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Publication numberCA2637684 A1
Publication typeApplication
Application numberCA 2637684
PCT numberPCT/US2006/037329
Publication date16 Aug 2007
Filing date25 Sep 2006
Priority date6 Feb 2006
Also published asCA2637684C, EP1981422A1, US8894655, US8979851, US9119684, US9247977, US9655685, US20070233079, US20090099605, US20140025118, US20140031871, US20160242866, WO2007092056A1
Publication numberCA 2637684, CA 2637684 A1, CA 2637684A1, CA-A1-2637684, CA2637684 A1, CA2637684A1, PCT/2006/37329, PCT/US/2006/037329, PCT/US/2006/37329, PCT/US/6/037329, PCT/US/6/37329, PCT/US2006/037329, PCT/US2006/37329, PCT/US2006037329, PCT/US200637329, PCT/US6/037329, PCT/US6/37329, PCT/US6037329, PCT/US637329
InventorsT. Wade Fallin, Joshua A. Butters
ApplicantStryker Spine, T. Wade Fallin, Joshua A. Butters
Export CitationBiBTeX, EndNote, RefMan
External Links: CIPO, Espacenet
Rod contouring apparatus and method for percutaneous pedicle screw extension
CA 2637684 A1
Abstract
Anatomic points within the body are projected outside the body through the use of extenders (180, 182, 188). The projected points may then be used for measurement, or to facilitate the selection or configuration of an implant that is positioned proximate the anatomic points using a slotted cannula (143). Such an implant may be a rod (270) for a posterior spinal fusion system. Pedicle screws (140, 142, 148) may be implanted into pedicles of the spine, and may then serve as anchors for the extenders. The extenders (180, 182, 188) may have rod interfaces (214, 216, 218) that receive the rod (270) in a manner that mimics the geometry of the pedicle screws (140, 142, 148) so that the selected or configured contoured rod (270) will properly fit into engagement with the pedicle screws (140, 142, 148).
Description  available in
Claims(35)
1. A system for configuring or selecting one or more implants and for implanting the implants proximate a bone in the body of a patient, the system comprising:
a first extender comprising a distal portion configured to be positioned proximate a first anatomic point proximate a bone within the body, through which the one or more implants are to pass;

a second extender comprising a distal portion configured to be positioned proximate a second anatomic point proximate a bone within the body, through which the one or more implants are to pass; and a first bridge configured to constrain an' orientation of the first extender with respect to the second extender to provide a spatial transformation of the first and second anatomic points to first and second projected points outside the body;

a first cannula having a distal end configured to be positioned proximate the first anatomic point within the body, a proximal end and an axis, and having a first slot and a second slot in the side wall thereof;

wherein the first and second extenders are configured to receive the one or more implants to facilitate configuration or selection of the one or more implants based on locations of the first and second projected points; and wherein the second slot of the first cannula is arranged with respect to the first slot of the first cannula to permit passage of said one or more configured or selected implants through the slots of the first cannula along a direction transverse to the central axis of the first cannula.
2. The system of claim 1, further comprising a pedicle screw implantable in a pedicle of a first vertebra of the spine proximate the first anatomic point, and a cage polyaxially movable with respect to the pedicle screw, the cage being configured to receive at least a portion of said one or more implants.
3. The system of claim 2, wherein the distal end of the first cannula is insertable into the patient proximate the spine such that each of the first and second slots extend unbroken along the entire subcutaneous length such that the distal ends of the slots permit percutaneous passage of said one or more implants into the cage of the pedicle screw.
4. The system of claim 2, wherein the distal end of the first cannula has a docking element discrete from and' securable to the cage of the pedicle screw.
5. The system of claim 2, wherein the one or more implants comprise a rod for a posterior spinal fusion system.
6. The system of claim 1, wherein the first cannula comprises:

a first blade; and a second blade discrete from the first blade;
wherein the first and second blades are positionable substantially parallel to each other to provide the first cannula.
7. The system of claim 1, further comprising an abutment member encircling at least a portion of the first cannula to abut an exterior skin surface of the patient, wherein the abutment member is movable along the first cannula to define a variable subcutaneous length of the first cannula.
8. The system of claim 6, further comprising an abutment member encircling at least a portion of the first cannula to abut an exterior skin surface of the patient, wherein the abutment member is movable along the first cannula to define a variable subcutaneous length of the first cannula wherein the abutment member is configured to the first and second blades to restrict relative motion between the first and second blades.
9. The system of claim 1, further comprising a second cannula having a distal end configured to be positioned proximate the second anatomic point within the body, a proximal end and an axis, and having a first slot and a second slot in the side wall thereof, the second slot of the second cannula being arranged with respect to the first slot of the second cannula to permit passage of said one or more implants through the second cannula along a direction transverse to the central axis of the second cannula, the second cannula securable to a second connecting element implantable proximate the second anatomical point in a second' vertebra of the spine, wherein the slots of the first, and second cannulas cooperate to facilitate attachment of said one or more configured or selected implants to the first and second connecting elements to restrict relative motion of the connecting elements.
10. The system of claim 9, further comprising a third cannula having a distal end configured to be positioned proximate a third anatomic point proximate a bone within the body, a proximal end and an axis, and having a first slot and a second slot in the side wall thereof, the second slot of the third cannula being arranged with respect to the first slot of the third cannula to permit passage of said one or more implants through the third cannula along a direction transverse to the central axis of the third cannula, the third cannula securable to a third connecting element implantable proximate the third anatomical point in a third vertebra of the spine, wherein the slots of the first, second, and third cannulas cooperate to facilitate attachment of said one or more configured or selected implants to the first, second, and third connecting elements to restrict relative motion of the connecting elements.
11. The system of claim 1, wherein each of the one or more implants is shaped to be implanted proximate a spine of the body, wherein the first anatomic point is proximate a first pedicle of the spine, and the second anatomic point is proximate a second pedicle of the spine.
12. The system of claim 11, wherein the distal portion of the first extender is shaped to mate with a rod interface of a first fixation member implantable in the first pedicle, wherein the distal portion of the second extender is shaped to mate with a rod interface of a second fixation member implantable in the second pedicle.
13. The system of claim 12, wherein each of the first and second extenders comprises a proximal portion comprising a rod interface shaped to receive the rod.
14. The system of claim 1, wherein the first bridge is configured to keep the first and second extenders parallel to each other.
15. The system of claim 1, wherein the first bridge is configured to keep the first and second extenders parallel to each other while permitting substantially free relative translation between the first and second extenders.
16. The system of claim 1, wherein the first bridge is configured to keep the first and second extenders parallel to each other while permitting each or the extenders to rotate about its axis.
17. The system of claim 14, wherein the first bridge comprises:

a first slider is configured to be coupled to a shaft of the first extender such that the first slider extends substantially perpendicular to the shaft and is rotatable about and slidable along the shaft; and a second slider configured to be coupled to a shaft of the second extender such that the second slider extends substantially perpendicular to the shaft and is rotatable about and slidable along the shaft;
wherein the first and second sliders are configured to be slidably coupled together.
18. The system of claim 1, further comprising a third extender comprising a distal portion configured to be positioned proximate a third anatomic point within the body, through which the one or more implants are to pass; and a second bridge configured to constrain an orientation of the second extender with respect to the third extender such that the system provides a spatial transformation of the first, second, and third anatomic points to first, second, and third projected points outside the body.
19. The system of claim 1 system wherein the distal portions of the first and second extenders are configured to be positioned proximate first and second anatomic points, respectively, through which the one or more configured or selected implants are to pass within the body and proximate the spine, such that the proximal portions are positioned outside the body and the proximal portions comprise implant interfaces shaped to receive the one or more implants to facilitate configuration or selection of the one or more implants.
20. A method for configuring or selecting one or more implants and percutaneously implantating the implants in a body of a patient, the method comprising:
positioning a distal portion of a first extender proximate a first anatomic point within the body, through which the one or more implants are to pass;
positioning a distal portion of a second extender proximate a second anatomic point within the body, through which the one or more implants are to pass;
constraining an orientation of the first extender with respect to the second extender to provide a spatial transformation of the first and second anatomic points to first and second projected points outside the body;
configuring or selecting the one or more implants based on locations of the first and second projected points;
positioning the distal end of a first cannula proximate the first anatomic point within the body, the cannula having a proximal end and an axis, and having a first slot and a second slot in the side wall thereof;
subcutaneously passing said one or more configured or selected implants through the slots of the first cannula along a direction transverse to the central axis of the first cannula.
21. The method of claim 20, wherein the first anatomic point is proximate a first pedicle of the spine and the second anatomic point is proximate a second pedicle of the spine, the method further comprising implanting the one or more implants proximate the spine.
22. The method of claim 21, wherein the one or more implants comprise a rod for a posterior spinal fusion system, wherein implanting the one or more implants proximate the spine comprises securing the rod to a plurality of vertebrae of the spine to restrict relative motion of the vertebrae.
23. The method of claim 22, wherein positioning the distal portion of the first extender proximate the first anatomic point comprises mating the distal portion of the first extender with a rod interface of a first fixation member implantable in the first pedicle, wherein positioning the distal portion of the second extender proximate the second anatomic point comprises mating the distal portion of the second extender with a rod interface of a second fixation member implantable in the second pedicle.
24. The method of claim 23, wherein configuring or selecting the one or more implants based on locations of the first and second projected points comprises receiving the rod with proximal portions of the first and second extenders.
25. The method of claim 24, wherein constraining the orientation of the first extender with respect to the second extender comprises coupling a first bridge to the first and second extenders to keep the first and second extenders parallel to each other while permitting substantially free relative translation between the first and second extenders.
26. The method of claim 25, further comprising:
positioning a distal portion of a third extender proximate a third anatomic point within the body, through which the one or more implants are to pass; and constraining an orientation of the second extender with respect to the third extender such that the method provides a spatial transformation of the first, second, and third anatomic points to first, second, and third projected points outside the body.
27. The method of claim 22, wherein the rod is secured to the spine by a pedicle screw implantable in a pedicle of a first vertebra of the spine proximate the first anatomic point, and a cage polyaxially movable with respect to the pedicle screw, the cage being configured to receive at least a portion of said one or more implants.
28. The method of claim 27, wherein the distal end of the first cannula is configured such that each of the first and second slots extend unbroken along the entire subcutaneous length and said one or more implants are passed through the slots into the cage of the pedicle screw.
29. The method of claim 27, wherein the distal end of the first cannula has a docking element and is secured to the cage of the pedicle screw using the docking element.
30. The method of claim 20, wherein the first cannula comprises:

a first blade; and a second blade discrete from the first blade;
wherein the first and second blades are positioned percutaneously and substantially parallel to each other to provide the first cannula.
31. The method of claim 20, wherein an abutment member is positioned to encircle at least a proximal portion of the first cannula and moved anteriorly along the first cannula to abut the exterior skin surface of the patient and define a variable subcutaneous length of the first cannula.
32. The method of claim 30, wherein an abutment member is positioned to control at least a proximal portion of the first and second blades to restrict relative motion between the first and second blades and said abutment member is moved anteriorly along the first cannula to abut the exterior skin surface of the patient and define a variable subcutaneous length of the first cannula.
33. The method of claim 20, wherein a cutting instrument is passed through the slots of the first cannula and used to incise a tissue path extending from said first cannula slot to said second body anatomical pint and said subcutaneously passing of said one or more configured or selected implants through the slots of the first cannula along a direction transverse to the central axis of the first cannula transfers at least a portion of said implant to a position proximate said second body anatomical point along said tissue path.
34. The method of claim 33 wherein at least a portion of said tissue path is located between located anteriorly to the lumbodorsal fascia.
35. The method of claim 20, wherein the first and second anatomic points are located anteriorly to the lumbodorsal fascia.
Classifications
International ClassificationA61B17/88
Cooperative ClassificationA61B2090/061, A61B17/88, A61B17/0218, A61B90/06, A61B17/7032, A61B17/7002, A61B17/7037, A61B17/7085, A61B17/8863, A61B17/8897, A61B17/7041
European ClassificationA61B17/88F, A61B17/70T4C
Legal Events
DateCodeEventDescription
18 Jul 2008EEERExamination request