 and the member 24 is used to maintain one or more vertebrae in the desired position. However, it should be understood that the implant used with the coupling assembly 20 may be any suitable bone anchor or bone engagement mechanism. Member 24 may also be any suitable elongate member such as a bar, coupling device, or other orthopedic component. Further, the member 24 can have one of several desired lengths.

  With reference to FIG. 2, the illustrated embodiment of the coupling assembly 20 includes a body 30 having two vertical portions 31 that define a channel 32 that is configured to receive an elongate member 24. The width of the channel 32 is approximately the same as or slightly larger than the diameter of the member 24, thereby facilitating insertion of the member 24 into the channel 32, correcting the shape of the member 24, and the same channel 32. In addition, members having various diameters or widths can be used. In other embodiments, the channel 32 is configured to allow the member 24 to snap fit within the channel 32. The body 30 further defines a hole 34 that extends through the body 30 and is configured to receive additional components of the assembly 20. The body 30 includes a concave extension 36 that allows the implant 22 to pivot, as will be described in more detail below. The coupling assembly 20 further includes a collet 38 that receives the implant 22, a ring member 40 that is inserted into the bore 34, a washer 42, and a nut 44.

  FIG. 3 is an exploded view of the coupling assembly 20 to better illustrate the components of the illustrated embodiment. The channel 32 is substantially U-shaped with a longitudinal axis L1, and the member 24 generally extends along the longitudinal axis L1. The vertical portion 31 can include an inner threaded portion 33 that is threadably coupled with a retaining member (not shown) to secure the member 24 within the channel 32. Inner threaded portion 33 is a reverse angle thread, i.e., with the front face down and inward as disclosed in U.S. Pat. No. 6,296,642, which is incorporated herein by reference in its entirety. Can be included. In one embodiment, the retaining member is a generally cylindrical set screw with an outer thread, but may alternatively be other types of retaining or locking mechanisms. In one embodiment in which the member 24 is sized to snap into the channel 32, the member 24 may be self-secured within the channel 32 thereby. However, it should be understood that the member 24 can be secured within the channel 32 in other suitable ways as would normally occur to those skilled in the art. As shown, the channel 32 is at least partially open along the longitudinal axis L1 to accommodate attachment of the member 24 from above. It should be understood that the channel 32 can be variously configured and shaped as would normally occur to those skilled in the art.

  The hole 34 extends through the body 30 along the longitudinal axis L2, and in the illustrated embodiment, has a generally circular cross-sectional dimension. In one embodiment, the hole 34 is substantially perpendicular to the channel 32 and substantially parallel to the vertical portion 31. However, it should be understood that the holes 34 can include other cross-sectional shapes, directions, and dimensions. In the illustrated embodiment, the channel 32 and the hole 34 are not in communication. Further, the channels 32 and holes 34 can be variously positioned relative to each other in a manner that maintains the function of the coupling assembly 20.

  In the illustrated embodiment, the collet 38 includes a threaded portion 50 along at least a portion of the proximal end 51. The threaded portion 50 includes one or more flat portions 52. In one embodiment, the collet 38 includes two flat portions 52 disposed substantially radially opposite one another along the outside of the collet 38. The hole 53 extends through the collet 38. The collet 38 further includes a protrusion 54 adjacent to the distal end 55. Its function is described in more detail below. The collet 38 also includes one or more slots 56. In one embodiment, there are four slots 56 that are evenly distributed along the circumference of the collet 38, and the slots 56 are generally parallel to the holes 53. The collet 38 is generally cylindrical except for the flat portion 52 and has a circular cross-sectional dimension. In the illustrated embodiment, the outer cross-sectional dimension of the collet 38 at the convex portion 54 is larger than the outer cross-sectional dimension of the collet 38 at other positions. Collet 38 is sized and shaped to fit within hole 34, a portion of ring member 40, washer 42, and nut 44 for easy movement. However, it should be understood that in other embodiments, the collet 38 may have a variety of configurations or shapes.

  The ring member 40 is generally annular and has a gap 60 so that the ring member 40 can expand and contract and includes a threaded inner portion 62. The threaded inner portion 62 is configured to be threadably coupled with the threaded portion 50 of the collet 38 to position the ring member 40 around a portion of the collet 38. The ring member 40 has an unstressed or natural outer diameter D1, ie, the outer diameter measured when the ring member 40 is not subjected to contraction (gap closed) or expansion (gap opened) stress. Have. The ring member 40 has an inner diameter D2 that is slightly larger than the outer diameter D3 of the threaded portion 50 of the collet 38 so that the ring member 40 can engage the collet 38. In the illustrated embodiment, the washer 42 includes a concave lower surface 64 that is translatable along the extension 36 of the body 30 such that the collet 38 and the implant 22 can pivot or move relative to the body 30. It will be made possible. The nut 44 includes a threaded inner portion 68 configured to threadably couple with the threaded portion 50 of the collet 38.

  Referring to FIG. 4, a cross-sectional view of the assembled coupling device 20 including the body 30, nut 44, washer 42, ring member 40, and collet 38 is shown. As shown in FIG. 4, the ring member 40 includes a concave surface 70. In one embodiment, the concave surface 70 is disposed on the inner lower surface of the ring member 40. Concave surface 70 is configured to contact convex portion 54 of collet 38 during operation of coupling device 20, as will be described in more detail below.

  FIG. 5 is a top view of the ring member 40 illustrating an embodiment of the illustrated gap 60 and threaded inner portion 62. The ring member 40 defines a hole 61 configured to receive a portion of the collet 38. As described above, the threaded inner portion 62 of the ring member 40 is configured to be threadably coupled with the threaded portion 50 of the collet 38 so that the collet 38 can be inserted into the ring member 40.

  FIG. 6 is a top view of the washer 42 showing the inner flat surface 72. The flat surface 72 of the washer 42 is configured to abut or contact the flat portion 52 of the collet 38 to prevent the collet 38 from rotating within the bore 34 of the body 30. In the illustrated embodiment, there are two flat surfaces 72. However, although the number of flat surfaces 72 may be more or less than two, it should be understood that there are preferably as many flat surfaces 72 of washers 42 as there are flat portions 52 of collet 38.

  Referring generally to FIGS. 1-6, with reference to surgical procedures involving the spine, the operation and use of the coupling assembly 20 will now be described. An annular ring member 40 is disposed around the collet 38. In one embodiment, the threaded inner portion 62 of the ring member 40 is threaded around the threaded portion 50 of the collet 38 and then disposed adjacent to or around the collet 38 proximal to the protrusion 54. The However, it should be understood that the annular ring member 40 and the collet 38 can be joined in different ways that would occur to those skilled in the art. The collet 38 is inserted into the hole 34 of the main body 30 with the ring member 40 connected to the collet 38. Alternatively, the ring member 40 can be positioned in the hole 34 such that the collet 38 is inserted into the ring member 40 and into the hole 34 substantially simultaneously. Washer 42 and nut 44 are disposed around a portion of collet 38 that extends through hole 34 in body 30. In one alternative embodiment, a washer 42 and a nut 44 are placed around the collet 38 after the implant 22 is inserted into the collet 38. The assembly 20 can be assembled prior to use in a surgical procedure. However, it should be understood that in an alternative embodiment, the coupling assembly 20 may be assembled during a surgical procedure.

  To treat a patient condition or injury, the surgeon gains access to the surgical site in a manner well known in the art, for example by incision and tissue pull. The surgeon may gain access to the surgical site through an opening, such as a midline incision over the affected area, and then perform a bone screw operation with the tissue resected laterally to a lateral protrusion or by other surgical procedure. One or more implants, etc. can be connected adjacent to or near the vertebrae where compression or distraction is required to alleviate or ameliorate the condition. For example, a guide hole can be formed in a vertebra, such as a pedicle, and a screw can be inserted into two or more vertebrae or otherwise connected. In one embodiment, the implant 22 is inserted into a desired location in the bone structure, such as the vertebra 26. The threaded portion of the implant 22 can be screwed into the bone to the desired depth. The implant 22 is received in the hole 53 of the collet 38 to a position where the collet 38 surrounds the desired portion of the implant 22. It should be understood that the implant 22 can be inserted into the bone structure before or after the implant 22 is inserted into the collet 38. In addition, the implant 22 can be variously positioned within the collet 38 such that, for example, a substantial amount extends out of the proximal end 51, or the implant 22 extends little or no from the proximal end 51. it can. The coupling assembly 20 can be placed at any distance from the vertebra 26 along the implant 22. The washer 42 is pivoted relative to the body 30 in a direction transverse to the longitudinal axis L2 in response to the concave lower surface 64 of the washer 42 in which the implant 22 and collet 38 are translatable along the extension 36 of the body 30. It can be so. In other words, the washer 42 allows the implant 22 to be positioned in any number of angular positions relative to the body 30. The nut 44 is screwed onto the threaded portion 50 of the collet 38 to secure the implant 22 in the desired angular position. By tightening the nut 44, the collet 38 is moved in the hole 34, and the contact of the washer 42 with the main body 30 is ensured. By the operation of the collet 38, the ring member 40 is expanded to a limited position where the ring member 40 contacts the inner surface of the hole 34. The expansion of the ring member 40 is caused by the movement of the convex portion 54 of the collet 38 into the ring member 40. After the ring member 40 reaches a limited position, further movement of the collet 38 into the ring member 40 causes the collet 38 to contract around the implant 22 by the slot 56. The concave surface 70 of the ring member 40 facilitates movement of the convex portion 54 of the collet 38 into the ring member 40. Contraction of the collet 38 around the implant 22 locks the implant 22 in the desired angle and / or translational position. Thereafter, the member 24 is placed in the channel 32 of the body 30. The channel 32 is configured such that the member 24 is mounted within the channel 32 in a direction parallel to the longitudinal axis L 2 of the hole 34. Further, the retaining member can be received within the channel 32 of the body 30 to secure the member 24 within the channel 32. Also, as shown in FIG. 1, the member 24 can be received within another coupling assembly with the implant inserted into the other vertebra to secure a portion of the vertebra.

  Referring to FIG. 7, an exploded view of another embodiment is shown. In the figures, like reference numerals refer to like features described above. The coupling assembly 120 includes a body 130 that includes a vertical portion 131 that defines a hole 134 and that defines a lateral mounting channel 132 that extends along a longitudinal axis L3. The hole 134 extends through the body 130 along the longitudinal axis L4 and has a generally circular cross-sectional shape. Also, in one embodiment, the hole 134 is substantially perpendicular to the channel 132. Similar to the coupling assembly 20, the illustrated embodiment of the coupling assembly 120 includes a collet 38, a ring member 40, a washer 42, and a nut 44. The coupling assembly 120 further includes a hole 140 in communication with the channel 132. The hole 140 is configured to receive the retaining member 142. The retaining member 142 is operable to secure the member 24 within the channel 132. In one embodiment, the retaining member 142 is a cylindrical set screw having an outer thread. In one alternative embodiment, hole 140 is not present and retaining member 142 is received in channel 132 through opening 143. However, as discussed with respect to channel 32, it should be understood that member 24 can be secured within channel 132 in other suitable ways that would normally occur to those skilled in the art. The transverse mounting channel 132 is configured such that in one embodiment, the member 24 is mounted within the channel 132 in a direction substantially perpendicular to the longitudinal axis L4 of the hole 134.

  In an alternative embodiment, the ring member 40 is not present and the movement of the collet 38 in the hole 34 and / or hole 134 is operable such that the collet 38 is secured around the implant 22. In other alternative embodiments, nut 44 and / or washer 42 are replaced with other clamping mechanisms that would normally occur to those skilled in the art.

The various components of the coupling device 20 are made of titanium, stainless steel, certain ceramics, or plastic, or other biocompatible material.
While the invention has been illustrated and described in detail in the drawings and foregoing, it is to be considered as illustrative and not restrictive in character. It should be understood that only the preferred embodiments have been shown and described, and that all changes and modifications that come within the spirit of the invention are desired to be protected.

Claims (33)

A device for connecting an implant to a rod,
A body defining a first channel configured to receive the rod, further defining a second channel extending through the body, the longitudinal axis of the first channel and the first channel; A body, wherein the longitudinal axes of the two channels are substantially orthogonal and the rod extends along the longitudinal axis of the first channel;
A collet positioned within the second channel and defining a hole configured to receive at least a portion of the implant, wherein the collet is substantially cylindrical and includes a protrusion and one or more slots. A collet having a portion including and a threaded portion including at least one flat portion;
An annular slotted ring member positioned in an unstressed position in the second channel and defining a hole sized to allow insertion of at least a portion of the collet, the inner portion including a thread; A ring member having an inner portion including a concave portion configured to contact the convex portion of the collet;
A washer adjacent to the second channel and defining a hole sized to allow insertion of at least a portion of the collet, the washer configured to be adjacent to the at least one flat portion of the collet; A washer including at least one flat portion and a concave surface that at least partially contacts the body to allow the collet and washer to pivot relative to the body;
A nut adjacent to the washer having a threaded portion adapted to be coupled to the upper threaded portion of the collet to move the collet within the second channel by rotation of the nut; A nut, and
The ring member is expandable to an extent allowed by the second channel by allowing at least a part of the convex portion of the collet to pass through the ring member, and the convex portion of the collet is The apparatus wherein further passing through the ring member causes the collet to contract around at least a portion of the implant to substantially lock the implant in a desired position.   The device of claim 0, wherein the device is positionable at various locations along the implant.   The apparatus of claim 0, wherein the longitudinal axis of the first channel and the longitudinal axis of the second channel are not coplanar.   The apparatus of claim 0, wherein the first channel is positioned to correspond to attachment of the rod in a direction parallel to the longitudinal axis of the second channel.   The apparatus of claim 0, wherein the first channel is positioned to correspond to attachment of the rod perpendicular to the longitudinal axis of the second channel.   The apparatus of claim 0, wherein the first channel includes an inner threaded portion and is configured to receive a threaded retaining member to secure the rod within the first channel.   The body includes a convex extension proximal to the second passage so as to be in mating contact with the concave lower surface of the washer, and the washer is translatable along the convex extension. Apparatus according to claim 0.   The apparatus of claim 0, wherein the first channel is U-shaped and the first channel is at least partially open along the longitudinal axis of the first channel. A device for connecting an implant to a rod,
A body defining a channel configured to receive the rod, further defining a hole extending through the body, wherein the longitudinal axis of the channel and the longitudinal axis of the hole are substantially orthogonal A body, wherein the channel is at least partially open along the longitudinal axis of the channel;
A collet that is positionable within the bore and defines a bore configured to receive at least a portion of the implant;
An annular ring member that defines a gap and is positionable within the hole in an unstressed position, further defining a hole sized to allow insertion of at least a portion of the collet;
A pivot member that is positionable adjacent to the hole and includes a concave surface configured to at least partially contact the body, the pivot allowing the collet to pivot with respect to the body A pivot member configured to:
A clamping member that is positionable adjacent to the pivot member and is coupled to the collet and adapted to move the collet within the hole, whereby movement of the collet is achieved with the ring A clamping member operable to expand the member and contract the collet around at least a portion of the implant to secure the implant in a desired position.   The apparatus of claim 0, wherein the collet includes a protrusion.   The apparatus of claim 0, wherein the ring member includes a recess configured to be in mating contact with the protrusion of the collet.   The apparatus of claim 0, wherein movement of the collet within the hole comprises at least partially pulling at least a portion of the convex portion of the collet into the concave portion of the ring member.   The collet is substantially cylindrical and includes an upper threaded portion, an intermediate unthreaded portion, and a lower convex portion, and the upper threaded portion includes at least one flat unthreaded portion. The device described in 1.   The pivot member includes at least one inner flat portion configured to mate and contact the at least one flat unthreaded portion of the collet to prevent rotation of the collet within the body. The apparatus of claim 0.   The apparatus of claim 0, wherein the ring member includes an inner threaded portion configured to contact the upper threaded portion of the collet.   The clamping member includes an inner threaded portion configured to contact the upper threaded portion of the collet, and the collet is inserted by screwing the clamping member along the upper threaded portion of the collet. The apparatus of claim 0, wherein the apparatus is moved within the hole.   The apparatus of claim 0, wherein the channel is opened in a direction parallel to the longitudinal axis of the hole along the longitudinal axis of the channel.   The apparatus of claim 0, wherein the channel is opened along the longitudinal axis of the channel in a direction perpendicular to the longitudinal axis of the hole.   A body defining a first channel and a second channel, wherein the first channel is configured to receive a spinal rod, and the second channel extends through the body; And configured to receive a collet surrounding a portion of the bone implant and a partially annular ring member disposed around the portion of the collet, the longitudinal axis of the first channel and the The longitudinal axis of the second channel is substantially orthogonal and not coplanar, the spinal rod extends along the longitudinal axis of the first channel, and the first channel is the first channel. An apparatus that is at least partially open along the longitudinal axis of the channel to accommodate attachment of the spinal rod into the first channel.   The ring member is expandable to a limited position in response to movement of the convex portion of the collet into the ring member, and the collet locks the bone screw in a desired position. The device of claim 0, wherein the device is retractable around the bone screw in response to further movement of the convex portion of a collet into the ring member.   The first channel is U-shaped and is positioned to accommodate attachment of the rod into the first channel in a direction parallel to the longitudinal axis of the second channel. The apparatus according to Item 0.   The first channel is U-shaped and is positioned to accommodate attachment of the rod into the first channel in a direction perpendicular to the longitudinal axis of the second channel. The apparatus according to Item 0.   The apparatus of claim 0, wherein the body defines a hole in communication with the first channel and configured to receive a retaining member and secure the rod within the first channel.   The apparatus of claim 0, wherein the first channel includes an inner thread and is configured to threadably couple with a threaded retaining member to secure the rod within the first channel. Locating an annular ring member having a slot around the collet, the annular ring member being coupled to a threaded upper portion of the collet so that the ring member can be positioned around the collet Including an inner threaded portion configured to be configured such that the collet is substantially cylindrical and defines a hollow interior;
Inserting an implant into the hollow interior of the collet to a position where the collet surrounds a desired portion of the implant;
Inserting the collet into a first channel in the body;
Inserting the distal threaded portion of the implant into a desired angular position within the patient's bone structure;
Aligning the implant at a desired angular position relative to the body;
Placing a washer around the collet proximal to the first channel of the body, wherein the washer is configured to move the collet and the body in a pivotal motion. Including a concave lower surface translatable along the set of convex extensions; and
Tightening a nut on the threaded upper portion of the collet, wherein the nut contacts an upper surface of the washer, and the clamping causes the collet to move within the first channel so that the washer and the body The ring member is expandable to a limited position according to the movement of the convex part of the collet into the ring member, and the collet is fixed around the implant. And retractable around the implant in response to further movement of the convex portion of the collet into the ring member such that the implant is locked in a desired angular position;
Disposing a rod in a second channel of the body, wherein a longitudinal axis of the first channel and a longitudinal axis of the second channel are substantially orthogonal, the second channel The channel has a U-shaped cross-sectional dimension along the longitudinal axis of the second channel to correspond to the placement of the rod in the second channel. Method.   Further comprising disposing the annular ring member in the first channel of the body, wherein the step of inserting the collet is substantially simultaneously with the step of disposing the annular ring member around the collet. The method of claim 0, wherein the method is performed.   The direction from the bottom of the second channel to the opening of the second channel along the longitudinal axis of the second channel is parallel to the longitudinal axis of the first channel The method of claim 0, wherein the direction is perpendicular to the longitudinal axis of the second channel.   The direction from the bottom of the second channel to the opening of the second channel along the longitudinal axis of the second channel is perpendicular to the longitudinal axis of the first channel The method of claim 0, wherein the direction is perpendicular to the longitudinal axis of the second channel. Providing a coupling device for coupling a bone anchor and a rod, the coupling device comprising a body having a first channel for receiving the bone anchor and a second channel for receiving the rod; A collet surrounding a portion of the bone anchor, an annular ring member having a slot and defining a hole sized to allow insertion of at least a portion of the collet, a washer having a concave lower surface, and a nut In addition,
The longitudinal axis of the first channel and the longitudinal axis of the second channel are substantially orthogonal;
The second channel is at least partially open along the longitudinal axis of the second channel to accommodate attachment of the rod into the second channel;
Placing the coupling device at a desired location on the bone anchor;
Forming a desired angular relationship between the bone anchor and the body by translating the concave surface of the washer along the body;
Rotating the nut along a threaded portion of the collet to move the collet within the first channel, wherein the body, the ring member, and the collet include a bone anchor mechanism in the body. Forming an interference fit operable to lock in a desired angular position with respect to.   The method of claim 0, further comprising inserting the rod into the second channel.   The method of claim 0, further comprising securing the rod within the second channel with a retaining member.   The method of claim 0, wherein the collet includes one or more slots to facilitate contraction of the collet around the bone anchor mechanism.   The collet includes a convex portion configured to be in fitting contact with the concave portion of the ring member, and the ring member is limited when the convex portion of the collet moves into the concave portion of the ring member. The collet is expandable to a predetermined position, whereby the collet is contractible around the implant in response to further movement of the convex portion of the collet into the concave portion of the ring member. The method described.

Images