CA2577130A1 - System for positioning a connecting member adjacent the spinal column in minimally invasive procedures - Google Patents

System for positioning a connecting member adjacent the spinal column in minimally invasive procedures Download PDF

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Publication number
CA2577130A1
CA2577130A1 CA002577130A CA2577130A CA2577130A1 CA 2577130 A1 CA2577130 A1 CA 2577130A1 CA 002577130 A CA002577130 A CA 002577130A CA 2577130 A CA2577130 A CA 2577130A CA 2577130 A1 CA2577130 A1 CA 2577130A1
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Canada
Prior art keywords
extender
extenders
connecting member
slots
anchor
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Granted
Application number
CA002577130A
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French (fr)
Other versions
CA2577130C (en
Inventor
John D. Pond, Jr.
Anthony J. Melkent
Stephen D. Stamps
John L. Perkins, Jr.
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Warsaw Orthopedic Inc
Original Assignee
Warsaw Orthopedic, Inc.
John D. Pond, Jr.
Anthony J. Melkent
Stephen D. Stamps
John L. Perkins, Jr.
Sdgi Holdings, Inc.
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Application filed by Warsaw Orthopedic, Inc., John D. Pond, Jr., Anthony J. Melkent, Stephen D. Stamps, John L. Perkins, Jr., Sdgi Holdings, Inc. filed Critical Warsaw Orthopedic, Inc.
Publication of CA2577130A1 publication Critical patent/CA2577130A1/en
Application granted granted Critical
Publication of CA2577130C publication Critical patent/CA2577130C/en
Expired - Fee Related legal-status Critical Current
Anticipated expiration legal-status Critical

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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
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • A61B17/7076—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation
    • A61B17/7082—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation for driving, i.e. rotating, screws or screw parts specially adapted for spinal fixation, e.g. for driving polyaxial or tulip-headed screws
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • A61B17/7076—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation
    • A61B17/7077—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation for moving bone anchors attached to vertebrae, thereby displacing the vertebrae
    • A61B17/7079—Tools requiring anchors to be already mounted on an implanted longitudinal or transverse element, e.g. where said element guides the anchor motion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • A61B17/7076—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation
    • A61B17/7077—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation for moving bone anchors attached to vertebrae, thereby displacing the vertebrae
    • A61B17/708—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation for moving bone anchors attached to vertebrae, thereby displacing the vertebrae with tubular extensions coaxially mounted on the bone anchors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • A61B17/7083—Tools for guidance or insertion of tethers, rod-to-anchor connectors, rod-to-rod connectors, or longitudinal elements
    • A61B17/7085—Tools for guidance or insertion of tethers, rod-to-anchor connectors, rod-to-rod connectors, or longitudinal elements for insertion of a longitudinal element down one or more hollow screw or hook extensions, i.e. at least a part of the element within an extension has a component of movement parallel to the extension's axis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • A61B17/7091—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for applying, tightening or removing longitudinal element-to-bone anchor locking elements, e.g. caps, set screws, nuts or wedges
    • 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
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7011—Longitudinal element being non-straight, e.g. curved, angled or branched
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7032—Screws or hooks with U-shaped head or back through which longitudinal rods pass

Abstract

A spinal surgical system (40) includes at least two extenders (50, 150, 250, 500) extending proximally from respective ones of first and second anchors (120, 160, 180) engaged to the spinal column. A connecting member (100) is positionable such that the connecting member (100) extends between the at least two extenders (50, 150, 250, 500). The connecting member (100) is movable distally along the at least two extenders (50, 150, 250, 500) and engageable to the first and second anchors (120, 160, 180).

Claims (82)

1. A spinal surgical system, comprising:
a first extender extending between a proximal end and a distal end, said distal end being releasably engageable to a first anchor engageable to the spinal column, said first extender including a passage extending at least partially therethrough and opening at said distal end, said first extender including an entry hole in one side thereof in communication with said passage and an elongated slot along another side thereof opposite said entry hole, said elongated slot being in communication with said passage and opening at said distal end;
a second extender extending between a proximal end and a distal end, said distal end being releasably engageable to a second anchor engageable to the spinal column, said second extender including a passage extending at least partially therethrough and opening at said distal end, said second extender including an elongated slot in one side thereof in communication with said passage, said elongated slot of said second extender being alignable with said elongated slot of said first extender; and a connecting member positionable through said entry hole of said first extender and into a position extending between said passages of said first and second extenders through said elongated slots of said first and second extenders.
2. The system of claim 1, wherein said first and second anchors each include a fastening portion engageable to the spinal column and a receiver member pivotal relative to said fastening portion when said fastening portion is engaged to the spinal column.
3. The system of claim 2, wherein each of said receiver members includes a pair of arms defining a U-shaped receptacle for receiving said connecting member.
4. The system of claim 2, further comprising a plug engageable to said receiver member of each of said first and second anchors to secure said connecting member in said receiver member.
5. The system of claim 1, wherein at least one of said extenders includes an engaging member defining said passage, said engaging member being removably engageable with a respective one of said first and second anchors, said at least one extender further including an actuator positioned about said engaging member and movable therealong to bias said engaging member into engagement with said respective anchor.
6. The system of claim 5, wherein said engaging member includes a pair of feet at a distal end thereof and said respective anchor is positionable between said feet.
7. The system of claim 6, wherein each of said feet includes a projection extending therefrom into said passage and toward the other of said pair of feet.
8. The system of claim 5, wherein said engaging member includes a pair of opposite legs separated from one another by a pair of opposite slots, said slots each including a proximal terminal end spaced distally from a proximal end of said engaging member.
9. The system of claim 8, wherein said passage extends between and opens at a proximal end and a distal end of said engaging member, said opposite slots being in communication with said passage.
10. The system of claim 8, wherein said actuator includes a tubular body positionable over said engaging member, said tubular body defining at least one slot extending therealong aligned with one of said slots of said engaging member to form said elongated slot of said at least one extender.
11. The system of claim 10, wherein said at least one slot of said tubular body includes a proximal terminal end aligned with said proximal terminal ends of said slots of said engaging member.
12. The system of claim 10, wherein said actuator defines said entry hole in a side thereof opposite said at least one slot of said actuator, said entry hole being aligned with said proximal terminal end of said slots of said engaging member.
13. The system of claim 10, wherein said actuator defines said entry hole in a side thereof opposite said at least one slot of said actuator, said entry hole being offset proximally of said proximal terminal ends of said slots of said engaging member.
14. The system of claim 13, wherein said engaging member includes an entry hole in communication with said passage and spaced proximally of said proximal terminal ends of said slots of said engaging member, said entry hole of said engaging member being aligned with said entry hole of said actuator.
15. The system of claim 8, wherein said actuator includes a tubular body positionable over said engaging member, said tubular body defining a pair of opposite slots extending proximally from a distal end of said tubular body, said slots of said tubular body being aligned with respective ones of said opposite slots of said engaging member.
16. The system of claim 15, wherein said slots of said actuator include proximal terminal ends spaced distally of a proximal end of said tubular body, said proximal terminal ends of said actuator slots being aligned with said proximal terminal ends of said engaging member slots.
17. The system of claim 1, wherein said extender includes a proximal end collar removably engageable with a reduction instrument.
18. The system of claim 17, wherein said reduction instrument includes a tubular reduction member positionable about at least one of said extenders, said tubular reduction member including a pair of opposite reduction arms extending distally therefrom.
19. The system of claim 18, wherein said reduction instrument includes a locking collar removably engageable to said proximal collar of said at least one extender, wherein when engaged to said proximal collar said locking collar is axially fixed relative to said at least one extender and said reduction member is movable axially along said at least one extender.
20. The system of claim 19, wherein said reduction instrument includes a first handle extending from said locking collar and a second handle pivotally coupled to said first handle, said reduction member extending from said second handle and movable along said at least one extender in response to pivoting of said second handle relative to said first handle.
21. The system of claim 19, wherein said locking collar and said proximal collar include a bayonet locking arrangement.
22. A spinal surgical system, comprising:
a first extender extending between a proximal end and a distal end, said distal end being releasably engageable to a first anchor engageable to bony structure, said first extender including a passage extending at least partially therethrough and opening at said distal end, said first extender including an elongated slot along one side thereof, said elongated slot being in communication with said passage and opening at said distal end, said first extender further including an opening in a side thereof opposite said slot;
a second extender extending between a proximal end and a distal end, said distal end being releasably engageable to a second anchor engageable to bony structure, said second extender including a passage extending at least partially therethrough and opening at said distal end, said second extender including opposite elongated slots in opposite sides thereof in communication with said passage, said elongated slots of said second extender being alignable with said elongated slot of said first extender; and a connecting member positioned through said opening of said first extender and into said passages of said first and second extenders through adjacent ones of said elongated slots of said first and second extenders.
23. The system of claim 22, wherein said opening of said first extender includes an entry hole in a side thereof opposite said slot, said entry hole being in communication with said passage.
24. The system of claim 23, wherein said slot of said first extender includes a proximal terminal end spaced distally of said proximal end of said first extender, said entry hole being aligned with said proximal terminal end of said slot of said first extender.
25. The system of claim 23, wherein said slot of said first extender includes a proximal terminal end spaced distally of said proximal end of said first extender, said entry hole being offset proximally of said proximal terminal end of said slot of said first extender.
26. The system of claim 22, wherein said slot of said first extender includes a proximal terminal end spaced distally of said proximal end of said first extender, said opposite slots of said second extender each including a proximal terminal end aligned with said proximal terminal end of said slot of said first extender.
27. The system of claim 22, further comprising a third extender extending between a proximal end and a distal end, said distal end being releasably engageable to a third anchor engageable to bony structure on a side of said second anchor opposite said first anchor, said third extender including a passage extending at least partially therethrough and opening at said distal end, said third extender including an elongated slot along a side thereof oriented toward said second extender, said elongated slot being in communication with said passage and opening at said distal end.
28. The system of claim 27, wherein said connecting member is positionable between said passages of said first, second and third extenders through said elongated slots of said first, second and third extenders.
29. The system of claim 28, wherein said of said first, second and third extenders are pivotal relative to at least a portion of said respective anchor when engaged thereto.
30. The system of claim 22, wherein said connecting member is movable distally along said first and second extenders while said connecting member extends through aligned adjacent slots of said first and second extenders.
31. A spinal surgical system, comprising:
at least three anchors engageable to the spinal column, each of said anchors including a receiver member;
at least three extenders positionable adjacent one another and engageable to respective ones of said at least three anchors, each of said at least three extenders extending along a longitudinal axis proximally from said respective anchor when engaged thereto, each said at least three extenders further defining a passage opening along at least a portion of a length of the respective extender adjacent at least at a distal end of said respective extender and into said receiver member of said respective anchor when engaged thereto, at least one of said extenders including an opening adjacent a proximal end thereof in a side thereof opposite the other of the at least three extenders; and a connecting member positioned through said opening between said at least three extenders transversely to said longitudinal axes of said extenders and in said passages thereof, said connecting member being movable in said passages and along said at least three extenders into said receiver members of said anchors.
32. The system of claim 31, wherein said anchors each include a fastening portion engageable to bony tissue of the spinal column and said receiver member of each of said anchors is pivotal relative to said fastening portion.
33. The system of claim 32, wherein each of said receiver members includes a pair of arms defining a U-shaped receptacle for receiving said connecting member.
34. The system of claim 33, further comprising a plug engageable to said receiver member of each of said anchors to secure said connecting member in said receiver member.
35. The system of claim 31, wherein at least one of said extenders includes an engaging member defining said passage, said engaging member being removably engageable with said receiver member, said at least one extender further including an actuator positioned about said engaging member and movable therealong to bias said engaging member into engagement with said receiver member.
36. The system of claim 35, wherein said engaging member includes a pair of feet at a distal end thereof and said receiver member is positionable between said feet.
37. The system of claim 35, wherein said engaging member includes a pair of opposite legs separated from one another by a pair of opposite slots, said slots each including a proximal terminal end spaced distally from a proximal end of said engaging member.
38. The system of claim 37, wherein said actuator includes a tubular body positionable over said engaging member, said tubular body defining at least one slot extending therealong alignable with one of said slots of said engaging member.
39. The system of claim 38, wherein said at least one slot of said tubular body includes a proximal terminal end aligned with said proximal terminal end of said slots of said engaging member.
40. The system of claim 38, wherein said actuator defines an entry hole in a side thereof opposite said at least one slot of said tubular body, said entry hole being aligned with the other of said slots of said engaging member to form said opening.
41. The system of claim 40, wherein said entry hole is aligned axially with said proximal terminal end of the other of said slots of said engaging member.
42. The system of claim 38, wherein said engaging member includes an entry hole in a side thereof spaced proximally of said proximal terminal end of the other of said slots of said engaging member.
43. The system of claim 42, wherein said actuator includes an entry hole in a side thereof alignable with said entry hole of said engaging member to form said opening.
44. The system of claim 37, wherein said actuator includes a tubular body positionable over said engaging member, said tubular body defining a pair of opposite slots extending therealong alignable with respective ones of said opposite slots of said engaging member, said aligned slots forming said opening.
45. The system of claim 31, wherein at least one of said extenders includes a proximal end collar removably engageable with a reduction instrument.
46. The system of claim 45, wherein said reduction instrument includes a tubular reduction member positionable about said at least one extender, said tubular reduction member including a pair of opposite reduction arms extending distally therefrom.
47. The system of claim 46, wherein said reduction instrument includes a locking collar removably engageable to said proximal end collar of said at least extender, wherein when engaged said locking collar is fixed relative to said at least one extender and said reduction member is movable axially along said at least one extender.
48. The system of claim 47, wherein said reduction instrument includes a first handle extending from said locking collar and a second handle pivotally coupled to said first handle, said reduction member extending from said first handle.
49. The system of claim 31, wherein said second extender is positionable between said first and third extenders, said second extender including a passage opening along at least portion of the length of opposite sides of said second extender, one of said open sides being aligned with said at least one slot of said first extender and the other of said open sides being aligned with said at least one slot of said third extender.
50. The system of claim 31, wherein said opening is an entry hole positioned adjacent said proximal end of said at least one extender.
51. The system of claim 31, wherein said opening is an elongated slot extending along said at least one extender.
52. A spinal surgical system, comprising:
at least one anchor engageable to the spinal column, said at least one anchor including a receiver member having a receptacle;
at least one extender engageable to said at least one anchor, said at least one extender extending along a longitudinal axis proximally from said at least one anchor when engaged thereto, said at least one extender further defining a passage opening along at least a major portion of said longitudinal axis, said passage further opening at a distal end of said at least one extender into said receptacle of said receiver member of said at least one anchor;
a connecting member positionable in said passage transversely to said longitudinal axis of said at least one extender with said connecting member extending through said opening along said longitudinal axis, said connecting member being movable distally in said passage along said at least one extender into said receptacle of said receiver member of said at least one anchor; and a reduction instrument positionable about said at least one extender, said reduction instrument including a reduction member extending along said at least one extender, said reduction member being positionable in contact with said connecting member and being movable along said at least one extender to move said connecting member distally along said at least one extender and into said receptacle of said receiver member of said at least one anchor.
53. The system of claim 52, wherein said reduction member is tubular.
54. The system of claim 53, wherein said reduction instrument includes a locking collar removably engageable to a proximal collar of said at least one extender, wherein when engaged to said proximal collar said locking collar is fixed relative to said at least one extender and said reduction member is movable axially along said at least one extender.
55. The system of claim 54, wherein said reduction instrument includes a first handle extending from said locking collar and a second handle pivotally coupled to said first handle, said reduction member extending from said second handle.
56. The system of claim 52, wherein said at least one extender includes a pair of opposing slots extending proximally from said distal end thereof, said pair of slots being in communication with said passage, and said connecting member projecting through said pair of opposite slots when positioned in said passage.
57. An instrument for reducing a connecting member into a receiver member of an anchor, comprising:
a proximal actuator assembly including a first handle pivotally coupled to a second handle;
a locking collar fixed relative to said first handle, said locking collar being removably engageable to an extender engaged to the receiver member of the anchor; and a reduction member pivotally coupled to said second handle and being movable relative to said locking collar upon pivoting of said second handle relative to said first handle, said reduction member being an elongated tube and said locking collar being positioned within a proximal end opening of said elongated tube.
58. The system of claim 57, wherein said elongated tube includes an inner passage extending between said proximal end and a distal end of said elongated tube.
59. The system of claim 58, wherein said reduction member includes a pair of reduction arms extending distally from opposite sides of said distal end of said elongated tube.
60. A spinal surgical method, comprising:
engaging a first anchor and a second anchor to the spinal column;
engaging a first extender and a second extender to respective ones of the first and second anchors, the first and second extenders each being elongated and defining a passage opening at a distal end thereof, the first and second extenders extending proximally from the first and second anchors;
positioning a connecting member through a side entry hole in the first extender;
advancing the connecting member through the passage of the first extender and into the passage of the second extender, wherein the connecting member extends between the passages of the first and second extenders; and advancing the connecting member distally along the extenders to the first and second anchors.
61. The method of claim 60, further comprising:
positioning a reduction instrument over one of the first and second extenders;
and operating the reduction instrument to seat the connecting member in the first and second anchors.
62. The method of claim 61, further comprising delivering plugs through the first and second extenders to secure the connecting member in the first and second anchors.
63. The method of claim 62, further comprising:
engaging a third anchor to the spinal column;
engaging a third extender to the third anchor, the third extender being elongated and defining a passage opening at a distal end thereof, said third extender extending proximally from the third anchor;
advancing the connecting member from the second extender into the passage of the third extender, wherein the connecting member extends between the passages of the first, second and third extenders; and advancing the connecting member distally along the extenders to the first, second and third anchors.
64. A spinal surgical method, comprising:
engaging a first anchor, a second anchor and a third anchor to the spinal column;
engaging a first extender, a second extender and a third extender to respective ones of the first, second and third anchors, the first, second and third extenders each being elongated and defining a passage opening at a distal end thereof, the first, second and third extenders extending proximally from respective ones of the first, second and third anchors;
positioning a connecting member in the passages first, second and third extenders by delivering the connecting member along an insertion path extending from a side of the first extender opposite the second and third extenders then through the first extender and the second extender and into the third extender; and advancing the connecting member distally along the extenders to the first, second and third anchors.
65. The method of claim 64, wherein the first, second and third extenders are pivotal relative to one another when engaged to the respective first, second and third anchors.
66. The method of claim 65, further comprising:
orienting the first and third extender parallel to one another;
measuring a length between the first and third extenders; and selecting the connecting member with a length based on the measured length.
67. The method of claim 64, further comprising compressing an adjacent pair of the first, second and third anchors before engaging the connecting element to the pair of adjacent anchors.
68. The method of claim 64, further comprising distracting an adjacent pair of the first, second and third anchors before engaging the connecting element to the pair of adjacent anchors.
69. The method of claim 64, further comprising:
positioning a reduction instrument over one of the first, second and third extenders;
and operating the reduction instrument to seat the connecting member in at least the anchor engaged to the one extender.
70. A spinal surgical method, comprising:
engaging a first anchor and a second anchor to the spinal column;
engaging a first extender and a second extender to respective ones of the first and second anchors, the first and second extenders each being elongated and defining a passage opening at a distal end thereof, the first and second extenders extending proximally from the first and second anchors;

positioning a connecting member between the first and second extenders, wherein positioning the connecting member includes positioning a leading end of the connecting member through opposing slots of at least one of the first and second extenders and through a slot and into the passage of the other of the first and second extenders along an insertion path beginning on a side of the at least one of the first and second extenders opposite the other of first and second extender, said insertion path extending transversely to longitudinal axes of said first and second extenders; and advancing the connecting member distally along the slots of the first and second extenders to the first and second anchors.
71. The method of claim 70, wherein each of the first and second extenders includes opposing slots and positioning the connecting member includes extending the connecting member through each of opposing slots of each of the first and second extenders.
72. The method of claim 70, further comprising:
contacting the connecting member on the side of the at least one of the first and second extenders opposite the other of the first and second extenders; and advancing the connecting member includes maintaining contact with the connecting member on the side of the at least one of the first and second extenders opposite the other of the first and second extenders.
73. The method of claim 70, further comprising:
engaging a third anchor to the spinal column; and engaging a third extender to the third anchor with the third extender extending proximally from the third anchor, the third extender being elongated and defining opposing slots extending therealong, and positioning the connecting member includes positioning the connecting member to extend between the first, second and third extenders.
74. The method of claim 73, wherein the connecting member projects from each of the opposing slots of each of the first, second and third extenders.
75. A spinal surgical method, comprising:
engaging a first anchor and a second anchor to the spinal column;
engaging a first extender and a second extender to respective ones of the first and second anchors, the first and second extenders each being elongated and defining elongated slots extending therealong opening along opposite sides of each of the respective extenders, the first and second extenders extending proximally from the first and second anchors when engaged thereto;
positioning a connecting member through the opposing slots of each of the first and second extenders, wherein the connecting member extends between the first and second extenders; and advancing the connecting member distally along the first and second extenders to the first and second anchors.
76. The method of claim 75, further comprising:
engaging a third anchor to the spinal column;
engaging a third extender to the third anchor, the third extender being elongated and defining elongated slots extending therealong opening along opposite sides thereof, the third extender extending proximally from the third anchor; and positioning the connecting member includes positioning the connecting member through the opposing slots of the third extender before advancing the connecting member distally along the extenders to the first and second anchors.
77. The method of claim 75, wherein positioning the connecting member includes positioning the connecting member along an insertion path extending transversely to longitudinal axes of the first and second extenders and advancing the connecting member includes advancing the connecting member along longitudinal axes of the first and second extenders.
78. The method of claim 75, further comprising delivering a plug through each of the first and second extender to secure the connecting member to the first and second anchors.
79. A spinal surgical system, comprising:
a first extender extending between a proximal end and a distal end, said distal end being releasably engageable to a first anchor engageable to bony structure, said first extender including a passage extending at least partially therethrough and opening at said distal end, said first extender including opposite elongated slots in opposite sides thereof, said elongated slots being in communication with said passage and opening at said distal end;
a second extender extending between a proximal end and a distal end, said distal end being releasably engageable to a second anchor engageable to bony structure, said second extender including a passage extending at least partially therethrough and opening at said distal end, said second extender including opposite elongated slots in opposite sides thereof in communication with said passage, said elongated slots of said second extender being alignable with said elongated slots of said first extender; and a connecting member positioned between said passages of said first and second extenders, wherein when positioned between said passages of said first and second extenders said connecting member includes a length sized to project through oppositely facing elongated slots of said first and second extenders as said connecting member is moved along said first and second extenders toward said first and second anchors.
80. The system of claim 79, further comprising a third extender extending between a proximal end and a distal end, said distal end being releasably engageable to a third anchor engageable to bony structure on a side of said second anchor opposite said first anchor, said third extender including a passage extending at least partially therethrough and opening at said distal end, said third extender including opposing slots therealong in communication with said passage and opening at said distal end of said third extender.
81. The system of claim 80, wherein said connecting member is positionable between said passages of said first, second and third extenders through said elongated slots of said first, second and third extenders.
82. The system of claim 80, wherein said of said first, second and third extenders are pivotal relative to at least a portion of said respective anchor when engaged thereto.
CA2577130A 2004-08-13 2005-08-11 System for positioning a connecting member adjacent the spinal column in minimally invasive procedures Expired - Fee Related CA2577130C (en)

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AU2005272566B2 (en) 2009-11-12
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KR100929955B1 (en) 2009-12-04
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US7465306B2 (en) 2008-12-16
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CN101721244A (en) 2010-06-09
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ATE490738T1 (en) 2010-12-15
ES2354443T3 (en) 2011-03-15
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JP2008509759A (en) 2008-04-03
EP1833394B1 (en) 2010-12-08

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