US20080161853A1 - Spine stabilization system with dynamic screw - Google Patents

Spine stabilization system with dynamic screw Download PDF

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Publication number
US20080161853A1
US20080161853A1 US11/646,877 US64687706A US2008161853A1 US 20080161853 A1 US20080161853 A1 US 20080161853A1 US 64687706 A US64687706 A US 64687706A US 2008161853 A1 US2008161853 A1 US 2008161853A1
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US
United States
Prior art keywords
rod
stabilization system
spine stabilization
receiver
screw
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.)
Abandoned
Application number
US11/646,877
Inventor
Benjamin Arnold
Charles M. Bartish
SeungKyu Daniel Kwak
William L. Dunbar
John Riley Hawkins
Amie Borgstrom
Erasmo A. Lopez
Anwar M. Upal
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
DePuy Spine LLC
DePuy Synthes Products Inc
Original Assignee
DePuy Spine LLC
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by DePuy Spine LLC filed Critical DePuy Spine LLC
Priority to US11/646,961 priority Critical patent/US8409256B2/en
Priority to US11/646,877 priority patent/US20080161853A1/en
Assigned to DEPUY SPINE, INC. reassignment DEPUY SPINE, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: KWAK, SEUNGKYU DANIEL, BARTISH, CHARLES M., JR., DUNBAR, WILLIAM L., JR., ARNOLD, BENJAMIN, LOPEZ, ERASMO A., HAWKINS, JOHN RILEY, UPAL, ANWAR M.
Priority to CA2674147A priority patent/CA2674147C/en
Priority to JP2009544032A priority patent/JP5437074B2/en
Priority to AU2007342474A priority patent/AU2007342474B2/en
Priority to PCT/US2007/025862 priority patent/WO2008085347A1/en
Priority to PCT/US2007/026009 priority patent/WO2008085369A1/en
Priority to EP07863062.1A priority patent/EP2117448B1/en
Publication of US20080161853A1 publication Critical patent/US20080161853A1/en
Assigned to DEPUY SPINE, INC. reassignment DEPUY SPINE, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: LABROM, ROBERT DAVID
Priority to US13/798,243 priority patent/US9629662B2/en
Assigned to DEPUY SPINE, LLC reassignment DEPUY SPINE, LLC CHANGE OF NAME (SEE DOCUMENT FOR DETAILS). Assignors: DEPUY SPINE, INC.
Assigned to HAND INNOVATIONS LLC reassignment HAND INNOVATIONS LLC ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: DEPUY SPINE, LLC
Assigned to DePuy Synthes Products, LLC reassignment DePuy Synthes Products, LLC CHANGE OF NAME (SEE DOCUMENT FOR DETAILS). Assignors: HAND INNOVATIONS LLC
Priority to US14/563,153 priority patent/US20150088207A1/en
Assigned to DePuy Synthes Products, Inc. reassignment DePuy Synthes Products, Inc. CHANGE OF NAME (SEE DOCUMENT FOR DETAILS). Assignors: DePuy Synthes Products, LLC
Abandoned legal-status Critical Current

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7035Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002Longitudinal elements, e.g. rods
    • A61B17/7004Longitudinal elements, e.g. rods with a cross-section which varies along its length
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002Longitudinal elements, e.g. rods
    • A61B17/7004Longitudinal elements, e.g. rods with a cross-section which varies along its length
    • A61B17/7005Parts of the longitudinal elements, e.g. their ends, being specially adapted to fit in the screw or hook heads
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002Longitudinal elements, e.g. rods
    • A61B17/7011Longitudinal element being non-straight, e.g. curved, angled or branched
    • A61B17/7013Longitudinal element being non-straight, e.g. curved, angled or branched the shape of the element being adjustable before use
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002Longitudinal elements, e.g. rods
    • A61B17/7019Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other
    • A61B17/7026Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other with a part that is flexible due to its form
    • A61B17/7028Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other with a part that is flexible due to its form the flexible part being a coil spring
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7032Screws or hooks with U-shaped head or back through which longitudinal rods pass
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7035Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • A61B17/7037Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other wherein pivoting is blocked when the rod is clamped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7035Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • A61B17/7038Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other to a different extent in different directions, e.g. within one plane only
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7035Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • A61B17/704Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other the longitudinal element passing through a ball-joint in the screw head
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831Material properties
    • A61B2017/00867Material properties shape memory effect

Definitions

  • This application relates to the field of spinal stabilization devices.
  • this application relates to a posterior stabilization unit configured for use with a segmental unit of the spine.
  • pedicle screws are placed through the pedicles on the posterior portion of two or more vertebrae of the spinal column.
  • the screws grab into the bone of the vertebral bodies, giving them a good solid hold on the vertebrae.
  • metal rods that connect all the screws together.
  • Posterior dynamic stabilization generally refers to such a stabilization procedure where dynamic rods are positioned between the pedicle screws. These dynamic rods can generally bend, extend, compress, or otherwise deform in order to allow some limited movement between the pedicle screws. By allowing this limited movement between the pedicle screws and the associated vertebrae, less strain is placed on adjoining, non-stabilized functional segmental units during patient movements. In addition, the dynamic rod generally decreases the stresses on the screw shank, minimizing the possibility of screw backout or related screw failures. However, even with dynamic rods, stresses are experienced by the screw shank which could potentially result in screw backout or related failures under the appropriate circumstances.
  • a PDS system capable of further protecting the screw-bone interface and reducing the chances of screw backout.
  • a PDS system with a flexible stabilization element that offers different kinematics and loading requirements from those stabilization elements found in the prior art.
  • Such a stabilization element would offer additional options to the surgeon when traditional PDS stabilization elements appear problematic.
  • a dynamic screw for a spine stabilization system comprises at least one bone anchor assembly comprising a bone engaging member and a receiver member.
  • the bone engaging member may comprise a bone screw including a screw head retained within the receiver member and a screw shank extending from the receiver member.
  • the screw head may be pivotably retained within the receiver member.
  • An elongated connecting member is pivotably connected to the bone engaging member.
  • the elongated connecting member may be provided as a rod spanning between two or more bone anchor assemblies.
  • the elongated connecting member is pivotably connected to the receiver member of the bone anchor assembly.
  • the pivotable connection between the elongated connection member and the receiver member is provided by a ball-shaped pivot member on the rod which engages a bearing surface provided within a cavity of the receiver member.
  • the pivot point for the rod may be provided within the cavity in the receiver member.
  • the rod may define an axis wherein the axis pivots about a pivot point on the axis when the rod pivots relative to the receiver member.
  • the pivot point of the rod is offset from the axis defined by the rod.
  • the rod may be a fixed length or adjustable to accommodate different segmental units and patients of different sizes.
  • the rod comprises a shaft with a flexible central portion and at least one adjustable end.
  • the adjustable end may be provided by various means.
  • the adjustable end may include a post configured to slide within the shaft of the rod.
  • the adjustable end is configured to threadedly engage the shaft.
  • the adjustable end is comprised of a shape memory alloy.
  • the spine stabilization system When assembled, the spine stabilization system generally comprises at least two bone anchors with a rod extending between the two bone anchors.
  • each bone anchor includes a bone screw and a receiver member configured to retain the bone screw.
  • the rod extends between the two receiver members.
  • the rod is fixed relative to the receiver members, the rod is adapted to bend when the receiver members move relative to one another.
  • the rod is pivotably connected to both the receiver members, and the rod is adapted to extend or compress when the receiver members move relative to one another.
  • one or more bone anchors of the spine stabilization system include an insert in the form of a retention member that acts to lock a bearing for the bone screw within the receiver member.
  • the receiver member includes a screw head cavity and a rod cavity with an insert positioned between the screw head cavity and the rod cavity.
  • the screw head cavity is configured to receive a bearing that engages the head of the bone screw with the screw shank extending from the receiver member.
  • the bone screw bearing is a split bearing.
  • the insert is positioned between the rod cavity and the bearing member and is configured to secure the split bearing within the receiver member.
  • the insert may be provided to fit within a groove formed in an interior sidewall of the receiver member.
  • the insert comprises a retaining ring that secures the split bearing within the screw cavity.
  • the insert is comprised of a compressible material positioned between the bearing member and the rod cavity. When the rod is positioned in the rod cavity, the insert is compressed against the bearing member, thus locking the bearing member within the screw cavity.
  • the bone anchor assembly is configured with a low profile, wherein the rod is locked within the receiver member without the use of a fixation screw.
  • the bone anchor assembly includes a head and a screw shank extending from the head. The screw shank is pivotable with respect to the head.
  • a rod cavity is formed within the head.
  • the end of the rod includes features that lock the rod within the rod cavity when the rod is inserted into the rod cavity, thus connecting the rod to the head.
  • the end of the rod comprises a plurality of fingers that may be flared to lock the rod within the rod cavity.
  • the rod may also include a plurality of teeth that grasp or mesh with the rod cavity to further secure the rod within the cavity.
  • FIG. 1 shows a posterior view of a spine stabilization system with a plurality of dynamic screws and dynamic rods connected between two vertebrae;
  • FIG. 2 shows a side view of the spine stabilization system of FIG. 1 ;
  • FIG. 3A shows a cross-sectional view of a bone anchor and rod which form part of the spine stabilization system of FIG. 1 ;
  • FIG. 3B shows an exploded perspective view of the bone anchor and rod of FIG. 3A ;
  • FIG. 3C shows a perspective view of a retainer insert of FIG. 3B ;
  • FIG. 3D shows a top view of the retainer insert of FIG. 3C ;
  • FIG. 4 shows a cross-sectional view of an alternative embodiment of the bone anchor and rod of FIG. 3 ;
  • FIG. 5 shows a perspective view of an alternative embodiment of the bone anchor and rod of FIG. 3 wherein the pivot point of the rod is offset from the central axis of the rod;
  • FIG. 6 shows a cross-sectional view of the bone anchor and rod of FIG. 5 ;
  • FIG. 7 shows an alternative embodiment of the bone anchor and rod of FIG. 5 ;
  • FIG. 8 shows a cross-sectional view of an alternative embodiment of the bone anchor and rod of FIG. 3 wherein the pivot point of the rod is provided on the central axis of the rod;
  • FIG. 9 shows another cross-sectional view of the bone anchor and rod of FIG. 8 rotated 90°
  • FIG. 10 shows a perspective view of an alternative embodiment of the bone anchor of FIG. 8 ;
  • FIG. 11 shows a perspective view of another alternative embodiment of the bone anchor of FIG. 8 ;
  • FIG. 12 shows a perspective view of another alternative embodiment of the bone anchor of FIG. 8 ;
  • FIG. 13 shows a cross-sectional view of the bone anchor of FIG. 12 ;
  • FIG. 14 shows a perspective view of yet another alternative embodiment of the bone anchor and rod of FIG. 8 ;
  • FIG. 15A shows a dynamic rod for use with the bone anchor of FIGS. 8-13 , wherein the dynamic rod includes ball shaped members on its ends;
  • FIG. 15B shows an alternative embodiment of the dynamic rod of FIG. 15A wherein the length of the rod is adjustable
  • FIG. 15C shows another alternative embodiment of the dynamic rod of FIG. 15A wherein the length of the rod is adjustable
  • FIG. 15D shows yet another alternative embodiment of the dynamic rod of FIG. 15A wherein the length of the rod is adjustable
  • FIG. 15E shows another alternative embodiment of the dynamic rod of FIG. 15A wherein the length of the rod is adjustable
  • FIG. 15F shows yet another alternative embodiment of the dynamic rod of FIG. 15A wherein the length of the rod is adjustable
  • FIG. 16 shows a perspective view of an alternative embodiment of a bone anchor and rod for use with the spine stabilization system of FIG. 1 wherein the rod is secured to a cavity in the bone anchor without the use of a fixation screw;
  • FIG. 17 shows a cross-sectional view of the bone anchor and rod of FIG. 16 ;
  • FIG. 18 shows a cross-sectional view of the bone anchor and rod of FIG. 17 rotated 90°.
  • an exemplary posterior dynamic stabilization (PDS) system 22 is shown arranged between two vertebrae 20 , 21 of a spine.
  • the PDS system 22 comprises a plurality of bone anchors 24 with a plurality of elongated connecting members 26 extending between the bone anchors 24 .
  • the plurality of connecting members 26 may comprise rods, bars, or other elongated connecting members.
  • Each bone anchor 24 is secured to the pedicle of one of the vertebrae 20 or 21 .
  • Each elongated connecting member 26 extends between a first bone anchor fixed to an upper vertebra 20 and a second bone anchor fixed to a lower vertebra 21 .
  • each bone anchor 24 is comprised of titanium, stainless steel, or other appropriate biocompatible material.
  • each bone anchor 24 comprises a bone engaging member 34 , such as a bone screw (as shown in FIG. 3 , for example).
  • a bone engaging member 34 such as a bone screw (as shown in FIG. 3 , for example).
  • other bone engaging members 34 are possible, such as posts, pins, cemented surfaces, adhesive surfaces and other bone engaging members as are known in the art.
  • each bone anchor 24 also comprises a receiver member 40 .
  • the receiver member 40 is configured to receive a bone engaging member 34 and/or an elongated connecting member 26 . If the bone engaging member 34 is a bone screw, the bone screw 34 includes a screw head 36 and a screw shank 38 . The screw head 36 is retained within the receiver member 40 and the screw shank 38 extends from the receiver member 40 . The screw shank 38 is configured to screw into the bone and secure the bone screw 34 to the pedicle or other portion of bone.
  • the receiver member 40 may be rigidly or pivotably connected to the screw 34 .
  • the receiver member 40 is also configured to receive an elongated connecting member, such as the rod 26 .
  • the rod 26 includes two rigid ends 30 , 32 with an elastic/resilient central portion 28 disposed between the rod ends.
  • the elastic central portion 28 allows for some limited flexibility in the rod, while still allowing the rod to spring back to its original shape. Therefore, when opposing forces are applied to the ends 30 , 32 of the rod 26 , the central portion flexes, allowing the rod to bend and/or elongate. When the opposing forces are removed, the rod returns to its original shape.
  • the PDS system generally stabilizes two adjacent vertebrae, while still allowing for some limited movement between the vertebrae 20 , 21 .
  • rigid rods or other flexible rods comprised of elastomeric material, metal, or superelastic material, or other types of PDS rods as are known in the art.
  • each bone anchor assembly 24 comprises a bone engaging member 34 retained within a receiver member 40 .
  • the bone engaging member is provided in the form of a bone screw 34 (which is also referred to herein as a “pedicle screw”).
  • the bone screw 34 comprises a screw head 36 and a screw shank 38 .
  • the screw head 36 is generally spherical in shape with a flat top 39 .
  • a slot 37 is formed in the top of the screw head 36 .
  • the slot 37 is configured to receive the tip of a screwdriver that may be used to drive the screw 34 into the bone.
  • the screw shank 38 extends from the screw head 36 .
  • the screw shank 38 is threaded to facilitate driving the screw into the bone.
  • the receiver member 40 is a generally cup-shaped structure configured to hold both the screw 34 and the rod 26 .
  • the receiver member 40 comprises cylindrical sidewalls 42 formed between a superior end 44 and an inferior end 46 .
  • a bone screw cavity 48 is formed within the sidewalls 42 near the inferior end 46 .
  • a fixation screw cavity 50 is formed within the sidewalls 42 near the superior end 44 .
  • a rod cavity and passage 52 is formed in the receiver member between the fixation screw cavity 50 and the bone screw cavity 48 .
  • the fixation screw cavity 50 is designed and dimensioned to receive a fixation screw 70 (also referred to herein as a setscrew). Accordingly, the cylindrical sidewalls 42 of the receiver member are threaded at the superior end 44 . These threads are configured to engage the threads on the fixation screw 70 .
  • the fixation screw includes a slot 72 in the top that is adapted to receive the tip of a screwdriver, thus allowing the fixation screw 70 to be driven into the fixation screw cavity 50 .
  • the rod passage 52 is provided directly below the fixation screw cavity 50 .
  • the rod passage is designed and dimensioned to receive one of the dynamic rods 26 of the PDS system 22 .
  • the rod passage 52 is designed to receive one of the rod ends 30 .
  • the rod is loaded into the rod passage from the top of the receiver member by laying the rod within U-shaped dips formed in the superior end 44 of the receiver member 40 .
  • a fixation screw is driven into the fixation screw cavity until it contacts the rod. When the fixation screw it tightened, it locks the rod in place within the receiver member 40 .
  • cam locks may be used to hold the rod in place.
  • the bone screw cavity 48 is designed and dimensioned to retain the screw head 36 of the bone screw 34 , with the shank 38 of the bone screw extending from the receiver member 40 .
  • An opening 56 is formed in the inferior end 46 of the receiver member 40 .
  • the diameter of the opening 56 is smaller than the diameter of the screw head 36 , but it is large enough to allow the screw shank 38 to pass through the opening 56 .
  • the cylindrical wall 42 is slightly thicker at the inferior end 46 of the receiver member 40 .
  • a bearing member 54 is positioned within the bone screw cavity 48 along with the screw head 36 .
  • the bearing member 54 includes an inner bearing surface that generally conforms to the spherical shape of the screw head 36 .
  • the screw head 36 is configured to rotate and pivot within the bearing member 54 .
  • the outer bearing surface is designed and dimensioned to engage the interior portion of the cylindrical sidewalls 42 of the receiver member.
  • the bearing member 54 is a split bearing that includes a left side member 54 a and a right side member 54 b .
  • the split bearing, 54 a , 54 b provides for easier assembly by allowing the bearing surface to be assembled around the spherical screw head 36 .
  • the split bearing members 54 a , 54 b facilitate the use of different bearing materials. Appropriate bearing materials will be recognized by those of skill in the art.
  • the bearing members 54 a , 54 b are comprised of ceramic. Examples of other types of appropriate bearing materials include cobalt chrome, UHMWPE, and other biocompatible materials.
  • An insert 60 is provided in the receiver member.
  • the insert 60 acts as a retention member to secure the bearing member 54 in place within the bone screw cavity 48 of the receiver member 40 .
  • the insert 60 is C-shaped plate that serves as a retaining ring.
  • the insert 60 includes a semi-circular wall 64 with a void 65 formed in the wall. Two opposing ends 66 a and 66 b define the sides of the void 65 .
  • the exterior perimeter 67 of the insert 60 is generally circular in shape, while the interior perimeter 68 is contoured to provide strength to the insert.
  • the insert may include other structural features such as holes 69 .
  • the insert 60 is generally comprised of a resilient biocompatible material, such as cobalt chrome or UHMWPE.
  • the resilient features of the insert 60 allow the ends 66 a , 66 b to be forced together, reducing the size of the void 65 , and then spring back to their original position.
  • the insert 60 is provided within a groove 62 formed in the cylindrical sidewalls 42 of the receiver member 40 .
  • the insert 60 is loaded into the retainer member 40 through a hole 50 in the top of the retainer member.
  • the split bearing members 54 a , 54 b are positioned about the head of the screw 38 and the screw is inserted into the receiver member 40 .
  • the split bearing members 54 a , 54 b and screw head 36 are seated in the screw head cavity and the shank 38 extends through the hole in the bottom of the receiver member 40 .
  • the insert 60 is compressed and inserted into the receiver member 40 .
  • the resilient insert When properly positioned, the resilient insert snaps into the groove 62 in the receiver member, thus locking the split bearing members 54 a , 54 b in place within the retainer member. With the insert 60 locked in the groove 62 , the bearing member 54 is secured in place within the receiver member such that various stresses on the bone screw will not dislodge the bearing member within the anchor assembly 24 .
  • the rod 26 After insertion of the insert 60 , the rod 26 is placed in the rod passage 53 of the receiver member and the fixation screw 70 is threaded in the fixation screw cavity 50 until it compresses against the rod, thus fixing the rod to the receiver member 40 .
  • FIG. 4 shows an alternative embodiment of a bone anchor assembly including an insert for securing the bearing 54 within the receiver member 40 .
  • the insert 60 comprises a polyethylene disc positioned between the rod 26 and the bearing 54 .
  • the top surface of the polyethylene disc 60 is positioned within the rod cavity 52 .
  • the fixation screw 70 is tightened against the rod 26 .
  • the polyethylene insert 60 is slightly compressed by the rod. The force of this compression is then transferred to the bearing member 54 , which is tightly compressed within the bone screw cavity 48 , thus securing the bearing in place.
  • FIGS. 3 and 4 show only two methods for holding the bearing 54 in place within the receiver member 40 , one of skill in the art will recognize that variations of the disclosed embodiments may be easily incorporated.
  • a combination retaining ring and compression disc may be used.
  • Rod Fixed to Receiver Member Providing with Pivot Point Offset from Rod Axis
  • an offset exists between the center axis of the rod and the pivot point of the rod 26 within the anchor assembly 24 .
  • the center axis 80 of the rod (shown by dotted line 80 ) is removed from the pivot point (shown by “X” 82 ) of the rod within the anchor assembly 24 .
  • This offset provides one embodiment that may be used to help control the necessary kinematics and loading requirements of the rod.
  • the rod 26 is fixed to the anchor assembly, and is not allowed to pivot relative to the receiver member 40 which holds the bone screw 34 .
  • FIGS. 5 and 6 An alternative embodiment of a bone anchor 24 where the center axis of the rod is offset from the pivot point of the rod within the anchor assembly is shown in FIGS. 5 and 6 .
  • the anchor assembly includes a bone screw 34 , a U-shaped screw holder 86 , and a rod holder 88 .
  • the bone screw includes a threaded shank 38 , but instead of a spherical head, the head 36 of the bone screw is flat and generally circular or disc-shaped. This flat screw head is designed and dimensioned to fit within a circular cavity formed in the base 90 of the U-shaped screw holder 86 .
  • the circular cavity 87 allows the head 36 to rotate within the cavity 87 about the axis of the screw.
  • a pivot pin 94 extends through the upright portions 92 of the U-shaped screw holder 86 .
  • the rod holder 88 is pivotably mounted on the pivot pin 94 .
  • the rod holder 88 is similar to the receiver member 40 described in FIGS. 3 and 4 .
  • the rod holder 88 of FIGS. 5 and 6 includes a pin channel 95 configured to receive the pivot pin 94 .
  • the rod holder 88 is allowed to rotate about the pivot pin 94 , thus allowing the rod holder 88 to pivot relative to the U-shaped screw holder 86 .
  • a rod passage 52 is formed in the rod holder 88 above the pin channel 95 .
  • a fixation screw 70 threadedly engages the interior threaded walls on the top of the rod holder 88 . When the fixation screw 70 is tightened against the rod, the rod is pinned in place within the rod holder 88 .
  • the rod is allowed only two degrees of freedom.
  • the rod 26 is allowed to pivot by radial rotation around an axis defined by the screw shank 38 by virtue of the rotatable engagement between the screw head 36 and the circular cavity 87 of the U-shaped screw holder 86 .
  • the rod 26 is allowed to pivot about the pin 94 which is perpendicular to the screw shank.
  • the U-shaped screw holder may be comprised of ultra high molecular weight polyethylene (UHMWPE), cobalt chrome, titanium, stainless steel or other appropriate biocompatible bearing material as will be recognized by those of skill in the art.
  • FIG. 7 Another alternative embodiment of a bone anchor 24 where the center axis of the rod is offset from the pivot point of the rod is shown in FIG. 7 .
  • the bone anchor 24 of FIG. 7 includes a receiver member in the form of a screw holding member 100 that is fixed to the shank 38 of the bone screw 34 .
  • the rod 26 is secured to a rod holding member 102 which includes a cavity that receives the rod 26 .
  • the rod holding member 102 includes a fixation screw 70 that clamps onto the rod in order to fix to the rod holding member 102 to the rod 26 .
  • the rod holding member further includes a ball-shaped pivot member (shown by dotted lines 104 within the screw holding member 100 ).
  • the screw holding member 100 includes a cavity with a spherical bearing 106 and bearing surface that is also fixed relative to the screw shank 38 .
  • the spherical bearing surface is configured to receive the pivot member 104 which is fixed to the rod 26 . Because the surface of the pivot member 104 is congruent with the bearing surface, the pivot member 104 is allowed to pivot within the screw holding member 100 . Accordingly, the rod 26 is configured to pivot relative to the shank 38 .
  • the pivot point for the rod 26 is defined at the center of the pivot member 104 which is located within the center of the cavity in the screw holding member 100 .
  • FIGS. 8-9 an alternative embodiment of a bone anchor 24 for a PDS system is shown where the rod 26 is pivotably connected to the receiver member 40 of the bone anchor.
  • the bone anchor 24 includes a bone screw 34 having a screw head 36 retained within the receiver member 40 with the screw shank 38 extending from the receiver member 40 .
  • a first bearing 110 provides a bearing surface for the screw head.
  • the first bearing acts to stabilize the screw head 36 within the receiver member 40 while providing a surface upon which the screw head may pivot relative to the receiver member 40 .
  • the first bearing may be comprised of a metallic insert that acts to lock the bone screw 34 in place when a fixation screw is tightened, as discussed in further detail below.
  • a second bearing 112 is also provided within the receiver member 40 shown in FIGS. 8 and 9 .
  • the second bearing 112 provides spherical bearing surface for the rod 26 , allowing the rod 26 to pivot relative to the receiver member 40 .
  • the rod 26 includes a pivot member 114 in the form of a spherical ball fixed on at least one end of the rod 26 .
  • the spherical ball 114 engages the spherical bearing surface of the second bearing 112 , thus pivotably retaining the rod 26 within the receiver member 40 and facilitating smooth movement of the rod relative to the receiver member.
  • the pivot member 114 is fixed to the rod 26 , being integrally formed upon the rod.
  • the second bearing 112 is a split bearing that includes a superior bearing member 116 provided above the spherical ball 114 and an inferior bearing member 118 provided below the spherical ball 114 .
  • the bearing is split into left and right halves such as the bearing shown in FIG. 3B .
  • the split bearing 112 is comprised of UHMWPE, ceramic, cobalt chrome, or any other biocompatible material.
  • the first bearing 110 and the inferior bearing member 118 of the second bearing 112 may be provided as a single integral component.
  • the components of the anchor assembly 24 may all be loaded into the receiver member 40 through a top hole.
  • the bone screw 34 is inserted into the receiver member 40 with the screw head 36 seated in the screw head cavity and the shank 38 extending through the hole in the bottom of the receiver member 40 .
  • the first bearing 110 is placed over the screw head.
  • the inferior bearing member 118 of the second bearing 112 is placed on top of the first bearing 110 .
  • the rod 26 is then placed in the receiver member with the spherical ball 114 engaging the bearing surface of the inferior bearing member 118 , and the cylindrical portion of the rod passing through the rod passage formed in the sidewalls of the receiver member.
  • the superior bearing member 116 is then placed over the spherical ball 114 .
  • fixation screw 70 is threaded into the top of the receiver member until it compresses against the second bearing member.
  • the bearing components, screw, and rod may be pre-assembled and inserted into the receiver member as a unit.
  • the anchor 24 acts as polyaxial screw that can be locked down by the metal insert 110 that is tightened by the fixation screw 70 when the screw head 36 is in the desired position.
  • the fixation screw 70 functions to lock the bone screw 34 and to slightly compress the second bearing 112 , thus keeping the second bearing in place within the receiver member 40 .
  • the rod 26 is configured to pivot relative to the receiver member 40 .
  • the pivot point 82 which the rod 26 pivots about is located on an axis defined by the rod and extending along the rod, such as a central axis 80 or an axis extending axially through the rod or along the surface of the elongated rod 26 .
  • the axis is the central axis 80 of the rod. Because of this, the rod is constrained to motion in the axial direction. In other words, in this embodiment, the dynamic central portion of the rod is elongated or compressed, but is not bent when the receiver member 40 moves.
  • the receiver members 40 also move along with the bone screws. Because the rod 26 is allowed to pivot relative to the receiver members 40 about pivot point 82 , movement of the receiver members 40 imparts axial forces on the rod 26 that cause the rod to either compress or elongate.
  • this arrangement offers different kinematics and loading requirements from those stabilization elements where the pivot point is offset from an axis defined by the rod. These differing kinematics and loading requirements may be advantageous with certain materials and designs or with certain patients.
  • FIGS. 8 and 9 One alternative embodiment to that of FIGS. 8 and 9 involves the use of a setscrew nested in the fixation screw, allowing the polyaxial screw to be locked separate from the compression of the bearing surface. Furthermore, although there is a specific shape and locking of the bearing surface shown in FIGS. 8 , this could be altered based on materials used and the constraints of the rod. Of course one of skill in the art will recognize that numerous other adaptations of the embodiment of FIGS. 8 and 9 are possible where the pivot point of the rod is located along the central or other axis of the rod.
  • FIG. 10 shows an embodiment of a bone anchor 24 which acts as a fixed screw instead of a polyaxial screw.
  • the screw shank 38 is fixed to the receiver member 40 .
  • the screw shank 38 may be integrally formed with the receiver member 40 such that the receiver member 40 serves as the bone screw head.
  • the screw shank 38 may be otherwise fixed to the receiver member 40 using some locking mechanism or other connection means.
  • the inferior portion 118 of the bearing member 112 is first placed in the cavity 120 formed in the receiver member 40 .
  • the ball shaped portion of the rod 26 is then loaded onto the inferior bearing surface and the superior bearing member 116 is placed on top of the rod within the cavity.
  • the fixation screw 70 is used to secure the bearing 112 within the cavity 120 of the receiver member 40 .
  • FIG. 11 shows another embodiment, similar to FIG. 10 , where the screw shank is fixed to the receiver member 40 , and the screw head is formed as the receiver member 40 .
  • the receiver member 40 is formed as a block 130 with a central cavity 132 .
  • a bearing member 134 with a toroidal bearing surface 136 is positioned within the cavity 132 of the receiver member 40 . Because the receiver member 40 is fixed relative to the screw shank 38 , the bearing 134 is also fixed relative to the screw shank 38 .
  • the toroidal bearing surface is configured to receive a spherical portion on the end of a rod, similar to the rod end in FIGS. 8 and 9 that includes a spherical ball 114 .
  • the bearing 134 is shown as being UHMWPE and as being held in place by a press fit.
  • the bone anchor disclosed in FIG. 11 provides an arrangement where the pivot point of the rod is located along the central axis of the rod.
  • FIGS. 12 and 13 show another alternative embodiment similar to FIG. 11 .
  • the bearing 134 is not fixed relative to the screw shank 38 .
  • the bone anchor 24 acts as a polyaxial screw, and the bone screw head 36 and shank 38 are connected to the block 130 /receiver member 40 in a pivotable relationship.
  • the bearing 134 is loaded in the top of the receiver member 40 , and a set screw or other locking member 71 holds the bearing 134 in place within the receiver member 40 .
  • the bone anchor acts as a polyaxial screw, the bone screw 34 can be locked in place relative to the block 130 when the locking member 71 is tightened within the block.
  • a metal insert 138 may be provided around the bearing 134 .
  • the metal insert 138 is locked into the screw head 36 , fixing the bone screw relative to the block 130 .
  • FIGS. 11-13 are possible.
  • a dual setscrew could be used and that although the bearing surface is shown as a solid piece, it could be split to allow for easier assembly and to facilitate the use of other materials.
  • FIG. 14 Yet another embodiment of a bone anchor 24 where the pivot point of the rod is located along the central axis of the rod is shown in FIG. 14 .
  • the embodiment of FIG. 14 is very similar to that of FIG. 11 , but in FIG. 14 the block 130 and bearing 134 is provided on the rod 26 rather than the screw shank 38 .
  • a spherical ball 115 is provided on the screw shank 138 rather than on the rod 26 .
  • the spherical ball 115 engages the bearing 134 , allowing the rod 26 to pivot relative to the bone screw 34 .
  • the bearing 134 is shown as being UHMWPE and as being held in place by a press fit.
  • numerous other viable bearing materials and locking mechanisms may be used.
  • FIGS. 15A-15F show six possible designs for an adjustable length rod that could be used with the designs of FIGS. 8-13 where the pivot point of the rod is provided along the center axis of the rod.
  • adjustable length rods are advantageous when providing a PDS system so that different sized systems may be constructed for segmental units of different sizes and patients of different sizes.
  • the rods of FIGS. 15A-15F may be used to provide an adjustable PDS system comprising: a plurality of bone anchors; and at least one connecting member connected to and extending between the plurality of bone anchors, wherein the at least one connecting member is adjustable in length.
  • the at least one connecting member is fixedly connected to the plurality of bone anchors.
  • the at least one connecting member is pivotably connected to the plurality of bone anchors.
  • the adjustable connecting member is provided as a telescoping shaft with two or more portions that slide relative to one another and may be locked to one another.
  • the adjustable connecting member comprises a shaft with a threaded ball on the end that can be turned to effectively lengthen or shorten the connecting member.
  • FIG. 15A shows a basic rod 26 that generally comprises a shaft with a flexible elastic central portion 28 , a first end 30 , and a second end 32 .
  • Ball-shaped members 114 are provided on the first end 30 and second end 32 of the rod 26 .
  • the ball-shaped members are substantially spherical in the disclosed embodiment and are configured to engage the bearing surface of the rod bearing 112 retained within the bone anchor 24 .
  • Exemplary bone anchors 24 configured to retain rod bearings for use with rods having ball-shaped ends are disclosed in FIGS. 8-13 .
  • the ball shaped members 114 are formed integral with the rod in FIG. 15A .
  • the ball-shaped members 114 may be molded as a single piece with the central dynamic portion 28 of the rod.
  • the ball-shaped members 114 may be fixed to the dynamic portion 28 by other means, such as welding, adhesion, or other appropriate methods as will be recognized by those of skill in the art.
  • the ball-shaped members 114 may be releasably connected to the dynamic portion 28 .
  • the ball shaped members 114 may be screwed, snapped, or friction fit onto the rod 26 at the rod ends 30 , 32 .
  • the rod 26 may be provided in numerous discrete lengths to accommodate size differences between different patients and/or different segmental units of the spine.
  • the ball shaped members 114 of the rod may be adjustably connected to the rod.
  • a single rod may be used to accommodate various size differences between patients and/or segmental units. Examples of rods 26 where the ball shaped member 114 is adjustable relative to the dynamic portion 28 are shown in FIGS. 15B-15F .
  • the ball-shaped members 114 are provided on posts 140 .
  • the posts 140 fit within the rod shaft, and particularly within a mouth 142 formed on the rod ends 30 , 32 .
  • Each mouth 142 includes an upper jaw 144 and a lower jaw 146 that taper outwardly from the central axis of the rod.
  • a passage is formed between the upper jaw 144 and the lower jaw that accepts one of the posts 140 .
  • a locking ring 148 is provided on each rod end 30 , 32 . When the locking ring 148 is moved over the mouth 142 , the upper jaw 144 and lower jaw 146 of the mouth are forced together, thus compressing the post 140 within the mouth 142 and locking the associated ball member 114 on the end of the rod 26 . Because the posts 140 and associated ball members 114 are slideable relative to the central dynamic portion 28 of the rod 26 , the size of the rod may be adjusted to various lengths to accommodate different segmental units of the spine and patients of different sizes.
  • the ball-shaped members 114 are taper-locked to a cap member 150 whose position can be adjusted to the desired length.
  • the cap member 150 includes a frusto-conical portion 152 that is inserted into a cavity 160 in the ball member 114 to taper-lock the ball member 114 to the cap member 150 .
  • another fastening means different from a taper-lock could be used to attach the ball member 114 to the cap member 150 .
  • the cap member 150 is secured to the rod using a setscrew. In the embodiment of FIG.
  • the cap member fits over the cylinder of the rod, and a screw hole 154 is formed in the cap member 150 .
  • a post 156 is inserted within the rod cylinder and a screw hole 158 is formed in the rod 26 .
  • the size of the rod may be adjusted to various lengths to accommodate different segmental units of the spine and patients of different sizes.
  • spaced teeth 160 are provided on the rod ends 30 , 32 .
  • Interlocking teeth 162 are also provided on the inside of the ball members 114 .
  • the teeth 160 , 162 are provided with slight tapers such that the teeth 160 on the rod cylinder interact with the teeth 162 on the inside of the ball members 114 .
  • the length of the rod can be adjusted and fixed using a simple turn.
  • the rod ends are comprised of a shape memory alloy (also referred to as “smart metals” or “memory metals”), such as nickel-titanium (NiTi), copper-zinc-aluminum, or copper-aluminum-nickel.
  • shape memory alloys exhibit temperature dependent memory properties which may be advantageously used to lock the ball members 114 on the ends 30 , 32 of the rod 26 .
  • the ends 30 , 32 of the rod include nested cups 166 comprised of a shape memory alloy. A slit 164 formed through the cups 166 along the end of the rod. Associated grooves are provided on the inside of the ball members.
  • the ball members 114 are free to slide on the cups 166 on the rod ends 30 , 32 at room temperature. However, at body temperature, the cups 166 splay outward, thus locking the cups 166 into the grooves on the inside of the ball member and securing the ball members in place.
  • FIGS. 16-18 show an alternative embodiment configured for use with any of the above-described designs where the pivot point of the rod is offset from the central or other axis defined by the rod (e.g., FIGS. 3-7 ).
  • the advantage addressed in the embodiment of FIGS. 16-18 is that of a dynamic screw with a lower profile.
  • the lower portion of the bone anchor 24 is similar to that of FIGS. 3 and 4 , and includes a bone screw cavity 48 configured to receive a bearing member 48 and the head 36 of a bone screw 34 .
  • An insert 60 is provided above the bearing member 54 that locks the bearing member in the cavity 48 .
  • a rod cavity/passage 52 is provided above the insert.
  • no fixation screw is provided above the rod 26 .
  • the rod 26 and bone anchor 24 include features that allow the rod 26 to be locked into the rod cavity 52 without the use of a fixation screw.
  • the locking features provided on the rod 26 include fingers 170 provided on the rod ends with slits 172 cut into each rod end between the fingers 170 . Teeth 174 are also provided on the rod ends.
  • the slits 172 allow the fingers 170 to contract toward each other as the end of the rod is forced into the rod cavity 52 . Once the rod is in the cavity 52 , the fingers 170 are flared back outwardly toward or past their original configuration. When the fingers are forced outwardly, they are pressed against the insert 60 , thus locking the rod in place within the rod cavity. Flaring of the fingers may be achieved through the use of a memory metal or by other means, such as a wedge forced into the slits at the end of the rod.
  • the rod With the rod in place within the rod cavity 52 , the rod presses against the insert 60 and receiver member 40 , which locks the bearing 54 in place within the bone anchor 24 .
  • the teeth 174 may cut into the insert to assist in securing the rod within the bone anchor.
  • the teeth 174 are designed to mate with complimentary teeth on insert 60 and receiver member 40 to assist in securing the rod within the bone anchor.
  • a cap is provided over the superior end 44 of the bone anchor. This may be desirable if the rod will be passed through tissue.
  • the cap could either be permanent or temporary.
  • the distance across the rod cavity 52 generally decreases when moving from the center of the rod cavity toward the superior end 44 . This decreased distance at the superior end 44 is less than the diameter of the rod 26 , and helps in preventing passage of the rod through the top of the receiver member 40 .
  • a cap were provided over the superior end 44 it could be used to further assist in retaining the rod 26 within the receiver member 40 .
  • the cap could mate with a feature on the screw head in such a way that it would insure that the heads are placed correctly and that the receiver member is properly secured.

Abstract

A spine stabilization system having a dynamic screw comprises at least one bone anchor assembly comprising a receiver member and a bone engaging member. In one embodiment, the bone engaging member is a screw shank extending from the receiver member. A rod is connected to the receiver member. In one embodiment, the rod comprises a ball-shaped member that engages a bearing surface provided within a cavity of the receiver member. In this embodiment, the rod is pivotably connected to the receiver member. In one such embodiment, a central axis defined by the rod pivots about a pivot point located on the central axis when the rod pivots relative to the receiver member. Accordingly, the pivot point for the rod may be provided within the cavity of the receiver member. The rod may be a fixed length or adjustable to accommodate different segmental units and patients of different sizes.

Description

    FIELD
  • This application relates to the field of spinal stabilization devices. In particular, this application relates to a posterior stabilization unit configured for use with a segmental unit of the spine.
  • BACKGROUND
  • Spinal surgeries are commonly used in the medical profession to treat spinal conditions that result when functional segmental units of the spine are moved out of proper position or otherwise damaged. Examples of procedures used to treat spinal conditions include disc replacement, laminectomy, and spinal fusion.
  • Following certain spinal procedures, such as spinal fusion, it is typically desirable to stabilize the spine by preventing movement between the vertebrae while the spine heals. This act of stabilizing the spine by holding bones in place during healing has greatly improved the success rate of spinal fusions and other procedures.
  • With spinal stabilization procedures, a combination of metal screws and rods creates a solid “brace” that holds the vertebrae in place. These devices are intended to stop movement from occurring between the vertebrae. These metal devices give more stability to the fusion site and allow the patient to be out of bed much sooner.
  • During the spinal stabilization procedure, pedicle screws are placed through the pedicles on the posterior portion of two or more vertebrae of the spinal column. The screws grab into the bone of the vertebral bodies, giving them a good solid hold on the vertebrae. Once the screws are placed on the vertebrae, they are attached to metal rods that connect all the screws together. When everything is bolted together and tightened, the assembly creates a stiff metal frame that holds the vertebrae still so that healing can occur.
  • Posterior dynamic stabilization (PDS) generally refers to such a stabilization procedure where dynamic rods are positioned between the pedicle screws. These dynamic rods can generally bend, extend, compress, or otherwise deform in order to allow some limited movement between the pedicle screws. By allowing this limited movement between the pedicle screws and the associated vertebrae, less strain is placed on adjoining, non-stabilized functional segmental units during patient movements. In addition, the dynamic rod generally decreases the stresses on the screw shank, minimizing the possibility of screw backout or related screw failures. However, even with dynamic rods, stresses are experienced by the screw shank which could potentially result in screw backout or related failures under the appropriate circumstances. Accordingly, it would be desirable to provide a PDS system capable of further protecting the screw-bone interface and reducing the chances of screw backout. For example, it would be advantageous to provide a PDS system with a flexible stabilization element that offers different kinematics and loading requirements from those stabilization elements found in the prior art. Such a stabilization element would offer additional options to the surgeon when traditional PDS stabilization elements appear problematic.
  • SUMMARY
  • Various embodiments of a dynamic screw for a spine stabilization system are disclosed herein. A dynamic screw for a spine stabilization system comprises at least one bone anchor assembly comprising a bone engaging member and a receiver member. The bone engaging member may comprise a bone screw including a screw head retained within the receiver member and a screw shank extending from the receiver member. The screw head may be pivotably retained within the receiver member. An elongated connecting member is pivotably connected to the bone engaging member. The elongated connecting member may be provided as a rod spanning between two or more bone anchor assemblies. The elongated connecting member is pivotably connected to the receiver member of the bone anchor assembly.
  • In one embodiment, the pivotable connection between the elongated connection member and the receiver member is provided by a ball-shaped pivot member on the rod which engages a bearing surface provided within a cavity of the receiver member. Accordingly, the pivot point for the rod may be provided within the cavity in the receiver member. In one such embodiment, the rod may define an axis wherein the axis pivots about a pivot point on the axis when the rod pivots relative to the receiver member. In other embodiments, the pivot point of the rod is offset from the axis defined by the rod.
  • The rod may be a fixed length or adjustable to accommodate different segmental units and patients of different sizes. In the adjustable embodiment, the rod comprises a shaft with a flexible central portion and at least one adjustable end. The adjustable end may be provided by various means. For example, the adjustable end may include a post configured to slide within the shaft of the rod. In one embodiment, the adjustable end is configured to threadedly engage the shaft. In another embodiment, the adjustable end is comprised of a shape memory alloy.
  • When assembled, the spine stabilization system generally comprises at least two bone anchors with a rod extending between the two bone anchors. As mentioned above, each bone anchor includes a bone screw and a receiver member configured to retain the bone screw. The rod extends between the two receiver members. In one embodiment where the rod is fixed relative to the receiver members, the rod is adapted to bend when the receiver members move relative to one another. In another embodiment, the rod is pivotably connected to both the receiver members, and the rod is adapted to extend or compress when the receiver members move relative to one another.
  • In an alternative embodiment, one or more bone anchors of the spine stabilization system include an insert in the form of a retention member that acts to lock a bearing for the bone screw within the receiver member. To this end, the receiver member includes a screw head cavity and a rod cavity with an insert positioned between the screw head cavity and the rod cavity. The screw head cavity is configured to receive a bearing that engages the head of the bone screw with the screw shank extending from the receiver member. In one embodiment, the bone screw bearing is a split bearing. The insert is positioned between the rod cavity and the bearing member and is configured to secure the split bearing within the receiver member. The insert may be provided to fit within a groove formed in an interior sidewall of the receiver member. In this embodiment, the insert comprises a retaining ring that secures the split bearing within the screw cavity. In another embodiment, the insert is comprised of a compressible material positioned between the bearing member and the rod cavity. When the rod is positioned in the rod cavity, the insert is compressed against the bearing member, thus locking the bearing member within the screw cavity.
  • In yet another embodiment, the bone anchor assembly is configured with a low profile, wherein the rod is locked within the receiver member without the use of a fixation screw. In this embodiment, the bone anchor assembly includes a head and a screw shank extending from the head. The screw shank is pivotable with respect to the head. Furthermore, a rod cavity is formed within the head. The end of the rod includes features that lock the rod within the rod cavity when the rod is inserted into the rod cavity, thus connecting the rod to the head. For example, in one embodiment, the end of the rod comprises a plurality of fingers that may be flared to lock the rod within the rod cavity. The rod may also include a plurality of teeth that grasp or mesh with the rod cavity to further secure the rod within the cavity.
  • The above described features and advantages, as well as others, will become more readily apparent to those of ordinary skill in the art by reference to the following detailed description and accompanying drawings.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • FIG. 1 shows a posterior view of a spine stabilization system with a plurality of dynamic screws and dynamic rods connected between two vertebrae;
  • FIG. 2 shows a side view of the spine stabilization system of FIG. 1;
  • FIG. 3A shows a cross-sectional view of a bone anchor and rod which form part of the spine stabilization system of FIG. 1;
  • FIG. 3B shows an exploded perspective view of the bone anchor and rod of FIG. 3A;
  • FIG. 3C shows a perspective view of a retainer insert of FIG. 3B;
  • FIG. 3D shows a top view of the retainer insert of FIG. 3C;
  • FIG. 4 shows a cross-sectional view of an alternative embodiment of the bone anchor and rod of FIG. 3;
  • FIG. 5 shows a perspective view of an alternative embodiment of the bone anchor and rod of FIG. 3 wherein the pivot point of the rod is offset from the central axis of the rod;
  • FIG. 6 shows a cross-sectional view of the bone anchor and rod of FIG. 5;
  • FIG. 7 shows an alternative embodiment of the bone anchor and rod of FIG. 5;
  • FIG. 8 shows a cross-sectional view of an alternative embodiment of the bone anchor and rod of FIG. 3 wherein the pivot point of the rod is provided on the central axis of the rod;
  • FIG. 9 shows another cross-sectional view of the bone anchor and rod of FIG. 8 rotated 90°;
  • FIG. 10 shows a perspective view of an alternative embodiment of the bone anchor of FIG. 8;
  • FIG. 11 shows a perspective view of another alternative embodiment of the bone anchor of FIG. 8;
  • FIG. 12 shows a perspective view of another alternative embodiment of the bone anchor of FIG. 8;
  • FIG. 13 shows a cross-sectional view of the bone anchor of FIG. 12;
  • FIG. 14 shows a perspective view of yet another alternative embodiment of the bone anchor and rod of FIG. 8;
  • FIG. 15A shows a dynamic rod for use with the bone anchor of FIGS. 8-13, wherein the dynamic rod includes ball shaped members on its ends;
  • FIG. 15B shows an alternative embodiment of the dynamic rod of FIG. 15A wherein the length of the rod is adjustable;
  • FIG. 15C shows another alternative embodiment of the dynamic rod of FIG. 15A wherein the length of the rod is adjustable;
  • FIG. 15D shows yet another alternative embodiment of the dynamic rod of FIG. 15A wherein the length of the rod is adjustable;
  • FIG. 15E shows another alternative embodiment of the dynamic rod of FIG. 15A wherein the length of the rod is adjustable;
  • FIG. 15F shows yet another alternative embodiment of the dynamic rod of FIG. 15A wherein the length of the rod is adjustable;
  • FIG. 16 shows a perspective view of an alternative embodiment of a bone anchor and rod for use with the spine stabilization system of FIG. 1 wherein the rod is secured to a cavity in the bone anchor without the use of a fixation screw;
  • FIG. 17 shows a cross-sectional view of the bone anchor and rod of FIG. 16; and
  • FIG. 18 shows a cross-sectional view of the bone anchor and rod of FIG. 17 rotated 90°.
  • DESCRIPTION
  • With reference to FIGS. 1 and 2, an exemplary posterior dynamic stabilization (PDS) system 22 is shown arranged between two vertebrae 20, 21 of a spine. The PDS system 22 comprises a plurality of bone anchors 24 with a plurality of elongated connecting members 26 extending between the bone anchors 24. The plurality of connecting members 26 may comprise rods, bars, or other elongated connecting members. Each bone anchor 24 is secured to the pedicle of one of the vertebrae 20 or 21. Each elongated connecting member 26 extends between a first bone anchor fixed to an upper vertebra 20 and a second bone anchor fixed to a lower vertebra 21.
  • The bone anchor 24 is comprised of titanium, stainless steel, or other appropriate biocompatible material. As explained in further detail herein, each bone anchor 24 comprises a bone engaging member 34, such as a bone screw (as shown in FIG. 3, for example). However, one of skill in the art will recognize that other bone engaging members 34 are possible, such as posts, pins, cemented surfaces, adhesive surfaces and other bone engaging members as are known in the art.
  • In addition to the bone engaging member 34, each bone anchor 24 also comprises a receiver member 40. The receiver member 40 is configured to receive a bone engaging member 34 and/or an elongated connecting member 26. If the bone engaging member 34 is a bone screw, the bone screw 34 includes a screw head 36 and a screw shank 38. The screw head 36 is retained within the receiver member 40 and the screw shank 38 extends from the receiver member 40. The screw shank 38 is configured to screw into the bone and secure the bone screw 34 to the pedicle or other portion of bone. The receiver member 40 may be rigidly or pivotably connected to the screw 34.
  • The receiver member 40 is also configured to receive an elongated connecting member, such as the rod 26. The rod 26 includes two rigid ends 30, 32 with an elastic/resilient central portion 28 disposed between the rod ends. The elastic central portion 28 allows for some limited flexibility in the rod, while still allowing the rod to spring back to its original shape. Therefore, when opposing forces are applied to the ends 30, 32 of the rod 26, the central portion flexes, allowing the rod to bend and/or elongate. When the opposing forces are removed, the rod returns to its original shape. With this configuration, the PDS system generally stabilizes two adjacent vertebrae, while still allowing for some limited movement between the vertebrae 20, 21. However, one of skill in the art will recognize that other types of rods are possible, including rigid rods or other flexible rods comprised of elastomeric material, metal, or superelastic material, or other types of PDS rods as are known in the art.
  • With reference now to FIGS. 3A-3D, one embodiment of a bone anchor assembly 24 is shown. In this embodiment, each bone anchor assembly 24 comprises a bone engaging member 34 retained within a receiver member 40. The bone engaging member is provided in the form of a bone screw 34 (which is also referred to herein as a “pedicle screw”). The bone screw 34 comprises a screw head 36 and a screw shank 38. The screw head 36 is generally spherical in shape with a flat top 39. A slot 37 is formed in the top of the screw head 36. The slot 37 is configured to receive the tip of a screwdriver that may be used to drive the screw 34 into the bone. The screw shank 38 extends from the screw head 36. The screw shank 38 is threaded to facilitate driving the screw into the bone.
  • In the embodiment of FIGS. 3A-3D, the receiver member 40 is a generally cup-shaped structure configured to hold both the screw 34 and the rod 26. The receiver member 40 comprises cylindrical sidewalls 42 formed between a superior end 44 and an inferior end 46. A bone screw cavity 48 is formed within the sidewalls 42 near the inferior end 46. A fixation screw cavity 50 is formed within the sidewalls 42 near the superior end 44. A rod cavity and passage 52 is formed in the receiver member between the fixation screw cavity 50 and the bone screw cavity 48.
  • The fixation screw cavity 50 is designed and dimensioned to receive a fixation screw 70 (also referred to herein as a setscrew). Accordingly, the cylindrical sidewalls 42 of the receiver member are threaded at the superior end 44. These threads are configured to engage the threads on the fixation screw 70. The fixation screw includes a slot 72 in the top that is adapted to receive the tip of a screwdriver, thus allowing the fixation screw 70 to be driven into the fixation screw cavity 50.
  • The rod passage 52 is provided directly below the fixation screw cavity 50. The rod passage is designed and dimensioned to receive one of the dynamic rods 26 of the PDS system 22. In particular, the rod passage 52 is designed to receive one of the rod ends 30. In the embodiment of FIG. 3, the rod is loaded into the rod passage from the top of the receiver member by laying the rod within U-shaped dips formed in the superior end 44 of the receiver member 40. After the rod 26 is positioned in the rod passage 52, a fixation screw is driven into the fixation screw cavity until it contacts the rod. When the fixation screw it tightened, it locks the rod in place within the receiver member 40. One of skill in the art will recognize that other appropriate locking features such as cam locks may be used to hold the rod in place.
  • The bone screw cavity 48 is designed and dimensioned to retain the screw head 36 of the bone screw 34, with the shank 38 of the bone screw extending from the receiver member 40. An opening 56 is formed in the inferior end 46 of the receiver member 40. In this disclosed embodiment, the diameter of the opening 56 is smaller than the diameter of the screw head 36, but it is large enough to allow the screw shank 38 to pass through the opening 56. Accordingly, the cylindrical wall 42 is slightly thicker at the inferior end 46 of the receiver member 40.
  • A bearing member 54 is positioned within the bone screw cavity 48 along with the screw head 36. The bearing member 54 includes an inner bearing surface that generally conforms to the spherical shape of the screw head 36. The screw head 36 is configured to rotate and pivot within the bearing member 54. The outer bearing surface is designed and dimensioned to engage the interior portion of the cylindrical sidewalls 42 of the receiver member.
  • In one embodiment, the bearing member 54 is a split bearing that includes a left side member 54 a and a right side member 54 b. The split bearing, 54 a, 54 b provides for easier assembly by allowing the bearing surface to be assembled around the spherical screw head 36. In addition, the split bearing members 54 a, 54 b facilitate the use of different bearing materials. Appropriate bearing materials will be recognized by those of skill in the art. In the embodiment of FIGS. 3A and 3B, the bearing members 54 a, 54 b are comprised of ceramic. Examples of other types of appropriate bearing materials include cobalt chrome, UHMWPE, and other biocompatible materials.
  • An insert 60 is provided in the receiver member. The insert 60 acts as a retention member to secure the bearing member 54 in place within the bone screw cavity 48 of the receiver member 40. In the embodiment of FIGS. 3A-3D, the insert 60 is C-shaped plate that serves as a retaining ring. As best seen in FIGS. 3C and 3D, the insert 60 includes a semi-circular wall 64 with a void 65 formed in the wall. Two opposing ends 66 a and 66 b define the sides of the void 65. The exterior perimeter 67 of the insert 60 is generally circular in shape, while the interior perimeter 68 is contoured to provide strength to the insert. In addition, the insert may include other structural features such as holes 69. The insert 60 is generally comprised of a resilient biocompatible material, such as cobalt chrome or UHMWPE. The resilient features of the insert 60 allow the ends 66 a, 66 b to be forced together, reducing the size of the void 65, and then spring back to their original position.
  • As shown in FIG. 3A, the insert 60 is provided within a groove 62 formed in the cylindrical sidewalls 42 of the receiver member 40. With reference to the exploded view of the anchor assembly 24 shown FIG. 3B, it can be seen that the insert 60 is loaded into the retainer member 40 through a hole 50 in the top of the retainer member. First, the split bearing members 54 a, 54 b are positioned about the head of the screw 38 and the screw is inserted into the receiver member 40. Upon insertion, the split bearing members 54 a, 54 b and screw head 36 are seated in the screw head cavity and the shank 38 extends through the hole in the bottom of the receiver member 40. Next, the insert 60 is compressed and inserted into the receiver member 40. When properly positioned, the resilient insert snaps into the groove 62 in the receiver member, thus locking the split bearing members 54 a, 54 b in place within the retainer member. With the insert 60 locked in the groove 62, the bearing member 54 is secured in place within the receiver member such that various stresses on the bone screw will not dislodge the bearing member within the anchor assembly 24. After insertion of the insert 60, the rod 26 is placed in the rod passage 53 of the receiver member and the fixation screw 70 is threaded in the fixation screw cavity 50 until it compresses against the rod, thus fixing the rod to the receiver member 40.
  • FIG. 4 shows an alternative embodiment of a bone anchor assembly including an insert for securing the bearing 54 within the receiver member 40. In this embodiment, the insert 60 comprises a polyethylene disc positioned between the rod 26 and the bearing 54. Before the fixation screw is tightened, the top surface of the polyethylene disc 60 is positioned within the rod cavity 52. Thus, when the fixation screw 70 is tightened against the rod 26, the polyethylene insert 60 is slightly compressed by the rod. The force of this compression is then transferred to the bearing member 54, which is tightly compressed within the bone screw cavity 48, thus securing the bearing in place. Although FIGS. 3 and 4 show only two methods for holding the bearing 54 in place within the receiver member 40, one of skill in the art will recognize that variations of the disclosed embodiments may be easily incorporated. For example, in one embodiment, a combination retaining ring and compression disc may be used.
  • Rod Fixed to Receiver Member Providing with Pivot Point Offset from Rod Axis
  • From FIGS. 3 and 4, it can be seen that an offset exists between the center axis of the rod and the pivot point of the rod 26 within the anchor assembly 24. In particular, as shown in FIG. 4, the center axis 80 of the rod (shown by dotted line 80) is removed from the pivot point (shown by “X” 82) of the rod within the anchor assembly 24. This offset provides one embodiment that may be used to help control the necessary kinematics and loading requirements of the rod. In these embodiments, the rod 26 is fixed to the anchor assembly, and is not allowed to pivot relative to the receiver member 40 which holds the bone screw 34.
  • An alternative embodiment of a bone anchor 24 where the center axis of the rod is offset from the pivot point of the rod within the anchor assembly is shown in FIGS. 5 and 6. In this embodiment, the anchor assembly includes a bone screw 34, a U-shaped screw holder 86, and a rod holder 88. The bone screw includes a threaded shank 38, but instead of a spherical head, the head 36 of the bone screw is flat and generally circular or disc-shaped. This flat screw head is designed and dimensioned to fit within a circular cavity formed in the base 90 of the U-shaped screw holder 86. The circular cavity 87 allows the head 36 to rotate within the cavity 87 about the axis of the screw. A pivot pin 94 extends through the upright portions 92 of the U-shaped screw holder 86.
  • The rod holder 88 is pivotably mounted on the pivot pin 94. The rod holder 88 is similar to the receiver member 40 described in FIGS. 3 and 4. However, in place of a screw cavity, the rod holder 88 of FIGS. 5 and 6 includes a pin channel 95 configured to receive the pivot pin 94. The rod holder 88 is allowed to rotate about the pivot pin 94, thus allowing the rod holder 88 to pivot relative to the U-shaped screw holder 86. A rod passage 52 is formed in the rod holder 88 above the pin channel 95. A fixation screw 70 threadedly engages the interior threaded walls on the top of the rod holder 88. When the fixation screw 70 is tightened against the rod, the rod is pinned in place within the rod holder 88.
  • In the embodiment of FIGS. 5 and 6, the rod is allowed only two degrees of freedom. First, the rod 26 is allowed to pivot by radial rotation around an axis defined by the screw shank 38 by virtue of the rotatable engagement between the screw head 36 and the circular cavity 87 of the U-shaped screw holder 86. Second, the rod 26 is allowed to pivot about the pin 94 which is perpendicular to the screw shank. To facilitate rotation of the screw head 36 and the pin 94 within the U-shaped screw holder, the U-shaped screw holder may be comprised of ultra high molecular weight polyethylene (UHMWPE), cobalt chrome, titanium, stainless steel or other appropriate biocompatible bearing material as will be recognized by those of skill in the art.
  • Another alternative embodiment of a bone anchor 24 where the center axis of the rod is offset from the pivot point of the rod is shown in FIG. 7. The bone anchor 24 of FIG. 7 includes a receiver member in the form of a screw holding member 100 that is fixed to the shank 38 of the bone screw 34. The rod 26 is secured to a rod holding member 102 which includes a cavity that receives the rod 26. The rod holding member 102 includes a fixation screw 70 that clamps onto the rod in order to fix to the rod holding member 102 to the rod 26. The rod holding member further includes a ball-shaped pivot member (shown by dotted lines 104 within the screw holding member 100). In this embodiment, the screw holding member 100 includes a cavity with a spherical bearing 106 and bearing surface that is also fixed relative to the screw shank 38. The spherical bearing surface is configured to receive the pivot member 104 which is fixed to the rod 26. Because the surface of the pivot member 104 is congruent with the bearing surface, the pivot member 104 is allowed to pivot within the screw holding member 100. Accordingly, the rod 26 is configured to pivot relative to the shank 38. The pivot point for the rod 26 is defined at the center of the pivot member 104 which is located within the center of the cavity in the screw holding member 100.
  • Rod Pivotably Connected to Receiver Member with Pivot Point on Rod Axis
  • With reference now to FIGS. 8-9, an alternative embodiment of a bone anchor 24 for a PDS system is shown where the rod 26 is pivotably connected to the receiver member 40 of the bone anchor. The bone anchor 24 includes a bone screw 34 having a screw head 36 retained within the receiver member 40 with the screw shank 38 extending from the receiver member 40.
  • Two different bearings are retained within the receiver member 40. In particular, a first bearing 110 provides a bearing surface for the screw head. The first bearing acts to stabilize the screw head 36 within the receiver member 40 while providing a surface upon which the screw head may pivot relative to the receiver member 40. In one embodiment, the first bearing may be comprised of a metallic insert that acts to lock the bone screw 34 in place when a fixation screw is tightened, as discussed in further detail below.
  • In addition to the first bearing 110, a second bearing 112 is also provided within the receiver member 40 shown in FIGS. 8 and 9. The second bearing 112 provides spherical bearing surface for the rod 26, allowing the rod 26 to pivot relative to the receiver member 40. Accordingly, the rod 26 includes a pivot member 114 in the form of a spherical ball fixed on at least one end of the rod 26. The spherical ball 114 engages the spherical bearing surface of the second bearing 112, thus pivotably retaining the rod 26 within the receiver member 40 and facilitating smooth movement of the rod relative to the receiver member. In this embodiment, the pivot member 114 is fixed to the rod 26, being integrally formed upon the rod.
  • In the embodiment disclosed in FIGS. 8 and 9, the second bearing 112 is a split bearing that includes a superior bearing member 116 provided above the spherical ball 114 and an inferior bearing member 118 provided below the spherical ball 114. In another alternative embodiment, the bearing is split into left and right halves such as the bearing shown in FIG. 3B. The split bearing 112 is comprised of UHMWPE, ceramic, cobalt chrome, or any other biocompatible material. In one alternative embodiment, the first bearing 110 and the inferior bearing member 118 of the second bearing 112 may be provided as a single integral component.
  • The components of the anchor assembly 24 may all be loaded into the receiver member 40 through a top hole. First, the bone screw 34 is inserted into the receiver member 40 with the screw head 36 seated in the screw head cavity and the shank 38 extending through the hole in the bottom of the receiver member 40. Second, the first bearing 110 is placed over the screw head. Next, the inferior bearing member 118 of the second bearing 112 is placed on top of the first bearing 110. The rod 26 is then placed in the receiver member with the spherical ball 114 engaging the bearing surface of the inferior bearing member 118, and the cylindrical portion of the rod passing through the rod passage formed in the sidewalls of the receiver member. The superior bearing member 116 is then placed over the spherical ball 114. This provides a superior bearing surface for the spherical ball. Finally, the fixation screw 70 is threaded into the top of the receiver member until it compresses against the second bearing member. Alternatively, the bearing components, screw, and rod may be pre-assembled and inserted into the receiver member as a unit.
  • In the embodiment of FIGS. 8 and 9, the anchor 24 acts as polyaxial screw that can be locked down by the metal insert 110 that is tightened by the fixation screw 70 when the screw head 36 is in the desired position. The fixation screw 70 functions to lock the bone screw 34 and to slightly compress the second bearing 112, thus keeping the second bearing in place within the receiver member 40.
  • In the embodiment of FIGS. 8 and 9, it can also be seen that the rod 26 is configured to pivot relative to the receiver member 40. Accordingly, as shown in FIG. 8, the pivot point 82 which the rod 26 pivots about is located on an axis defined by the rod and extending along the rod, such as a central axis 80 or an axis extending axially through the rod or along the surface of the elongated rod 26. In the case of FIG. 8, the axis is the central axis 80 of the rod. Because of this, the rod is constrained to motion in the axial direction. In other words, in this embodiment, the dynamic central portion of the rod is elongated or compressed, but is not bent when the receiver member 40 moves. Thus, for a given PDS assembly of two bone anchors and a rod, when the vertebrae move the bone screws 34, the receiver members 40 also move along with the bone screws. Because the rod 26 is allowed to pivot relative to the receiver members 40 about pivot point 82, movement of the receiver members 40 imparts axial forces on the rod 26 that cause the rod to either compress or elongate. Advantageously, this arrangement offers different kinematics and loading requirements from those stabilization elements where the pivot point is offset from an axis defined by the rod. These differing kinematics and loading requirements may be advantageous with certain materials and designs or with certain patients.
  • One alternative embodiment to that of FIGS. 8 and 9 involves the use of a setscrew nested in the fixation screw, allowing the polyaxial screw to be locked separate from the compression of the bearing surface. Furthermore, although there is a specific shape and locking of the bearing surface shown in FIGS. 8, this could be altered based on materials used and the constraints of the rod. Of course one of skill in the art will recognize that numerous other adaptations of the embodiment of FIGS. 8 and 9 are possible where the pivot point of the rod is located along the central or other axis of the rod.
  • Another example of an alternative embodiment for the bone anchor of FIGS. 8 and 9 is shown in FIG. 10. FIG. 10 shows an embodiment of a bone anchor 24 which acts as a fixed screw instead of a polyaxial screw. In particular, in FIG. 10, the screw shank 38 is fixed to the receiver member 40. In this embodiment, the screw shank 38 may be integrally formed with the receiver member 40 such that the receiver member 40 serves as the bone screw head. Alternatively, the screw shank 38 may be otherwise fixed to the receiver member 40 using some locking mechanism or other connection means. In the embodiment of FIG. 10, the inferior portion 118 of the bearing member 112 is first placed in the cavity 120 formed in the receiver member 40. The ball shaped portion of the rod 26 is then loaded onto the inferior bearing surface and the superior bearing member 116 is placed on top of the rod within the cavity. Finally, the fixation screw 70 is used to secure the bearing 112 within the cavity 120 of the receiver member 40.
  • FIG. 11 shows another embodiment, similar to FIG. 10, where the screw shank is fixed to the receiver member 40, and the screw head is formed as the receiver member 40. In FIG. 11, the receiver member 40 is formed as a block 130 with a central cavity 132. A bearing member 134 with a toroidal bearing surface 136 is positioned within the cavity 132 of the receiver member 40. Because the receiver member 40 is fixed relative to the screw shank 38, the bearing 134 is also fixed relative to the screw shank 38. The toroidal bearing surface is configured to receive a spherical portion on the end of a rod, similar to the rod end in FIGS. 8 and 9 that includes a spherical ball 114. Engagement of the spherical ball 114 and the toroidal bearing surface 136 allows the rod 26 to pivot relative to the shank 38 of the bone screw 38. In this embodiment, the bearing 134 is shown as being UHMWPE and as being held in place by a press fit. However, one of skill in the art will recognize that numerous other viable bearing materials and locking mechanisms may be used. Similar to the embodiments of FIGS. 8-10, the bone anchor disclosed in FIG. 11 provides an arrangement where the pivot point of the rod is located along the central axis of the rod.
  • FIGS. 12 and 13 show another alternative embodiment similar to FIG. 11. However, in the embodiment of FIGS. 12 and 13, the bearing 134 is not fixed relative to the screw shank 38. Instead, the bone anchor 24 acts as a polyaxial screw, and the bone screw head 36 and shank 38 are connected to the block 130/receiver member 40 in a pivotable relationship. Like the bone screw 34, the bearing 134 is loaded in the top of the receiver member 40, and a set screw or other locking member 71 holds the bearing 134 in place within the receiver member 40. Although the bone anchor acts as a polyaxial screw, the bone screw 34 can be locked in place relative to the block 130 when the locking member 71 is tightened within the block. Accordingly, a metal insert 138 may be provided around the bearing 134. When the locking member 71 is tightened, the metal insert 138 is locked into the screw head 36, fixing the bone screw relative to the block 130. One of skill in the art will recognize that various alternative versions of the embodiments of FIGS. 11-13 are possible. For example, it will be recognized that a dual setscrew could be used and that although the bearing surface is shown as a solid piece, it could be split to allow for easier assembly and to facilitate the use of other materials.
  • Yet another embodiment of a bone anchor 24 where the pivot point of the rod is located along the central axis of the rod is shown in FIG. 14. The embodiment of FIG. 14 is very similar to that of FIG. 11, but in FIG. 14 the block 130 and bearing 134 is provided on the rod 26 rather than the screw shank 38. Likewise, a spherical ball 115 is provided on the screw shank 138 rather than on the rod 26. The spherical ball 115 engages the bearing 134, allowing the rod 26 to pivot relative to the bone screw 34. In this embodiment, the bearing 134 is shown as being UHMWPE and as being held in place by a press fit. However, one of skill in the art will recognize that numerous other viable bearing materials and locking mechanisms may be used.
  • FIGS. 15A-15F show six possible designs for an adjustable length rod that could be used with the designs of FIGS. 8-13 where the pivot point of the rod is provided along the center axis of the rod. As mentioned above, adjustable length rods are advantageous when providing a PDS system so that different sized systems may be constructed for segmental units of different sizes and patients of different sizes. Accordingly, the rods of FIGS. 15A-15F may be used to provide an adjustable PDS system comprising: a plurality of bone anchors; and at least one connecting member connected to and extending between the plurality of bone anchors, wherein the at least one connecting member is adjustable in length. In one embodiment, the at least one connecting member is fixedly connected to the plurality of bone anchors. In another embodiment, the at least one connecting member is pivotably connected to the plurality of bone anchors. In other embodiments, the adjustable connecting member is provided as a telescoping shaft with two or more portions that slide relative to one another and may be locked to one another. In another embodiment, the adjustable connecting member comprises a shaft with a threaded ball on the end that can be turned to effectively lengthen or shorten the connecting member. These and other embodiments are shown in FIGS. 15A-15F. The embodiments of FIGS. 15A-15F show rods with helical dynamic portions provided in the center of the rod. However, it is intended that the embodiments disclosed herein could be used with any dynamic element, and not just helical dynamic portions.
  • FIG. 15A shows a basic rod 26 that generally comprises a shaft with a flexible elastic central portion 28, a first end 30, and a second end 32. Ball-shaped members 114 are provided on the first end 30 and second end 32 of the rod 26. The ball-shaped members are substantially spherical in the disclosed embodiment and are configured to engage the bearing surface of the rod bearing 112 retained within the bone anchor 24. Exemplary bone anchors 24 configured to retain rod bearings for use with rods having ball-shaped ends are disclosed in FIGS. 8-13. In FIG. 15A, the ball shaped members 114 are formed integral with the rod in FIG. 15A. To this end, the ball-shaped members 114 may be molded as a single piece with the central dynamic portion 28 of the rod. Alternatively, the ball-shaped members 114 may be fixed to the dynamic portion 28 by other means, such as welding, adhesion, or other appropriate methods as will be recognized by those of skill in the art. In other alternative embodiments, the ball-shaped members 114 may be releasably connected to the dynamic portion 28. For example, the ball shaped members 114 may be screwed, snapped, or friction fit onto the rod 26 at the rod ends 30, 32. Those of skill in the art will recognize various other possibilities for securing the ball shaped members on the rod. In this embodiment, where the ball shaped members 114 are fixed relative to the dynamic portion 28, the rod 26 may be provided in numerous discrete lengths to accommodate size differences between different patients and/or different segmental units of the spine.
  • In an alternative embodiment, the ball shaped members 114 of the rod may be adjustably connected to the rod. With this arrangement, a single rod may be used to accommodate various size differences between patients and/or segmental units. Examples of rods 26 where the ball shaped member 114 is adjustable relative to the dynamic portion 28 are shown in FIGS. 15B-15F.
  • In FIG. 15B, the ball-shaped members 114 are provided on posts 140. The posts 140 fit within the rod shaft, and particularly within a mouth 142 formed on the rod ends 30, 32. Each mouth 142 includes an upper jaw 144 and a lower jaw 146 that taper outwardly from the central axis of the rod. A passage is formed between the upper jaw 144 and the lower jaw that accepts one of the posts 140. A locking ring 148 is provided on each rod end 30, 32. When the locking ring 148 is moved over the mouth 142, the upper jaw 144 and lower jaw 146 of the mouth are forced together, thus compressing the post 140 within the mouth 142 and locking the associated ball member 114 on the end of the rod 26. Because the posts 140 and associated ball members 114 are slideable relative to the central dynamic portion 28 of the rod 26, the size of the rod may be adjusted to various lengths to accommodate different segmental units of the spine and patients of different sizes.
  • In FIGS. 15C and 15D, the ball-shaped members 114 are taper-locked to a cap member 150 whose position can be adjusted to the desired length. In both of the embodiments of 15C and 15D, the cap member 150 includes a frusto-conical portion 152 that is inserted into a cavity 160 in the ball member 114 to taper-lock the ball member 114 to the cap member 150. Of course, in the embodiments of FIGS. 15C and 15D, another fastening means different from a taper-lock could be used to attach the ball member 114 to the cap member 150. In both embodiments of FIGS. 15C and 15D, the cap member 150 is secured to the rod using a setscrew. In the embodiment of FIG. 15C, the cap member fits over the cylinder of the rod, and a screw hole 154 is formed in the cap member 150. In the embodiment of FIG. 15D, a post 156 is inserted within the rod cylinder and a screw hole 158 is formed in the rod 26. Again, with both FIGS. 15C and 15D, because the ball members 114 are slideable relative to the central dynamic portion 28 of the rod 26, the size of the rod may be adjusted to various lengths to accommodate different segmental units of the spine and patients of different sizes.
  • In the embodiment of FIG. 15E spaced teeth 160 are provided on the rod ends 30, 32. Interlocking teeth 162 are also provided on the inside of the ball members 114. The teeth 160, 162 are provided with slight tapers such that the teeth 160 on the rod cylinder interact with the teeth 162 on the inside of the ball members 114. Depending on which set of spaced teeth 160, 162 are used, the length of the rod can be adjusted and fixed using a simple turn.
  • In the embodiment of FIG. 15F, the rod ends are comprised of a shape memory alloy (also referred to as “smart metals” or “memory metals”), such as nickel-titanium (NiTi), copper-zinc-aluminum, or copper-aluminum-nickel. Shape memory alloys exhibit temperature dependent memory properties which may be advantageously used to lock the ball members 114 on the ends 30, 32 of the rod 26. In the embodiment of FIG. 15F, the ends 30, 32 of the rod include nested cups 166 comprised of a shape memory alloy. A slit 164 formed through the cups 166 along the end of the rod. Associated grooves are provided on the inside of the ball members. The ball members 114 are free to slide on the cups 166 on the rod ends 30, 32 at room temperature. However, at body temperature, the cups 166 splay outward, thus locking the cups 166 into the grooves on the inside of the ball member and securing the ball members in place.
  • Low Profile Design
  • FIGS. 16-18 show an alternative embodiment configured for use with any of the above-described designs where the pivot point of the rod is offset from the central or other axis defined by the rod (e.g., FIGS. 3-7). The advantage addressed in the embodiment of FIGS. 16-18 is that of a dynamic screw with a lower profile. In this embodiment, the lower portion of the bone anchor 24 is similar to that of FIGS. 3 and 4, and includes a bone screw cavity 48 configured to receive a bearing member 48 and the head 36 of a bone screw 34. An insert 60 is provided above the bearing member 54 that locks the bearing member in the cavity 48. Also similar to FIGS. 3 and 4, a rod cavity/passage 52 is provided above the insert. However, unlike FIGS. 3 and 4, no fixation screw is provided above the rod 26. Instead, the rod 26 and bone anchor 24 include features that allow the rod 26 to be locked into the rod cavity 52 without the use of a fixation screw.
  • In the exemplary embodiment of FIGS. 16-18 the locking features provided on the rod 26 include fingers 170 provided on the rod ends with slits 172 cut into each rod end between the fingers 170. Teeth 174 are also provided on the rod ends. The slits 172 allow the fingers 170 to contract toward each other as the end of the rod is forced into the rod cavity 52. Once the rod is in the cavity 52, the fingers 170 are flared back outwardly toward or past their original configuration. When the fingers are forced outwardly, they are pressed against the insert 60, thus locking the rod in place within the rod cavity. Flaring of the fingers may be achieved through the use of a memory metal or by other means, such as a wedge forced into the slits at the end of the rod. With the rod in place within the rod cavity 52, the rod presses against the insert 60 and receiver member 40, which locks the bearing 54 in place within the bone anchor 24. If the insert 60 is comprised of a relatively soft material, the teeth 174 may cut into the insert to assist in securing the rod within the bone anchor. In one alternative embodiment, the teeth 174 are designed to mate with complimentary teeth on insert 60 and receiver member 40 to assist in securing the rod within the bone anchor.
  • In one embodiment, a cap is provided over the superior end 44 of the bone anchor. This may be desirable if the rod will be passed through tissue. The cap could either be permanent or temporary. As best seen in FIG. 18, the distance across the rod cavity 52 generally decreases when moving from the center of the rod cavity toward the superior end 44. This decreased distance at the superior end 44 is less than the diameter of the rod 26, and helps in preventing passage of the rod through the top of the receiver member 40. However, if a cap were provided over the superior end 44 it could be used to further assist in retaining the rod 26 within the receiver member 40. Furthermore, if this embodiment were used in an minimally-invasive surgery procedure, where it would be more difficult to assure that the receiver members 40 are aligned in the correct configuration to properly engage and lock down the rod, the cap could mate with a feature on the screw head in such a way that it would insure that the heads are placed correctly and that the receiver member is properly secured.
  • Although the present invention has been described with respect to certain preferred embodiments, it will be appreciated by those of skill in the art that other implementations and adaptations are possible. For example, although the invention has been disclosed for use with reference to a single segmental spine unit, it could also be adapted for use with multi-level constructions. As another example, the dynamic rods disclosed herein include a helical flexible portion, but different dynamic rods may be used in other embodiments. As yet another example, the connection of the rod to the bone anchor may vary from those embodiments disclosed herein. Moreover, there are advantages to individual advancements described herein that may be obtained without incorporating other aspects described above. Therefore, the spirit and scope of the appended claims should not be limited to the description of the preferred embodiments contained herein.

Claims (34)

1. A spine stabilization system configured for connection between vertebrae, the spine stabilization system comprising:
a) at least one bone anchor assembly comprising a bone engaging member; and
b) an elongated connecting member pivotably connected to the bone engaging member of the at least one bone anchor assembly, wherein the elongated connecting member defines an axis that extends along the elongated connecting member and the axis pivots about a pivot point on the axis when the elongated connecting member pivots relative to the bone engaging member.
2. The spine stabilization system of claim 1 wherein the elongated connecting member is adjustable in length.
3. The spine stabilization system of claim 1 wherein the at least one bone anchor assembly further comprises a receiver member engaging both the elongated connecting member and the bone engaging member.
4. The spine stabilization system of claim 3 wherein the elongated connecting member is pivotably connected to the receiver member.
5. The spine stabilization system of claim 3 wherein the elongated connecting member is fixedly connected to the receiver member.
6. The spine stabilization system of claim 3 wherein the receiver member is pivotably connected to the bone engaging member.
7. The spine stabilization system of claim 3 wherein the receiver member is fixedly connected to the bone engaging member.
8. The spine stabilization system of claim 1 wherein the bone engaging member comprises a shank.
9. The spine stabilization system of claim 8 wherein the bone engaging member further comprises a head.
10. The spine stabilization system of claim 9 wherein the head is a screw head and the shank is a threaded screw shank.
11. A spine stabilization system configured for connection between vertebrae, the spine stabilization system comprising:
a) at least one bone engaging member;
b) at least one receiver member pivotably connected to a portion of the bone engaging member; and
c) an elongated connecting member pivotably connected to the at least one receiver member.
12. The spine stabilization system of claim 11 wherein the elongated connecting member defines an axis and the axis pivots about a pivot point when the elongated connecting member pivots relative to the receiver member.
13. The spine stabilization system of claim 12 wherein the pivot point is located within the receiver member.
14. The spine stabilization system of claim 12 wherein the axis is a central axis and the pivot point is located along the central axis.
15. The spine stabilization system of claim 11 wherein the elongated connecting member includes a shaft having an elastic central portion.
16. The spine stabilization system of claim 14 wherein the elongated connecting member is an adjustable length rod.
17. The spine stabilization system of claim 16 wherein the rod includes a shaft having at least one adjustable end.
18. The spine stabilization system of claim 17 wherein the at least one adjustable end includes a post configured to slide within the shaft in order to provide a telescoping rod.
19. The spine stabilization system of claim 17 wherein the at least one adjustable end is configured to threadedly engage the shaft.
20. The spine stabilization system of claim 19 wherein a ball is provided on the at least one adjustable end, and rotation of the ball effectively lengthens or shortens the rod.
21. The spine stabilization system of claim 17 wherein the shaft or the at least one adjustable end is comprised of a shape memory alloy.
22. The spine stabilization system of claim 12 wherein the at least one receiver member comprises a cavity configured to receive the elongated connecting member.
23. The spine stabilization system of claim 22 further comprising a bearing positioned within the cavity and configured to engage the elongated connecting member.
24. The spine stabilization system of claim 22 wherein the pivot point is located within the cavity.
25. The spine stabilization system of claim 11 wherein the at least one bone engaging member comprises a first bone engaging member and a second bone engaging member, wherein the at least one receiver member comprises a first receiver member and a second receiver member, wherein the elongated connecting member extends between the first receiver member and the second receiver member, and wherein the elongated connecting member is pivotably connected to both the first receiver member and the second receiver member.
26. The spine stabilization system of claim 25 wherein the elongated connecting member is configured for extension or compression, and wherein movement of the first bone engaging member relative to the second bone engaging member causes compression or extension of the elongated connecting member.
27. The spine stabilization system of claim 11 wherein the at least one bone engaging member comprises a bone screw including a screw head and a screw shank, wherein the screw head is pivotably connected to the receiver member.
28. A spine stabilization system comprising:
a) at least one bone engaging member;
b) an elongated connecting member pivotably connected to the at least one bone engaging member;
c) a pivot member fixed to the elongated connecting member; and
d) a receiver member connected to the at least one bone engaging member, the receiver member configured to engage the pivot member such that the pivot member is pivotable within the receiver member.
29. The spine stabilization system of claim 28 wherein the pivot member is integral with the elongated connecting member.
30. The spine stabilization system of claim 28 wherein the pivot member is clamped onto the elongated connecting member.
31. The spine stabilization system of claim 28 wherein the pivot member is a ball-shaped member.
32. The spine stabilization system of claim 28 wherein the receiver member is fixed to the at least one bone engaging member.
33. The spine stabilization system of claim 28 wherein the receiver member is pivotably connected to the at least one bone engaging member.
34. The spine stabilization system of claim 28 wherein the bone engaging member comprises a shank extending from the receiver member.
US11/646,877 2006-12-28 2006-12-28 Spine stabilization system with dynamic screw Abandoned US20080161853A1 (en)

Priority Applications (10)

Application Number Priority Date Filing Date Title
US11/646,961 US8409256B2 (en) 2006-12-28 2006-12-28 Spinal anchoring screw
US11/646,877 US20080161853A1 (en) 2006-12-28 2006-12-28 Spine stabilization system with dynamic screw
EP07863062.1A EP2117448B1 (en) 2006-12-28 2007-12-19 Spinal anchoring screw
PCT/US2007/026009 WO2008085369A1 (en) 2006-12-28 2007-12-19 Spine stabilization system with dynamic screw
JP2009544032A JP5437074B2 (en) 2006-12-28 2007-12-19 Spinal fixation screw
AU2007342474A AU2007342474B2 (en) 2006-12-28 2007-12-19 Spinal anchoring screw
PCT/US2007/025862 WO2008085347A1 (en) 2006-12-28 2007-12-19 Spinal anchoring screw
CA2674147A CA2674147C (en) 2006-12-28 2007-12-19 Spinal anchoring screw
US13/798,243 US9629662B2 (en) 2006-12-28 2013-03-13 Spinal anchoring screw
US14/563,153 US20150088207A1 (en) 2006-12-28 2014-12-08 Method of Using Spine Stabilization System With Dynamic Screw

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US11/646,961 US8409256B2 (en) 2006-12-28 2006-12-28 Spinal anchoring screw
US11/646,877 US20080161853A1 (en) 2006-12-28 2006-12-28 Spine stabilization system with dynamic screw

Related Child Applications (1)

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US14/563,153 Division US20150088207A1 (en) 2006-12-28 2014-12-08 Method of Using Spine Stabilization System With Dynamic Screw

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US20080161853A1 true US20080161853A1 (en) 2008-07-03

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US11/646,961 Active 2028-08-05 US8409256B2 (en) 2006-12-28 2006-12-28 Spinal anchoring screw
US11/646,877 Abandoned US20080161853A1 (en) 2006-12-28 2006-12-28 Spine stabilization system with dynamic screw
US13/798,243 Active 2028-11-08 US9629662B2 (en) 2006-12-28 2013-03-13 Spinal anchoring screw
US14/563,153 Abandoned US20150088207A1 (en) 2006-12-28 2014-12-08 Method of Using Spine Stabilization System With Dynamic Screw

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US11/646,961 Active 2028-08-05 US8409256B2 (en) 2006-12-28 2006-12-28 Spinal anchoring screw

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US13/798,243 Active 2028-11-08 US9629662B2 (en) 2006-12-28 2013-03-13 Spinal anchoring screw
US14/563,153 Abandoned US20150088207A1 (en) 2006-12-28 2014-12-08 Method of Using Spine Stabilization System With Dynamic Screw

Country Status (6)

Country Link
US (4) US8409256B2 (en)
EP (1) EP2117448B1 (en)
JP (1) JP5437074B2 (en)
AU (1) AU2007342474B2 (en)
CA (1) CA2674147C (en)
WO (2) WO2008085369A1 (en)

Cited By (67)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20080045963A1 (en) * 2006-08-21 2008-02-21 Abdou M S Bone screw systems and methods of use
US20080082103A1 (en) * 2006-06-16 2008-04-03 Alphatec Spine, Inc. Systems and methods for manipulating and/or installing a pedicle screw
US20090312804A1 (en) * 2008-06-17 2009-12-17 Thomas Gamache Adjustable implant assembly
ITMI20082238A1 (en) * 2008-12-17 2010-06-18 Giuseppe Calvosa MODULAR VERTEBRAL STABILIZER.
US20110184412A1 (en) * 2010-01-28 2011-07-28 Warsaw Orthopedic, Inc. Pre-Assembled Construct With One or More Non-Rotating Connectors for Insertion Into a Patient
EP2408384A1 (en) * 2009-03-20 2012-01-25 Spinal Usa Llc Pedicle screws and methods of using the same
US20120143254A1 (en) * 2007-10-22 2012-06-07 Flexuspine, Inc. Posterior stabilization systems with shared, dual dampener systems
US8377098B2 (en) 2007-01-19 2013-02-19 Flexuspine, Inc. Artificial functional spinal unit system and method for use
US8449578B2 (en) 2009-11-09 2013-05-28 Ebi, Llc Multiplanar bone anchor system
US8469999B2 (en) 2008-04-17 2013-06-25 Eduardo Gonzalez-Hernandez Soft tissue attachment system and clip
US8603168B2 (en) 2003-08-05 2013-12-10 Flexuspine, Inc. Artificial functional spinal unit system and method for use
US8641734B2 (en) 2009-02-13 2014-02-04 DePuy Synthes Products, LLC Dual spring posterior dynamic stabilization device with elongation limiting elastomers
US8647386B2 (en) 2003-08-05 2014-02-11 Charles R. Gordon Expandable intervertebral implant system and method
US8657856B2 (en) 2009-08-28 2014-02-25 Pioneer Surgical Technology, Inc. Size transition spinal rod
US20140142640A1 (en) * 2011-03-09 2014-05-22 Zimmer Spine, Inc. Polyaxial pedicle screw with increased angulation
US8764808B2 (en) 2008-03-10 2014-07-01 Eduardo Gonzalez-Hernandez Bone fixation system
US8870963B2 (en) 2010-10-27 2014-10-28 Toby Orthopaedics, Inc. System and method for fracture replacement of comminuted bone fractures or portions thereof adjacent bone joints
US8940051B2 (en) 2011-03-25 2015-01-27 Flexuspine, Inc. Interbody device insertion systems and methods
US8961573B2 (en) 2010-10-05 2015-02-24 Toby Orthopaedics, Inc. System and method for facilitating repair and reattachment of comminuted bone portions
US8979901B2 (en) 2010-08-26 2015-03-17 Warsaw Orthopedic, Inc. Dynamic bone fastener with a preset range of motion
US9044272B2 (en) 2009-11-09 2015-06-02 Ebi, Llc Multiplanar bone anchor system
US9072546B2 (en) 2010-08-26 2015-07-07 Warsaw Orthopedic, Inc. Spinal constructs with improved load-sharing
US9232968B2 (en) 2007-12-19 2016-01-12 DePuy Synthes Products, Inc. Polymeric pedicle rods and methods of manufacturing
US9254154B2 (en) 2011-03-03 2016-02-09 Toby Orthopaedic, Inc. Anterior lesser tuberosity fixed angle fixation device and method of use associated therewith
US9271772B2 (en) 2011-10-27 2016-03-01 Toby Orthopaedics, Inc. System and method for fracture replacement of comminuted bone fractures or portions thereof adjacent bone joints
US9271761B2 (en) 2012-12-11 2016-03-01 Zimmer Spine Bone anchoring device
US9283008B2 (en) 2012-12-17 2016-03-15 Toby Orthopaedics, Inc. Bone plate for plate osteosynthesis and method for use thereof
US9320543B2 (en) 2009-06-25 2016-04-26 DePuy Synthes Products, Inc. Posterior dynamic stabilization device having a mobile anchor
US9333014B2 (en) 2013-03-15 2016-05-10 Eduardo Gonzalez-Hernandez Bone fixation and reduction apparatus and method for fixation and reduction of a distal bone fracture and malunion
US9393045B2 (en) 2013-03-15 2016-07-19 Biomet Manufacturing, Llc. Clamping assembly for external fixation system
US9402667B2 (en) 2011-11-09 2016-08-02 Eduardo Gonzalez-Hernandez Apparatus and method for use of the apparatus for fracture fixation of the distal humerus
USRE46115E1 (en) 2005-09-19 2016-08-23 Ebi, Llc Bone screw apparatus, system and method
US9445844B2 (en) 2010-03-24 2016-09-20 DePuy Synthes Products, Inc. Composite material posterior dynamic stabilization spring rod
US9492288B2 (en) 2013-02-20 2016-11-15 Flexuspine, Inc. Expandable fusion device for positioning between adjacent vertebral bodies
US9504497B2 (en) 2013-02-20 2016-11-29 K2M, Inc. Iliosacral polyaxial screw
US9517144B2 (en) 2014-04-24 2016-12-13 Exactech, Inc. Limited profile intervertebral implant with incorporated fastening mechanism
US9526627B2 (en) 2011-11-17 2016-12-27 Exactech, Inc. Expandable interbody device system and method
US9730797B2 (en) 2011-10-27 2017-08-15 Toby Orthopaedics, Inc. Bone joint replacement and repair assembly and method of repairing and replacing a bone joint
USD799949S1 (en) * 2007-10-24 2017-10-17 Nuvasive, Inc. Favored angle screw
US20190142478A1 (en) * 2013-09-27 2019-05-16 Spinal Elements, Inc. Method of placing an implant between bone portions
US10398565B2 (en) 2014-04-24 2019-09-03 Choice Spine, Llc Limited profile intervertebral implant with incorporated fastening and locking mechanism
US20190365428A1 (en) * 2004-11-23 2019-12-05 Roger P. Jackson Pivotal bone anchor assembly with multi-part shank retainer and rod-engaging insert
US10543107B2 (en) 2009-12-07 2020-01-28 Samy Abdou Devices and methods for minimally invasive spinal stabilization and instrumentation
US10548740B1 (en) 2016-10-25 2020-02-04 Samy Abdou Devices and methods for vertebral bone realignment
US10575961B1 (en) 2011-09-23 2020-03-03 Samy Abdou Spinal fixation devices and methods of use
US10695105B2 (en) 2012-08-28 2020-06-30 Samy Abdou Spinal fixation devices and methods of use
US10857003B1 (en) 2015-10-14 2020-12-08 Samy Abdou Devices and methods for vertebral stabilization
US10918418B2 (en) 2015-08-21 2021-02-16 Kyocera Corporation Spinal implant
US10918498B2 (en) 2004-11-24 2021-02-16 Samy Abdou Devices and methods for inter-vertebral orthopedic device placement
US10973648B1 (en) 2016-10-25 2021-04-13 Samy Abdou Devices and methods for vertebral bone realignment
US11000315B2 (en) 2005-03-04 2021-05-11 Medos International Sarl Constrained motion bone screw assembly
US11006982B2 (en) 2012-02-22 2021-05-18 Samy Abdou Spinous process fixation devices and methods of use
DE102012202797B4 (en) * 2011-07-12 2021-05-20 Ngmedical Gmbh Dynamic movement element of a spinal implant
USD926982S1 (en) 2011-10-26 2021-08-03 Spinal Elements, Inc. Interbody bone implant
US11173040B2 (en) 2012-10-22 2021-11-16 Cogent Spine, LLC Devices and methods for spinal stabilization and instrumentation
US11179248B2 (en) 2018-10-02 2021-11-23 Samy Abdou Devices and methods for spinal implantation
US11272961B2 (en) 2013-03-14 2022-03-15 Spinal Elements, Inc. Apparatus for bone stabilization and distraction and methods of use
US11304733B2 (en) 2020-02-14 2022-04-19 Spinal Elements, Inc. Bone tie methods
US11369417B1 (en) * 2021-06-08 2022-06-28 Curiteva, Inc. Modular polyaxial pedicle screw assembly with split ring
WO2022187662A1 (en) * 2021-03-04 2022-09-09 Board Of Supervisors Of Louisiana State University And Agricultural And Mechanical College Pelvic internal fixation device and methods of using the same
US11446066B2 (en) 2005-03-04 2022-09-20 DePuy Synthes Products, Inc. Instruments and methods for manipulating vertebra
US11457959B2 (en) 2019-05-22 2022-10-04 Spinal Elements, Inc. Bone tie and bone tie inserter
US11464551B2 (en) 2011-02-24 2022-10-11 Spinal Elements, Inc. Methods and apparatus for stabilizing bone
US11464552B2 (en) 2019-05-22 2022-10-11 Spinal Elements, Inc. Bone tie and bone tie inserter
US11478275B2 (en) 2014-09-17 2022-10-25 Spinal Elements, Inc. Flexible fastening band connector
US11583318B2 (en) 2018-12-21 2023-02-21 Paradigm Spine, Llc Modular spine stabilization system and associated instruments
US11918486B2 (en) 2020-12-07 2024-03-05 Samy Abdou Devices and methods for minimally invasive spinal stabilization and instrumentation

Families Citing this family (87)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7833250B2 (en) 2004-11-10 2010-11-16 Jackson Roger P Polyaxial bone screw with helically wound capture connection
US10729469B2 (en) 2006-01-09 2020-08-04 Roger P. Jackson Flexible spinal stabilization assembly with spacer having off-axis core member
US7862587B2 (en) 2004-02-27 2011-01-04 Jackson Roger P Dynamic stabilization assemblies, tool set and method
US8292926B2 (en) 2005-09-30 2012-10-23 Jackson Roger P Dynamic stabilization connecting member with elastic core and outer sleeve
US8353932B2 (en) * 2005-09-30 2013-01-15 Jackson Roger P Polyaxial bone anchor assembly with one-piece closure, pressure insert and plastic elongate member
US10258382B2 (en) 2007-01-18 2019-04-16 Roger P. Jackson Rod-cord dynamic connection assemblies with slidable bone anchor attachment members along the cord
US8876868B2 (en) 2002-09-06 2014-11-04 Roger P. Jackson Helical guide and advancement flange with radially loaded lip
US7621918B2 (en) 2004-11-23 2009-11-24 Jackson Roger P Spinal fixation tool set and method
US7377923B2 (en) 2003-05-22 2008-05-27 Alphatec Spine, Inc. Variable angle spinal screw assembly
US8137386B2 (en) 2003-08-28 2012-03-20 Jackson Roger P Polyaxial bone screw apparatus
US8377102B2 (en) 2003-06-18 2013-02-19 Roger P. Jackson Polyaxial bone anchor with spline capture connection and lower pressure insert
US7766915B2 (en) 2004-02-27 2010-08-03 Jackson Roger P Dynamic fixation assemblies with inner core and outer coil-like member
US7967850B2 (en) 2003-06-18 2011-06-28 Jackson Roger P Polyaxial bone anchor with helical capture connection, insert and dual locking assembly
US8398682B2 (en) 2003-06-18 2013-03-19 Roger P. Jackson Polyaxial bone screw assembly
US7776067B2 (en) 2005-05-27 2010-08-17 Jackson Roger P Polyaxial bone screw with shank articulation pressure insert and method
US8926670B2 (en) 2003-06-18 2015-01-06 Roger P. Jackson Polyaxial bone screw assembly
US7179261B2 (en) 2003-12-16 2007-02-20 Depuy Spine, Inc. Percutaneous access devices and bone anchor assemblies
US11419642B2 (en) 2003-12-16 2022-08-23 Medos International Sarl Percutaneous access devices and bone anchor assemblies
US7527638B2 (en) 2003-12-16 2009-05-05 Depuy Spine, Inc. Methods and devices for minimally invasive spinal fixation element placement
US11241261B2 (en) 2005-09-30 2022-02-08 Roger P Jackson Apparatus and method for soft spinal stabilization using a tensionable cord and releasable end structure
US7160300B2 (en) 2004-02-27 2007-01-09 Jackson Roger P Orthopedic implant rod reduction tool set and method
US8152810B2 (en) 2004-11-23 2012-04-10 Jackson Roger P Spinal fixation tool set and method
AU2004317551B2 (en) 2004-02-27 2008-12-04 Roger P. Jackson Orthopedic implant rod reduction tool set and method
US7651502B2 (en) 2004-09-24 2010-01-26 Jackson Roger P Spinal fixation tool set and method for rod reduction and fastener insertion
US8926672B2 (en) 2004-11-10 2015-01-06 Roger P. Jackson Splay control closure for open bone anchor
JP2008519656A (en) 2004-11-10 2008-06-12 ロジャー・ピー・ジャクソン Helical guide and forward flange with break extension
US8444681B2 (en) 2009-06-15 2013-05-21 Roger P. Jackson Polyaxial bone anchor with pop-on shank, friction fit retainer and winged insert
US9980753B2 (en) 2009-06-15 2018-05-29 Roger P Jackson pivotal anchor with snap-in-place insert having rotation blocking extensions
US8308782B2 (en) 2004-11-23 2012-11-13 Jackson Roger P Bone anchors with longitudinal connecting member engaging inserts and closures for fixation and optional angulation
US8556938B2 (en) 2009-06-15 2013-10-15 Roger P. Jackson Polyaxial bone anchor with non-pivotable retainer and pop-on shank, some with friction fit
WO2006057837A1 (en) 2004-11-23 2006-06-01 Jackson Roger P Spinal fixation tool attachment structure
US9216041B2 (en) 2009-06-15 2015-12-22 Roger P. Jackson Spinal connecting members with tensioned cords and rigid sleeves for engaging compression inserts
US9168069B2 (en) 2009-06-15 2015-10-27 Roger P. Jackson Polyaxial bone anchor with pop-on shank and winged insert with lower skirt for engaging a friction fit retainer
US7901437B2 (en) 2007-01-26 2011-03-08 Jackson Roger P Dynamic stabilization member with molded connection
US10076361B2 (en) 2005-02-22 2018-09-18 Roger P. Jackson Polyaxial bone screw with spherical capture, compression and alignment and retention structures
US8105368B2 (en) 2005-09-30 2012-01-31 Jackson Roger P Dynamic stabilization connecting member with slitted core and outer sleeve
ES2453196T3 (en) * 2006-08-24 2014-04-04 Biedermann Technologies Gmbh & Co. Kg Bone anchoring device
CA2670988C (en) 2006-12-08 2014-03-25 Roger P. Jackson Tool system for dynamic spinal implants
US8475498B2 (en) 2007-01-18 2013-07-02 Roger P. Jackson Dynamic stabilization connecting member with cord connection
US8366745B2 (en) 2007-05-01 2013-02-05 Jackson Roger P Dynamic stabilization assembly having pre-compressed spacers with differential displacements
US10792074B2 (en) 2007-01-22 2020-10-06 Roger P. Jackson Pivotal bone anchor assemly with twist-in-place friction fit insert
US8979904B2 (en) 2007-05-01 2015-03-17 Roger P Jackson Connecting member with tensioned cord, low profile rigid sleeve and spacer with torsion control
US10383660B2 (en) 2007-05-01 2019-08-20 Roger P. Jackson Soft stabilization assemblies with pretensioned cords
US20090182384A1 (en) * 2008-01-14 2009-07-16 Warsaw Orthopedic, Inc. Material combinations for medical device implants
US20100004693A1 (en) * 2008-07-01 2010-01-07 Peter Thomas Miller Cam locking spine stabilization system and method
US8118837B2 (en) * 2008-07-03 2012-02-21 Zimmer Spine, Inc. Tapered-lock spinal rod connectors and methods for use
US8167914B1 (en) 2008-07-16 2012-05-01 Zimmer Spine, Inc. Locking insert for spine stabilization and method of use
US8197512B1 (en) 2008-07-16 2012-06-12 Zimmer Spine, Inc. System and method for spine stabilization using resilient inserts
JP2012529969A (en) 2008-08-01 2012-11-29 ロジャー・ピー・ジャクソン Longitudinal connecting member with tensioning cord with sleeve
FR2937531B1 (en) * 2008-10-23 2016-01-29 Lotfi Miladi SPINAL OSTEOSYNTHESIS SYSTEM
US9247967B2 (en) * 2008-12-03 2016-02-02 Warsaw Orthopedic, Inc. Rod and anchor system and method for using
US20100160978A1 (en) * 2008-12-23 2010-06-24 John Carbone Bone screw assembly with non-uniform material
US11229457B2 (en) 2009-06-15 2022-01-25 Roger P. Jackson Pivotal bone anchor assembly with insert tool deployment
CN103826560A (en) 2009-06-15 2014-05-28 罗杰.P.杰克逊 Polyaxial bone anchor with pop-on shank and winged insert with friction fit compressive collet
US9668771B2 (en) 2009-06-15 2017-06-06 Roger P Jackson Soft stabilization assemblies with off-set connector
US11464549B2 (en) 2009-06-15 2022-10-11 Roger P. Jackson Pivotal bone anchor assembly with horizontal tool engagement grooves and insert with upright arms having flared outer portions
US8998959B2 (en) 2009-06-15 2015-04-07 Roger P Jackson Polyaxial bone anchors with pop-on shank, fully constrained friction fit retainer and lock and release insert
US20110118783A1 (en) * 2009-11-16 2011-05-19 Spartek Medical, Inc. Load-sharing bone anchor having a flexible post and method for dynamic stabilization of the spine
US8647370B2 (en) 2010-01-15 2014-02-11 Ebi, Llc Uniplanar bone anchor system
US8419778B2 (en) * 2010-01-15 2013-04-16 Ebi, Llc Uniplanar bone anchor system
DE102010040236A1 (en) 2010-09-03 2012-03-08 Aces Gmbh Dynamic stabilization device for joints or spinal column segments, having head region that is connected to fixing block via joint kinematics
CA2810978A1 (en) 2010-09-08 2012-03-15 Roger P. Jackson Dynamic stabilization members with elastic and inelastic sections
GB2507620A (en) * 2010-11-02 2014-05-07 Roger P Jackson Polyaxial bone anchor with pop-on shank and pivotable retainer
DE112011104338A5 (en) 2010-12-08 2013-11-07 Aces Gmbh Dynamic bone anchoring device
WO2012128825A1 (en) 2011-03-24 2012-09-27 Jackson Roger P Polyaxial bone anchor with compound articulation and pop-on shank
US20120310284A1 (en) * 2011-06-03 2012-12-06 Royal Oak Industries Polyaxial pedicle screw
US11103286B2 (en) * 2011-07-15 2021-08-31 Globus Medical, Inc. Orthopedic fixation devices and methods of installation thereof
EP2559389B1 (en) * 2011-08-18 2013-04-03 Biedermann Technologies GmbH & Co. KG Polyaxial bone anchoring device
DE102011082044A1 (en) 2011-09-02 2013-03-07 Aces Gmbh Dynamic bone mounting device for joints, particularly vertebral column segments, has section to be mounted with bone, head area and fixing block which is suitable to receive bar
US20130079826A1 (en) * 2011-09-23 2013-03-28 Peter M. Simonson Spinal rod and bone screw caps for spinal systems assemblies
US20140018866A1 (en) * 2012-01-01 2014-01-16 Vaskrsije Jankovic Surgical screw assembly with increased articulation
US8911479B2 (en) 2012-01-10 2014-12-16 Roger P. Jackson Multi-start closures for open implants
US20130218207A1 (en) * 2012-02-16 2013-08-22 Warsaw Orthopedic, Inc Dynamic multi-axial anchor
US8911478B2 (en) 2012-11-21 2014-12-16 Roger P. Jackson Splay control closure for open bone anchor
US10058354B2 (en) 2013-01-28 2018-08-28 Roger P. Jackson Pivotal bone anchor assembly with frictional shank head seating surfaces
US8852239B2 (en) 2013-02-15 2014-10-07 Roger P Jackson Sagittal angle screw with integral shank and receiver
US9566092B2 (en) 2013-10-29 2017-02-14 Roger P. Jackson Cervical bone anchor with collet retainer and outer locking sleeve
US9717533B2 (en) 2013-12-12 2017-08-01 Roger P. Jackson Bone anchor closure pivot-splay control flange form guide and advancement structure
US9451993B2 (en) 2014-01-09 2016-09-27 Roger P. Jackson Bi-radial pop-on cervical bone anchor
US9597119B2 (en) 2014-06-04 2017-03-21 Roger P. Jackson Polyaxial bone anchor with polymer sleeve
US10064658B2 (en) 2014-06-04 2018-09-04 Roger P. Jackson Polyaxial bone anchor with insert guides
US9924975B2 (en) 2014-10-21 2018-03-27 Roger P. Jackson Bone anchor having a snap-fit assembly
US10543021B2 (en) 2014-10-21 2020-01-28 Roger P. Jackson Pivotal bone anchor assembly having an open ring positioner for a retainer
FR3035318B1 (en) * 2015-04-24 2017-05-19 Medicrea Int MATERIAL OF VERTEBRAL OSTEOSYNTHESIS
JP6892993B2 (en) * 2016-01-22 2021-06-23 京セラ株式会社 Spinal screw assembly
WO2018039485A1 (en) 2016-08-24 2018-03-01 Integrity Implants, Inc. Adjustable bone fixation systems
US10610265B1 (en) 2017-07-31 2020-04-07 K2M, Inc. Polyaxial bone screw with increased angulation

Citations (55)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5002542A (en) * 1989-10-30 1991-03-26 Synthes U.S.A. Pedicle screw clamp
US5176680A (en) * 1990-02-08 1993-01-05 Vignaud Jean Louis Device for the adjustable fixing of spinal osteosynthesis rods
US5207678A (en) * 1989-07-20 1993-05-04 Prufer Pedicle screw and receiver member therefore
US5344422A (en) * 1989-10-30 1994-09-06 Synthes (U.S.A.) Pedicular screw clamp
US5360431A (en) * 1990-04-26 1994-11-01 Cross Medical Products Transpedicular screw system and method of use
US5429639A (en) * 1993-05-17 1995-07-04 Tornier S.A. Spine fixator for holding a vertebral column
US5569246A (en) * 1993-12-28 1996-10-29 Asahi Kogaku Kogyo Kabushiki Kaisha Fixing instrument for spinal fusion members
US5584831A (en) * 1993-07-09 1996-12-17 September 28, Inc. Spinal fixation device and method
US5672176A (en) * 1995-03-15 1997-09-30 Biedermann; Lutz Anchoring member
US5728098A (en) * 1996-11-07 1998-03-17 Sdgi Holdings, Inc. Multi-angle bone screw assembly using shape-memory technology
US5776135A (en) * 1996-12-23 1998-07-07 Third Millennium Engineering, Llc Side mounted polyaxial pedicle screw
US5879350A (en) * 1996-09-24 1999-03-09 Sdgi Holdings, Inc. Multi-axial bone screw assembly
US5910142A (en) * 1998-10-19 1999-06-08 Bones Consulting, Llc Polyaxial pedicle screw having a rod clamping split ferrule coupling element
US5938663A (en) * 1995-03-06 1999-08-17 Stryker France, S.A. Spinal instruments, particularly for a rod
US5984923A (en) * 1996-05-09 1999-11-16 Science Et Medecine (Sem) Anti-shifting system for spinal arthrodesis bar
US6063090A (en) * 1996-12-12 2000-05-16 Synthes (U.S.A.) Device for connecting a longitudinal support to a pedicle screw
US6083226A (en) * 1998-04-22 2000-07-04 Fiz; Daniel Bone fixation device and transverse linking bridge
US6248105B1 (en) * 1997-05-17 2001-06-19 Synthes (U.S.A.) Device for connecting a longitudinal support with a pedicle screw
US20020082602A1 (en) * 2000-12-22 2002-06-27 Lutz Biedermann Fixing element
US6471705B1 (en) * 1999-08-02 2002-10-29 Lutz Biedermann Bone screw
US6485491B1 (en) * 2000-09-15 2002-11-26 Sdgi Holdings, Inc. Posterior fixation system
US6520963B1 (en) * 2001-08-13 2003-02-18 Mckinley Lawrence M. Vertebral alignment and fixation assembly
US20030100896A1 (en) * 2001-11-27 2003-05-29 Lutz Biedermann Element with a shank and a holding element connected to it for connecting to a rod
US20030149431A1 (en) * 2002-02-01 2003-08-07 Varieur Michael S. Closure system for spinal fixation instrumentation
US20030158552A1 (en) * 2001-10-31 2003-08-21 Chang-Hun Jeon Bone fixation apparatus
US6723100B2 (en) * 2001-07-27 2004-04-20 Biedermann Motech Gmbh Bone screw and fastening tool for same
US6755829B1 (en) * 2000-09-22 2004-06-29 Depuy Acromed, Inc. Lock cap anchor assembly for orthopaedic fixation
US20040186474A1 (en) * 2002-12-02 2004-09-23 Biedermann Motech Gmbh Implant having a shaft and a holding element connected therewith for connecting with a rod
US6802844B2 (en) * 2001-03-26 2004-10-12 Nuvasive, Inc Spinal alignment apparatus and methods
US20040225289A1 (en) * 2003-05-07 2004-11-11 Biedermann Motech Gmbh Dynamic anchoring device and dynamic stabilization device for bones, in particular for vertebrae, with such an anchoring device
US20040236329A1 (en) * 2003-05-02 2004-11-25 Panjabi Manohar M. Dynamic spine stabilizer
US20040236327A1 (en) * 2003-05-23 2004-11-25 Paul David C. Spine stabilization system
US20040260284A1 (en) * 2003-06-23 2004-12-23 Matthew Parker Anti-splay pedicle screw
US6843791B2 (en) * 2003-01-10 2005-01-18 Depuy Acromed, Inc. Locking cap assembly for spinal fixation instrumentation
US20050143823A1 (en) * 2003-12-31 2005-06-30 Boyd Lawrence M. Dynamic spinal stabilization system
US20050154390A1 (en) * 2003-11-07 2005-07-14 Lutz Biedermann Stabilization device for bones comprising a spring element and manufacturing method for said spring element
US20050171543A1 (en) * 2003-05-02 2005-08-04 Timm Jens P. Spine stabilization systems and associated devices, assemblies and methods
US20050177164A1 (en) * 2003-05-02 2005-08-11 Carmen Walters Pedicle screw devices, systems and methods having a preloaded set screw
US20050182409A1 (en) * 2003-05-02 2005-08-18 Ronald Callahan Systems and methods accommodating relative motion in spine stabilization
US20050182401A1 (en) * 2003-05-02 2005-08-18 Timm Jens P. Systems and methods for spine stabilization including a dynamic junction
US6932822B2 (en) * 2000-03-28 2005-08-23 Showa Ika Kohgyo Co., Ltd. Spinal implant, driver tool and nut guide
US20050203516A1 (en) * 2004-03-03 2005-09-15 Biedermann Motech Gmbh Anchoring element and stabilization device for the dynamic stabilization of vertebrae or bones using such anchoring elements
US20050216003A1 (en) * 2004-03-03 2005-09-29 Biedermann Motech Gmbh Bone anchoring element for anchoring in a bone or vertebra, and stabilization device with such a bone anchoring element
US20050277919A1 (en) * 2004-05-28 2005-12-15 Depuy Spine, Inc. Anchoring systems and methods for correcting spinal deformities
US7018378B2 (en) * 2000-12-27 2006-03-28 Biedermann Motech Gmbh Screw
US20060142758A1 (en) * 2002-09-11 2006-06-29 Dominique Petit Linking element for dynamically stabilizing a spinal fixing system and spinal fixing system comprising same
US20060149237A1 (en) * 2004-12-30 2006-07-06 Markworth Aaron D Screw with deployable interlaced dual rods
US20060241600A1 (en) * 2005-03-23 2006-10-26 Ensign Michael D Percutaneous pedicle screw assembly
US20070055244A1 (en) * 2004-02-27 2007-03-08 Jackson Roger P Dynamic fixation assemblies with inner core and outer coil-like member
US20080161859A1 (en) * 2006-10-16 2008-07-03 Innovative Delta Technology Llc Bone Screw and Associated Assembly and Methods of Use Thereof
US20080177332A1 (en) * 2003-12-15 2008-07-24 Archus Orthopedics, Inc. Polyaxial adjustment of facet joint prostheses
US20080183215A1 (en) * 2004-10-20 2008-07-31 Moti Altarac Multi-level minimally invasive spinal stabilization system
US20080183214A1 (en) * 2004-09-08 2008-07-31 Matthew Copp System and Methods For Performing Spinal Fixation
US7625394B2 (en) * 2005-08-05 2009-12-01 Warsaw Orthopedic, Inc. Coupling assemblies for spinal implants
US7686833B1 (en) * 2004-04-02 2010-03-30 Muhanna Nabil L Ball jointed pedicle screw and rod system

Family Cites Families (38)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
PL114098B1 (en) * 1978-04-14 1981-01-31 Wyzsza Szkola Inzynierska Apparatus for correcting spinal curvature
US4274401A (en) * 1978-12-08 1981-06-23 Miskew Don B W Apparatus for correcting spinal deformities and method for using
US4269178A (en) * 1979-06-04 1981-05-26 Keene James S Hook assembly for engaging a spinal column
US4409968A (en) * 1980-02-04 1983-10-18 Drummond Denis S Method and apparatus for engaging a hook assembly to a spinal column
US4743260A (en) * 1985-06-10 1988-05-10 Burton Charles V Method for a flexible stabilization system for a vertebral column
US4661028A (en) * 1986-02-20 1987-04-28 Sanger Leon A Reverse cutting expansion tap
DE3800052A1 (en) * 1987-07-08 1989-07-13 Harms Juergen POSITIONING SCREW
JPH0620466B2 (en) * 1989-03-31 1994-03-23 有限会社田中医科器械製作所 Spinal column correction device
CH685850A5 (en) * 1990-11-26 1995-10-31 Synthes Ag anchoring device
US5176678A (en) * 1991-03-14 1993-01-05 Tsou Paul M Orthopaedic device with angularly adjustable anchor attachments to the vertebrae
US5176679A (en) * 1991-09-23 1993-01-05 Lin Chih I Vertebral locking and retrieving system
EP0572790B1 (en) * 1992-06-04 1996-02-14 Synthes AG, Chur Osteosynthesis anchoring element
US5281222A (en) * 1992-06-30 1994-01-25 Zimmer, Inc. Spinal implant system
US5423818A (en) * 1993-02-17 1995-06-13 Danek Medical, Inc. Clamp for attaching a vertebral fixation element to a spinal rod
US5466238A (en) * 1993-08-27 1995-11-14 Lin; Chih-I Vertebral locking and retrieving system having a fixation crossbar
DE4425357C2 (en) * 1994-07-18 1996-07-04 Harms Juergen Anchoring element
US5882350A (en) * 1995-04-13 1999-03-16 Fastenetix, Llc Polyaxial pedicle screw having a threaded and tapered compression locking mechanism
FR2734147B1 (en) * 1995-05-19 1997-10-10 Klein Jean Michel IMPLANTABLE OSTEOSYNTHESIS DEVICE
US5575792A (en) * 1995-07-14 1996-11-19 Fastenetix, L.L.C. Extending hook and polyaxial coupling element device for use with top loading rod fixation devices
US5658286A (en) * 1996-02-05 1997-08-19 Sava; Garard A. Fabrication of implantable bone fixation elements
US6440137B1 (en) * 2000-04-18 2002-08-27 Andres A. Horvath Medical fastener cap system
US6551318B1 (en) 2000-07-26 2003-04-22 Stahurski Consulting Inc. Spinal column retaining apparatus
US6451021B1 (en) * 2001-02-15 2002-09-17 Third Millennium Engineering, Llc Polyaxial pedicle screw having a rotating locking element
DE10136162B4 (en) 2001-07-25 2016-05-12 Biedermann Technologies Gmbh & Co. Kg Connecting element for connecting two used for bone and spine stabilization rod-shaped elements
US7066937B2 (en) * 2002-02-13 2006-06-27 Endius Incorporated Apparatus for connecting a longitudinal member to a bone portion
ATE299671T1 (en) * 2002-05-21 2005-08-15 Spinelab Gmbh ELASTIC STABILIZATION SYSTEM FOR SPINES
FR2847152B1 (en) * 2002-11-19 2005-02-18 Eurosurgical VERTEBRAL ANCHORING DEVICE AND ITS LOCKING DEVICE ON A POLY AXIAL SCREW
US7473267B2 (en) * 2003-04-25 2009-01-06 Warsaw Orthopedic, Inc. System and method for minimally invasive posterior fixation
US7794476B2 (en) * 2003-08-08 2010-09-14 Warsaw Orthopedic, Inc. Implants formed of shape memory polymeric material for spinal fixation
CN100430029C (en) * 2003-08-20 2008-11-05 华沙整形外科股份有限公司 Multi-axial orthopedic device and system, e.g. for spinal surgery
PL364275A1 (en) * 2003-12-30 2005-07-11 Advanced Digital Broadcast Ltd. Method and system for recording and tracing markers in a data flow
US8764801B2 (en) * 2005-03-28 2014-07-01 Gmedelaware 2 Llc Facet joint implant crosslinking apparatus and method
DE102004048938B4 (en) * 2004-10-07 2015-04-02 Synthes Gmbh Device for the dynamic stabilization of vertebral bodies
ATE536821T1 (en) * 2004-11-23 2011-12-15 Roger P Jackson POLYAXIAL BONE SCREW WITH MULTIPLE SHAFT FIXATION
US7875065B2 (en) * 2004-11-23 2011-01-25 Jackson Roger P Polyaxial bone screw with multi-part shank retainer and pressure insert
US7338491B2 (en) * 2005-03-22 2008-03-04 Spinefrontier Inc Spinal fixation locking mechanism
US20070118117A1 (en) * 2005-10-20 2007-05-24 Ebi, L.P. Bone fixation assembly
US8361129B2 (en) * 2006-04-28 2013-01-29 Depuy Spine, Inc. Large diameter bone anchor assembly

Patent Citations (64)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5207678A (en) * 1989-07-20 1993-05-04 Prufer Pedicle screw and receiver member therefore
US5002542A (en) * 1989-10-30 1991-03-26 Synthes U.S.A. Pedicle screw clamp
US5344422A (en) * 1989-10-30 1994-09-06 Synthes (U.S.A.) Pedicular screw clamp
US5176680A (en) * 1990-02-08 1993-01-05 Vignaud Jean Louis Device for the adjustable fixing of spinal osteosynthesis rods
US5360431A (en) * 1990-04-26 1994-11-01 Cross Medical Products Transpedicular screw system and method of use
US5474555A (en) * 1990-04-26 1995-12-12 Cross Medical Products Spinal implant system
US5429639A (en) * 1993-05-17 1995-07-04 Tornier S.A. Spine fixator for holding a vertebral column
US5584831A (en) * 1993-07-09 1996-12-17 September 28, Inc. Spinal fixation device and method
US5569246A (en) * 1993-12-28 1996-10-29 Asahi Kogaku Kogyo Kabushiki Kaisha Fixing instrument for spinal fusion members
US5938663A (en) * 1995-03-06 1999-08-17 Stryker France, S.A. Spinal instruments, particularly for a rod
US5672176A (en) * 1995-03-15 1997-09-30 Biedermann; Lutz Anchoring member
US5984923A (en) * 1996-05-09 1999-11-16 Science Et Medecine (Sem) Anti-shifting system for spinal arthrodesis bar
US5879350A (en) * 1996-09-24 1999-03-09 Sdgi Holdings, Inc. Multi-axial bone screw assembly
US6053917A (en) * 1996-09-24 2000-04-25 Sdgi Holdings, Inc. Multi-axial bone screw assembly
US5728098A (en) * 1996-11-07 1998-03-17 Sdgi Holdings, Inc. Multi-angle bone screw assembly using shape-memory technology
US5954725A (en) * 1996-11-07 1999-09-21 Sdgi Holdings, Inc. Multi-angle bone screw assembly using shape memory technology
US6063090A (en) * 1996-12-12 2000-05-16 Synthes (U.S.A.) Device for connecting a longitudinal support to a pedicle screw
US5776135A (en) * 1996-12-23 1998-07-07 Third Millennium Engineering, Llc Side mounted polyaxial pedicle screw
US6063089A (en) * 1996-12-23 2000-05-16 Spinal Concepts, Inc. Side mounted polyaxial pedicle screw
US6248105B1 (en) * 1997-05-17 2001-06-19 Synthes (U.S.A.) Device for connecting a longitudinal support with a pedicle screw
US6083226A (en) * 1998-04-22 2000-07-04 Fiz; Daniel Bone fixation device and transverse linking bridge
US5910142A (en) * 1998-10-19 1999-06-08 Bones Consulting, Llc Polyaxial pedicle screw having a rod clamping split ferrule coupling element
US6471705B1 (en) * 1999-08-02 2002-10-29 Lutz Biedermann Bone screw
US6932822B2 (en) * 2000-03-28 2005-08-23 Showa Ika Kohgyo Co., Ltd. Spinal implant, driver tool and nut guide
US6485491B1 (en) * 2000-09-15 2002-11-26 Sdgi Holdings, Inc. Posterior fixation system
US6755829B1 (en) * 2000-09-22 2004-06-29 Depuy Acromed, Inc. Lock cap anchor assembly for orthopaedic fixation
US6695843B2 (en) * 2000-12-22 2004-02-24 Biedermann Motech Gmbh Fixing element
US20020082602A1 (en) * 2000-12-22 2002-06-27 Lutz Biedermann Fixing element
US7018378B2 (en) * 2000-12-27 2006-03-28 Biedermann Motech Gmbh Screw
US6802844B2 (en) * 2001-03-26 2004-10-12 Nuvasive, Inc Spinal alignment apparatus and methods
US6723100B2 (en) * 2001-07-27 2004-04-20 Biedermann Motech Gmbh Bone screw and fastening tool for same
US6520963B1 (en) * 2001-08-13 2003-02-18 Mckinley Lawrence M. Vertebral alignment and fixation assembly
US20030158552A1 (en) * 2001-10-31 2003-08-21 Chang-Hun Jeon Bone fixation apparatus
US6905500B2 (en) * 2001-10-31 2005-06-14 U & I Corporation Bone fixation apparatus
US20030100896A1 (en) * 2001-11-27 2003-05-29 Lutz Biedermann Element with a shank and a holding element connected to it for connecting to a rod
US6641586B2 (en) * 2002-02-01 2003-11-04 Depuy Acromed, Inc. Closure system for spinal fixation instrumentation
US20030149431A1 (en) * 2002-02-01 2003-08-07 Varieur Michael S. Closure system for spinal fixation instrumentation
US20060142758A1 (en) * 2002-09-11 2006-06-29 Dominique Petit Linking element for dynamically stabilizing a spinal fixing system and spinal fixing system comprising same
US20040186474A1 (en) * 2002-12-02 2004-09-23 Biedermann Motech Gmbh Implant having a shaft and a holding element connected therewith for connecting with a rod
US6843791B2 (en) * 2003-01-10 2005-01-18 Depuy Acromed, Inc. Locking cap assembly for spinal fixation instrumentation
US20050177164A1 (en) * 2003-05-02 2005-08-11 Carmen Walters Pedicle screw devices, systems and methods having a preloaded set screw
US20050171543A1 (en) * 2003-05-02 2005-08-04 Timm Jens P. Spine stabilization systems and associated devices, assemblies and methods
US20040236329A1 (en) * 2003-05-02 2004-11-25 Panjabi Manohar M. Dynamic spine stabilizer
US20050182409A1 (en) * 2003-05-02 2005-08-18 Ronald Callahan Systems and methods accommodating relative motion in spine stabilization
US20050182401A1 (en) * 2003-05-02 2005-08-18 Timm Jens P. Systems and methods for spine stabilization including a dynamic junction
US20050182400A1 (en) * 2003-05-02 2005-08-18 Jeffrey White Spine stabilization systems, devices and methods
US20040225289A1 (en) * 2003-05-07 2004-11-11 Biedermann Motech Gmbh Dynamic anchoring device and dynamic stabilization device for bones, in particular for vertebrae, with such an anchoring device
US20040236328A1 (en) * 2003-05-23 2004-11-25 Paul David C. Spine stabilization system
US20040236327A1 (en) * 2003-05-23 2004-11-25 Paul David C. Spine stabilization system
US20040260284A1 (en) * 2003-06-23 2004-12-23 Matthew Parker Anti-splay pedicle screw
US20050154390A1 (en) * 2003-11-07 2005-07-14 Lutz Biedermann Stabilization device for bones comprising a spring element and manufacturing method for said spring element
US20080177332A1 (en) * 2003-12-15 2008-07-24 Archus Orthopedics, Inc. Polyaxial adjustment of facet joint prostheses
US20050143823A1 (en) * 2003-12-31 2005-06-30 Boyd Lawrence M. Dynamic spinal stabilization system
US20070055244A1 (en) * 2004-02-27 2007-03-08 Jackson Roger P Dynamic fixation assemblies with inner core and outer coil-like member
US20050216003A1 (en) * 2004-03-03 2005-09-29 Biedermann Motech Gmbh Bone anchoring element for anchoring in a bone or vertebra, and stabilization device with such a bone anchoring element
US20050203516A1 (en) * 2004-03-03 2005-09-15 Biedermann Motech Gmbh Anchoring element and stabilization device for the dynamic stabilization of vertebrae or bones using such anchoring elements
US7686833B1 (en) * 2004-04-02 2010-03-30 Muhanna Nabil L Ball jointed pedicle screw and rod system
US20050277919A1 (en) * 2004-05-28 2005-12-15 Depuy Spine, Inc. Anchoring systems and methods for correcting spinal deformities
US20080183214A1 (en) * 2004-09-08 2008-07-31 Matthew Copp System and Methods For Performing Spinal Fixation
US20080183215A1 (en) * 2004-10-20 2008-07-31 Moti Altarac Multi-level minimally invasive spinal stabilization system
US20060149237A1 (en) * 2004-12-30 2006-07-06 Markworth Aaron D Screw with deployable interlaced dual rods
US20060241600A1 (en) * 2005-03-23 2006-10-26 Ensign Michael D Percutaneous pedicle screw assembly
US7625394B2 (en) * 2005-08-05 2009-12-01 Warsaw Orthopedic, Inc. Coupling assemblies for spinal implants
US20080161859A1 (en) * 2006-10-16 2008-07-03 Innovative Delta Technology Llc Bone Screw and Associated Assembly and Methods of Use Thereof

Cited By (125)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8603168B2 (en) 2003-08-05 2013-12-10 Flexuspine, Inc. Artificial functional spinal unit system and method for use
US9579124B2 (en) 2003-08-05 2017-02-28 Flexuspine, Inc. Expandable articulating intervertebral implant with limited articulation
US8753398B2 (en) 2003-08-05 2014-06-17 Charles R. Gordon Method of inserting an expandable intervertebral implant without overdistraction
US8647386B2 (en) 2003-08-05 2014-02-11 Charles R. Gordon Expandable intervertebral implant system and method
US10702309B2 (en) * 2004-11-23 2020-07-07 Roger P. Jackson Pivotal bone anchor assembly with multi-part shank retainer and rod-engaging insert
US20190365428A1 (en) * 2004-11-23 2019-12-05 Roger P. Jackson Pivotal bone anchor assembly with multi-part shank retainer and rod-engaging insert
US10918498B2 (en) 2004-11-24 2021-02-16 Samy Abdou Devices and methods for inter-vertebral orthopedic device placement
US11096799B2 (en) 2004-11-24 2021-08-24 Samy Abdou Devices and methods for inter-vertebral orthopedic device placement
US11000315B2 (en) 2005-03-04 2021-05-11 Medos International Sarl Constrained motion bone screw assembly
US11849978B2 (en) 2005-03-04 2023-12-26 Medos International Sarl Constrained motion bone screw assembly
US11446066B2 (en) 2005-03-04 2022-09-20 DePuy Synthes Products, Inc. Instruments and methods for manipulating vertebra
USRE46115E1 (en) 2005-09-19 2016-08-23 Ebi, Llc Bone screw apparatus, system and method
US20080082103A1 (en) * 2006-06-16 2008-04-03 Alphatec Spine, Inc. Systems and methods for manipulating and/or installing a pedicle screw
US8834527B2 (en) * 2006-06-16 2014-09-16 Alphatec Spine, Inc. Systems and methods for manipulating and/or installing a pedicle screw
US8876874B2 (en) * 2006-08-21 2014-11-04 M. Samy Abdou Bone screw systems and methods of use
US20080045963A1 (en) * 2006-08-21 2008-02-21 Abdou M S Bone screw systems and methods of use
US8940022B2 (en) 2007-01-19 2015-01-27 Flexuspine, Inc. Artificial functional spinal unit system and method for use
US8597358B2 (en) 2007-01-19 2013-12-03 Flexuspine, Inc. Dynamic interbody devices
US8377098B2 (en) 2007-01-19 2013-02-19 Flexuspine, Inc. Artificial functional spinal unit system and method for use
US9066811B2 (en) 2007-01-19 2015-06-30 Flexuspine, Inc. Artificial functional spinal unit system and method for use
US20120143254A1 (en) * 2007-10-22 2012-06-07 Flexuspine, Inc. Posterior stabilization systems with shared, dual dampener systems
US8523912B2 (en) 2007-10-22 2013-09-03 Flexuspine, Inc. Posterior stabilization systems with shared, dual dampener systems
USD799949S1 (en) * 2007-10-24 2017-10-17 Nuvasive, Inc. Favored angle screw
US9232968B2 (en) 2007-12-19 2016-01-12 DePuy Synthes Products, Inc. Polymeric pedicle rods and methods of manufacturing
US8764808B2 (en) 2008-03-10 2014-07-01 Eduardo Gonzalez-Hernandez Bone fixation system
US8690916B2 (en) 2008-04-17 2014-04-08 Eduardo Gonzalez-Hernandez Soft tissue attachment system and clip
US8469999B2 (en) 2008-04-17 2013-06-25 Eduardo Gonzalez-Hernandez Soft tissue attachment system and clip
US20090312804A1 (en) * 2008-06-17 2009-12-17 Thomas Gamache Adjustable implant assembly
US10973556B2 (en) * 2008-06-17 2021-04-13 DePuy Synthes Products, Inc. Adjustable implant assembly
ITMI20082238A1 (en) * 2008-12-17 2010-06-18 Giuseppe Calvosa MODULAR VERTEBRAL STABILIZER.
WO2010069967A1 (en) * 2008-12-17 2010-06-24 N.B.R. New Biotechnology Research Modular vertebral stabilizer
US20120136394A1 (en) * 2008-12-17 2012-05-31 Lanx, Inc. Modular vertebral stabilizer
US9339303B2 (en) 2008-12-17 2016-05-17 Lanx, S.R.L. Modular vertebral stabilizer
US8641734B2 (en) 2009-02-13 2014-02-04 DePuy Synthes Products, LLC Dual spring posterior dynamic stabilization device with elongation limiting elastomers
US8882809B2 (en) 2009-03-20 2014-11-11 Spinal Usa, Inc. Pedicle screws and methods of using the same
EP2408384A1 (en) * 2009-03-20 2012-01-25 Spinal Usa Llc Pedicle screws and methods of using the same
US9254151B2 (en) 2009-03-20 2016-02-09 Spinal Usa, Inc. Pedicle screws and methods of using the same
EP2408384A4 (en) * 2009-03-20 2013-12-11 Spinal USA LLC Pedicle screws and methods of using the same
US9320543B2 (en) 2009-06-25 2016-04-26 DePuy Synthes Products, Inc. Posterior dynamic stabilization device having a mobile anchor
US8657856B2 (en) 2009-08-28 2014-02-25 Pioneer Surgical Technology, Inc. Size transition spinal rod
US11806051B2 (en) 2009-11-09 2023-11-07 Ebi, Llc Multiplanar bone anchor system
US10729471B2 (en) 2009-11-09 2020-08-04 Ebi, Llc Multiplanar bone anchor system
US9763701B2 (en) 2009-11-09 2017-09-19 Ebi, Llc Multiplanar bone anchor system
US8449578B2 (en) 2009-11-09 2013-05-28 Ebi, Llc Multiplanar bone anchor system
US9044272B2 (en) 2009-11-09 2015-06-02 Ebi, Llc Multiplanar bone anchor system
US10610380B2 (en) 2009-12-07 2020-04-07 Samy Abdou Devices and methods for minimally invasive spinal stabilization and instrumentation
US10857004B2 (en) 2009-12-07 2020-12-08 Samy Abdou Devices and methods for minimally invasive spinal stabilization and instrumentation
US10543107B2 (en) 2009-12-07 2020-01-28 Samy Abdou Devices and methods for minimally invasive spinal stabilization and instrumentation
US10945861B2 (en) 2009-12-07 2021-03-16 Samy Abdou Devices and methods for minimally invasive spinal stabilization and instrumentation
US20110184412A1 (en) * 2010-01-28 2011-07-28 Warsaw Orthopedic, Inc. Pre-Assembled Construct With One or More Non-Rotating Connectors for Insertion Into a Patient
US9445844B2 (en) 2010-03-24 2016-09-20 DePuy Synthes Products, Inc. Composite material posterior dynamic stabilization spring rod
US9072546B2 (en) 2010-08-26 2015-07-07 Warsaw Orthopedic, Inc. Spinal constructs with improved load-sharing
US8979901B2 (en) 2010-08-26 2015-03-17 Warsaw Orthopedic, Inc. Dynamic bone fastener with a preset range of motion
US8961573B2 (en) 2010-10-05 2015-02-24 Toby Orthopaedics, Inc. System and method for facilitating repair and reattachment of comminuted bone portions
US9271776B2 (en) 2010-10-05 2016-03-01 Toby Orthopaedics, Inc. System and method for facilitating repair and reattachment of comminuted bone portions
US11266506B2 (en) 2010-10-27 2022-03-08 Toby Orthopaedics, Inc. System for fracture replacement of comminuted bone fractures or portions thereof adjacent bone joints
US8870963B2 (en) 2010-10-27 2014-10-28 Toby Orthopaedics, Inc. System and method for fracture replacement of comminuted bone fractures or portions thereof adjacent bone joints
US9757240B2 (en) 2010-10-27 2017-09-12 Toby Orthopaedics, Inc. System and method for fracture replacement of comminuted bone fractures or portions thereof adjacent bone joints
US10524919B2 (en) 2010-10-27 2020-01-07 Toby Orthopaedics, Inc. System and method for fracture replacement of comminuted bone fractures or portions thereof adjacent bone joints
US11464551B2 (en) 2011-02-24 2022-10-11 Spinal Elements, Inc. Methods and apparatus for stabilizing bone
US9254154B2 (en) 2011-03-03 2016-02-09 Toby Orthopaedic, Inc. Anterior lesser tuberosity fixed angle fixation device and method of use associated therewith
US9289244B2 (en) * 2011-03-09 2016-03-22 Zimmer Spine, Inc. Polyaxial pedicle screw with increased angulation
US20140142640A1 (en) * 2011-03-09 2014-05-22 Zimmer Spine, Inc. Polyaxial pedicle screw with increased angulation
US9532810B2 (en) * 2011-03-09 2017-01-03 Zimmer Spine, Inc. Polyaxial pedicle screw with increased angulation
US8940051B2 (en) 2011-03-25 2015-01-27 Flexuspine, Inc. Interbody device insertion systems and methods
DE102012202797B4 (en) * 2011-07-12 2021-05-20 Ngmedical Gmbh Dynamic movement element of a spinal implant
US11517449B2 (en) 2011-09-23 2022-12-06 Samy Abdou Spinal fixation devices and methods of use
US11324608B2 (en) 2011-09-23 2022-05-10 Samy Abdou Spinal fixation devices and methods of use
US10575961B1 (en) 2011-09-23 2020-03-03 Samy Abdou Spinal fixation devices and methods of use
USD979062S1 (en) 2011-10-26 2023-02-21 Spinal Elements, Inc. Interbody bone implant
USD926982S1 (en) 2011-10-26 2021-08-03 Spinal Elements, Inc. Interbody bone implant
USD958366S1 (en) 2011-10-26 2022-07-19 Spinal Elements, Inc. Interbody bone implant
US9271772B2 (en) 2011-10-27 2016-03-01 Toby Orthopaedics, Inc. System and method for fracture replacement of comminuted bone fractures or portions thereof adjacent bone joints
US10188522B2 (en) 2011-10-27 2019-01-29 Toby Orthopaedics, Inc. System for replacement of at least a portion of a carpal articular surface of a radius
US9730797B2 (en) 2011-10-27 2017-08-15 Toby Orthopaedics, Inc. Bone joint replacement and repair assembly and method of repairing and replacing a bone joint
US11129723B2 (en) 2011-10-27 2021-09-28 Toby Orthopaedics, Inc System and method for fracture replacement of comminuted bone fractures or portions thereof adjacent bone joints
US10299939B2 (en) 2011-10-27 2019-05-28 Toby Orthopaedics, Inc. Bone joint replacement and repair assembly and method of repairing and replacing a bone joint
US11285020B2 (en) 2011-10-27 2022-03-29 Toby Orthopaedics, Inc. Bone joint replacement and repair assembly and method of repairing and replacing a bone joint
US9402667B2 (en) 2011-11-09 2016-08-02 Eduardo Gonzalez-Hernandez Apparatus and method for use of the apparatus for fracture fixation of the distal humerus
US9526627B2 (en) 2011-11-17 2016-12-27 Exactech, Inc. Expandable interbody device system and method
US11006982B2 (en) 2012-02-22 2021-05-18 Samy Abdou Spinous process fixation devices and methods of use
US11839413B2 (en) 2012-02-22 2023-12-12 Samy Abdou Spinous process fixation devices and methods of use
US11559336B2 (en) 2012-08-28 2023-01-24 Samy Abdou Spinal fixation devices and methods of use
US10695105B2 (en) 2012-08-28 2020-06-30 Samy Abdou Spinal fixation devices and methods of use
US11173040B2 (en) 2012-10-22 2021-11-16 Cogent Spine, LLC Devices and methods for spinal stabilization and instrumentation
US9271761B2 (en) 2012-12-11 2016-03-01 Zimmer Spine Bone anchoring device
US9956017B2 (en) 2012-12-17 2018-05-01 Toby Orthopaedics, Inc. Bone plate for plate osteosynthesis and method for use thereof
US10835302B2 (en) 2012-12-17 2020-11-17 Toby Orthopaedics, Inc. Bone plate for plate osteosynthesis and method for use thereof
US9283008B2 (en) 2012-12-17 2016-03-15 Toby Orthopaedics, Inc. Bone plate for plate osteosynthesis and method for use thereof
US11583324B2 (en) 2012-12-17 2023-02-21 Toby Orthopaedics, Llc Bone plate for plate osteosynthesis and method for use thereof
US11369484B2 (en) 2013-02-20 2022-06-28 Flexuspine Inc. Expandable fusion device for positioning between adjacent vertebral bodies
US9492288B2 (en) 2013-02-20 2016-11-15 Flexuspine, Inc. Expandable fusion device for positioning between adjacent vertebral bodies
US11766341B2 (en) 2013-02-20 2023-09-26 Tyler Fusion Technologies, Llc Expandable fusion device for positioning between adjacent vertebral bodies
US9504497B2 (en) 2013-02-20 2016-11-29 K2M, Inc. Iliosacral polyaxial screw
US11272961B2 (en) 2013-03-14 2022-03-15 Spinal Elements, Inc. Apparatus for bone stabilization and distraction and methods of use
US9333014B2 (en) 2013-03-15 2016-05-10 Eduardo Gonzalez-Hernandez Bone fixation and reduction apparatus and method for fixation and reduction of a distal bone fracture and malunion
US9393045B2 (en) 2013-03-15 2016-07-19 Biomet Manufacturing, Llc. Clamping assembly for external fixation system
US9827011B2 (en) 2013-03-15 2017-11-28 Biomet Manufacturing, Llc Polyaxial pivot housing for external fixation system
US9463045B2 (en) 2013-03-15 2016-10-11 Biomet Manufacturing, Llc Polyaxial pivot housing for external fixation system
US10299830B2 (en) 2013-03-15 2019-05-28 Biomet Manufacturing, Llc Clamping assembly for external fixation system
US11517354B2 (en) * 2013-09-27 2022-12-06 Spinal Elements, Inc. Method of placing an implant between bone portions
US20190142478A1 (en) * 2013-09-27 2019-05-16 Spinal Elements, Inc. Method of placing an implant between bone portions
US11253373B2 (en) 2014-04-24 2022-02-22 Choice Spine, Llc Limited profile intervertebral implant with incorporated fastening and locking mechanism
US10398565B2 (en) 2014-04-24 2019-09-03 Choice Spine, Llc Limited profile intervertebral implant with incorporated fastening and locking mechanism
US9517144B2 (en) 2014-04-24 2016-12-13 Exactech, Inc. Limited profile intervertebral implant with incorporated fastening mechanism
US11478275B2 (en) 2014-09-17 2022-10-25 Spinal Elements, Inc. Flexible fastening band connector
US10918418B2 (en) 2015-08-21 2021-02-16 Kyocera Corporation Spinal implant
US10857003B1 (en) 2015-10-14 2020-12-08 Samy Abdou Devices and methods for vertebral stabilization
US11246718B2 (en) 2015-10-14 2022-02-15 Samy Abdou Devices and methods for vertebral stabilization
US11259935B1 (en) 2016-10-25 2022-03-01 Samy Abdou Devices and methods for vertebral bone realignment
US10548740B1 (en) 2016-10-25 2020-02-04 Samy Abdou Devices and methods for vertebral bone realignment
US11058548B1 (en) 2016-10-25 2021-07-13 Samy Abdou Devices and methods for vertebral bone realignment
US10744000B1 (en) 2016-10-25 2020-08-18 Samy Abdou Devices and methods for vertebral bone realignment
US10973648B1 (en) 2016-10-25 2021-04-13 Samy Abdou Devices and methods for vertebral bone realignment
US11752008B1 (en) 2016-10-25 2023-09-12 Samy Abdou Devices and methods for vertebral bone realignment
US11179248B2 (en) 2018-10-02 2021-11-23 Samy Abdou Devices and methods for spinal implantation
US11583318B2 (en) 2018-12-21 2023-02-21 Paradigm Spine, Llc Modular spine stabilization system and associated instruments
US11464552B2 (en) 2019-05-22 2022-10-11 Spinal Elements, Inc. Bone tie and bone tie inserter
US11457959B2 (en) 2019-05-22 2022-10-04 Spinal Elements, Inc. Bone tie and bone tie inserter
US11304733B2 (en) 2020-02-14 2022-04-19 Spinal Elements, Inc. Bone tie methods
US11918258B2 (en) 2020-03-11 2024-03-05 Spinal Elements, Inc. Device and method for reinforcement of a facet
US11918486B2 (en) 2020-12-07 2024-03-05 Samy Abdou Devices and methods for minimally invasive spinal stabilization and instrumentation
WO2022187662A1 (en) * 2021-03-04 2022-09-09 Board Of Supervisors Of Louisiana State University And Agricultural And Mechanical College Pelvic internal fixation device and methods of using the same
US11369417B1 (en) * 2021-06-08 2022-06-28 Curiteva, Inc. Modular polyaxial pedicle screw assembly with split ring
US11918483B2 (en) 2021-11-15 2024-03-05 Cogent Spine Llc Devices and methods for spinal stabilization and instrumentation

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WO2008085369A1 (en) 2008-07-17
US8409256B2 (en) 2013-04-02
US20080161863A1 (en) 2008-07-03
AU2007342474A1 (en) 2008-07-17
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US20130197583A1 (en) 2013-08-01
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US9629662B2 (en) 2017-04-25
WO2008085347A1 (en) 2008-07-17
US20150088207A1 (en) 2015-03-26
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CA2674147C (en) 2015-02-10
EP2117448B1 (en) 2017-01-25

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