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Publication numberUS20050149020 A1
Publication typeApplication
Application numberUS 10/997,165
Publication dateJul 7, 2005
Filing dateNov 24, 2004
Priority dateDec 5, 2003
Also published asUS7763052, US20050124991
Publication number10997165, 997165, US 2005/0149020 A1, US 2005/149020 A1, US 20050149020 A1, US 20050149020A1, US 2005149020 A1, US 2005149020A1, US-A1-20050149020, US-A1-2005149020, US2005/0149020A1, US2005/149020A1, US20050149020 A1, US20050149020A1, US2005149020 A1, US2005149020A1
InventorsTae-Ahn Jahng
Original AssigneeTae-Ahn Jahng
Export CitationBiBTeX, EndNote, RefMan
External Links: USPTO, USPTO Assignment, Espacenet
Method and apparatus for flexible fixation of a spine
US 20050149020 A1
Abstract
A flexible spinal fixation device having a flexible connection unit for non-rigid stabilization of the spinal column. In one embodiment, the fixation device includes at least two securing members configured to be inserted into respective adjacent spinal pedicles, each securing member each including a coupling assembly. The fixation device further includes a flexible connection unit configured to be received and secured within the coupling assemblies of each securing member so as to flexibly stabilize the affected area of the spine.
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Claims(29)
1. A flexible connection unit for use in a spinal fixation device, the flexible connection unit comprising a longitudinal member having at least one groove formed along at least a portion of the longitudinal member thereby providing additional flexibility to the longitudinal member.
2. The flexible connection unit of claim 1 wherein the longitudinal member comprises a solid rod.
3. The flexible connection unit of 2 wherein the solid rod comprises a solid metal rod.
4. The flexible connection unit of claim 1 wherein the at least one groove has a depth between 1 and 5 millimeters and a width between 0.1 and 2.0 millimeters.
5. The flexible connection unit of claim 1 wherein the at least one groove is formed in a spiral configuration along a longitudinal axis of the longitudinal member.
6. The flexible connection unit of claim 5 wherein the at least one groove is formed at a spiral angle θ from horizontal between 30 and 89 degrees.
7. The flexible connection unit of claim 1 further including at least one transverse tunnel formed within at least a portion of the longitudinal member.
8. The flexible connection unit of claim 7 wherein the longitudinal member comprises a solid rod cylindrical in shape and the at least one transverse tunnel passes through the cylindrical rod such that respective openings for the at least one transverse tunnel are located on opposing side surfaces of the cylindrical rod.
9. The flexible connection unit of claim 8 wherein the at least one transverse tunnel comprises a plurality of transverse tunnels and each transverse tunnel passes through a center longitudinal axis of the cylindrical rod at a predetermined angle Φ and wherein adjacent transverse tunnels share a common opening on one side of a cylindrical wall, forming a zigzag pattern of interior tunnels passing transversely through the central longitudinal axis of the rod.
10. The flexible connection unit of claim 9 wherein the location of the common openings intersect with respective portions of the at least one groove at an exterior surface of the rod.
11. The flexible connection unit of claim 1 wherein the longitudinal member comprises a cylindrical tube.
12. The flexible connection unit of 11 wherein the cylindrical tube comprises a metal cylindrical tube.
13. The flexible connection unit of claim 11 further comprising a rod having a smaller diameter than the cylindrical tube such that the rod is configured to fit inside a longitudinal axial channel of the cylindrical tube.
14. The flexible connection unit of claim 13 wherein the rod comprises a solid rod.
15. The flexible connection unit of claim 14 wherein the solid rod is made from a flexible core material selected from a group consisting of: carbon graphite, PEEK, PEEKEK, NITINOL, and UHMWPE.
16. The flexible connection unit of claim 14 wherein the solid rod comprises a second groove formed thereon for providing additional flexibility to the solid rod.
17. The flexible connection unit of claim 13 wherein the rod comprises a second tube.
18. The flexible connection unit of claim 17 wherein the second tube is made from a flexible core material selected from a group consisting of: carbon graphite, PEEK, PEEKEK, NITINOL, and UHMWPE.
19. The flexible connection unit of claim 17 wherein the second tube comprises a second groove formed thereon for provided additional flexibility to the second tube.
20. The flexible connection unit of claim 1 wherein the longitudinal member is configured in the shape of a cylindrical rod.
21. The flexible connection unit of claim 20 wherein the cylindrical rod has a substantially uniform outer diameter along its longitudinal axis.
22. The flexible connection unit of claim 1 wherein the portion of the longitudinal member having at least one groove has a cross-sectional area that is different from respective end portions of the longitudinal member.
23. A flexible connection unit for use in a spinal fixation device comprising a solid longitudinal member and at least one transverse tunnel formed within the solid longitudinal member so as to provide flexibility to the longitudinal member.
24. The flexible connection unit of claim 23 wherein the solid longitudinal member comprises a cylindrical rod and the at least one transverse tunnel passes through a center longitudinal axis of the cylindrical rod such that respective openings for the at least one transverse tunnel are located on opposite sides of a cylindrical wall of the rod.
25. The flexible connection unit of claim 23 wherein the at least one transverse tunnel comprises a plurality of transverse tunnels, each transverse tunnel intersecting a center longitudinal axis of the longitudinal member at a predetermined angle Φ and wherein adjacent transverse tunnels share a common opening at a lateral surface of the longitudinal member, forming a zigzag pattern of interior tunnels intersecting the center longitudinal axis of the longitudinal member.
26. A flexible connection unit for use in a spinal fixation device comprising:
a longitudinal member configured to be secured to a patient's spine using at least three securing members;
wherein a first portion of the longitudinal member is configured to be located between a first pair of securing members and a second portion of the longitudinal member is configured to be located between a second pair of securing members; and
wherein at least one of the first and second portions comprises a groove formed therein for providing flexibility to the at least one of the first and second portions.
27. The flexible connection unit of claim 26 wherein the longitudinal member comprises a cylindrical rod and the groove comprises a spiral groove formed along a longitudinal axis of the at least one of the first and second portions.
28. The flexible connection unit of claim 26 wherein each of the first and second portions comprises a groove formed therein for providing flexibility thereto.
29. The flexible connection unit of claim 28 wherein the grooves formed in the first and second portions each comprise a spiral groove formed around a respective longitudinal axis of the first and second portions.
Description
    CROSS-REFERENCE TO RELATED APPLICATIONS
  • [0001]
    The present application is a continuation of U.S. application Ser. No. 10,798,014, filed Mar. 10, 2004, which is a continuation-in-part of U.S. patent application Ser. No. 10/728,566, filed Dec. 5, 2003.
  • BACKGROUND OF THE INVENTION
  • [0002]
    1. Field of the Invention
  • [0003]
    The present invention relates to a method and system for fixing and stabilizing a spinal column and, more particularly, to a method and system of spinal fixation in which one or more screw type fixing members are implanted and fixed into a portion of a patient's spinal column and flexible, semi-rigid rods or plates are connected and fixed to the upper ends of the fixing members to provide dynamic stabilization of the spinal column.
  • [0004]
    2. Description of the Related Art
  • [0005]
    Degenerative spinal column diseases, such as disc degenerative diseases (DDD), spinal stenosis, spondylolisthesis, and so on, need surgical operation if they do not take a turn for the better by conservative management. Typically, spinal decompression is the first surgical procedure that is performed. The primary purpose of decompression is to reduce pressure in the spinal canal and on nerve roots located therein by removing a certain tissue of the spinal column to reduce or eliminate the pressure and pain caused by the pressure. If the tissue of the spinal column is removed the pain is reduced but the spinal column is weakened. Therefore, fusion surgery (e.g., ALIF, PLIF or posterolateral fusion) is often necessary for spinal stability following the decompression procedure. However, following the surgical procedure, fusion takes additional time to achieve maximum stability and a spinal fixation device is typically used to support the spinal column until a desired level of fusion is achieved. Depending on a patient's particular circumstances and condition, a spinal fixation surgery can sometimes be performed immediately following decompression, without performing the fusion procedure. The fixation surgery is performed in most cases because it provides immediate postoperative stability and, if fusion surgery has also been performed, it provides support of the spine until sufficient fusion and stability has been achieved.
  • [0006]
    Conventional methods of spinal fixation utilize a rigid spinal fixation device to support an injured spinal part and prevent movement of the injured part. These conventional spinal fixation devices include: fixing screws configured to be inserted into the spinal pedicle or sacral of the backbone to a predetermined depth and angle, rods or plates configured to be positioned adjacent to the injured spinal part, and coupling elements for connecting and coupling the rods or plates to the fixing screws such that the injured spinal part is supported and held in a relatively fixed position by the rods or plates.
  • [0007]
    U.S. Pat. No. 6,193,720 discloses a conventional spinal fixation device, in which connection members of a rod or plate type are mounted on the upper ends of at least one or more screws inserted into the spinal pedicle or sacral of the backbone. The connection units, such as the rods and plates, are used to stabilize the injured part of the spinal column which has been weakened by decompression. The connection units also prevent further pain and injury to the patient by substantially restraining the movement of the spinal column. However, because the connection units prevent normal movement of the spinal column, after prolonged use, the spinal fixation device can cause ill effects, such as “junctional syndrome” (transitional syndrome) or “fusion disease” resulting in further complications and abnormalities associated with the spinal column. In particular, due to the high rigidity of the rods or plates used in conventional fixation devices, the patient's fixed joints are not allowed to move after the surgical operation, and the movement of the spinal joints located above or under the operated area is increased. Consequently, such spinal fixation devices cause decreased mobility of the patient and increased stress and instability to the spinal column joints adjacent to the operated area.
  • [0008]
    It has been reported that excessive rigid spinal fixation is not helpful to the fusion process due to load shielding caused by rigid fixation. Thus, trials using load sharing semi-rigid spinal fixation devices have been performed to eliminate this problem and assist the bone fusion process. For example, U.S. Pat. No. 5,672,175, U.S. Pat. No. 5,540,688, and U.S. Pub No 2001/0037111 disclose dynamic spine stabilization devices having flexible designs that permit axial load translation (i.e., along the vertical axis of the spine) for bone fusion promotion. However, because these devices are intended for use following a bone fusion procedure, they are not well-suited for spinal fixation without fusion. Thus, in the end result, these devices do not prevent the problem of rigid fixation resulting from fusion.
  • [0009]
    To solve the above-described problems associated with rigid fixation, non-fusion technologies have been developed. The Graf band is one example of a non-fusion fixation device that is applied after decompression without bone fusion. The Graf band is composed of a polyethylene band and pedicle screws to couple the polyethylene band to the spinal vertebrae requiring stabilization. The primary purpose of the Graf band is to prevent sagittal rotation (flexion instability) of the injured spinal parts. Thus, it is effective in selected cases but is not appropriate for cases that require greater stability and fixation. See, Kanayama et al, Journal of Neurosurgery 95(1 Suppl): 5-10, 2001, Markwalder & Wenger, Acta Neurochrgica 145(3): 209-14.). Another non-fusion fixation device called “Dynesys” has recently been introduced. See Stoll et al, European Spine Journal 11 Suppl 2: S170-8, 2002, Schmoelz et al, J of spinal disorder & techniques 16(4): 418-23, 2003. The Dynesys device is similar to the Graf band except it uses a polycarburethane spacer between the screws to maintain the distance between the heads of two corresponding pedicle screws and, hence, adjacent vertebrae in which the screws are fixed. Early reports by the inventors of the Dynesys device indicate it has been successful in many cases. However, it has not yet been determined whether the Dynesys device can maintain long-term stability with flexibility and durability in a controlled study. Because it has polyethylene components and interfaces, there is a risk of mechanical failure. Furthermore, due to the mechanical configuration of the device, the surgical technique required to attach the device to the spinal column is complex and complicated.
  • [0010]
    U.S. Pat. Nos. 5,282,863 and 4,748,260 disclose a flexible spinal stabilization system and method using a plastic, non-metallic rod. U.S. patent publication no. 2003/0083657 discloses another example of a flexible spinal stabilization device that uses a flexible elongate member. These devices are flexible but they are not well-suited for enduring long-term axial loading and stress. Additionally, the degree of desired flexibility vs. rigidity may vary from patient to patient. The design of existing flexible fixation devices are not well suited to provide varying levels of flexibility to provide optimum results for each individual candidate. For example, U.S. Pat. No. 5,672,175 discloses a flexible spinal fixation device which utilizes a flexible rod made of metal alloy and/or a composite material. Additionally, compression or extension springs are coiled around the rod for the purpose of providing de-rotation forces on the vertebrae in a desired direction. However, this patent is primarily concerned with providing a spinal fixation device that permits “relative longitudinal translational sliding movement along [the] vertical axis” of the spine and neither teaches nor suggests any particular designs of connection units (e.g., rods or plates) that can provide various flexibility characteristics. Prior flexible rods such as that mentioned in U.S. Pat. No. 5,672,175 typically have solid construction with a relatively small diameter in order to provide a desired level of flexibility. Because they are typically very thin to provide suitable flexibility, such prior art rods are prone to mechanical failure and have been known to break after implantation in patients.
  • [0011]
    Therefore, conventional spinal fixation devices have not provided a comprehensive and balanced solution to the problems associated with curing spinal diseases. Many of the prior devices are characterized by excessive rigidity, which leads to the problems discussed above while others, though providing some flexibility, are not well-adapted to provide varying degrees of flexibility. Additionally, existing flexible fixation devices utilize non-metallic components that are not proven to provide long-term stability and durability. Therefore, there is a need for an improved dynamic spinal fixation device that provides a desired level of flexibility to the injured parts of the spinal column, while also providing long-term durability and consistent stabilization of the spinal column.
  • [0012]
    Additionally, in a conventional surgical method for fixing the spinal fixation device to the spinal column, a doctor incises the midline of the back to about 10-15 centimeters, and then, dissects and retracts it to both sides. In this way, the doctor performs muscular dissection to expose the outer part of the facet joint. Next, after the dissection, the doctor finds an entrance point to the spinal pedicle using radiographic devices (e.g., C-arm flouroscopy), and inserts securing members of the spinal fixation device (referred to as “spinal pedicle screws”) into the spinal pedicle. Thereafter, the connection units (e.g., rods or plates) are attached to the upper portions of the pedicle screws in order to provide support and stability to the injured portion of the spinal column. Thus, in conventional spinal fixation procedures, the patient's back is incised about 10˜15 cm, and as a result, the back muscle, which is important for maintaining the spinal column, is incised or injured, resulting in significant post-operative pain to the patient and a slow recovery period.
  • [0013]
    Recently, to reduce patient trauma, a minimally invasive surgical procedure has been developed which is capable of performing spinal fixation surgery through a relatively small hole or “window” that is created in the patient's back at the location of the surgical procedure. Through the use of an endoscope, or microscope, minimally invasive surgery allows a much smaller incision of the patient's affected area. Through this smaller incision, two or more securing members (e.g., pedicle screws) of the spinal fixation device are screwed into respective spinal pedicle areas using a navigation system. Thereafter, special tools are used to connect the stabilizing members (e.g., rods or plates) of the fixation device to the securing members. Alternatively, or additionally, the surgical procedure may include inserting a step dilator into the incision and then gradually increasing the diameter of the dilator. Thereafter, a tubular retractor is inserted into the dilated area to retract the patient's muscle and provide a visual field for surgery. After establishing this visual field, decompression and, if desired, fusion procedures may be performed, followed by a fixation procedure, which includes the steps of finding the position of the spinal pedicle, inserting pedicle screws into the spinal pedicle, using an endoscope or a microscope, and securing the stabilization members (e.g., rods or plates) to the pedicle screws in order to stabilize and support the weakened spinal column.
  • [0014]
    One of the most challenging aspects of performing the minimally invasive spinal fixation procedure is locating the entry point for the pedicle screw under endoscopic or microscopic visualization. Usually anatomical landmarks and/or radiographic devices are used to find the entry point, but clear anatomical relationships are often difficult to identify due to the confined working space. Additionally, the minimally invasive procedure requires that a significant amount of the soft tissue must be removed to reveal the anatomy of the regions for pedicle screw insertion. The removal of this soft tissue results in bleeding in the affected area, thereby adding to the difficulty of finding the correct position to insert the securing members and causing damage to the muscles and soft tissue surrounding the surgical area. Furthermore, because it is difficult to accurately locate the point of insertion for the securing members, conventional procedures are unnecessarily traumatic.
  • [0015]
    Radiography techniques have been proposed and implemented in an attempt to more accurately and quickly find the position of the spinal pedicle in which the securing members will be inserted. However, it is often difficult to obtain clear images required for finding the corresponding position of the spinal pedicle using radiography techniques due to radiographic interference caused by metallic tools and equipment used during the surgical operation. Moreover, reading and interpreting radiographic images is a complex task requiring significant training and expertise. Radiography poses a further problem in that the patient is exposed to significant amounts of radiation.
  • [0016]
    Although some guidance systems have been developed which guide the insertion of a pedicle screw to the desired entry point on the spinal pedicle, these prior systems have proven difficult to use and, furthermore, hinder the operation procedure. For example, prior guidance systems for pedicle screw insertion utilize a long wire that is inserted through a guide tube that is inserted through a patient's back muscle and tissue. The location of insertion of the guide tube is determined by radiographic means (e.g., C-arm flouroscope) and driven until a first end of the guide tube reaches the desired location on the surface of the pedicle bone. Thereafter, a first end of the guide wire, typically made of a biocompatible metal material, is inserted into the guide tube and pushed into the pedicle bone, while the opposite end of the wire remains protruding out of the patient's back. After the guide wire has been fixed into the pedicle bone, the guide tube is removed, and a hole centered around the guide wire is dilated and retracted. Finally, a pedicle screw having an axial hole or channel configured to receive the guide wire therethrough is guided by the guide wire to the desired location on the pedicle bone, where the pedicle screw is screw-driven into the pedicle.
  • [0017]
    Although the concept of the wire guidance system is a good one, in practice, the guide wire has been very difficult to use. Because it is a relatively long and thin wire, the structural integrity of the guide wire often fails during attempts to drive one end of the wire into the pedicle bone, making the process unnecessarily time-consuming and laborious. Furthermore, because the wire bends and crimps during insertion, it does not provide a smooth and secure anchor for guiding subsequent tooling and pedicle screws to the entry point on the pedicle. Furthermore, current percutaneous wire guiding systems are used in conjunction with C-arm flouroscopy (or other radiographic device) without direct visualization with the use of an endoscope or microscope. Thus, current wire guidance systems pose a potential risk of misplacement or pedicle breakage. Finally, because one end of the wire remains protruding out of the head of the pedicle screw, and the patient's back, this wire hinders freedom of motion by the surgeon in performing the various subsequent procedures involved in spinal fixation surgery. Thus, there is a need to provide an improved guidance system, adaptable for use in minimally invasive pedicle screw fixation procedures under endoscopic or microscopic visualization, which is easier to implant into the spinal pedicle and will not hinder subsequent procedures performed by the surgeon.
  • [0018]
    As discussed above, existing methods and devices used to cure spinal diseases are in need of much improvement. Most conventional spinal fixation devices are too rigid and inflexible. This excessive rigidity causes further abnormalities and diseases of the spine, as well as significant discomfort to the patient. Although some existing spinal fixation devices do provide some level of flexibility, these devices are not designed or manufactured so that varying levels of flexibility may be easily obtained to provide a desired level of flexibility for each particular patient. Additionally, prior art devices having flexible connection units (e.g., rods or plates) pose a greater risk of mechanical failure and do not provide long-term durability and stabilization of the spine. Furthermore, existing methods of performing the spinal fixation procedure are unnecessarily traumatic to the patient due to the difficulty in finding the precise location of the spinal pedicle or sacral of the backbone where the spinal fixation device will be secured.
  • BRIEF SUMMARY OF THE INVENTION
  • [0019]
    The invention addresses the above and other needs by providing an improved method and system for stabilizing an injured or weakened spinal column.
  • [0020]
    To overcome the deficiencies of conventional spinal fixation devices, in one embodiment, the inventor of the present invention has invented a novel flexible spinal fixation device with an improved construction and design.
  • [0021]
    In one embodiment of the present invention, a flexible connection unit for use in a spinal fixation device includes a rod having at least one groove formed along at least a portion of the rod so as to provide flexibility to rod.
  • [0022]
    In another embodiment, a flexible connection unit for use in a spinal fixation device includes a solid rod and at least one transverse tunnel formed within the solid rod so as to provide flexibility to the rod.
  • [0023]
    As a result of long-term studies to reduce the operation time required for minimally invasive spinal surgery, to minimize injury to tissues near the surgical area, in another embodiment, the invention provides a method and device for accurately and quickly finding a position of the spinal column in which securing members of the spinal fixation device will be inserted. A novel guidance/marking device is used to indicate the position in the spinal column where the securing members will be inserted.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • [0024]
    FIG. 1 illustrates a perspective view of a spinal fixation device in accordance with one embodiment of the invention.
  • [0025]
    FIG. 2 illustrates a perspective view of spinal fixation device in accordance with another embodiment of the invention.
  • [0026]
    FIG. 3 illustrates an exploded view of the coupling assembly 14 of the pedicle screw 2 of FIGS. 1 and 2, in accordance with one embodiment of the invention.
  • [0027]
    FIG. 4 illustrates a perspective view of a flexible rod connection unit in accordance with one embodiment of the invention.
  • [0028]
    FIG. 5 illustrates a perspective view of a flexible rod connection unit in accordance with another embodiment of the invention.
  • [0029]
    FIG. 6 illustrates a perspective view of a flexible rod connection unit in accordance with a further embodiment of the invention.
  • [0030]
    FIG. 7 illustrates a perspective view of a pre-bent flexible rod connection unit in accordance with one embodiment of the invention.
  • [0031]
    FIG. 8 illustrates a perspective, cross-sectional view of a flexible portion of connection unit in accordance with one embodiment of the invention.
  • [0032]
    FIG. 9 illustrates a perspective, cross-sectional view of a flexible portion of connection unit in accordance with another embodiment of the invention.
  • [0033]
    FIG. 10 illustrates a perspective, cross-sectional view of a flexible portion of connection unit in accordance with a further embodiment of the invention.
  • [0034]
    FIG. 11 illustrates a perspective view of a flexible rod connection unit in accordance with one embodiment of the invention.
  • [0035]
    FIG. 12A illustrates a perspective view of a flexible connection unit having one or more spacers in between two end portions, in accordance with one embodiment of the invention.
  • [0036]
    FIG. 12B illustrates an exploded view of the flexible connection unit of FIG. 12A.
  • [0037]
    FIG. 12C provides a view of the male and female interlocking elements of the flexible connection unit of FIGS. 12A and 12B, in accordance with one embodiment of the invention.
  • [0038]
    FIG. 13 shows a perspective view of a flexible connection unit, in accordance with a further embodiment of the invention.
  • [0039]
    FIG. 14 illustrates a perspective view of a spinal fixation device in accordance with another embodiment of the invention.
  • [0040]
    FIG. 15 illustrates an exploded view of the spinal fixation device of FIG. 14.
  • [0041]
    FIG. 16A shows a perspective view of a flexible plate connection unit in accordance with one embodiment of the invention.
  • [0042]
    FIG. 16B illustrates a perspective view of a flexible plate connection unit in accordance with a further embodiment of the invention.
  • [0043]
    FIG. 16C shows a side view of the flexible plate connection unit of FIG. 16A.
  • [0044]
    FIG. 16D shows a top view of the flexible plate connection unit of FIG. 16A.
  • [0045]
    FIG. 16E illustrates a side view of the flexible plate connection unit of FIG. 16A having a pre-bent configuration in accordance with a further embodiment of the invention.
  • [0046]
    FIG. 17 is a perspective view of a flexible plate connection unit in accordance with another embodiment of the invention.
  • [0047]
    FIG. 18 illustrates a perspective view of a flexible plate connection unit in accordance with another embodiment of the invention.
  • [0048]
    FIG. 19 illustrates a perspective view of a hybrid rod-plate connection unit having a flexible middle portion according to a further embodiment of the present invention.
  • [0049]
    FIG. 20 is a perspective view of a spinal fixation device that utilizes the hybrid rod-plate connection unit of FIG. 19.
  • [0050]
    FIG. 21 illustrates a perspective view of the spinal fixation device of FIG. 1 after it has been implanted into a patient's spinal column.
  • [0051]
    FIGS. 22A and 22B provide perspective views of spinal fixation devices utilizing the plate connection units of FIGS. 16A and 16B, respectively.
  • [0052]
    FIG. 23A illustrates a perspective view of two pedicle screws inserted into the pedicles of two adjacent vertebrae at a skewed angle, in accordance with one embodiment of the invention.
  • [0053]
    FIG. 23B illustrates a structural view of a coupling assembly of a pedicle screw in accordance with one embodiment of the invention.
  • [0054]
    FIG. 23C provides a perspective view of a slanted stabilizing spacer in accordance with one embodiment of the invention.
  • [0055]
    FIG. 23D illustrates a side view of the slanted stabilizing spacer of FIG. 23C.
  • [0056]
    FIG. 23E is a top view of the cylindrical head of the pedicle screw of FIG. 23.
  • [0057]
    FIG. 24 illustrates a perspective view of a marking and guiding device in accordance with one embodiment of the invention.
  • [0058]
    FIG. 25 is an exploded view of the marking and guidance device of FIG. 24.
  • [0059]
    FIG. 26A provides a perspective, cross-section view of a patient's spine after the marking and guiding device of FIG. 24 has been inserted during surgery.
  • [0060]
    FIG. 26B provides a perspective, cross-section view of a patient's spine as an inner trocar of the marking and guiding device of FIG. 24 is being removed.
  • [0061]
    FIGS. 27A and 27B illustrate perspective views of two embodiments of a fiducial pin, respectively.
  • [0062]
    FIG. 28 is a perspective view of a pushing trocar in accordance with a further embodiment of the invention.
  • [0063]
    FIG. 29A illustrates a perspective, cross-sectional view of a patient's spine as the pushing trocar of FIG. 28 is used to drive a fiducial pin into a designate location of a spinal pedicle, in accordance with one embodiment of the invention.
  • [0064]
    FIG. 29B illustrates a perspective, cross-sectional view of a patient's spine after two fiducial pins have been implanted into two adjacent spinal pedicles, in accordance with one embodiment of the invention.
  • [0065]
    FIG. 30 is a perspective view of a cannulated awl in accordance with one embodiment of the invention.
  • [0066]
    FIG. 31 is a perspective, cross-sectional view of a patient's spine as the cannulated awl of FIG. 30 is being used to enlarge an entry hole for a pedicle screw, in accordance with one embodiment of the invention.
  • [0067]
    FIG. 32 provides a perspective view of fiducial pin retrieving device, in accordance with one embodiment of the invention.
  • [0068]
    FIG. 33 is a perspective view of a pedicle screw having an axial cylindrical cavity for receiving at least a portion of a fiducial pin therein, in accordance with a further embodiment of the invention.
  • [0069]
    FIG. 34 is a perspective, cross-sectional view of a patient's spine after one pedicle screw has been implanted into a designated location of a spinal pedicle, in accordance with one embodiment of the invention.
  • [0070]
    FIG. 35 is a perspective, cross-sectional view of a patient's spine after two pedicle screws have been implanted into designated locations of two adjacent spinal pedicles, in accordance with one embodiment of the invention.
  • [0071]
    FIG. 36A is perspective view of a flexible rod for spinal fixation having a spiral groove cut therein, in accordance with one embodiment of the present invention.
  • [0072]
    FIG. 36B provides a cross-sectional view of the flexible rod of FIG. 36A, taken along lines B-B of FIG. 36A.
  • [0073]
    FIG. 37A illustrates a perspective view of a flexible rod for spinal fixation having transverse tunnels within the body of the rod, in accordance with one embodiment of the invention.
  • [0074]
    FIG. 37B is a cross-sectional view of the flexible rod of FIG. 37A, taken along lines B-B of FIG. 37A.
  • [0075]
    FIG. 38A is a perspective view of a flexible rod for spinal fixation having a spiral groove cut therein and transverse tunnels in the body of the rod, in accordance with a further embodiment of the invention.
  • [0076]
    FIG. 38B is a top view of the flexible rod of FIG. 38A, from the perspective of lines B-B of FIG. 38A.
  • [0077]
    FIG. 39A is a perspective view of a flexible rod for spinal fixation having transverse tunnels within the body of the rod, in accordance with another embodiment of the invention.
  • [0078]
    FIG. 39B is a cross-sectional view of the flexible rod of FIG. 39A, taken along lines B-B of that figure.
  • [0079]
    FIG. 39C is an alternative cross-sectional view of the flexible rod of FIG. 39A, taken along lines B-B of that figure, having substantially orthogonal transverse tunnels in the body of the rod, in accordance with a further embodiment of the invention.
  • [0080]
    FIG. 40A illustrates a perspective view of a flexible rod for spinal fixation, in accordance with a further embodiment of the invention.
  • [0081]
    FIG. 40B illustrates a cross-sectional view of a flexible rod for spinal fixation in accordance with a further embodiment of the invention.
  • DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
  • [0082]
    The invention is described in detail below with reference to the figures wherein like elements are referenced with like numerals throughout.
  • [0083]
    FIG. 1 depicts a spinal fixation device in accordance with one embodiment of the present invention. The spinal fixation device includes two securing members 2 (designated as 2′ and 2″), and a flexible fixation rod 4 configured to be received and secured within a coupling assembly 14, as described in further detail below with respect to FIG. 3. Each securing member 2 includes a threaded screw-type shaft 10 configured to be inserted and screwed into a patient's spinal pedicle. As shown in FIG. 1, the screw-type shaft 10 includes an external spiral screw thread 12 formed over the length of the shaft 10 and a conical tip at the end of the shaft 10 configured to be inserted into the patient's spinal column at a designated location. Other known forms of the securing member 2 may be used in connection with the present invention provided the securing member 2 can be inserted and fixed into the spinal column and securely coupled to the rod 4.
  • [0084]
    As described above, the spinal fixation device is used for surgical treatment of spinal diseases by mounting securing members 2 at desired positions in the spinal column. In one embodiment, the rod 4 extends across two or more vertebrae of the spinal column and is secured by the securing members 2 so as to stabilize movement of the two or more vertebrae.
  • [0085]
    FIG. 2 illustrates a perspective view of a spinal fixation device in accordance with a further embodiment of the present invention. The spinal fixation device of FIG. 2 is similar to the spinal fixation device of FIG. 1 except that the rod 4 comprises a flexible middle portion 8 juxtaposed between two rigid end portions 9 of the rod 4.
  • [0086]
    FIG. 3 provides an exploded view of the securing member 2 of FIGS. 1 and 2 illustrating various components of the coupling assembly 14, in accordance with one embodiment of the invention. As shown in FIG. 3, the coupling assembly 14 includes: a cylindrical head 16 located at a top end of the screw-type shaft 10, a spiral thread or groove 18 formed along portions of the inner wall surface of the cylindrical head 16, and a U-shaped seating groove 20 configured to receive the rod 4 therein. The coupling assembly 14 further comprises an outside-threaded nut 22 having a spiral thread 24 formed on the outside lateral surface of the nut 22, wherein the spiral thread 24 is configured to mate with the internal spiral thread 18 of the cylindrical head 16. In a further embodiment, the coupling assembly 14 includes a fixing cap 26 configured to be mounted over a portion of the cylindrical head 16 to cover and protect the outside-threaded nut 22 and more securely hold rod 4 within seating groove 20. In one embodiment an inner diameter of the fixing gap 26 is configured to securely mate with the outer diameter of the cylindrical head 16. Other methods of securing the fixing cap 26 to the cylindrical head, such as correspondingly located notches and groove (not shown), would be readily apparent to those of skill in the art. In preferred embodiments the components and parts of the securing member 2 may be made of highly rigid and durable bio-compatible materials such as: stainless steel, iron steel, titanium or titanium alloy. Such materials are known in the art. As also known in the art, and used herein, “bio-compatible” materials refers to those materials that will not cause any adverse chemical or immunological reactions after being implanted into a patient's body.
  • [0087]
    As shown in FIGS. 1 and 2, in preferred embodiments, the rod 4 is coupled to the securing means 2 by seating the rod 4 horizontally into the seating groove 20 of the coupling means 14 perpendicularly to the direction of the length of the threaded shaft 10 of securing member 2. The outside threaded nut 22 is then received and screwed into the cylindrical head 16 above the rod 4 so as to secure the rod 4 in the seating groove 20. The fixing cap 26 is then placed over the cylindrical head 16 to cover, protect and more firmly secure the components in the internal cavity of the cylindrical head 16. FIGS. 4-7 illustrate perspective views of various embodiments of a rod 4 that may be used in a fixation device, in accordance with the present invention. FIG. 4 illustrates the rod 4 of FIG. 1 wherein the entire rod is made and designed to be flexible. In this embodiment, rod 4 comprises a metal tube or pipe having a cylindrical wall 5 of a predefined thickness. In one embodiment, in order to provide flexibility to the rod 4, the cylindrical wall 5 is cut in a spiral fashion along the length of the rod 4 to form spiral cuts or grooves 6. As would be apparent to one of ordinary skill in the art, the width and density of the spiral grooves 6 may be adjusted to provide a desired level of flexibility. In one embodiment, the grooves 6 are formed from very thin spiral cuts or incisions that penetrate through the entire thickness of the cylindrical wall of the rod 4. As known to those skilled in the art, the thickness and material of the tubular walls 5 also affect the level of flexibility.
  • [0088]
    In one embodiment, the rod 4 is designed to have a flexibility that substantially equals that of a normal back. Flexibility ranges for a normal back are known by those skilled in the art, and one of ordinary skill can easily determine a thickness and material of the tubular walls 5 and a width and density of the grooves 6 to achieve a desired flexibility or flexibility range within the range for a normal back. When referring to the grooves 6 herein, the term “density” refers to tightness of the spiral grooves 6 or, in other words, the distance between adjacent groove lines 6 as shown in FIG. 4, for example. However, it is understood that the present invention is not limited to a particular, predefined flexibility range. In one embodiment, in addition to having desired lateral flexibility characteristics, the rigidity of the rod 4 should be able to endure a vertical axial load applied to the patient's spinal column along a vertical axis of the spine in a uniform manner with respect to the rest of the patient's natural spine.
  • [0089]
    FIG. 5 illustrates the rod 4 of FIG. 2 wherein only a middle portion 8 is made and designed to be flexible and two end portions 9 are made to be rigid. In one embodiment, metal end rings or caps 9′, having no grooves therein, may be placed over respective ends of the rod 4 of FIG. 4 so as make the end portions 9 rigid. The rings or caps 9′ may be permanently affixed to the ends of the rod 4 using known methods such as pressing and/or welding the metals together. In another embodiment, the spiral groove 6 is only cut along the length of the middle portion 8 and the end portions 9 comprise the tubular wall 5 without grooves 6. Without the grooves 6, the tubular wall 5, which is made of a rigid metal or metal hybrid material, exhibits high rigidity.
  • [0090]
    FIG. 6 illustrates a further embodiment of the rod 4 having multiple sections, two flexible sections 8 interleaved between three rigid sections 9. This embodiment may be used, for example, to stabilize three adjacent vertebrae with respect to each other, wherein three pedicle screws are fixed to a respective one of the vertebrae and the three rigid sections 9 are connected to a coupling assembly 14 of a respective pedicle screw 2, as described above with respect to FIG. 3. Each of the flexible sections 8 and rigid sections 9 may be made as described above with respect to FIG. 5.
  • [0091]
    FIG. 7 illustrates another embodiment of the rod 4 having a pre-bent structure and configuration to conform to and maintain a patient's curvature of the spine, known as “lordosis,” while stabilizing the spinal column. Generally, a patient's lumbar is in the shape of a ‘C’ form, and the structure of the rod 4 is formed to coincide to the normal lumbar shape when utilized in the spinal fixation device of FIG. 2, in accordance with one embodiment of the invention. In one embodiment, the pre-bent rod 4 includes a middle portion 8 that is made and designed to be flexible interposed between two rigid end portions 9. The middle portion 8 and end portions 9 may be made as described above with respect to FIG. 5. Methods of manufacturing metallic or metallic-hybrid tubular rods of various sizes, lengths and pre-bent configurations are well-known in the art. Additionally, or alternatively, the pre-bent structure and design of the rod 4 may offset a skew angle when two adjacent pedicle screws are not inserted parallel to one another, as described in further detail below with respect to FIG. 23A.
  • [0092]
    Additional designs and materials used to create a flexible tubular rod 4 or flexible middle portion 8 are described below with respect to FIGS. 8-10. FIG. 8 illustrates a perspective, cross-sectional view of a flexible tubular rod 4, or rod portion 8 in accordance with one embodiment of the invention. In this embodiment, the flexible rod 4, 8 is made from a first metal tube 5 having a spiral groove 6 cut therein as described above with respect to FIGS. 4-7. A second tube 30 having spiral grooves 31 cut therein and having a smaller diameter than the first tube 5 is inserted into the cylindrical cavity of the first tube 5. In one embodiment, the second tube 30 has spiral grooves 31 which are cut in an opposite spiral direction with respect to the spiral grooves 6 cut in the first tube 5, such that the rotational torsion characteristics of the second tube 30 offset at least some of the rotational torsion characteristics of the first tube 5. The second flexible tube 30 is inserted into the core of the first tube to provide further durability and strength to the flexible rod 4, 8. The second tube 30 may be made of the same or different material than the first tube 5. In preferred embodiments, the material used to manufacture the first and second tubes 5 and 30, respectively, may be any one or combination of the following exemplary metals: stainless steel, iron steel, titanium, and titanium alloy.
  • [0093]
    FIG. 9 illustrates a perspective, cross-sectional view of a flexible rod 4, 8 in accordance with a further embodiment of the invention. In this embodiment, the flexible rod 4, 8 includes an inner core made of a metallic wire 32 comprising a plurality of overlapping thin metallic yarns, such as steel yarns, titanium yarns, or titanium-alloy yarns. The wire 32 is encased by a metal, or metal hybrid, flexible tube 5 having spiral grooves 6 cut therein, as discussed above. The number and thickness of the metallic yarns in the wire 32 also affects the rigidity and flexibility of the rod 4, 8. By changing the number, thickness or material of the yarns flexibility can be increased or decreased. Thus, the number, thickness and/or material of the metallic yarns in the wire 32 can be adjusted to provide a desired rigidity and flexibility in accordance with a patient's particular needs. Those of ordinary skill in the art can easily determine the number, thickness and material of the yarns, in conjunction with a given flexibility of the tube 5 in order to achieve a desired rigidity v. flexibility profile for the rod 4, 8.
  • [0094]
    FIG. 10 shows yet another embodiment of a flexible rod 4 wherein the flexible tube 5 encases a non-metallic, flexible core 34. The core 34 may be made from known biocompatible shape memory alloys (e.g., NITINOL), or biocompatible synthetic materials such as: carbon fiber, Poly Ether Ether Ketone (PEEK), Poly Ether Ketone Ketone Ether Ketone (PEKKEK), or Ultra High Molecular Weight Poly Ethylene (UHMWPE).
  • [0095]
    FIG. 11 illustrates a perspective view of another embodiment of the flexible rod 35 in which a plurality of metal wires 32, as described above with respect to FIG. 9, are interweaved or braided together to form a braided metal wire rod 35. Thus, the braided metal wire rod 35 can be made from the same materials as the metal wire 32. In addition to the variability of the rigidity and flexibility of the wire 32 as explained above, the rigidity and flexibility of the braided rod 35 can be further modified to achieve desired characteristics by varying the number and thickness of the wires 32 used in the braided structure 35. For example, in order to achieve various flexion levels or ranges within the known flexion range of a normal healthy spine, those of ordinary skill in the art can easily manufacture various designs of the braided wire rod 35 by varying and measuring the flexion provided by different gauges, numbers and materials of the wire used to create the braided wire rod 35. In a further embodiment each end of the braided metal wire rod 35 is encased by a rigid metal cap or ring 9′ as described above with respect to FIGS. 5-7, to provide a rod 4 having a flexible middle portion 8 and rigid end portions 9. In a further embodiment (not shown), the metal braided wire rod 35 may be utilized as a flexible inner core encased by a metal tube 5 having spiral grooves 6 cut therein to create a flexible metal rod 4 or rod portion 8, in a similar fashion to the embodiments shown in FIGS. 8-10. As used herein the term “braid” or “braided structure” encompasses two or more wires, strips, strands, ribbons and/or other shapes of material interwoven in an overlapping fashion. Various methods of interweaving wires, strips, strands, ribbons and/or other shapes of material are known in the art. Such interweaving techniques are encompassed by the present invention. In another exemplary embodiment (not shown), the flexible metal rod 35 includes a braided metal structure having two or more metal strips, strands or ribbons interweaved in a diagonally overlapping pattern.
  • [0096]
    FIG. 12A illustrates a further embodiment of a flexible connection unit 36 having two rigid end portions 9′ and an exemplary number of rigid spacers 37. In one embodiment, the rigid end portions 9′ and spacers can be made of bio-compatible metal or metal-hybrid materials as discussed above. The connection unit 36 further includes a flexible wire 32, as discussed above with respect to FIG. 9′, which traverses an axial cavity or hole (not shown) in each of the rigid end portions 9′ and spacers 37. FIG. 12B illustrates an exploded view of the connection unit 36 that further shows how the wire 32 is inserted through center axis holes of the rigid end portions 9′ and spacers 37. As further shown in FIG. 12B, each of the end portions 9′ and spacers 37 include a male interlocking member 38 which is configured to mate with a female interlocking cavity (not shown) in the immediately adjacent end portion 9′ or spacer 37. FIG. 12C illustrates an exploded side view and indicates with dashed lines the location and configuration of the female interlocking cavity 39 for receiving corresponding male interlocking members 38.
  • [0097]
    FIG. 13 shows a perspective view of a flexible connection unit 40 in accordance with another embodiment of the invention. The connection 40 is similar to the connection unit 36 described above, however, the spacers 42 are configured to have the same shape and design as the rigid end portions 9′. Additionally, the end portions 9′ have an exit hole or groove 44 located on a lateral side surface through which the wire 32 may exit, be pulled taut, and clamped or secured using a metal clip (not shown) or other known techniques. In this way, the length of the flexible connection unit 36 or 40 may be varied at the time of surgery to fit each patient's unique anatomical characteristics. In one embodiment, the wire 32 may be secured using a metallic clip or stopper (not shown). For example, a clip or stopper may include a small tubular cylinder having an inner diameter that is slightly larger than the diameter of the wire 32 to allow the wire 32 to pass therethrough. After the wire 32 is pulled to a desired tension through the tubular stopper, the stopper is compressed so as to pinch the wire 32 contained therein. Alternatively, the wire 32 may be pre-secured using known techniques during the manufacture of the rod-like connection units 36, 40 having a predetermined number of spacers 37, 42 therein.
  • [0098]
    FIG. 14 depicts a spinal fixation device according to another embodiment of the present invention. The spinal fixation device includes: at least two securing members 2 containing an elongate screw type shaft 10 having an external spiral thread 12, and a coupling assembly 14. The device further includes a plate connection unit 50, or simply “plate 50,” configured to be securely connected to the coupling parts 14 of the two securing members 2. The plate 50 comprises two rigid connection members 51 each having a planar surface and joined to each other by a flexible middle portion 8. The flexible middle portion 8 may be made in accordance with any of the embodiments described above with respect to FIGS. 4-11. Each connection member 51 contains a coupling hole 52 configured to receive therethrough a second threaded shaft 54 (FIG. 15) of the coupling assembly 14.
  • [0099]
    As shown in FIG. 15, the coupling assembly 14 of the securing member 2 includes a bolt head 56 adjoining the top of the first threaded shaft 10 and having a circumference or diameter greater than the circumference of the first threaded shaft 10. The second threaded shaft 54 extends upwardly from the bolt head 56. The coupling assembly 14 further includes a nut 58 having an internal screw thread configured to mate with the second threaded shaft 54, and one or more washers 60, for clamping the connection member 51 against the top surface of the bolt head 56, thereby securely attaching the plate 50 to the pedicle screw 2.
  • [0100]
    FIGS. 16A and 16B illustrate two embodiments of a plate connection unit 40 having at least two coupling members 51 and at least one flexible portion 8 interposed between and attached to two adjacent connection members 51. As shown in FIGS. 16A and 16B, the flexible middle portion 8 comprises a flexible metal braided wire structure 36 as described above with respect to FIG. 11. However, the flexible portion 8 can be designed and manufactured in accordance with any of the embodiments described above with respect to FIGS. 4-11, or combinations thereof. FIGS. 16C and 16D illustrate a side view and top view, respectively, of the plate 50 of FIG. 16A. The manufacture of different embodiments of the flexible connection units 50 and 58 having different types of flexible middle portions 8, as described above, is easily accomplished using known metallurgy manufacturing processes.
  • [0101]
    FIG. 16E illustrate a side view of a pre-bent plate connection unit 50′, in accordance with a further embodiment of the invention. This plate connection unit 50′ is similar to the plate 50 except that connection members 51′ are formed or bent at an angle θ from a parallel plane 53 during manufacture of the plate connection unit 50′. As discussed above with respect to the pre-bent rod-like connection unit 4 of FIG. 7, this pre-bent configuration is designed to emulate and support a natural curvature of the spine (e.g., lordosis). Additionally, or alternatively, this pre-bent structure may offset a skew angle when two adjacent pedicle screws are not inserted parallel to one another, as described in further detail below with respect to FIG. 23A.
  • [0102]
    FIG. 17 illustrates a perspective view of a plate connection unit 60 having two planar connection members 62 each having a coupling hole 64 therein for receiving the second threaded shaft 44 of the pedicle screw 2. A flexible middle portion 8 is interposed between the two connection members 62 and attached thereto. In one embodiment, the flexible middle portion 8 is made in a similar fashion to wire 32 described above with respect to FIG. 9, except it has a rectangular configuration instead of a cylindrical or circular configuration as shown in FIG. 9. It is understood, however, that the flexible middle portion 8 may be made in accordance with the design and materials of any of the embodiments previously discussed.
  • [0103]
    FIG. 18 illustrates a perspective view of a further embodiment of the plate 60 of FIG. 17 wherein the coupling hole 64 includes one or more nut guide grooves 66 cut into the top portion of the connection member 62 to seat and fix the nut 58 (FIG. 15) into the coupling hole 64. The nut guide groove 66 is configured to receive and hold at least a portion of the nut 58 therein and prevent lateral sliding of the nut 58 within the coupling hole 64 after the connection member 62 has been clamped to the bolt head 56 of the pedicle screw 2.
  • [0104]
    FIG. 19 illustrates a perspective view of a hybrid plate and rod connection unit 70 having a rigid rod-like connection member 4, 9 or 9′, as described above with respect to FIGS. 4-7, at one end of the connection unit 70 and a plate-like connection member 51 or 62, as described above with respect to FIGS. 14-18, at the other end of the connection unit 70. In one embodiment, interposed between rod-like connection member 9 (9′) and the plate-like connection member 52 (64) is a flexible member 8. The flexible member 8 may be designed and manufactured in accordance with any of the embodiments discussed above with reference to FIGS. 8-13.
  • [0105]
    FIG. 20 illustrates a perspective view of a spinal fixation device that utilizes the hybrid plate and rod connection unit 70 of FIG. 19. As shown in FIG. 20, this fixation device utilizes two types of securing members 2 (e.g., pedicle screws), the first securing member 2′ being configured to securely hold the plate connection member 42(64) as described above with respect to FIG. 15, and the second securing member 2″ being configured to securely hold the rod connection member 4, 9 or 9′, as described above with respect to FIG. 3.
  • [0106]
    FIG. 21 illustrates a perspective top view of two spinal fixation devices, in accordance with the embodiment illustrated in FIG. 1, after they are attached to two adjacent vertebrae 80 and 82 to flexibly stabilize the vertebrae. FIGS. 22A and 22B illustrate perspective top views of spinal fixation devices using the flexible stabilizing members 50 and 58 of FIGS. 16A and 16B, respectively, after they are attached to two or more adjacent vertebrae of the spine.
  • [0107]
    FIG. 23A illustrates a side view of a spinal fixation device after it has been implanted into the pedicles of two adjacent vertebrae. As shown in this figure, the pedicle screws 2 are mounted into the pedicle bone such that a center axis 80 of the screws 2 are offset by an angle θfrom a parallel plane 82 and the center axes 80 of the two screws 2 are offset by an angle of approximately 2θ from each other. This type of non-parallel insertion of the pedicle screws 2 often results due to the limited amount of space that is available when performing minimally invasive surgery. Additionally, the pedicle screws 2 may have a tendency to be skewed from parallel due to a patient's natural curvature of the spine (e.g., lordosis). Thus, due to the non-parallel nature of how the pedicle screws 2 are ultimately fixed to the spinal pedicle, it is desirable to offset this skew when attaching a rod or plate connection unit to each of the pedicle screws 2.
  • [0108]
    FIG. 23B illustrates a side view of the head of the pedicle screw in accordance with one embodiment of the invention. The screw 2 includes a cylindrical head 84 which is similar to the cylindrical head 16 described above with respect to FIG. 3 except that the cylindrical head 84 includes a slanted seat 86 configured to receive and hold a flexible rod 4 in a slanted orientation that offsets the slant or skew θ of the pedicle screw 2 as described above. The improved pedicle screw 2 further includes a slanted stabilizing spacer 88 which is configured to securely fit inside the cavity of the cylindrical head 84 and hold down the rod 4 at the same slant as the slanted seat 86. The pedicle screw 2 further includes an outside threaded nut 22 configured to mate with spiral threads along the interior surface (not shown) of the cylindrical head 84 for clamping down and securing the slanted spacer 88 and the rod 4 to the slanted seat 86 and, hence, to the cylindrical head 84 of the pedicle screw 2.
  • [0109]
    FIG. 23C shows a perspective view of the slanted spacer 88, in accordance with embodiment of the invention. The spacer 88 includes a circular middle portion 90 and two rectangular-shaped end portions 92 extending outwardly from opposite sides of the circular middle portion 90. FIG. 23D shows a side view of the spacer 88 that further illustrates the slant from one end to another to compensate or offset the skew angle θ of the pedicle screw 2. FIG. 23E illustrates a top view of the cylindrical head 84 configured to receive a rod 4 and slanted spacer 88 therein. The rod 4 is received through two openings or slots 94 in the cylindrical walls of the cylindrical head 84, which allow the rod 4 to enter the circular or cylindrical cavity 96 of the cylindrical head 84 and rest on top of the slanted seat 86 formed within the circular or cylindrical cavity 94.
  • [0110]
    After the rod 4 is positioned on the slanted seat 86, the slanted stabilizing spacer 88 is received in the cavity 96 such that the two rectangular-shaped end portions 92 are received within the two slots 94, thereby preventing lateral rotation of the spacer 88 within the cylindrical cavity 96. Finally, the outside threaded nut 22 and fixing cap 26 are inserted on top of the slanted spacer 88 to securely hold the spacer 88 and rod 4 within the cylindrical head 84.
  • [0111]
    FIG. 24 illustrates a perspective view of a marking and guidance device 100 for marking a desired location on the spinal pedicle where a pedicle screw 2 will be inserted and guiding the pedicle screw 2 to the marked location using a minimally invasive surgical technique. As shown in FIG. 24, the marking device 100 includes a tubular hollow guider 52 which receives within its hollow an inner trocar 104 having a sharp tip 105 at one end that penetrates a patient's muscle and tissue to reach the spinal pedicle. the inner trocar 104 further includes a trocar grip 106 at the other end for easy insertion and removal of the trocar 104. In one embodiment, the marking and guidance device 100 includes a guider handle 108 to allow for easier handling of the device 100.
  • [0112]
    As shown in FIG. 25, the trocar 104 is in the form of a long tube or cylinder having a diameter smaller than the inner diameter of the hollow of the guider 102 so as to be inserted into the hollow of the tubular guider 102. The trocar 104 further includes a sharp or pointed tip 105 for penetrating the vertebral body through the pedicle. The trocar 104 further includes a trocar grip 106 having a diameter larger than the diameter of the hollow of the guider tube 102 in order to stop the trocar 104 from sliding completely through the hollow. The trocar grip 106 also allows for easier handling of the trocar 104.
  • [0113]
    FIGS. 26A and 26B provide perspective views of the marking and guidance device 100 after it has been inserted into a patient's back and pushed through the muscle and soft tissue to reach a desired location on the spinal pedicle. The desired location is determined using known techniques such as x-ray or radiographic imaging for a relatively short duration of time. After the marking and guidance device 100 has been inserted, prolonged exposure of the patient to x-ray radiation is unnecessary. As shown in FIG. 26B, after the guidance tube 102 is positioned over the desired location on the pedicle, the inner trocar 104 is removed to allow fiducial pins (not shown) to be inserted into the hollow of the guidance tube 102 and thereafter be fixed into the pedicle.
  • [0114]
    FIGS. 27A and 27B illustrate perspective views of two embodiments of the fiducial pins 110 and 112, respectively. As mentioned above, the fiducial pins 110 and 112 according to the present invention are inserted and fixed into the spinal pedicle after passing through the hollow guider 102. The pins 110 and 112 have a cylindrical shape with a diameter smaller than the inner diameter of the hollow of the guider tube 102 in order to pass through the hollow of the guider 102. An end of each fiducial pin is a sharp point 111 configured to be easily inserted and fixed into the spinal pedicle of the spinal column. In one embodiment, as shown in FIG. 27B, the other end of the fiducial pin incorporates a threaded shaft 114 which is configured to mate with an internally threaded tube of a retriever (not shown) for extraction of the pin 112. This retriever is described in further detail below with respect to FIG. 32.
  • [0115]
    The fiducial pins 110, 112 are preferably made of a durable and rigid biocompatible metal (e.g., stainless steel, iron steel, titanium, titanium alloy) for easy insertion into the pedicle bone. In contrast to prior art guide wires, because of its comparatively shorter length and more rigid construction, the fiducial pins 110, 112 are easily driven into the spinal pedicle without risk of bending or structural failure. As explained above, the process of driving in prior art guidance wires was often very difficult and time-consuming. The insertion of the fiducial pins 110, 112 into the entry point on the spinal pedicle is much easier and convenient for the surgeon and, furthermore, does not hinder subsequent procedures due to a guide wire protruding out of the patient's back.
  • [0116]
    FIG. 28 shows a cylindrical pushing trocar 116 having a cylindrical head 118 of larger diameter than the body of the pushing trocar 116. The pushing trocar 116, according to the present invention, is inserted into the hollow of the guider 102 after the fiducial pin 110 or 112 has been inserted into the hollow of the guider 102 to drive and fix the fiducial pin 110 or 112 into the spinal pedicle. During this pin insertion procedure, a doctor strikes the trocar head 118 with a chisel or a hammer to drive the fiducial pin 110 and 112 into the spinal pedicle. In preferred embodiments, the pushing trocar 116 is in the form of a cylindrical tube, which has a diameter smaller than the inner diameter of the hollow of the guider tube 112. The pushing trocar 116 also includes a cylindrical head 118 having a diameter larger than the diameter of the pushing trocar 116 to allow the doctor to strike it with a chisel or hammer with greater ease. Of course, in alternative embodiments, a hammer or chisel is not necessarily required. For example, depending on the circumstances of each case, a surgeon may choose to push or tap the head 118 of the pushing trocar 116 with the palm of his or her hand or other object.
  • [0117]
    FIG. 29A illustrates how a hammer or mallet 120 and the pushing trocar 116 may be used to drive the pin 110, 112 through the hollow of the guider tube 102 and into the designated location of the spinal pedicle. FIG. 29B illustrates a perspective cross-sectional view of the spinal column after two fiducial pins 110, 112 have been driven and fixed into two adjacent vertebrae.
  • [0118]
    After the fiducial pins 110 or 112 have been inserted into the spinal pedicle as discussed above, in one embodiment, a larger hole or area centered around each pin 110, 112 is created to allow easer insertion and mounting of a pedicle screw 2 into the pedicle bone. The larger hole is created using a cannulated awl 122 as shown in FIG. 30. The cannulated awl 122 is inserted over the fiducial pin 110, 112 fixed at the desired position of the spinal pedicle. The awl 122 is in the form of a cylindrical hollow tube wherein an internal diameter of the hollow is larger than the outer diameter of the fiducial pins 110 and 112 so that the pins 110, 112 may be inserted into the hollow of the awl 122. The awl 122 further includes one or more sharp teeth 124 at a first end for cutting and grinding tissue and bone so as to create the larger entry point centered around the fiducial pin 110, 112 so that the pedicle screw 2 may be more easily implanted into the spinal pedicle. FIG. 31 illustrates a perspective cross-sectional view of a patient's spinal column when the cannulated awl 122 is inserted into a minimally invasive incision in the patient's back, over a fiducial pin 110, 112 to create a larger insertion hole for a pedicle screw 2 (not shown). As shown in FIG. 31, a retractor 130 has been inserted into the minimally invasive incision over the surgical area and a lower tubular body of the retractor 130 is expanded to outwardly push surrounding tissue away from the surgical area and provide more space and a visual field for the surgeon to operate. In order to insert the retractor 130, in one embodiment, the minimally invasive incision is made in the patient's back between and connecting the two entry points of the guide tube 102 used to insert the two fiducial pins 110, 112. Before the retractor 130 is inserted, prior expansion of the minimally invasive incision is typically required using a series of step dilators (not shown), each subsequent dilator having a larger diameter than the previous dilator. After the last step dilator is in place, the retractor 130 is inserted with its lower tubular body in a retracted, non-expanded state. After the retractor 130 is pushed toward the spinal pedicle to a desired depth, the lower tubular portion is then expanded as shown in FIG. 31. The use of step dilators and retractors are well known in the art.
  • [0119]
    After the cannulated awl 122 has created a larger insertion hole for the pedicle screw 2, in one embodiment, the fiducial pin 110, 112 is removed. As discussed above, if the fiducial pin 112 has been used, a retrieving device 140 may be used to remove the fiducial pin 112 before implantation of a pedicle screw 2. As shown in FIG. 32, the retriever 140 comprises a long tubular or cylindrical portion having an internally threaded end 142 configured to mate with the externally threaded top portion 114 of the fiducial pin 112. After the retriever end 142 has been screwed onto the threaded end 114, a doctor my pull the fiducial pin 112 out of the spinal pedicle. In another embodiment, if the fiducial pin 110 without a threaded top portion has been used, appropriate tools (e.g., specially designed needle nose pliers) may be used to pull the pin 110 out.
  • [0120]
    In alternate embodiments, the fiducial pins 110, 112 are not extracted from the spinal pedicle. Instead, a specially designed pedicle screw 144 may be inserted into the spinal pedicle over the pin 110, 112 without prior removal of the pin 110, 112. As shown in FIG. 33, the specially designed pedicle screw 144 includes an externally threaded shaft 10 and a coupling assembly 14 (FIG. 3) that includes a cylindrical head 16 (FIG. 3) for receiving a flexible rod-shaped connection unit 4 (FIGS. 4-13). Alternatively, the coupling assembly 14 may be configured to receive a plate-like connection unit as shown in FIGS. 14-20. The pedicle screw 144 further includes a longitudinal axial channel (not shown) inside the threaded shaft 10 having an opening 146 at the tip of the shaft 10 and configured to receive the fiducial pin 110, 112 therein.
  • [0121]
    FIG. 34 illustrates a perspective cross-sectional view of the patient's spinal column after a pedicle screw 2 has been inserted into a first pedicle of the spine using an insertion device 150. Various types of insertion devices 150 known in the art may be used to insert the pedicle screw 2. As shown in FIG. 34, after a first pedicle screw 2 has been implanted, the retractor 130 is adjusted and moved slightly to provide space and a visual field for insertion of a second pedicle screw at the location of the second fiducial pin 110, 112.
  • [0122]
    FIG. 35 provides a perspective, cross sectional view of the patient's spinal column after two pedicle screws 2 have been implanted in two respective adjacent pedicles of the spine, in accordance with the present invention. After the pedicle screws 2 are in place, a flexible rod, plate or hybrid connection unit as described above with respect to FIGS. 4-20 may be connected to the pedicle screws to provide flexible stabilization of the spine. Thereafter, the retractor 130 is removed and the minimally invasive incision is closed and/or stitched.
  • [0123]
    FIG. 36A illustrates a perspective view of a flexible rod 200 for spinal fixation, in accordance with a further embodiment of the invention. The rod 200 is configured to be secured by securing members 2 as described above with reference to FIGS. 1-3. In preferred embodiments, the rod 200, and rods 210, 220, 230 and 240 described below, are comprised of a solid cylindrically-shaped rod made of known bio-compatible materials such as: stainless steel, iron steel, titanium, titanium alloy, NITINOL, and other suitable materials or compositions. As shown in FIG. 36A, spiral grooves 202 are cut or formed along at least a portion of the length of the cylindrical body of the rod 200. In an exemplary embodiment, the length of the rod “l” may be between 4 and 8 centimeters (cm), and its cylindrical diameter “D” is between 4-8 millimeters (mm). The spiral grooves 202 have a width “w” between 0.1 and 0.5 mm and a spiral angle θ between 50 and 85 degrees from horizontal. The distance between spiral grooves 202 can be between 3 and 6 mm. However, as understood by those skilled in the art, the above dimensions are exemplary only and may be varied to achieve desired flexibility, torsion and strength characteristics that are suitable for a particular patient or application.
  • [0124]
    FIG. 36B illustrates a cross-sectional view of the flexible rod 200, taken along lines B-B of FIG. 36A. As shown, spiral groove 202 is cut toward the center longitudinal axis of the cylindrical rod 200. In one embodiment, the depth of the groove 202 is approximately equal to the cylindrical radius of the rod 200, as shown in FIG. 36B, and penetrates as deep as the center longitudinal axis of the cylindrical rod 200. However, the depth and width of the groove 202 can be varied to adjust the mechanical and structural characteristics of the rod 200 as desired.
  • [0125]
    FIG. 37A illustrates a flexible rod 210 for spinal fixation in accordance with another embodiment of the invention. The rod 210 includes a plurality of transverse holes or tunnels 212 drilled or formed within the body of the rod 210. In one embodiment, the tunnels 212 pass through a center longitudinal axis of the cylindrical rod 210 at an angle Φ from horizontal. The openings for each respective tunnel 212 are located on opposite sides of the cylindrical wall of the rod 210 and adjacent tunnels 212 share a common opening on one side of the cylindrical wall, forming a zigzag pattern of interior tunnels 212 passing transversely through the central longitudinal axis of the rod 210, as shown in FIG. 37A. In one embodiment, the diameter D of each tunnel 212 may be varied between 0.2 to 3 mm, depending the desired mechanical and structural characteristics (e.g., flexibility, torsion and strength) of the rod 210. However, it is understood that these dimensions are exemplary and other diameters D may be desired depending on the materials used and the desired structural and mechanical characteristics. Similarly, the angle from horizontal Φ may be varied to change the number of tunnels 212 or the distance between adjacent tunnels 212.
  • [0126]
    FIG. 37B illustrates a cross-sectional view of the flexible rod 210 taken along lines B-B of FIG. 37A. The tunnel 212 cuts through the center cylindrical axis of the rod 210 such that openings of the tunnel 212 are formed at opposite sides of the cylindrical wall of the rod 210.
  • [0127]
    FIG. 38A illustrates a perspective view of a flexible rod 220 for spinal fixation, in accordance with a further embodiment of the invention. Rod 220 incorporates the spiral grooves 202 described above with reference to FIGS. 36A and 36B as well as the transverse tunnels 212 described above with respect to FIGS. 37A and 37B. The spiral grooves 202 are cut into the surface of the cylindrical wall of the rod 220 toward a center longitudinal axis of the rod 220. As discussed above, the dimensions of the spiral grooves 202 and their angle from horizontal θ (FIG. 36A) may be varied in accordance with desired mechanical and structural characteristics. Similarly, the dimensions of the transverse tunnels 212 and their angle from horizontal Φ (FIG. 37A) may be varied in accordance with desired mechanical and structural characteristics. In one embodiment, the angles θ and Φ are substantially similar such that the openings of the tunnels 212 substantially coincide with the spiral grooves 202 on opposite sides of the cylindrical wall of the rod 220.
  • [0128]
    FIG. 38B shows a top view of the flexible rod 220 taken along the perspective indicated by lines B-B of FIG. 38A. As shown in FIG. 38B, the openings of the tunnels 212 coincide with the spiral grooves 202. By providing both spiral grooves 202 and transverse tunnels 212 within a solid rod 220, many desired mechanical and structural characteristics that are suitable for different patients, applications and levels of spinal fixation may be achieved.
  • [0129]
    FIG. 39A illustrates a flexible rod 230 for spinal fixation, in accordance with another embodiment of the invention. The rod 230 includes a plurality of transverse tunnels 232 formed in the body of the rod 230. The tunnels 232 are substantially similar to the tunnels 212 described above with respect to FIGS. 37A and 37B, however, the tunnels 232 are not linked together in a zigzag pattern. Rather, each tunnel 232 is substantially parallel to its immediate adjacent tunnels 232 and the openings of one tunnel 232 do not coincide with the openings of adjacent tunnels 232. As shown in FIG. 39A, the angle from horizontal Φ in this embodiment is approximately 90 degrees. However, it is understood that other angles Φ may be incorporated in accordance with the present invention. It is further understood that the dimensions, size and shape of the tunnels 232 (as well as tunnels 212) may be varied to achieve desired mechanical and structural characteristics. For example, the cross-sectional shape of the tunnels 212 and 232 need not be circular. Instead, for example, they may be an oval or diamond shape, or other desired shape.
  • [0130]
    FIG. 39B illustrates a cross-sectional view of the rod 230 taken along lines B-B of FIG. 39A. As shown in FIG. 39B, the transverse tunnel 232 travels vertically and transversely through the center longitudinal axis of the rod 230. FIG. 39C illustrates a cross-sectional view of a further embodiment of the rod 230, wherein an additional transverse tunnel 232′ is formed substantially orthogonal to the first transverse tunnel 232 and intersects the first transverse tunnel 232 at the center, cylindrical axis point. In this way, further flexibility of the rod 230 may be provided as desired.
  • [0131]
    FIG. 40A illustrates a perspective view of a flexible rod 240, in accordance with a further embodiment of the invention. The rod 240 includes a plurality of interleaved transverse tunnels 232 and 242 which are substantially orthogonal to each other and which do not intersect, as shown in FIG. 40A. In another embodiment, a cross-sectional view of which is shown in FIG. 40B, adjacent tunnels 232 and 242 need not be orthogonal to one another. Each tunnel 232, 242 can be offset at a desired angle co from its immediately preceding adjacent tunnel 232, 242. As can be verified by those of skill in the art, without undue experimentation, by varying the dimensions of the tunnels, their numbers, and their angular directions with respect to one another, various desired mechanical and structural characteristics for flexible rods used in spinal fixation devices may be achieved.
  • [0132]
    Various embodiments of the invention have been described above. However, those of ordinary skill in the art will appreciate that the above descriptions of the preferred embodiments are exemplary only and that the invention may be practiced with modifications or variations of the devices and techniques disclosed above. Those of ordinary skill in the art will know, or be able to ascertain using no more than routine experimentation, many equivalents to the specific embodiments of the invention described herein. Such modifications, variations and equivalents are contemplated to be within the spirit and scope of the present invention as set forth in the claims below.
Patent Citations
Cited PatentFiling datePublication dateApplicantTitle
US2379577 *Jan 25, 1943Jul 3, 1945Harsted Harry HFoldable antenna
US3635233 *Mar 19, 1970Jan 18, 1972Robertson Charles HCollapsible cane and crutch construction
US3669133 *Jun 8, 1971Jun 13, 1972Hycor IncCollapsible rod
US4041939 *Apr 26, 1976Aug 16, 1977Downs Surgical LimitedSurgical implant spinal screw
US4378712 *Aug 10, 1981Apr 5, 1983Nippon Cable System, Inc.Control cable
US4483562 *Oct 16, 1981Nov 20, 1984Arnold SchoolmanLocking flexible shaft device with live distal end attachment
US4743260 *Jun 10, 1985May 10, 1988Burton Charles VMethod for a flexible stabilization system for a vertebral column
US4932975 *Oct 16, 1989Jun 12, 1990Vanderbilt UniversityVertebral prosthesis
US4979531 *Dec 15, 1988Dec 25, 1990Toor John WTent pole and method of manufacture therefor
US5029847 *Aug 7, 1989Jul 9, 1991Helen RossFoldable exercise stick
US5030220 *Mar 29, 1990Jul 9, 1991Advanced Spine Fixation Systems IncorporatedSpine fixation system
US5055104 *Nov 6, 1989Oct 8, 1991Surgical Dynamics, Inc.Surgically implanting threaded fusion cages between adjacent low-back vertebrae by an anterior approach
US5092867 *Jul 11, 1989Mar 3, 1992Harms JuergenCorrection and supporting apparatus, in particular for the spinal column
US5133716 *Nov 7, 1990Jul 28, 1992Codespi CorporationDevice for correction of spinal deformities
US5180393 *Mar 17, 1992Jan 19, 1993Polyclinique De Bourgogne & Les HortensiadArtificial ligament for the spine
US5246442 *Dec 31, 1991Sep 21, 1993Danek Medical, Inc.Spinal hook
US5251611 *May 7, 1991Oct 12, 1993Zehel Wendell EMethod and apparatus for conducting exploratory procedures
US5282863 *Jul 24, 1992Feb 1, 1994Charles V. BurtonFlexible stabilization system for a vertebral column
US5387213 *Aug 20, 1993Feb 7, 1995Safir S.A.R.L.Osseous surgical implant particularly for an intervertebral stabilizer
US5423816 *Jul 29, 1993Jun 13, 1995Lin; Chih I.Intervertebral locking device
US5540688 *Mar 8, 1994Jul 30, 1996Societe "Psi"Intervertebral stabilization device incorporating dampers
US5562660 *Feb 2, 1994Oct 8, 1996Plus Endoprothetik AgApparatus for stiffening and/or correcting the vertebral column
US5672175 *Feb 5, 1996Sep 30, 1997Martin; Jean RaymondDynamic implanted spinal orthosis and operative procedure for fitting
US5688275 *Feb 9, 1996Nov 18, 1997Koros; TiborSpinal column rod fixation system
US5964767 *Sep 12, 1997Oct 12, 1999Tapia; Eduardo ArmandoHollow sealable device for temporary or permanent surgical placement through a bone to provide a passageway into a cavity or internal anatomic site in a mammal
US6102912 *May 28, 1998Aug 15, 2000Sofamor S.N.C.Vertebral rod of constant section for spinal osteosynthesis instrumentations
US6187000 *Aug 20, 1998Feb 13, 2001Endius IncorporatedCannula for receiving surgical instruments
US6193720 *Nov 24, 1999Feb 27, 2001Depuy Orthopaedics, Inc.Cervical spine stabilization method and system
US6241730 *Nov 27, 1998Jun 5, 2001Scient'x (Societe A Responsabilite Limitee)Intervertebral link device capable of axial and angular displacement
US6290700 *Jul 31, 1998Sep 18, 2001Plus Endoprothetik AgDevice for stiffening and/or correcting a vertebral column or such like
US6296644 *Feb 25, 2000Oct 2, 2001Jean SauratSpinal instrumentation system with articulated modules
US6447546 *Aug 11, 2000Sep 10, 2002Dale G. BramletApparatus and method for fusing opposing spinal vertebrae
US6475220 *May 11, 2000Nov 5, 2002Whiteside Biomechanics, Inc.Spinal cable system
US6475242 *Jan 26, 1999Nov 5, 2002Dale G. BramletArthroplasty joint assembly
US6530934 *Jun 6, 2000Mar 11, 2003Sarcos LcEmbolic device composed of a linear sequence of miniature beads
US6576018 *Jun 23, 2000Jun 10, 2003Edward S. HoltApparatus configuration and method for treating flatfoot
US6589246 *Apr 26, 2001Jul 8, 2003Poly-4 Medical, Inc.Method of applying an active compressive force continuously across a fracture
US6986771 *May 23, 2003Jan 17, 2006Globus Medical, Inc.Spine stabilization system
US7083621 *Aug 15, 2003Aug 1, 2006Sdgi Holdings, Inc.Articulating spinal fixation rod and system
US20010020169 *May 1, 2001Sep 6, 2001Peter Metz-StavenhagenApparatus for bracing vertebrae
US20010037111 *May 1, 2001Nov 1, 2001Dixon Robert A.Method and apparatus for dynamized spinal stabilization
US20010049559 *Jan 5, 2001Dec 6, 2001Ja Kyo KooProsthetic cage for spine
US20020010467 *Jun 29, 2001Jan 24, 2002Corin Spinal Systems LimitedPedicle attachment assembly
US20020035366 *Sep 18, 2001Mar 21, 2002Reto WalderPedicle screw for intervertebral support elements
US20020049394 *Aug 24, 2001Apr 25, 2002The Cleveland Clinic FoundationApparatus and method for assessing loads on adjacent bones
US20020055740 *Jul 5, 2001May 9, 2002The Cleveland Clinic FoundationMethod and apparatus for correcting spinal deformity
US20020065557 *Nov 29, 2000May 30, 2002Goble E. MarloweFacet joint replacement
US20020082600 *Aug 29, 2001Jun 27, 2002Shaolian Samuel M.Formable orthopedic fixation system
US20020087159 *Dec 27, 2001Jul 4, 2002James ThomasVertebral alignment system
US20020095154 *Mar 7, 2002Jul 18, 2002Atkinson Robert E.Devices and methods for the treatment of spinal disorders
US20020099378 *Mar 25, 2002Jul 25, 2002Michelson Gary KarlinApparatus, instrumentation and method for spinal fixation
US20020107570 *Dec 8, 2000Aug 8, 2002Sybert Daryl R.Biocompatible osteogenic band for repair of spinal disorders
US20020111628 *Apr 3, 2002Aug 15, 2002Ralph James D.Polyaxial pedicle screw having a rotating locking element
US20020111630 *Feb 13, 2002Aug 15, 2002Ralph James D.Longitudinal plate assembly having an adjustable length
US20020120270 *Feb 26, 2002Aug 29, 2002Hai TrieuFlexible systems for spinal stabilization and fixation
US20020123668 *Jan 29, 2002Sep 5, 2002Stephen RitlandRetractor and method for spinal pedicle screw placement
US20020123750 *Feb 25, 2002Sep 5, 2002Lukas EisermannWoven orthopedic implants
US20020123806 *Feb 4, 2002Sep 5, 2002Total Facet Technologies, Inc.Facet arthroplasty devices and methods
US20020138077 *Mar 25, 2002Sep 26, 2002Ferree Bret A.Spinal alignment apparatus and methods
US20020143329 *Mar 30, 2001Oct 3, 2002Serhan Hassan A.Intervertebral connection system
US20020143401 *Mar 25, 2002Oct 3, 2002Michelson Gary K.Radially expanding interbody spinal fusion implants, instrumentation, and methods of insertion
US20020169450 *Apr 23, 2002Nov 14, 2002Co-Ligne AgInstrumentation for stabilizing certain vertebrae of the spine
US20020183748 *Jul 17, 2002Dec 5, 2002Stryker SpinePedicle screw assembly and methods therefor
US20030040746 *Jul 19, 2002Feb 27, 2003Mitchell Margaret E.Spinal stabilization system and method
US20030040797 *Jul 16, 2002Feb 27, 2003Fallin T. WadeProsthesis for the replacement of a posterior element of a vertebra
US20030045875 *Sep 4, 2001Mar 6, 2003Bertranou Patrick P.Spinal assembly plate
US20030055426 *Mar 5, 2002Mar 20, 2003John CarboneBiased angulation bone fixation assembly
US20030060823 *Feb 13, 2002Mar 27, 2003Bryan Donald W.Pedicle screw spinal fixation device
US20030073998 *Oct 25, 2002Apr 17, 2003Endius IncorporatedMethod of securing vertebrae
US20030083657 *Oct 30, 2001May 1, 2003Drewry Troy D.Flexible spinal stabilization system and method
US20030083688 *Oct 30, 2001May 1, 2003Simonson Robert E.Configured and sized cannula
US20030088251 *May 2, 2002May 8, 2003Braun John TDevices and methods for the correction and treatment of spinal deformities
US20030093078 *Sep 30, 2002May 15, 2003Stephen RitlandConnection rod for screw or hook polyaxial system and method of use
US20030109880 *Jul 29, 2002Jun 12, 2003Showa Ika Kohgyo Co., Ltd.Bone connector
US20030171749 *Jul 25, 2001Sep 11, 2003Regis Le CouedicSemirigid linking piece for stabilizing the spine
US20030191371 *Apr 5, 2002Oct 9, 2003Smith Maurice M.Devices and methods for percutaneous tissue retraction and surgery
US20030191470 *Apr 4, 2003Oct 9, 2003Stephen RitlandDynamic fixation device and method of use
US20030195551 *May 16, 2003Oct 16, 2003Davison Thomas W.Cannula for receiving surgical instruments
US20030220643 *May 23, 2003Nov 27, 2003Ferree Bret A.Devices to prevent spinal extension
US20040002708 *May 8, 2003Jan 1, 2004Stephen RitlandDynamic fixation device and method of use
US20040049190 *Aug 7, 2003Mar 11, 2004Biedermann Motech GmbhDynamic stabilization device for bones, in particular for vertebrae
US20040049819 *Sep 10, 2002Mar 11, 2004First Line Seeds, Ltd.Soybean cultivar SN83544
US20040138661 *Jan 14, 2003Jul 15, 2004Bailey Kirk J.Spinal fixation system
US20040143264 *Aug 21, 2003Jul 22, 2004Mcafee Paul C.Metal-backed UHMWPE rod sleeve system preserving spinal motion
US20040147928 *Oct 30, 2003Jul 29, 2004Landry Michael E.Spinal stabilization system using flexible members
US20040172025 *Mar 4, 2004Sep 2, 2004Drewry Troy D.Flexible spinal stabilization system and method
US20040215191 *Apr 22, 2004Oct 28, 2004Kitchen Michael S.Spinal curvature correction device
US20040236327 *May 23, 2003Nov 25, 2004Paul David C.Spine stabilization system
US20040236328 *Jan 23, 2004Nov 25, 2004Paul David C.Spine stabilization system
US20040236329 *Apr 30, 2004Nov 25, 2004Panjabi Manohar M.Dynamic spine stabilizer
US20050033295 *Aug 8, 2003Feb 10, 2005Paul WisnewskiImplants formed of shape memory polymeric material for spinal fixation
US20050033299 *Sep 13, 2004Feb 10, 2005Shluzas Alan E.Surgical instrument for moving a vertebra
US20050038432 *Aug 15, 2003Feb 17, 2005Shaolian Samuel M.Articulating spinal fixation rod and system
US20050085815 *Oct 15, 2004Apr 21, 2005Biedermann Motech GmbhRod-shaped implant element for application in spine surgery or trauma surgery, stabilization apparatus comprising said rod-shaped implant element, and production method for the rod-shaped implant element
US20050154390 *Nov 5, 2004Jul 14, 2005Lutz BiedermannStabilization device for bones comprising a spring element and manufacturing method for said spring element
US20050171540 *Jan 30, 2004Aug 4, 2005Roy LimInstruments and methods for minimally invasive spinal stabilization
US20050203519 *Mar 8, 2005Sep 15, 2005Jurgen HarmsRod-like element for application in spinal or trauma surgery, and stabilization device with such a rod-like element
US20060149238 *Jan 4, 2005Jul 6, 2006Sherman Michael CSystems and methods for spinal stabilization with flexible elements
USRE36221 *May 15, 1996Jun 1, 1999Breard; Francis HenriFlexible inter-vertebral stabilizer as well as process and apparatus for determining or verifying its tension before installation on the spinal column
Referenced by
Citing PatentFiling datePublication dateApplicantTitle
US7556639Jan 4, 2006Jul 7, 2009Accelerated Innovation, LlcMethods and apparatus for vertebral stabilization using sleeved springs
US7578849Jan 27, 2006Aug 25, 2009Warsaw Orthopedic, Inc.Intervertebral implants and methods of use
US7682376Jan 27, 2006Mar 23, 2010Warsaw Orthopedic, Inc.Interspinous devices and methods of use
US7708778May 20, 2005May 4, 2010Flexuspine, Inc.Expandable articulating intervertebral implant with cam
US7753958Jul 13, 2010Gordon Charles RExpandable intervertebral implant
US7766915Aug 3, 2010Jackson Roger PDynamic fixation assemblies with inner core and outer coil-like member
US7766941May 14, 2004Aug 3, 2010Paul Kamaljit SSpinal support, stabilization
US7766942Aug 3, 2010Warsaw Orthopedic, Inc.Polymer rods for spinal applications
US7785351Mar 8, 2006Aug 31, 2010Flexuspine, Inc.Artificial functional spinal implant unit system and method for use
US7794480Sep 14, 2010Flexuspine, Inc.Artificial functional spinal unit system and method for use
US7799082Sep 21, 2010Flexuspine, Inc.Artificial functional spinal unit system and method for use
US7815663Jan 27, 2006Oct 19, 2010Warsaw Orthopedic, Inc.Vertebral rods and methods of use
US7862587Jan 9, 2006Jan 4, 2011Jackson Roger PDynamic stabilization assemblies, tool set and method
US7875059Jan 25, 2011Warsaw Orthopedic, Inc.Variable stiffness support members
US7901437Mar 8, 2011Jackson Roger PDynamic stabilization member with molded connection
US7909869Feb 12, 2004Mar 22, 2011Flexuspine, Inc.Artificial spinal unit assemblies
US7931676Jan 18, 2007Apr 26, 2011Warsaw Orthopedic, Inc.Vertebral stabilizer
US7935134Jun 29, 2006May 3, 2011Exactech, Inc.Systems and methods for stabilization of bone structures
US7951170May 30, 2008May 31, 2011Jackson Roger PDynamic stabilization connecting member with pre-tensioned solid core
US7959677Jun 14, 2011Flexuspine, Inc.Artificial functional spinal unit system and method for use
US7968037Jun 28, 2011Warsaw Orthopedic, Inc.Polymer rods for spinal applications
US7998175Aug 16, 2011The Board Of Trustees Of The Leland Stanford Junior UniversitySystems and methods for posterior dynamic stabilization of the spine
US8012177Jun 19, 2009Sep 6, 2011Jackson Roger PDynamic stabilization assembly with frusto-conical connection
US8012182Sep 6, 2011Zimmer Spine S.A.S.Semi-rigid linking piece for stabilizing the spine
US8025680Sep 27, 2011Exactech, Inc.Systems and methods for posterior dynamic stabilization of the spine
US8029548Oct 4, 2011Warsaw Orthopedic, Inc.Flexible spinal stabilization element and system
US8052723Nov 8, 2011Flexuspine Inc.Dynamic posterior stabilization systems and methods of use
US8066739Nov 29, 2011Jackson Roger PTool system for dynamic spinal implants
US8075595Dec 13, 2011The Board Of Trustees Of The Leland Stanford Junior UniversitySystems and methods for posterior dynamic stabilization of the spine
US8092500Jan 10, 2012Jackson Roger PDynamic stabilization connecting member with floating core, compression spacer and over-mold
US8092502Oct 5, 2007Jan 10, 2012Jackson Roger PPolyaxial bone screw with uploaded threaded shank and method of assembly and use
US8096996Jan 17, 2012Exactech, Inc.Rod reducer
US8100915Jan 24, 2012Jackson Roger POrthopedic implant rod reduction tool set and method
US8105360Jul 16, 2009Jan 31, 2012Orthonex LLCDevice for dynamic stabilization of the spine
US8105368Aug 1, 2007Jan 31, 2012Jackson Roger PDynamic stabilization connecting member with slitted core and outer sleeve
US8114133 *Apr 18, 2007Feb 14, 2012Joseph Nicholas LoganSpinal rod system
US8118840Feb 27, 2009Feb 21, 2012Warsaw Orthopedic, Inc.Vertebral rod and related method of manufacture
US8118869Mar 8, 2006Feb 21, 2012Flexuspine, Inc.Dynamic interbody device
US8118870May 20, 2005Feb 21, 2012Flexuspine, Inc.Expandable articulating intervertebral implant with spacer
US8118871May 20, 2005Feb 21, 2012Flexuspine, Inc.Expandable articulating intervertebral implant
US8123810May 20, 2005Feb 28, 2012Gordon Charles RExpandable intervertebral implant with wedged expansion member
US8147550May 20, 2005Apr 3, 2012Flexuspine, Inc.Expandable articulating intervertebral implant with limited articulation
US8152810Nov 23, 2004Apr 10, 2012Jackson Roger PSpinal fixation tool set and method
US8157844Apr 17, 2012Flexuspine, Inc.Dampener system for a posterior stabilization system with a variable length elongated member
US8162948Apr 24, 2012Jackson Roger POrthopedic implant rod reduction tool set and method
US8162985Oct 20, 2004Apr 24, 2012The Board Of Trustees Of The Leland Stanford Junior UniversitySystems and methods for posterior dynamic stabilization of the spine
US8162994Apr 24, 2012Flexuspine, Inc.Posterior stabilization system with isolated, dual dampener systems
US8172903May 20, 2005May 8, 2012Gordon Charles RExpandable intervertebral implant with spacer
US8182514May 22, 2012Flexuspine, Inc.Dampener system for a posterior stabilization system with a fixed length elongated member
US8187330May 29, 2012Flexuspine, Inc.Dampener system for a posterior stabilization system with a variable length elongated member
US8226690Feb 23, 2006Jul 24, 2012The Board Of Trustees Of The Leland Stanford Junior UniversitySystems and methods for stabilization of bone structures
US8252028Dec 19, 2007Aug 28, 2012Depuy Spine, Inc.Posterior dynamic stabilization device
US8257440Sep 4, 2012Gordon Charles RMethod of insertion of an expandable intervertebral implant
US8267965Sep 18, 2012Flexuspine, Inc.Spinal stabilization systems with dynamic interbody devices
US8267969Sep 18, 2012Exactech, Inc.Screw systems and methods for use in stabilization of bone structures
US8273089Sep 25, 2012Jackson Roger PSpinal fixation tool set and method
US8292892May 13, 2009Oct 23, 2012Jackson Roger POrthopedic implant rod reduction tool set and method
US8292926Aug 17, 2007Oct 23, 2012Jackson Roger PDynamic stabilization connecting member with elastic core and outer sleeve
US8317841 *Nov 27, 2012Bray Jr Robert SCervical dynamic stabilization system
US8348952Jan 8, 2013Depuy International Ltd.System and method for cooling a spinal correction device comprising a shape memory material for corrective spinal surgery
US8353932Jan 15, 2013Jackson Roger PPolyaxial bone anchor assembly with one-piece closure, pressure insert and plastic elongate member
US8357181Jan 22, 2013Warsaw Orthopedic, Inc.Intervertebral prosthetic device for spinal stabilization and method of implanting same
US8366745Jul 1, 2009Feb 5, 2013Jackson Roger PDynamic stabilization assembly having pre-compressed spacers with differential displacements
US8377067Feb 19, 2013Roger P. JacksonOrthopedic implant rod reduction tool set and method
US8377098Jan 19, 2007Feb 19, 2013Flexuspine, Inc.Artificial functional spinal unit system and method for use
US8394133Jul 23, 2010Mar 12, 2013Roger P. JacksonDynamic fixation assemblies with inner core and outer coil-like member
US8414614Oct 20, 2006Apr 9, 2013Depuy International LtdImplant kit for supporting a spinal column
US8414619Apr 9, 2013Warsaw Orthopedic, Inc.Vertebral rods and methods of use
US8425563Jan 11, 2007Apr 23, 2013Depuy International Ltd.Spinal rod support kit
US8425601Sep 11, 2006Apr 23, 2013Warsaw Orthopedic, Inc.Spinal stabilization devices and methods of use
US8430914Oct 24, 2008Apr 30, 2013Depuy Spine, Inc.Assembly for orthopaedic surgery
US8444681May 21, 2013Roger P. JacksonPolyaxial bone anchor with pop-on shank, friction fit retainer and winged insert
US8475498 *Jan 3, 2008Jul 2, 2013Roger P. JacksonDynamic stabilization connecting member with cord connection
US8506599Aug 5, 2011Aug 13, 2013Roger P. JacksonDynamic stabilization assembly with frusto-conical connection
US8523865Jan 16, 2009Sep 3, 2013Exactech, Inc.Tissue splitter
US8523912Oct 22, 2007Sep 3, 2013Flexuspine, Inc.Posterior stabilization systems with shared, dual dampener systems
US8540753Oct 5, 2004Sep 24, 2013Roger P. JacksonPolyaxial bone screw with uploaded threaded shank and method of assembly and use
US8545538Apr 26, 2010Oct 1, 2013M. Samy AbdouDevices and methods for inter-vertebral orthopedic device placement
US8551142Dec 13, 2010Oct 8, 2013Exactech, Inc.Methods for stabilization of bone structures
US8556938Oct 5, 2010Oct 15, 2013Roger P. JacksonPolyaxial bone anchor with non-pivotable retainer and pop-on shank, some with friction fit
US8585692Apr 11, 2013Nov 19, 2013Nxthera, Inc.Systems and methods for treatment of prostatic tissue
US8591515Aug 26, 2009Nov 26, 2013Roger P. JacksonSpinal fixation tool set and method
US8591560Aug 2, 2012Nov 26, 2013Roger P. JacksonDynamic stabilization connecting member with elastic core and outer sleeve
US8597358Jan 19, 2007Dec 3, 2013Flexuspine, Inc.Dynamic interbody devices
US8603168Mar 8, 2006Dec 10, 2013Flexuspine, Inc.Artificial functional spinal unit system and method for use
US8613760Dec 14, 2011Dec 24, 2013Roger P. JacksonDynamic stabilization connecting member with slitted core and outer sleeve
US8632530Mar 25, 2011Jan 21, 2014Nxthera, Inc.Systems and methods for prostate treatment
US8641734Apr 29, 2009Feb 4, 2014DePuy Synthes Products, LLCDual spring posterior dynamic stabilization device with elongation limiting elastomers
US8647386Jul 22, 2010Feb 11, 2014Charles R. GordonExpandable intervertebral implant system and method
US8657856Aug 30, 2010Feb 25, 2014Pioneer Surgical Technology, Inc.Size transition spinal rod
US8696711Jul 30, 2012Apr 15, 2014Roger P. JacksonPolyaxial bone anchor assembly with one-piece closure, pressure insert and plastic elongate member
US8721566Nov 12, 2010May 13, 2014Robert A. ConnorSpinal motion measurement device
US8740944Feb 28, 2007Jun 3, 2014Warsaw Orthopedic, Inc.Vertebral stabilizer
US8753398May 20, 2005Jun 17, 2014Charles R. GordonMethod of inserting an expandable intervertebral implant without overdistraction
US8801702Feb 11, 2013Aug 12, 2014Nxthera, Inc.Systems and methods for treatment of BPH
US8814913Sep 3, 2013Aug 26, 2014Roger P JacksonHelical guide and advancement flange with break-off extensions
US8845649May 13, 2009Sep 30, 2014Roger P. JacksonSpinal fixation tool set and method for rod reduction and fastener insertion
US8852239Feb 17, 2014Oct 7, 2014Roger P JacksonSagittal angle screw with integral shank and receiver
US8870928Apr 29, 2013Oct 28, 2014Roger P. JacksonHelical guide and advancement flange with radially loaded lip
US8894657Nov 28, 2011Nov 25, 2014Roger P. JacksonTool system for dynamic spinal implants
US8900272Jan 28, 2013Dec 2, 2014Roger P JacksonDynamic fixation assemblies with inner core and outer coil-like member
US8911477Oct 21, 2008Dec 16, 2014Roger P. JacksonDynamic stabilization member with end plate support and cable core extension
US8911478Nov 21, 2013Dec 16, 2014Roger P. JacksonSplay control closure for open bone anchor
US8920473Dec 7, 2007Dec 30, 2014Paradigm Spine, LlcPosterior functionally dynamic stabilization system
US8926670Mar 15, 2013Jan 6, 2015Roger P. JacksonPolyaxial bone screw assembly
US8926672Nov 21, 2013Jan 6, 2015Roger P. JacksonSplay control closure for open bone anchor
US8936623Mar 15, 2013Jan 20, 2015Roger P. JacksonPolyaxial bone screw assembly
US8940022Jan 19, 2007Jan 27, 2015Flexuspine, Inc.Artificial functional spinal unit system and method for use
US8940051Mar 4, 2013Jan 27, 2015Flexuspine, Inc.Interbody device insertion systems and methods
US8968366Jan 4, 2007Mar 3, 2015DePuy Synthes Products, LLCMethod and apparatus for flexible fixation of a spine
US8979900Feb 13, 2007Mar 17, 2015DePuy Synthes Products, LLCSpinal stabilization device
US8979904Sep 7, 2012Mar 17, 2015Roger P JacksonConnecting member with tensioned cord, low profile rigid sleeve and spacer with torsion control
US8998959Oct 19, 2011Apr 7, 2015Roger P JacksonPolyaxial bone anchors with pop-on shank, fully constrained friction fit retainer and lock and release insert
US8998960May 17, 2013Apr 7, 2015Roger P. JacksonPolyaxial bone screw with helically wound capture connection
US9011494Sep 24, 2009Apr 21, 2015Warsaw Orthopedic, Inc.Composite vertebral rod system and methods of use
US9017384May 13, 2009Apr 28, 2015Stryker SpineComposite spinal rod
US9050139Mar 15, 2013Jun 9, 2015Roger P. JacksonOrthopedic implant rod reduction tool set and method
US9050148Nov 10, 2005Jun 9, 2015Roger P. JacksonSpinal fixation tool attachment structure
US9055978Oct 2, 2012Jun 16, 2015Roger P. JacksonOrthopedic implant rod reduction tool set and method
US9066811Jan 19, 2007Jun 30, 2015Flexuspine, Inc.Artificial functional spinal unit system and method for use
US9101404Jan 26, 2011Aug 11, 2015Roger P. JacksonDynamic stabilization connecting member with molded connection
US9144439Mar 26, 2013Sep 29, 2015Warsaw Orthopedic, Inc.Vertebral rods and methods of use
US9144444May 12, 2011Sep 29, 2015Roger P JacksonPolyaxial bone anchor with helical capture connection, insert and dual locking assembly
US9179940Sep 7, 2011Nov 10, 2015Globus Medical, Inc.System and method for replacement of spinal motion segment
US9198708Dec 13, 2013Dec 1, 2015Nxthera, Inc.Systems and methods for prostate treatment
US9211142Mar 3, 2009Dec 15, 2015Globus Medical, Inc.Flexible element for spine stabilization system
US9211150Sep 23, 2010Dec 15, 2015Roger P. JacksonSpinal fixation tool set and method
US9216039Nov 19, 2010Dec 22, 2015Roger P. JacksonDynamic spinal stabilization assemblies, tool set and method
US9216041Feb 8, 2012Dec 22, 2015Roger P. JacksonSpinal connecting members with tensioned cords and rigid sleeves for engaging compression inserts
US9220538Feb 27, 2009Dec 29, 2015Globus Medical, Inc.Flexible element for spine stabilization system
US9232968Sep 19, 2008Jan 12, 2016DePuy Synthes Products, Inc.Polymeric pedicle rods and methods of manufacturing
US9308027Sep 13, 2013Apr 12, 2016Roger P JacksonPolyaxial bone screw with shank articulation pressure insert and method
US9320543Oct 27, 2009Apr 26, 2016DePuy Synthes Products, Inc.Posterior dynamic stabilization device having a mobile anchor
US9339297May 15, 2013May 17, 2016Globus Medical, Inc.Flexible spine stabilization system
US9345507Aug 6, 2014May 24, 2016Nxthera, Inc.Systems and methods for treatment of BPH
US9393047Sep 7, 2012Jul 19, 2016Roger P. JacksonPolyaxial bone anchor with pop-on shank and friction fit retainer with low profile edge lock
US9414863Jul 31, 2012Aug 16, 2016Roger P. JacksonPolyaxial bone screw with spherical capture, compression insert and alignment and retention structures
US9439683Mar 10, 2015Sep 13, 2016Roger P JacksonDynamic stabilization member with molded connection
US20040143264 *Aug 21, 2003Jul 22, 2004Mcafee Paul C.Metal-backed UHMWPE rod sleeve system preserving spinal motion
US20050261686 *May 14, 2004Nov 24, 2005Paul Kamaljit SSpinal support, stabilization
US20060111715 *Jan 9, 2006May 25, 2006Jackson Roger PDynamic stabilization assemblies, tool set and method
US20060212033 *Jul 21, 2005Sep 21, 2006Accin CorporationVertebral stabilization using flexible rods
US20060229607 *Mar 16, 2005Oct 12, 2006Sdgi Holdings, Inc.Systems, kits and methods for treatment of the spinal column using elongate support members
US20060229612 *Jan 4, 2006Oct 12, 2006Accin CorporationMethods and apparatus for vertebral stabilization using sleeved springs
US20060282080 *May 30, 2006Dec 14, 2006Accin CorporationVertebral facet stabilizer
US20070093814 *Oct 11, 2005Apr 26, 2007Callahan Ronald IiDynamic spinal stabilization systems
US20070191953 *Jan 27, 2006Aug 16, 2007Sdgi Holdings, Inc.Intervertebral implants and methods of use
US20070233064 *Feb 17, 2006Oct 4, 2007Holt Development L.L.C.Apparatus and method for flexible spinal fixation
US20070270821 *Apr 28, 2006Nov 22, 2007Sdgi Holdings, Inc.Vertebral stabilizer
US20070288011 *Apr 18, 2007Dec 13, 2007Joseph Nicholas LoganSpinal Rod System
US20080021469 *Jun 18, 2007Jan 24, 2008Richard HoltApparatus and method for flexible spinal fixation
US20080051787 *Jun 29, 2007Feb 28, 2008Neuropro Technologies, Inc.Percutaneous system for dynamic spinal stabilization
US20080065079 *Sep 11, 2006Mar 13, 2008Aurelien BruneauSpinal Stabilization Devices and Methods of Use
US20080077141 *Sep 21, 2007Mar 27, 2008Bray Robert SCervical dynamic stabilization system
US20080077143 *Sep 25, 2007Mar 27, 2008Zimmer Spine, Inc.Apparatus for connecting a longitudinal member to a bone portion
US20080086127 *Aug 31, 2006Apr 10, 2008Warsaw Orthopedic, Inc.Polymer Rods For Spinal Applications
US20080097431 *Sep 22, 2006Apr 24, 2008Paul Peter VessaFlexible spinal stabilization
US20080177318 *Jan 18, 2007Jul 24, 2008Warsaw Orthopedic, Inc.Vertebral Stabilizer
US20080177388 *Jan 18, 2007Jul 24, 2008Warsaw Orthopedic, Inc.Variable Stiffness Support Members
US20080234736 *Feb 28, 2007Sep 25, 2008Warsaw Orthopedic, Inc.Vertebral Stabilizer
US20080269804 *Apr 30, 2008Oct 30, 2008Holt Development L.L.C.Apparatus and method for flexible spinal fixation
US20090082815 *Sep 20, 2007Mar 26, 2009Zimmer GmbhSpinal stabilization system with transition member
US20090088782 *Sep 28, 2007Apr 2, 2009Missoum MoumeneFlexible Spinal Rod With Elastomeric Jacket
US20090261505 *Oct 22, 2009Warsaw Orthopedic, Inc.Polymer rods for spinal applications
US20090287251 *May 13, 2009Nov 19, 2009Stryker SpineComposite spinal rod
US20100016898 *Jan 21, 2010Zimmer Spine, Inc.Apparatus for connecting a longitudinal member to a bone portion
US20100063548 *Jul 6, 2009Mar 11, 2010Depuy International LtdSpinal Correction Method Using Shape Memory Spinal Rod
US20100087863 *Aug 31, 2009Apr 8, 2010Lutz BiedermannRod-shaped implant in particular for stabilizing the spinal column and stabilization device including such a rod-shaped implant
US20100318130 *Dec 2, 2008Dec 16, 2010Parlato Brian DFlexible rod assembly for spinal fixation
US20110238144 *Sep 29, 2011Michael HoeySystems and Methods for Prostate Treatment
US20120029564 *Jul 29, 2010Feb 2, 2012Warsaw Orthopedic, Inc.Composite Rod for Spinal Implant Systems With Higher Modulus Core and Lower Modulus Polymeric Sleeve
US20120109207 *May 3, 2012Warsaw Orthopedic, Inc.Enhanced Interfacial Conformance for a Composite Rod for Spinal Implant Systems with Higher Modulus Core and Lower Modulus Polymeric Sleeve
US20140018857 *May 17, 2013Jan 16, 2014Roger P. JacksonDynamic stabilization connecting member with cord connection
EP1970018A2 *Feb 28, 2008Sep 17, 2008Zimmer Spine, Inc.Dynamic spinal stabilization systems
EP2142121A2 *Apr 30, 2008Jan 13, 2010Globus Medical, Inc.Flexible spine stabilization system
EP2142121A4 *Apr 30, 2008Oct 24, 2012Globus Medical IncFlexible spine stabilization system
WO2008134703A2 *Apr 30, 2008Nov 6, 2008Globus Medical, Inc.Flexible spine stabilization system
WO2008134703A3 *Apr 30, 2008Jan 8, 2009Globus Medical IncFlexible spine stabilization system
WO2009039060A2 *Sep 15, 2008Mar 26, 2009Zimmer Spine, Inc.Spinal stabilization system with transition member
WO2009039060A3 *Sep 15, 2008May 7, 2009Thomas EgliSpinal stabilization system with transition member
WO2011066231A1 *Nov 22, 2010Jun 3, 2011Seaspine, Inc.Hybrid rod constructs for spinal applications
WO2013152119A1 *Apr 3, 2013Oct 10, 2013Nxthera, Inc.Induction coil vapor generator
Classifications
U.S. Classification606/254, 606/261, 606/907
International ClassificationA61B17/70, A61B17/58, A61B17/56, A61B17/17, A61B17/00, A61F2/30
Cooperative ClassificationA61B2090/3987, A61B2090/3916, A61B2090/363, A61B90/39, Y10T403/45, A61B17/7029, A61B17/3421, A61B17/701, A61B17/3472, A61B17/1757, A61B17/3439, A61B17/7007, A61B17/7002, A61B17/7032, A61B17/7004, A61B2017/00862, A61B2017/0256, A61B17/7001, A61B17/02, A61B17/3468, A61B17/7028, A61B17/7026
European ClassificationA61B17/34G4, A61B17/34J, A61B17/70B1, A61B19/54, A61B17/70B1R10, A61B17/70B1R10B, A61B17/70B1R10D, A61B17/17S4, A61B17/70B1C, A61B17/70B1C4
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