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1. (WO2011159492) SYSTÈME DE FIXATION PERCUTANÉE D'UNE TIGE INTERMÉDIAIRE SUR UNE COLONNE VERTÉBRALE
Note: Texte fondé sur des processus automatiques de reconnaissance optique de caractères. Seule la version PDF a une valeur juridique

What is claimed is:

1. A system for percutaneously fixing a connecting rod to vertebrae of a spine, comprising:

a first bone screw including a shaft having a threaded portion for engagement with a first vertebra and a yoke articulatingly attached to said shaft, said yoke having a slot defined by a pair of upstanding opposed arms for receiving a connecting rod;

a first hollow bone screw extension having a distal end and a proximal end, said first screw extension including a tubular member defined by a perimetric sidewall and a hollow interior, said first screw extension having a pair of opposing slots through said sidewall and opening at said distal end, said first screw extension having a rotationally movable screw engaging member for releasably engaging and holding said first screw extension to said first bone screw upon rotation thereof;

a second bone screw including a shaft having a threaded portion for engagement with a second vertebra and a yoke articulatingly attached to said shaft, said yoke having a slot defined by a pair of upstanding opposed arms for receiving a connecting rod;

a second hollow bone screw extension having a distal end and a proximal end, said second screw extension including a tubular member defined by a perimetric sidewall and a hollow interior, said second screw extension having a pair of opposing slots through said sidewall and opening at said distal end, said second screw extension having a rotationally movable screw engaging member for releasably engaging and holding said second screw extension to said second bone screw upon rotation thereof;

a connecting rod of length sized for receipt in the respective slots in the yokes of said first and second bone screws;

a rod introducer for inserting said connecting rod into the slots of said first and second screw extensions and into the slots of the yokes of said first and second screws;

a first locking element for passage through said first screw extension and locking said rod in the slot of said yoke of said first bone screw; and

a second locking element for passage through said second screw extension and locking said rod in the slot of said yoke of said second bone screw.

2. The system of claim 1, wherein each of said first hollow bone screw extension and said second hollow bone screw extension includes an elongate hollow outer sleeve having a distal end and a proximal end and an elongate hollow inner sleeve disposed within said outer sleeve and having a distal end and a proximal end, said outer sleeve and said inner sleeve being movable rotationally relative to each other, each said respective rotationally movable screw engaging member projecting radially from the distal end of one of said outer sleeve and said inner sleeve.

3. The system of claim 2, wherein said yoke of each of said first bone screw and said second bone screw includes an extension coupling surface respectively engaging a rotationally movable screw engaging member said upon relative rotation of said inner sleeve and said outer sleeve.

4. The system of claim 3, wherein each respective screw engaging member is disposed on said inner sleeve of each of said respective first and second screw extensions and projects radially outwardly therefrom.

5. The system of claim 4, wherein each respective screw engaging member includes a flange having a thickness.

6. The system of claim 5, wherein the thickness of said respective flange increases radially outwardly.

7. The system of claim 8, wherein each respective extension coupling surface of each said yoke is disposed on at least one of said interior surfaces of said upstanding arms.

8. The system of claim 7, wherein each respective extension coupling surface of each said yoke is defined by an undercut extending radially into said at least one interior surface of said upstanding arms, the undercut being configured to receive the flange of the screw engaging member.

9. The system of claim 1, wherein the interior surfaces of both upstanding arms of said first bone screw and said second bone screw includes internal threads, and wherein said first locking element and said second locking element each comprise external threads for respective threaded engagement with the threads on said arms.

10. The system of claim 8, wherein each said respective undercut extends into the interior surfaces of both upstanding arms.

1 1. The system of claim 10, wherein each respective outer sleeve includes a perimetric sidewall defining a bore through which each said respective inner sleeve extends and wherein a pair of opposing slots in formed through said sidewall, each opening at the distal end of each said outer sleeve and extending for a length proximally, said slots of each said outer sleeve being aligned with the slot of said yoke.

12. The system of claim 1 1, wherein each respective inner sleeve includes a perimetric sidewall defining a bore and where a pair of opposing slots is formed through said sidewall, each opening at the distal end of each said inner sleeve and extending for a length proximally.

13. The system of claim 12, wherein a pair of opposing such respective screw engaging flanges is disposed between the pair of opposing slots of each respective inner sleeve.

14. The system of claim 13, wherein each of said first and said second screw extensions is coupled to a respective yoke in an unlocked first position wherein said slots of each respective outer sleeve are aligned with said slot of said yoke and said slots of each respective inner sleeve are not aligned with and thereby close the slot of said yoke.

15. The system of claim 14, wherein each of said first and said second screw extensions is coupled to a respective yoke in a locked second position upon the rotation of each respective inner sleeve relative to said outer sleeve, wherein said respective screw engaging flanges are received in the undercuts in the interior surfaces of said upstanding arms and the slots of said inner sleeve are aligned with the slots of said outer sleeve and the slot of said yoke in a manner to receive a connection rod.

16. The system of claim 2, further comprising a securement member defined by cooperative surfaces adjacent the distal end of the inner sleeve and the outer sleeve of each of said respective first and second bone screw extensions operable upon relative rotation of each said respective inner sleeve and said outer sleeve to radially secure a respective inner sleeve and said outer sleeve together and to maintain the engagement of each said screw engaging member and each said bone screw.

17. The system of claim 16, wherein the cooperative surfaces of each respective securement member on said inner sleeve includes a flange extending radially outwardly from said inner sleeve and wherein the cooperative surfaces of each respective securement member on said outer sleeve is defined by a groove extending into an inner surface of said outer sleeve.

18. The system of claim 17, wherein each respective securement member flange includes a portion projecting toward the distal end of said inner sleeve and wherein said securement member groove opens upwardly toward the proximal end of said outer sleeve and is configured to receive said distally projecting portion of each respective securement member flange.

19. The system of claim 2, further comprising a lock to selectively prevent relative rotation between each said respective outer sleeve and said inner sleeve of said first hollow bone screw extension and said second hollow bone screw extension.

20. The system of claim 19, wherein each respective lock includes a displaceable retention ring supported between said outer sleeve and said inner sleeve and operable in a

first position to allow free rotational relative movement between each said respective outer sleeve and said inner sleeve and a second position preventing such movement.

21. The system of claim 20, wherein each respective retention ring is spring biased to a normally locked position.

22. A system for percutaneously fixing a connecting rod to vertebrae of a spine, comprising:

a first bone screw including a shaft having a threaded portion for engagement with a first vertebra and a yoke articulatingly attached to said shaft, said yoke having a slot defined by a pair of upstanding opposed arms for receiving a connecting rod;

a first hollow bone screw extension having a distal end and a proximal end, said first screw extension including a tubular member defined by a perimetric sidewall and a hollow interior, said first screw extension having a pair of opposing slots through said sidewall and opening at said distal end, said first screw extension being releasably engaged to said first screw;

a second bone screw including a shaft having a threaded portion for engagement with a second vertebra and a yoke articulatingly attached to said shaft, said yoke having a slot defined by a pair of upstanding opposed arms for receiving a connecting rod;

a second hollow bone screw extension having a distal end and a proximal end, said second screw extension including a tubular member defined by a perimetric sidewall and a hollow interior, said second screw extension having a pair of opposing slots through said sidewall and opening at said distal end, said second screw extension being releasably engaged to said second screw;

a connecting rod of length for receipt in the respective slots in the yokes of said first and second bone screws;

a rod introducer for inserting said connecting rod into the slots of said first and second screw extensions and into the slots of the yokes of said first and second screws;

a rod persuader attachable to a coupling member on at least one of said first screw extension and said second screw extension, said rod persuader being operable in cooperation with said coupling member to engage said connecting rod and urge said rod into the slot of the yoke of at least one of said first and said second bone screws;

a first locking element for passage through said first screw extension and locking said rod in the slot of said yoke of said first bone screw; and

a second locking element for passage through said second screw extension and locking said rod in the slot of said yoke of said second bone screw.

23. The system of claim 22, wherein said rod persuader includes an elongate hollow sleeve configured to extend over the exterior of said at least one screw extension and releasably couple to said persuader coupling member, said persuader sleeve having a distal end defining a rod engaging surface disposed in a first position to allow a rod to be introduced through the opposing slots in said one of said first and said second bone screw extensions and operably movable in cooperation with said persuader coupling member to a second position wherein said rod engaging surface extends over at least a portion of said extension slots of said at least one screw extension to urge said rod into the slot of said yoke.

24. The system of claim 23, wherein said rod persuader includes a coupling element configured to releasably engage said persuader coupling member.

25. The system of claim 24, wherein said coupling element and said persuader coupling member form a rack and pinion arrangement.

26. The system of claim 25, wherein said coupling element is defined by a pinion gear and said coupling member defines a rack.

27. The system of claim 26, wherein said rod persuader further includes an advancement mechanism.

28. The system of claim 27, wherein said advancement mechanism includes a lever connected to said coupling element.

29. The system of claim 22, wherein said persuader coupling member is disposed on said one of said first and said second bone screw extensions at an orientation

approximately ninety degrees with respect to said extension slots.

30. The system of claim 29 wherein there are a pair of persuader coupling members oppositely arranged on said one of said first and said second bone screw extension and oriented approximately ninety degrees with respect to said extension slots for selective coupling of said persuader on opposite sides of said extension.

31. The system of claim 22, further comprising at least two rod persuaders, each rod persuader being attachable to a coupling member on individual ones of said first screw extension and said second screw extension.

32. The system of claim 22, wherein said first screw extension and said second screw extension each have a rotationally movable screw engaging member for releasably engaging and holding such extension to said first bone screw and said second bone screw respectively upon rotation thereof.

33. A system for percutaneously fixing a connecting rod to vertebrae of a spine, comprising:

a first bone screw including a shaft having a threaded portion for engagement with a first vertebra and a yoke articulatingly attached to said shaft, said yoke having a slot defined by a pair of upstanding opposed arms for receiving a connecting rod;

a first hollow bone screw extension having a distal end and a proximal end, said first screw extension including a tubular member defined by a perimetric sidewall and a hollow interior, said first screw extension having a pair of opposing slots through said sidewall and opening at said distal end, said first screw extension being releasably engaged to said first screw;

a second bone screw including a shaft having a threaded portion for engagement with a second vertebra and a yoke articulatingly attached to said shaft, said yoke having a slot defined by a pair of upstanding opposed arms for receiving a connecting rod;

a second hollow bone screw extension having a distal end and a proximal end, said second screw extension including a tubular member defined by a perimetric sidewall and a hollow interior, said second screw extension having a pair of opposing slots through said sidewall and opening at said distal end, said second screw extension being releasably engaged to said second screw;

a connecting rod of length for receipt in the respective slots in the yokes of said first and second bone screws;

a rod introducer for inserting said connecting rod into the slots of said first and second screw extensions and into the slots of the yokes of said first and second screws;

a rod detector for selective insertion into the interior of at least one of said first screw extension and said second screw extension, said rod detector having an indicator sensing the presence of a rod in the slot of the yoke of at least one of said first and said second bone screws;

a first locking element for passage through said first screw extension and locking said rod in the slot of said yoke of said first bone screw; and

a second locking element for passage through said second screw extension and locking said rod in the slot of said yoke of said second bone screw.

34. The system of claim 33, wherein said rod detector includes an elongate tubular member having a proximal end and a distal end and an opening therethrough and defining a first side and an opposing second side, said detector tubular member sized and configured for insertion into the interior of at least one of said first screw extension and said second screw extension.

35. The system of claim 34, wherein:

said tubular member includes a proximal end and an opposite distal end;

said indicator is defined by an elongate strip extending longitudinally through said detector tubular member and having a proximal end defining a flag projecting outwardly from the proximal end of said tubular member and a distal end axially offset from the flag and defining an elastically flexible rod detection tip projecting outwardly from the distal end of said detector tubular member and outwardly from the distal end of said one of said first screw extension and said second screw extension;

said detector tubular member being releasably coupled to said extension to align said detection tip with the pair of slots of said extension and with the slot of said yoke of at least one of said first and said second bone screws, said detection tip projecting into the slot of said yoke in a manner to flexibly obstruct the passage therethrough of said connecting rod.

36. The system of claim 35, wherein said rod detector further includes:

a pivot supporting said strip within said detector tubular member for pivoting movement of said strip relative to the longitudinal axis of said detector tubular member; and a bias member biasing said strip member in a first position wherein said flag at the proximal end is adjacent said first side of said detector tubular member and said detection tip at the distal end is adjacent the opposite second side, said strip being pivotal about said pivot upon application of a force against said detection tip in a direction generally transverse to the axis of the detector tubular member sufficient to overcome said bias to elastically flex said detection tip and to pivotally shift said flag to a second position adjacent said second side.

37. The system of claim 36, wherein said bias member is a spring.

38. The system of claim 35, wherein said detector tubular member is coupled to said one of said first screw extension and said second screw extension screw extension by a spring loaded ball plunger.

39. The system of claim 35, wherein strip is comprised of two different materials, said detection tip being a material different from said flag.

40. The system of claim 35, wherein said detection tip includes a nickel titanium alloy.

41. The system of claim 33, further comprising at least two rod detectors for selective insertion into the interior respectively of said first screw extension and said second screw extension.

42. The system of claim 33, wherein said first screw extension and said second screw extension each have a rotationally movable screw engaging member for releasably engaging and holding such extension to said first bone screw and said second bone screw respectively upon rotation thereof.