CA2125030C - Spinal implant and method for installing - Google Patents
Spinal implant and method for installing Download PDFInfo
- Publication number
- CA2125030C CA2125030C CA002125030A CA2125030A CA2125030C CA 2125030 C CA2125030 C CA 2125030C CA 002125030 A CA002125030 A CA 002125030A CA 2125030 A CA2125030 A CA 2125030A CA 2125030 C CA2125030 C CA 2125030C
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- CA
- Canada
- Prior art keywords
- clamp
- bore
- nuts
- screw
- flange
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Fee Related
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
- A61B17/7041—Screws or hooks combined with longitudinal elements which do not contact vertebrae with single longitudinal rod offset laterally from single row of screws or hooks
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
- A61B17/8665—Nuts
- A61B2017/867—Nuts with integral locking or clamping means
- A61B2017/868—Nuts with integral locking or clamping means self-locking due to part of nut being deformed upon tightening
Abstract
A spinal implant (10) that has a rod (40) that connects and stabilizes the vertebrae of a vertebral column. The implant (10) has screws (16) that are attached to the vertebrae. Each screw (16) has a clamp (26) with a first bore (28) that allows the clamp (26) to be placed over the screw (16). The first bore (28) of the clamp (26) is larger than the major diameter of the screw (16), so that the clamp (26) can float about the Screws (16). The clamps (26) each have a second bore (34) perpendicular to the first bore (28), adapted to receive and hold the rod (40). Integrally formed with the second bore (34) of each clamp (26) are a pair of flanges (46, 48). When the flanges (46, 48) are deflected inward, the clamp (26) "grabs"
the rod (40). The clamp (26) is placed on a hexagonally shaped shoulder (64) of the screw ( 16). A nut (50a) is fastened onto the opposite side of the clamp, such that the flanges (46, 48) are pressed between the shoulder (60) and the nut (50a). The diameter of the second bore (34) and rod (40) are approximately the same so that a small deflection of the flanges (46, 48) produces a large clamping force on the rod (40).
the rod (40). The clamp (26) is placed on a hexagonally shaped shoulder (64) of the screw ( 16). A nut (50a) is fastened onto the opposite side of the clamp, such that the flanges (46, 48) are pressed between the shoulder (60) and the nut (50a). The diameter of the second bore (34) and rod (40) are approximately the same so that a small deflection of the flanges (46, 48) produces a large clamping force on the rod (40).
Description
Spinal Implant and Method For Installing BAC.'KGROIJND OF THE INVENTION
FIELD OF THE INVENTIOI'~
This invention relates to a spinal implant that holds and stabilizes the vertebrae of a vertebral column.
DESCRIPTION OF THE RELATED ART
When the vertebrae of a 'backbone are fused together it is critical that the vertebrae are in proper orientation with respect to each other and remain that way throughout the fusing process.
One present method of insuring alignment is to attach a plate to the vertebrae, which holds the skeletal members in position during the fusing process. The plate is attached to each vertebrae by screws that are screwed into the pedicle of each vertebra. The plate has holes or slots that fit over the screws, wherein two nwa are located on each side of the plate to fasten the same to the screws.
Because the spine is curved, the plate must have a radius to conform to the shape of the vertebral column. To create such a curvature, the plate is usually bent by the surgeon in the operating room before the installation of the implant. The WCs 93/1072b ~ ~ ~ ~ ~~ ~ - 2 _ PC.'f1U~92/10376~,...,.
formation of the plate and the assembly of the implant is inexact,, such that the plate and screws are typically at an angle to each other. This lack of perpendicularity causes the nuts to engage the member in an uneven manner, wherein it has been found that the nuts would break at the threads of the screws after installation.
;Another type of spinal implant includes screws that have a j lug at one, end. The screws are screwed into the pedicles and a s preformed rod is inserted through the lugs to connect the vertebrae together. The hole diameter of the lug is larger than the diameter of the rods, so that absolute perpendicularity between the two members is not required. The rod is secured to s the screws by set screws which are inserted through the lugs and engage the rod. Set screws are not the most rigid means of attachment, wherein there is a possibility that the rod will disengage from the screws and allow. the vertebrae to move AA.
relative. to each other. Therefore it would be desirable to have an easy to install rigid spinal implant, that would not require perpendicularity between'the screws and the tie rod.
r_.,~ W~ 93/14726 - 3 ~ ~ 2 ~ U ~ ~ PCT/US92/1037(, ~~,BFt'l OF r,'T',.~fE I~1~TEN~IO,~j The present invention is a spinal implant that has a rod that connects and stabilizes the vertebrae of a vertebral column. The implant has screws that are attached to the pedicles of the vertebrae. Each screw has a clamp with a first bore that allows the clamp to be placed over the screw. The first bore of the clamp is larger than the major diameter of the screw, so that the clamp can float about the screw. The oversized first bore compensates for a lack of perpendicuiarity between the clamp and rod, so that a nonconformir~g rod may be installed onto the spine.
The clamps each have a secoryd bore which is essentially perpendicular to the first bore. The second bore is adapted to ',;t ?~ receive and hold the rod. Integrally formed with the second bore of each clamp are a pair of flanges. When the flanges are deflected inward, the clamp '°grabs" the rod. The clamp is ~, placed on a hexagonal shaped shoulder of the screw. A nu. is fastened onto the opposite side of the.clamp, such that the flanges are pressed between the shoulder and nut. The diameter of the second bore,and rod are approximately the same, so that a.
t ,~ , f, small deflection of the flanges produces a large clamping force on the rod:
Therefore, it is~an object of this invention to provide a spinal implant that is rigidly secured to the vertebral column and does not require perpendicularity between the rod and screws.
V1r~ 93/i~726 2 ~ 2 ~ ~ ~ ~~ 9 PCf/US92/10376" j ~~tIEF DE~t'~]~,;~,~TgON OF THE DRAWINGS
The objects and advantages of this invention will become more readily apparent to those skilled in the art after reviewing the following detailed description and accompanying drawings, wherein:
Figure 1 is a posterior view of a vertebral column, showing a pair of spinal implants of the present invention attached to ;.; , the vertebral column;
;~.~, Figure 2 is a lateral view of a portion of a vertebral column, showing a spinal implant attached to the vertebral column;
Figure 3 is an axial view of an vertebra, showing screws embedded into the body of the vertebra;
Figure 4 is a side view of a portionof the spinal implant, showing nuts in c ontact with a clamp;
Figure 5 is a cross-sectionol view r. of Fig. 9, taken at line 5-5, showing the screw inserted through clamp bore and annular r a <
.
, ,.,r x! flanges of the nu ts;
~'> Figure 6 is aside view of Fig. 4, taken at line 6-6, r showing a portion of the clamp broken out to reveal how the rod N' extends through a bore of the clamp;
~..
Figure ? is a perspective view of alternative embodiment an ' . , of the present in vention.
:.:, ,.
r?
,' P~'/L1S92/ 10376 .,.~,yr0 9:3110726 -Referring to the drawings more particularly by reference numbers, Figure 1 shows spinal implants 10 of the present invention attached to a vertebral column 12 comprising a plurality of vertebra 14. The implants 10 shown are attached to three vertebra 14 that can then fuse together. Although the attachment of three vertebrae are shown, it is to be understood that the implant 10 can vary in size such that any number of vertebrae can be held in place. Tt further being understood that one or two implants can be attached to the vertebrae, it <c~ being preferable to use two implants for greater stability.
t~ ~ Figures 2-6 more clearly shows the particular elements of the implant l0, wherein screws l6 are attached,to the pedicles l8 of each vertebra 14. To attach one of the screws 16, a pedicle 18 is drilled with a bit having a diameter significantly smaller than the diameter of the screw 16. The drill,bit is left in the bone while, the bone is X-rayed, to determine if the tapped hole is of the proper depth and location in the pedicle 18. Ths drill bit is then removed and a hole 20 is drilled into the pedicle 18. The diameter of the hole 20 is no greater than the minor thread diameter of a first threaded portion 22 of the screw 16, such that the screw 16 can be screwed into tight ~~,',~~ engagement with the pedicle 18. The first threaded portion 22 'a typically has a course thread to increase the contact area between the threads and the bone. The screw l6 has a threaded second portion 24 that extends out from the pedicle 18, to allow ,, a clamp 26 to be attached to each screw 16.
:., Pte'/ iJS92A 10~37~, 1~~ 93/10726 , '. _ 6 _ i ..' ,~
As more clearly shown in Fig. 5, the clamp 26 has a first _, bore 28 extending from a top surface 30 to a bottom surface 32 that allows the screw 16 to extend through the clamp 26. The r clamp 26 has a second bore 39 that extends from a first side 36 to a second side 38, wherein the second bare 34 is essentially perpendicular to the first bore 28. Inserted through the second ..a.
bore 39 of each clamp is a rod 90. The rod 40 creates a structural attachment between the clamps 26 and screws 16, such that when the rod 40 is clamped in place, the vertebrae 14 cannot move relative to each other. The rod 90 is preferably constructed from a metal and has a stiffness great enough to f the vertebrae 19 durin the fusing prevent excessme movement o g :F
process. A slit 42 extends from orie end 44 of the clamp 26 to iiF
r the second bore 39. The slit 92, clamp end 49 and top 30 and bottom 32 surfaces define first 46 and second 98 flanges, ~;3 respectively. An inward deflection ~of the flanges causes the clamp.26 to grasp the rod 40. In the preferred embodiment, the rod 90 and second bore 34 are approximately the same diameter so that a .small deflection of the flanges 96 and 98, produces.a large clamping force.' The tolerances of the rod 40 and second bore 39 are preferably very close, wherein it is preferable to ream the second bore 34.
''~ Each screw 16 has a first 50a and second nut 50b that ,.;
threadably engage the threaded second portion 29 of the screw 16: The nuts 50 can be turned such that they engage and deflect ", r:j both the first 46 and second flanges 48, so that the clamp 26 is Aa,.y, i~ ;J
';~ pressed onto the rod 40. The incorporation of the flanges 4~
F
":' and 48 into the clamp 26, provide an easy means of rigidly :\..rY
i::9 .
:!' 7:1 ~~~i.. .
i~~ ~. .
'r':~:x>.
..~. W(3 93110726 _ 7 _ ~ ~ ~ ~ ~ ~ ~ PCT/L1S92/10376 ._..attaching and. detaching the rod 40, by tightening or loosening the nuts 50.
It is preferable that the nuts 50 have annular flanges 52 on the ends thereof, that have counterbores.54 to define an annular rim 5~6 that engages the clamp 26. As shown in Fig'. 5 the nuts can be turned until the annular nut flanges 52 deflect, locking the nuts 50 against the clamp 26. It is preferable to have annular flanges 52 on both ends of each nut 50a and 50b so that the nuts 50 are reversible. The second annular flanges 52 also provide a better means to grasp the nuts 50.
In the preferred embodiment the first~bore 28 and the second threaded portion 24 are of such dimensions to allow the Clamp 26f to rotate 20° to 3C° about an axis perpendicular to the longitudinal axis of the screw l6. The movement;of the clamp 26 relative t o the screw l6 allows a rdd 90 to be installed, that 7 ~k is not perpendicular to the screws I6 and does not conform exactly with the vertebral column 12. The screws 16 may have a i;~
thread relief 58 between threaded portions 22 and 24.
"- To attach and use the spinal implant 10, the screws 16 are attached to the vertebrae 19 that are to be fused as described ': above: A first nut 50a is screwed onto the second threaded portion 24 0~ each screw 16. The first nut SOa is preferably a,a turned until the nut 50a engages the fixst threaded portion 22 o~ the screw. The rods 90 are then bent to a radius approximating the curvature of the vertebral column l2 and inserted into the second bore 34 of the clamps '26. The clamps _ ~~
26 yd rod 90 are placed onto the screws 15 by inserting the k,~ s second threaded portions 24 through the first bore 28 of the clamps 2C. A second nut 50b is screwed onto the second threaded 'WO 93/10726 ~ ~ ~ ~ ~ ~ ~ 8 - PC f1U~92/1037~.~~..a portion 29, wherein the first~and second nuts ar.e turned until the second nut 50b engages the top surface 30 of the clamp 26, and the first nut 50a engages the bottom surface 32, see Figure 5. The flanges 96 and 98, are deflected by the nuts 50a and 50b, such that the clamp 26 securely grasp and holds the°rod 40 in place.
Figure 7 shows an alternate embodiment of the present invention. Instead of the nut 50a, the screw 22' may have a shoulder 60 with an essentially flat first surface 62.' The shoulder 60 is hexagonally shaped so that the screw 22' can be i,a burned into the vertebra 19. The clamp 26 is placed on top of the shoulder 60 so that the flange 98 is contiguous with the first surface 62. The nut 50b is placed on top of the clamp 26 '°.y , and tightened until the flanges are deflected and the rod 90 is y ~;~
secured to the clamp 26: The integration of the shoulder 60 into the screw 22°, simplifies theinstallation of the implant, user wherein only the nut 50b need be manypulated by the While certain exemplary embodiments have been shown and described in:the above description and accompanying drawings, it is to be understood that such embodiments are., merely illustrative of, and not restrictive on the broad invention, and that this invention not be limited to the specific constructions and arrangements shown and described; since various other .'°~J~.
modifications may occur to those ordinarily skilled in the art.
y,y a'~~'~
FIELD OF THE INVENTIOI'~
This invention relates to a spinal implant that holds and stabilizes the vertebrae of a vertebral column.
DESCRIPTION OF THE RELATED ART
When the vertebrae of a 'backbone are fused together it is critical that the vertebrae are in proper orientation with respect to each other and remain that way throughout the fusing process.
One present method of insuring alignment is to attach a plate to the vertebrae, which holds the skeletal members in position during the fusing process. The plate is attached to each vertebrae by screws that are screwed into the pedicle of each vertebra. The plate has holes or slots that fit over the screws, wherein two nwa are located on each side of the plate to fasten the same to the screws.
Because the spine is curved, the plate must have a radius to conform to the shape of the vertebral column. To create such a curvature, the plate is usually bent by the surgeon in the operating room before the installation of the implant. The WCs 93/1072b ~ ~ ~ ~ ~~ ~ - 2 _ PC.'f1U~92/10376~,...,.
formation of the plate and the assembly of the implant is inexact,, such that the plate and screws are typically at an angle to each other. This lack of perpendicularity causes the nuts to engage the member in an uneven manner, wherein it has been found that the nuts would break at the threads of the screws after installation.
;Another type of spinal implant includes screws that have a j lug at one, end. The screws are screwed into the pedicles and a s preformed rod is inserted through the lugs to connect the vertebrae together. The hole diameter of the lug is larger than the diameter of the rods, so that absolute perpendicularity between the two members is not required. The rod is secured to s the screws by set screws which are inserted through the lugs and engage the rod. Set screws are not the most rigid means of attachment, wherein there is a possibility that the rod will disengage from the screws and allow. the vertebrae to move AA.
relative. to each other. Therefore it would be desirable to have an easy to install rigid spinal implant, that would not require perpendicularity between'the screws and the tie rod.
r_.,~ W~ 93/14726 - 3 ~ ~ 2 ~ U ~ ~ PCT/US92/1037(, ~~,BFt'l OF r,'T',.~fE I~1~TEN~IO,~j The present invention is a spinal implant that has a rod that connects and stabilizes the vertebrae of a vertebral column. The implant has screws that are attached to the pedicles of the vertebrae. Each screw has a clamp with a first bore that allows the clamp to be placed over the screw. The first bore of the clamp is larger than the major diameter of the screw, so that the clamp can float about the screw. The oversized first bore compensates for a lack of perpendicuiarity between the clamp and rod, so that a nonconformir~g rod may be installed onto the spine.
The clamps each have a secoryd bore which is essentially perpendicular to the first bore. The second bore is adapted to ',;t ?~ receive and hold the rod. Integrally formed with the second bore of each clamp are a pair of flanges. When the flanges are deflected inward, the clamp '°grabs" the rod. The clamp is ~, placed on a hexagonal shaped shoulder of the screw. A nu. is fastened onto the opposite side of the.clamp, such that the flanges are pressed between the shoulder and nut. The diameter of the second bore,and rod are approximately the same, so that a.
t ,~ , f, small deflection of the flanges produces a large clamping force on the rod:
Therefore, it is~an object of this invention to provide a spinal implant that is rigidly secured to the vertebral column and does not require perpendicularity between the rod and screws.
V1r~ 93/i~726 2 ~ 2 ~ ~ ~ ~~ 9 PCf/US92/10376" j ~~tIEF DE~t'~]~,;~,~TgON OF THE DRAWINGS
The objects and advantages of this invention will become more readily apparent to those skilled in the art after reviewing the following detailed description and accompanying drawings, wherein:
Figure 1 is a posterior view of a vertebral column, showing a pair of spinal implants of the present invention attached to ;.; , the vertebral column;
;~.~, Figure 2 is a lateral view of a portion of a vertebral column, showing a spinal implant attached to the vertebral column;
Figure 3 is an axial view of an vertebra, showing screws embedded into the body of the vertebra;
Figure 4 is a side view of a portionof the spinal implant, showing nuts in c ontact with a clamp;
Figure 5 is a cross-sectionol view r. of Fig. 9, taken at line 5-5, showing the screw inserted through clamp bore and annular r a <
.
, ,.,r x! flanges of the nu ts;
~'> Figure 6 is aside view of Fig. 4, taken at line 6-6, r showing a portion of the clamp broken out to reveal how the rod N' extends through a bore of the clamp;
~..
Figure ? is a perspective view of alternative embodiment an ' . , of the present in vention.
:.:, ,.
r?
,' P~'/L1S92/ 10376 .,.~,yr0 9:3110726 -Referring to the drawings more particularly by reference numbers, Figure 1 shows spinal implants 10 of the present invention attached to a vertebral column 12 comprising a plurality of vertebra 14. The implants 10 shown are attached to three vertebra 14 that can then fuse together. Although the attachment of three vertebrae are shown, it is to be understood that the implant 10 can vary in size such that any number of vertebrae can be held in place. Tt further being understood that one or two implants can be attached to the vertebrae, it <c~ being preferable to use two implants for greater stability.
t~ ~ Figures 2-6 more clearly shows the particular elements of the implant l0, wherein screws l6 are attached,to the pedicles l8 of each vertebra 14. To attach one of the screws 16, a pedicle 18 is drilled with a bit having a diameter significantly smaller than the diameter of the screw 16. The drill,bit is left in the bone while, the bone is X-rayed, to determine if the tapped hole is of the proper depth and location in the pedicle 18. Ths drill bit is then removed and a hole 20 is drilled into the pedicle 18. The diameter of the hole 20 is no greater than the minor thread diameter of a first threaded portion 22 of the screw 16, such that the screw 16 can be screwed into tight ~~,',~~ engagement with the pedicle 18. The first threaded portion 22 'a typically has a course thread to increase the contact area between the threads and the bone. The screw l6 has a threaded second portion 24 that extends out from the pedicle 18, to allow ,, a clamp 26 to be attached to each screw 16.
:., Pte'/ iJS92A 10~37~, 1~~ 93/10726 , '. _ 6 _ i ..' ,~
As more clearly shown in Fig. 5, the clamp 26 has a first _, bore 28 extending from a top surface 30 to a bottom surface 32 that allows the screw 16 to extend through the clamp 26. The r clamp 26 has a second bore 39 that extends from a first side 36 to a second side 38, wherein the second bare 34 is essentially perpendicular to the first bore 28. Inserted through the second ..a.
bore 39 of each clamp is a rod 90. The rod 40 creates a structural attachment between the clamps 26 and screws 16, such that when the rod 40 is clamped in place, the vertebrae 14 cannot move relative to each other. The rod 90 is preferably constructed from a metal and has a stiffness great enough to f the vertebrae 19 durin the fusing prevent excessme movement o g :F
process. A slit 42 extends from orie end 44 of the clamp 26 to iiF
r the second bore 39. The slit 92, clamp end 49 and top 30 and bottom 32 surfaces define first 46 and second 98 flanges, ~;3 respectively. An inward deflection ~of the flanges causes the clamp.26 to grasp the rod 40. In the preferred embodiment, the rod 90 and second bore 34 are approximately the same diameter so that a .small deflection of the flanges 96 and 98, produces.a large clamping force.' The tolerances of the rod 40 and second bore 39 are preferably very close, wherein it is preferable to ream the second bore 34.
''~ Each screw 16 has a first 50a and second nut 50b that ,.;
threadably engage the threaded second portion 29 of the screw 16: The nuts 50 can be turned such that they engage and deflect ", r:j both the first 46 and second flanges 48, so that the clamp 26 is Aa,.y, i~ ;J
';~ pressed onto the rod 40. The incorporation of the flanges 4~
F
":' and 48 into the clamp 26, provide an easy means of rigidly :\..rY
i::9 .
:!' 7:1 ~~~i.. .
i~~ ~. .
'r':~:x>.
..~. W(3 93110726 _ 7 _ ~ ~ ~ ~ ~ ~ ~ PCT/L1S92/10376 ._..attaching and. detaching the rod 40, by tightening or loosening the nuts 50.
It is preferable that the nuts 50 have annular flanges 52 on the ends thereof, that have counterbores.54 to define an annular rim 5~6 that engages the clamp 26. As shown in Fig'. 5 the nuts can be turned until the annular nut flanges 52 deflect, locking the nuts 50 against the clamp 26. It is preferable to have annular flanges 52 on both ends of each nut 50a and 50b so that the nuts 50 are reversible. The second annular flanges 52 also provide a better means to grasp the nuts 50.
In the preferred embodiment the first~bore 28 and the second threaded portion 24 are of such dimensions to allow the Clamp 26f to rotate 20° to 3C° about an axis perpendicular to the longitudinal axis of the screw l6. The movement;of the clamp 26 relative t o the screw l6 allows a rdd 90 to be installed, that 7 ~k is not perpendicular to the screws I6 and does not conform exactly with the vertebral column 12. The screws 16 may have a i;~
thread relief 58 between threaded portions 22 and 24.
"- To attach and use the spinal implant 10, the screws 16 are attached to the vertebrae 19 that are to be fused as described ': above: A first nut 50a is screwed onto the second threaded portion 24 0~ each screw 16. The first nut SOa is preferably a,a turned until the nut 50a engages the fixst threaded portion 22 o~ the screw. The rods 90 are then bent to a radius approximating the curvature of the vertebral column l2 and inserted into the second bore 34 of the clamps '26. The clamps _ ~~
26 yd rod 90 are placed onto the screws 15 by inserting the k,~ s second threaded portions 24 through the first bore 28 of the clamps 2C. A second nut 50b is screwed onto the second threaded 'WO 93/10726 ~ ~ ~ ~ ~ ~ ~ 8 - PC f1U~92/1037~.~~..a portion 29, wherein the first~and second nuts ar.e turned until the second nut 50b engages the top surface 30 of the clamp 26, and the first nut 50a engages the bottom surface 32, see Figure 5. The flanges 96 and 98, are deflected by the nuts 50a and 50b, such that the clamp 26 securely grasp and holds the°rod 40 in place.
Figure 7 shows an alternate embodiment of the present invention. Instead of the nut 50a, the screw 22' may have a shoulder 60 with an essentially flat first surface 62.' The shoulder 60 is hexagonally shaped so that the screw 22' can be i,a burned into the vertebra 19. The clamp 26 is placed on top of the shoulder 60 so that the flange 98 is contiguous with the first surface 62. The nut 50b is placed on top of the clamp 26 '°.y , and tightened until the flanges are deflected and the rod 90 is y ~;~
secured to the clamp 26: The integration of the shoulder 60 into the screw 22°, simplifies theinstallation of the implant, user wherein only the nut 50b need be manypulated by the While certain exemplary embodiments have been shown and described in:the above description and accompanying drawings, it is to be understood that such embodiments are., merely illustrative of, and not restrictive on the broad invention, and that this invention not be limited to the specific constructions and arrangements shown and described; since various other .'°~J~.
modifications may occur to those ordinarily skilled in the art.
y,y a'~~'~
Claims (39)
1. A spinal implant for stabilizing the vertebrae of a vertebral column, wherein the vertebral column has a curvature along at least one vertical axis and each vertebra has a pair of pedicles, comprising:
at least two clamps each having a first bore and a second bore essentially perpendicular to said first bore, said clamp further having a slit extending to said second bore, wherein said slit defines a first flange and a second flange, said clamps further having said,first bore extending through said first and second flanges;
a rod adapted to be inserted into and extend through said second bores;
at least two screws, each said screw having a first threaded portion adapted to be attached to the pedicle of a vertebra and a second threaded portion adapted to extend through said first bore;
at least two first nuts adapted to thread onto said second threaded portion of sand screws; each said screw has one first nut adapted to engage said second flange of said clamp; and at lea t two second nuts adapted to thread onto said second portion of said screws, each screw having one second nut adapted to engage said first flange of said clamp.
at least two clamps each having a first bore and a second bore essentially perpendicular to said first bore, said clamp further having a slit extending to said second bore, wherein said slit defines a first flange and a second flange, said clamps further having said,first bore extending through said first and second flanges;
a rod adapted to be inserted into and extend through said second bores;
at least two screws, each said screw having a first threaded portion adapted to be attached to the pedicle of a vertebra and a second threaded portion adapted to extend through said first bore;
at least two first nuts adapted to thread onto said second threaded portion of sand screws; each said screw has one first nut adapted to engage said second flange of said clamp; and at lea t two second nuts adapted to thread onto said second portion of said screws, each screw having one second nut adapted to engage said first flange of said clamp.
2. The spinal implant as recited in claim 1, wherein said rod and said second bore have approximately the same diameter.
3. The spinal implant as recited in claim 1, wherein said first and second nuts have an annular flange adapted to engage said second and first flanges respectively, said annular flanges being constructed such that said annular flanges deflect when said nuts are turned into tight engagement with said clamp, locking said nuts onto said clamp.
9. The spinal implant as recited in claim 1, wherein said first and second nuts each have two annular flanges adapted to engage said second and first flanges respectively, said annular flanges being constructed such that said annular flanges deflect when said nuts are turned into tight engagement with said clamp, locking said nuts onto said clamp.
5. The spinal implant as recited in claim 1, wherein said second threaded portion of said screw and said first bore are of such dimensions that said clamp can rotate up to 30° about an axis perpendicular to the longitudinal axis of said screw.
6. A spinal implant for stabilizing the vertebrae of a vertebral column, wherein the vertebral column has a curvature along at least one vertical axis and each vertebra has a pair of pedicles, comprising:
at least two clamps each having a first bore and a second bore essentially perpendicular to said first bore, said clamp further having a slit extending to said second bore, wherein said slit defines a first flange and a second flange, said clamps further having said first bore extending through said first and second flanges;
a rod adapted to he inserted into and extend through said second bores;
at least two screws, each said screw having a first threaded portion adapted to be attached to the pedicle of a vertebra and a second threaded portion adapted to extents through said first bore, said second threaded portion and said first bore being of such dimensions that said clamp can rotate up to 30° about an axis perpendicular to the longitudinal axis of said screw;
at least two first nuts adapted to thread onto said second threaded portion of said screws, each said screw has one first nut with an annular flange adapted to engage said second flange of said clamp such that said annular flange deflects to lock said first nut onto said clamp; and at least two second nuts adapted to thread onto said second portion of said screws, each screw having one second nut with an annular flange adapted to engage said first flange of said clamp such hat said annular flange deflects to lock said first nut onto said clamp.
at least two clamps each having a first bore and a second bore essentially perpendicular to said first bore, said clamp further having a slit extending to said second bore, wherein said slit defines a first flange and a second flange, said clamps further having said first bore extending through said first and second flanges;
a rod adapted to he inserted into and extend through said second bores;
at least two screws, each said screw having a first threaded portion adapted to be attached to the pedicle of a vertebra and a second threaded portion adapted to extents through said first bore, said second threaded portion and said first bore being of such dimensions that said clamp can rotate up to 30° about an axis perpendicular to the longitudinal axis of said screw;
at least two first nuts adapted to thread onto said second threaded portion of said screws, each said screw has one first nut with an annular flange adapted to engage said second flange of said clamp such that said annular flange deflects to lock said first nut onto said clamp; and at least two second nuts adapted to thread onto said second portion of said screws, each screw having one second nut with an annular flange adapted to engage said first flange of said clamp such hat said annular flange deflects to lock said first nut onto said clamp.
7. A spinal implant for stabilizing the vertebrae of a vertebral column, wherein the vertebral column has a curvature along at least one vertical axis and each vertebra has a first and second pedicle, comprising:
at least two clamps, each said clamp having a first bore end a second bore essentially perpendicular to said first bore, said clamp further having a slit extending to said second bore, wherein said slit defines a first flange and a second flange, said clamps further having said first bore extending through said first and second flanges;
a rod that extends through said second bores, said rod having a bend radius approximating the curvature of the vertebral column;
at least two screws, each said screw having a first threaded portion attached to the first pedicle of a vertebra and a second threaded portion that extends through said first bore such that each said screw has a clamp attached thereto;
at least two first nuts attached to said second portion of said screws, each said first screw having one first nut that engages said second flange of said clamp such that said second flange is deflected; and at least two second nuts attached to said second portion of said screws, each screw having one second nut engaging said first flange of said clamp such that said first flange is deflected;
whereby said nuts deflect said first and second flanges so that said clamp is pressed onto said rod such that said rod is held in firm engagement by said clamp.
at least two clamps, each said clamp having a first bore end a second bore essentially perpendicular to said first bore, said clamp further having a slit extending to said second bore, wherein said slit defines a first flange and a second flange, said clamps further having said first bore extending through said first and second flanges;
a rod that extends through said second bores, said rod having a bend radius approximating the curvature of the vertebral column;
at least two screws, each said screw having a first threaded portion attached to the first pedicle of a vertebra and a second threaded portion that extends through said first bore such that each said screw has a clamp attached thereto;
at least two first nuts attached to said second portion of said screws, each said first screw having one first nut that engages said second flange of said clamp such that said second flange is deflected; and at least two second nuts attached to said second portion of said screws, each screw having one second nut engaging said first flange of said clamp such that said first flange is deflected;
whereby said nuts deflect said first and second flanges so that said clamp is pressed onto said rod such that said rod is held in firm engagement by said clamp.
8. The spinal implant of claim 7, further comprising a second set of clamps, screws, rod and nuts assembled as described in claim 7, said screws of said second set being attached to the second pedicles of the vertebrae, whereby there are two spinal implants attached to the vertebral column.
9. The spinal implant as recited in claim 7, wherein said rod and said second bore have approximately the same diameter.
10. The spinal implant as recited in claim 7, wherein said first and second nuts have an annular flange that engages said second and first flanges respectively, said annular flanges being constructed such that said annular flanges deflect when said nuts are turned into tight engagement with said clamp, locking said nuts onto said clamp.
11. The spinal implant as recited in claim 7, wherein said first and second nuts each have two annular flanges, wherein one of said two annular flanges engages said second and first flanges respectively, said annular flanges being constructed such that said annular flanges deflect when said nuts are turned into tight engagement with said clamp, locking said nuts onto said clamp.
12. The spinal implant as recited in claim 7, wherein said second threaded portion of said screw and said first bore are of such dimensions that said clamp can rotate up to 30° about an axis perpendicular to the longitudinal axis of said screw.
23. A method for attaching a spinal implant to the vertebrae of a vertebral column to stabilize the vertebrae, wherein the vertebral column has a curvature along at least one vertical axis and each vertebra has a first and second pedicle, comprising the steps of:
providing;
at least two clamps each having a first bore and a second bore essentially perpendicular to said first bore, said clamp further having a slit extending to said second bore, wherein said slit defines a first flange and a second flange, said clamps further having said first bore extending through said first and second flanges;
a rod adapted to be inserted into and extend through said second bores;
at least two screws, each said screw haying a first threaded portion adapted to be attached to the pedicle of a vertebra and a second threaded portion adapted to extend through said first bore;
at least two first nuts adapted to thread onto said second threaded portion of said screws, each said screw has one first nut adapted to engage said second flange of said clamp;
at least two second nuts adapted to thread onto said second threaded portion of said screws, each screw having one second nut adapted to engage said first flange of said clamp;
attaching said screws to the first pedicle of at least two vertebra such that each vertebra has one screw;
screwing said first nuts onto said second threaded portion of said screws, such that each screw has one first nut;
inserting said rod into said second bores of said clamps;
,placing said clamps and said rod onto said screws such that said second portion of said screws is inserted through said first bores of said clamps;
screwing said second nuts onto said second threaded portion.
of said screws, such that each screw has one second nut, each said second nut being screwed onto said second threaded portion until said second nut engages said first flange of said clamp and said first nut engages said second flange of said clamp; and tightening said first and second nut of each screw such that said first and second flanges are deflected, pressing said clamp onto said rod, whereby said rod is securely fastened to the vertebrae to hold the vertebrae in place.
providing;
at least two clamps each having a first bore and a second bore essentially perpendicular to said first bore, said clamp further having a slit extending to said second bore, wherein said slit defines a first flange and a second flange, said clamps further having said first bore extending through said first and second flanges;
a rod adapted to be inserted into and extend through said second bores;
at least two screws, each said screw haying a first threaded portion adapted to be attached to the pedicle of a vertebra and a second threaded portion adapted to extend through said first bore;
at least two first nuts adapted to thread onto said second threaded portion of said screws, each said screw has one first nut adapted to engage said second flange of said clamp;
at least two second nuts adapted to thread onto said second threaded portion of said screws, each screw having one second nut adapted to engage said first flange of said clamp;
attaching said screws to the first pedicle of at least two vertebra such that each vertebra has one screw;
screwing said first nuts onto said second threaded portion of said screws, such that each screw has one first nut;
inserting said rod into said second bores of said clamps;
,placing said clamps and said rod onto said screws such that said second portion of said screws is inserted through said first bores of said clamps;
screwing said second nuts onto said second threaded portion.
of said screws, such that each screw has one second nut, each said second nut being screwed onto said second threaded portion until said second nut engages said first flange of said clamp and said first nut engages said second flange of said clamp; and tightening said first and second nut of each screw such that said first and second flanges are deflected, pressing said clamp onto said rod, whereby said rod is securely fastened to the vertebrae to hold the vertebrae in place.
14. The method as recited in claim 23, further comprising the step of bending said rod before said clamp and said rod are placed on said second threaded portion, such that said rod approximates the curvature of the vertebral column.
15. The method as recited in claim 13, further comprising providing a second set of clamps, rod, screws and nuts and attaching said screws of said second set to the second pedicle of at least two vertebra and following the steps recited in claim 13, whereby there are two spinal implants attached to the vertebral column.
16. The method as recited in claim 13, wherein said first rod and said second bore have approximately the same diameter.
17. The method as recited in claim 13, wherein said first and second nuts have an annular flange adapted to engage said second and first flanges respectively, said annular flanges being constructed such that said annular flanges deflect when said nuts are turned into tight engagement with said clamp, locking said nuts onto said clamp.
18. The method as recited in claim 13, wherein said first and second nuts each have two annular flanges adapted to engage said second and first flanges respectively, said annular flanges being constructed such that said annular flanges deflect when said nuts are turned into tight engagement with said clamp;
locking said nuts onto said clamp.
locking said nuts onto said clamp.
19. The method as recited in claim 13, wherein said second threaded portion of said screw and said first bore are of such dimensions that said clamp can rotate up to 30° about an axis perpendicular to the longitudinal a}:is of said screw.
20. A spinal implant for stabilizing the vertebrae of a vertebral column, wherein the vertebral column has a curvature along at least one vertical axis and each vertebra has a pair of pedicles, comprising:
at least two clamps each having a first bore and a second bore essentially perpendicular to said first bore, said clamp further having a slit extending to said second bore, wherein said slit defines a first flange and a second flange, said clamps further having said first bore extending through said first and second flanges;
a rod adapted to be inserted onto and extend through said second bores:
at least two screws, each said screw having a first threaded portion adapted to be attached to the pedicle of a vertebra and a second threaded portion adapted to extend through said first bore, each said screw further having a shoulder between said first and second threaded portions; and at least two second nuts adapted to be threaded onto said second portion of said screws, each screw having one second nut adapted to engage said first flange of said clamp.
at least two clamps each having a first bore and a second bore essentially perpendicular to said first bore, said clamp further having a slit extending to said second bore, wherein said slit defines a first flange and a second flange, said clamps further having said first bore extending through said first and second flanges;
a rod adapted to be inserted onto and extend through said second bores:
at least two screws, each said screw having a first threaded portion adapted to be attached to the pedicle of a vertebra and a second threaded portion adapted to extend through said first bore, each said screw further having a shoulder between said first and second threaded portions; and at least two second nuts adapted to be threaded onto said second portion of said screws, each screw having one second nut adapted to engage said first flange of said clamp.
21. The spinal implant as recited in claim 20, wherein said shoulder is hexagonal in shape.
22. The spinal implant as recited in claim 20, wherein said rod and said second bore have approximately the same diameter.
23. The spinal implant as recited in claim 20, wherein said second nuts each have an annular flange adapted to engage said first flange, said annular flanges being constructed such that said annular flanges deflect when said nuts are turned into tight engagement with said clamp, locking said nut onto said clamp.
24. The spinal implant as recited in claim 20, wherein said second nuts each have two annular flanges adapted to engage said first flanges, said annular flanges being constructed such that said annular flanges deflect when said nuts are turned into tight engagement with said clamp, locking said nuts onto said clamp.
25. The spinal implant as recited in claim 20, wherein said second threaded portion of said screw and said first bore are of such dimensions that said clamp can rotate up to 30°
about an axis perpendicular to the longitudinal axis of said screw.
about an axis perpendicular to the longitudinal axis of said screw.
26. A spinal implant for stabilizing the vertebrae of a vertebral column, wherein the vertebral column has a curvature along at least one vertical axis and each vertebra has a pair of pedicles, comprising:
at least two clamps each having a first bore and a second bore essentially perpendicular to said first bore, said clamp further having a slit extending to said second bore, wherein said slit defines a first flange and a second flange, said clamps further having said first bore extending through said first and second flanges;
a rod adapted to be inserted into and extend through said second bores;
at least two screws, each said screw having a first threaded portion adapted to be attached to the pedicle of a vertebra and a second threaded portion adapted to extend through said first bore, each said screw further having a hexagonally shaped shoulder between said first and second threaded portions, said second threaded portion and said first bore being of such dimensions that said clamp can rotate up to 30° about an axis perpendicular to the longitudinal axis of said screw; and at least two second nuts adapted to be threaded onto said second portion of said screws, each screw having one second nut with an annular flange adapted to engage said first flange of said clamp such that said annular flange deflects to lock said first nut onto said clamp.
at least two clamps each having a first bore and a second bore essentially perpendicular to said first bore, said clamp further having a slit extending to said second bore, wherein said slit defines a first flange and a second flange, said clamps further having said first bore extending through said first and second flanges;
a rod adapted to be inserted into and extend through said second bores;
at least two screws, each said screw having a first threaded portion adapted to be attached to the pedicle of a vertebra and a second threaded portion adapted to extend through said first bore, each said screw further having a hexagonally shaped shoulder between said first and second threaded portions, said second threaded portion and said first bore being of such dimensions that said clamp can rotate up to 30° about an axis perpendicular to the longitudinal axis of said screw; and at least two second nuts adapted to be threaded onto said second portion of said screws, each screw having one second nut with an annular flange adapted to engage said first flange of said clamp such that said annular flange deflects to lock said first nut onto said clamp.
27. A spinal implant for stabilizing the vertebrae of a vertebral column, wherein the vertebral column has a curvature along at least one vertical axis and each vertebra has a first and second pedicle, comprising:
at least two clamps, each said clamp having a first bore and a second bore essentially perpendicular to said first bore, said clamp further having a slit extending to said second bare, wherein said slit defines a first flange and a second flange, said clamps further having said first bore extending through said first and second flanges;
a rod that extends through said second bores, said rod having a radius approximating the curvature of the vertebral column;
at least two screws, each said screw having a first threaded portion attached to the first pedicle of a vertebra and a second threaded portion that extends through said first bore such that each said screw has a clamp attached thereto, each said screw further having a shoulder that engages said second flange of said clamp;
at least two second nuts attached to said second portion of said screws, each screw having one second nut engaging said first flange of said clamp such that said first flange is deflected:
whereby said nut and said shoulder deflect said first and second flanges so that said clamp is pressed onto said rod such that said rod is held in firm engagement by said clamp.
at least two clamps, each said clamp having a first bore and a second bore essentially perpendicular to said first bore, said clamp further having a slit extending to said second bare, wherein said slit defines a first flange and a second flange, said clamps further having said first bore extending through said first and second flanges;
a rod that extends through said second bores, said rod having a radius approximating the curvature of the vertebral column;
at least two screws, each said screw having a first threaded portion attached to the first pedicle of a vertebra and a second threaded portion that extends through said first bore such that each said screw has a clamp attached thereto, each said screw further having a shoulder that engages said second flange of said clamp;
at least two second nuts attached to said second portion of said screws, each screw having one second nut engaging said first flange of said clamp such that said first flange is deflected:
whereby said nut and said shoulder deflect said first and second flanges so that said clamp is pressed onto said rod such that said rod is held in firm engagement by said clamp.
28. The spinal implant of claim 27, further comprising a second set of clamps, screws, rod and nuts assembled as described in claim 7, said screws of said second set being attached to the second pedicles of the vertebrae, whereby there are two spinal implants attached to the vertebral column.
29. The spinal implant as recited in claim 27, wherein said rod and said second bore have approximately the same diameter.
30. The spinal implant as recited in claim 27, wherein said second nuts each nave an annular flange that engages said first flanges, said annular flanges being constructed such that said annular flanges deflect when said nuts are turned into tight engagement with said clamp, locking said nuts onto said clamp.
31. The spinal implant as recited in claim 27, wherein said second nuts each have two annular flanges, wherein one of said two annular flanges engages said first flanges, said annular flanges being constructed such that said annular flanges deflect when said nuts are turned into tight engagement with said clamp, lacking said nuts onto said clamp.
32. The spinal implant as recited in claim 27, wherein said second threaded portion of said screw and said first bore axe of such dimensions that said clamp can rotate up to 30°
about an axis perpendicular to the longitudinal axis of said screw.
about an axis perpendicular to the longitudinal axis of said screw.
33. A method for attaching a spinal implant to the vertebrae of a vertebral column to stabilize the vertebrae, wherein the vertebral column has a curvature along at least one vertical axis and each vertebra has a first and second pedicle, comprising the steps of:
providing;
at least two clamps each having a first bore and a second bore essentially perpendicular to said first bore, said clamp further having a slit extending to said second bore, wherein said slit defines a first flange and a second flange, said clamps further having said first bore extending through said first and second flanges:
a rod adapted to be inserted into and extend through said second bores:
at least two screws, each said screw having a first threaded portion adapted to be attached to the pedicle of a vertebra and a second threaded portion adapted to extend through said first bore, each said screw further having a shoulder between said first acid second threaded portions:
at least two second nuts adapted to thread onto said second threaded portion of said screws, each screw having one second nut adapted to engage said first flange of said clamp;
attaching said screws to the first pedicle of at least two vertebra such that each vertebra has one screw;
inserting said rod into said second bares of said clamps;
placing said clamps and said rod onto said screws such that said second portion of said screws is inserted through said first bores of said clamps;
screwing said second nuts onto said second threaded portion of said screws, such that each screw has one second nut, each said second nut being screwed onto said second threaded portion until said second nut engages said first flange of said clamp and said second flange of said clamp engages said shoulder; and tightening said second nut of each screw such that said first and second flanges are deflected, pressing said, clamp onto said rod, whereby said rod is securely fastened to the vertebrae to hold the vertebrae in place.
providing;
at least two clamps each having a first bore and a second bore essentially perpendicular to said first bore, said clamp further having a slit extending to said second bore, wherein said slit defines a first flange and a second flange, said clamps further having said first bore extending through said first and second flanges:
a rod adapted to be inserted into and extend through said second bores:
at least two screws, each said screw having a first threaded portion adapted to be attached to the pedicle of a vertebra and a second threaded portion adapted to extend through said first bore, each said screw further having a shoulder between said first acid second threaded portions:
at least two second nuts adapted to thread onto said second threaded portion of said screws, each screw having one second nut adapted to engage said first flange of said clamp;
attaching said screws to the first pedicle of at least two vertebra such that each vertebra has one screw;
inserting said rod into said second bares of said clamps;
placing said clamps and said rod onto said screws such that said second portion of said screws is inserted through said first bores of said clamps;
screwing said second nuts onto said second threaded portion of said screws, such that each screw has one second nut, each said second nut being screwed onto said second threaded portion until said second nut engages said first flange of said clamp and said second flange of said clamp engages said shoulder; and tightening said second nut of each screw such that said first and second flanges are deflected, pressing said, clamp onto said rod, whereby said rod is securely fastened to the vertebrae to hold the vertebrae in place.
34. The method as recited in claim 33, further comprising the step of bending said rod before said clamp and said rod are placed tin said second threaded portion, such that said rod approximates the curvature of the vertebral column.
35. The method as recited in claim 33, further comprising providing a second set of clamps, rod, screws and nuts and attaching said screws of said second set to the second pedicle of at least two vertebra and following the steps recited in claim 13, whereby there are two spinal implants attached to the vertebral column.
36. The method as recited in claim 33, wherein said first rod and said second bore have approximately the same diameter.
37. The method as recited in claim 33, wherein said second nuts each have an annular flange adapted to engage said first flanges, said annular flanges being constructed such that said annular flanges deflect when said nuts are turned into tight engagement with said clamp, locking said nuts onto said clamp.
38. The method as recited in claim 33, wherein said second nuts each have two annular flanges adapted to engage said first flanges, said annular flanges being constructed such that said annular flanges deflect when said nuts are turned into tight engagement with said clamp, locking said nuts onto said clamp.
39. The method as recited in claim 33, wherein said second threaded portion of said screw and said first bore are of such dimensions that said clamp can rotate up to 30° about an axis perpendicular to the longitudinal axis of said screw.
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
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US07/802,009 US5282862A (en) | 1991-12-03 | 1991-12-03 | Spinal implant system and a method for installing the implant onto a vertebral column |
US802,009 | 1991-12-03 | ||
PCT/US1992/010376 WO1993010726A1 (en) | 1991-12-03 | 1992-12-02 | Spinal implant and method for installing |
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CA2125030A1 CA2125030A1 (en) | 1993-06-10 |
CA2125030C true CA2125030C (en) | 2000-10-17 |
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Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CA002125030A Expired - Fee Related CA2125030C (en) | 1991-12-03 | 1992-12-02 | Spinal implant and method for installing |
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US (1) | US5282862A (en) |
EP (1) | EP0615429A4 (en) |
AU (1) | AU677168B2 (en) |
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SG (1) | SG47963A1 (en) |
WO (1) | WO1993010726A1 (en) |
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- 1992-12-02 CA CA002125030A patent/CA2125030C/en not_active Expired - Fee Related
- 1992-12-02 WO PCT/US1992/010376 patent/WO1993010726A1/en not_active Application Discontinuation
- 1992-12-02 SG SG1996005719A patent/SG47963A1/en unknown
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CA2125030A1 (en) | 1993-06-10 |
EP0615429A1 (en) | 1994-09-21 |
SG47963A1 (en) | 1998-04-17 |
AU3233793A (en) | 1993-06-28 |
US5282862A (en) | 1994-02-01 |
AU677168B2 (en) | 1997-04-17 |
EP0615429A4 (en) | 1994-11-17 |
WO1993010726A1 (en) | 1993-06-10 |
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