CA2587011A1 - Minimally invasive spinal fixation guide systems and methods - Google Patents

Minimally invasive spinal fixation guide systems and methods Download PDF

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Publication number
CA2587011A1
CA2587011A1 CA002587011A CA2587011A CA2587011A1 CA 2587011 A1 CA2587011 A1 CA 2587011A1 CA 002587011 A CA002587011 A CA 002587011A CA 2587011 A CA2587011 A CA 2587011A CA 2587011 A1 CA2587011 A1 CA 2587011A1
Authority
CA
Canada
Prior art keywords
spinal
rod
anchor
fixation element
patient
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.)
Granted
Application number
CA002587011A
Other languages
French (fr)
Other versions
CA2587011C (en
Inventor
Steven Ludwig
David Greg Anderson
Michael Carl Michielli
Philip Cormier
Nicholas J. Miller
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.)
DePuy Spine LLC
Original Assignee
Depuy Spine, Inc.
Steven Ludwig
David Greg Anderson
Michael Carl Michielli
Philip Cormier
Nicholas J. Miller
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 Depuy Spine, Inc., Steven Ludwig, David Greg Anderson, Michael Carl Michielli, Philip Cormier, Nicholas J. Miller filed Critical Depuy Spine, Inc.
Publication of CA2587011A1 publication Critical patent/CA2587011A1/en
Application granted granted Critical
Publication of CA2587011C publication Critical patent/CA2587011C/en
Expired - Fee Related 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, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
    • A61B17/1757—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the spine
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • 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, setting implements or the like
    • 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 ; Bone 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
    • A61B17/7088—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 wherein the rod is moved transverse to the axis of the bone anchor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1735—Guides or aligning means for drills, mills, pins or wires for rasps or chisels
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • 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, setting implements or the like
    • 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 ; Bone 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
    • A61B17/7034—Screws or hooks with U-shaped head or back through which longitudinal rods pass characterised by a lateral opening

Abstract

Methods and devices for implanting spinal fixation implants and devices are provided. In one embodiment, a method for implanting a spinal fixation system is provided and it includes the step of positioning a spinal fixation element to extend along a patient~s spinal column adjacent to one or more vertebrae, determining an implant site on at least one spinal anchor at the implant site on at least one vertebra, and coupling the spinal fixation element to each implant.

Claims (41)

1. A method for implanting a spinal fixation system, comprising:
positioning a spinal fixation element to extend along a patient's spinal column adjacent to a plurality of vertebrae;
determining an implant site on at least one vertebra;
implanting at least one spinal anchor at the implant site on at least one vertebra;
and coupling the spinal fixation element to the at least one spinal anchor.
2. The method of claim 1, wherein coupling the spinal fixation element to the at least one spinal anchor comprises approximating the spinal fixation element toward the spinal anchor.
3. The method of claim 1, further comprising locking the spinal fixation element to the at least one spinal anchor to maintain the vertebrae in a fixed position relative to one another.
4. The method of claim 1, wherein the spinal fixation element is inserted through a first incision, and each of the at least one spinal anchors are inserted through separate incisions.
5. The method of claim 1, wherein the spinal fixation element is inserted through a cannula.
6. The method of claim 1, wherein the spinal fixation element is inserted using an insertion tool that is adapted to insert the spinal fixation element in a first orientation and to pivot the spinal fixation element into a second orientation in which the spinal fixation element is substantially parallel to a patient's spinal column.
7. The method of claim 1, wherein the at least one spinal anchor comprises a side-loading, top-tightening spinal anchor.
8. The method of claim 1, wherein each spinal anchor is percutaneously delivered to the anchor site through a cannula.
9. The method of claim 1, wherein each spinal anchor is delivered to the anchor site through an access port.
10. The method of claim 8, wherein each cannula is positioned through a minimally invasive pathway to the spinal anchor site.
11. The method of claim 1, wherein determining an implant site comprises positioning a targeting member relative to a target implant site on a vertebra, aligning the targeting instrument relative to the target implant site using an imaging device.
12. The method of claim 1, wherein the spinal fixation element is coupled to a guide system having a guide portion adapted to be positioned outside a patient's body and to extend along a patient's spinal column, and a rod-engaging member adapted to couple to the spinal fixation element and to maintain the spinal fixation element in a fixed position within the patient's body extending adjacent to a patient's spinal column.
13. The method of claim 12, wherein the guide system includes a plurality of targeting members slidably disposed on the guide portion, each targeting member being adapted to target an implant site on a vertebra.
14. The method of claim 2, wherein approximating the spinal fixation element toward the at least one spinal anchor comprises engaging the spinal fixation element and the spinal anchor with a grasping tool to pull the spinal fixation element toward the spinal anchor.
15. The method of claim 14, wherein the grasping tool is cannulated.
16. The method of claim 2, wherein the spinal fixation element is approximated into a side-opening formed in the at least one spinal anchor.
17. A surgical method, comprising:
inserting a spinal rod through a first incision to position the spinal rod adjacent to a plurality of vertebrae in a patient's spinal column;
determining an implant site on each vertebra;
making a percutaneous incision at the implant site on each vertebra;
creating a pathway from the percutaneous incision to the implant site on each vertebra;
placing an anchor through each pathway to implant an anchor in each vertebra;
coupling the spinal rod to the anchors; and locking the spinal rod to each anchor.
18. The method of claim 17, wherein coupling the spinal rod to the anchors comprises approximating the spinal rod toward the anchors.
19. The method of claim 17, wherein the spinal rod is inserted through a cannula.
20. The method of claim 17, wherein the spinal rod is coupled to an inserter instrument that is effective to insert the spinal rod in a first position and to pivot the spinal rod into a second position in which the rod is substantially parallel with the patient's spinal column.
21. The method of claim 17, wherein the spinal rod is coupled to a guide system having a guide portion adapted to be positioned outside a patient's body and to extend along a patient's spinal column, and a rod-engaging member adapted to couple to the spinal rod and to maintain the spinal rod in a fixed position within the patient's body extending adjacent to a patient's spinal column.
22. The method of claim 21, wherein the guide system includes a plurality of slidable support members, and the method further comprises the step of positioning a cannula such that the cannula defines a working channel extending through tissue to an implant site, coupling each cannula to a support member to maintain the cannula in a fixed position, and placing a spinal anchor through each cannula to implant each anchor in a vertebra.
23. The method of claim 21, wherein the guide system includes a plurality of targeting members for determining an implant site on each vertebra.
24. The method of claim 23, wherein the targeting members are slidably disposed on the guide portion.
25. The method of claim 17, wherein the pathway from the percutaneous incision to the implant site on each vertebra is formed through a cannula.
26. The method of claim 17, wherein creating a pathway from the percutaneous incision to the implant site on each vertebra comprises inserting a series of dilators through the incision, positioning a cannula over the dilators, and removing the dilators such that a pathway defining a working channel extends through the cannula.
27. The method of claim 17, wherein the pathway from the percutaneous incision to the implant site on each vertebra is formed through an access port.
28. The method of claim 17, wherein the anchor comprises a spinal screw.
29. The method of claim 28, wherein the spinal screw includes a side opening formed therein for receiving the spinal rod and a top opening formed therein for receiving a locking mechanism that is effective to lock the spinal rod to the spinal screw.
30. The method of claim 18, wherein approximating the spinal rod toward the spinal anchors comprises engaging the spinal rod and a spinal anchor with a grasping tool to pull the spinal rod toward the spinal anchor.
31. The method of claim 30, wherein the grasping tool is cannulated.
32. A guide system for use in spinal surgery, comprising:
a guide portion adapted to be positioned outside a patient's body and to extend along a patient's spinal column;
a rod-engaging member mated to the guide portion and adapted to couple to a spinal rod and to maintain the spinal rod in a fixed position within the patient's body extending adjacent to a patient's spinal column; and a plurality of targeting members slidably coupled to the guide portion, each targeting member being adapted to target an implant site on a vertebra in the patient's spinal column.
33. The system of claim 32, wherein the rod-engaging member is effective to maintain the rod in a fixed position that is spaced a distance apart from the guide portion and substantially parallel to the guide portion.
34. The system of claim 33, wherein each targeting member is adapted to target an implant site on a vertebra that is at a location offset from the spinal rod.
35. The system of claim 32, wherein the rod-engaging member has an axis that is substantially transverse to an axis of the guide portion.
36. The system of claim 32, wherein the targeting members are removably coupled to support members slidably disposed on the guide portion.
37. The system of claim 36, wherein each support member is adapted to removably mate to a cannula defining a working channel extending to an implant site on a vertebra.
38. The system of claim 32, further comprising a locking mechanism coupled to the rod-engaging member and effective to removably mate a spinal fixation rod to the rod-engaging member.
39. The system of claim 32, further comprising a handle formed on the guide portion.
40. A guide system for use in spinal surgery, comprising:
a guide member having a rod-engaging portion that is adapted to maintain a spinal fixation element at a fixed position in a patient's body that is substantially parallel to the guide member; and at least one targeting element that is adapted to target an implant site on a vertebra at a location that is offset from the spinal fixation element.
41. A method for implanting a spinal fixation system, comprising:
positioning a spinal fixation element proximate to a plurality of vertebrae;
identifying an implant site proximate the spinal fixation element;
implanting at least one spinal anchor at the implant site; and coupling the spinal fixation element to the at least one spinal anchor.
CA2587011A 2004-11-09 2005-11-07 Minimally invasive spinal fixation guide systems and methods Expired - Fee Related CA2587011C (en)

Applications Claiming Priority (5)

Application Number Priority Date Filing Date Title
US62613804P 2004-11-09 2004-11-09
US60/626,138 2004-11-09
US11/163,963 2005-11-04
US11/163,963 US8075591B2 (en) 2004-11-09 2005-11-04 Minimally invasive spinal fixation guide systems and methods
PCT/US2005/040158 WO2006052819A2 (en) 2004-11-09 2005-11-07 Minimally invasive spinal fixation guide systems and methods

Publications (2)

Publication Number Publication Date
CA2587011A1 true CA2587011A1 (en) 2006-05-18
CA2587011C CA2587011C (en) 2010-08-03

Family

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Family Applications (1)

Application Number Title Priority Date Filing Date
CA2587011A Expired - Fee Related CA2587011C (en) 2004-11-09 2005-11-07 Minimally invasive spinal fixation guide systems and methods

Country Status (6)

Country Link
US (2) US8075591B2 (en)
EP (1) EP1820114A4 (en)
JP (1) JP5208509B2 (en)
AU (1) AU2005304872B8 (en)
CA (1) CA2587011C (en)
WO (1) WO2006052819A2 (en)

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AU2005304872A1 (en) 2006-05-18
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US9179926B2 (en) 2015-11-10
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JP5208509B2 (en) 2013-06-12
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EP1820114A4 (en) 2009-12-16
CA2587011C (en) 2010-08-03
US8075591B2 (en) 2011-12-13
US20060167454A1 (en) 2006-07-27
US20120022599A1 (en) 2012-01-26

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