Surgery – Instruments – Orthopedic instrumentation
Reexamination Certificate
1998-02-24
2001-01-30
Buiz, Michael (Department: 3731)
Surgery
Instruments
Orthopedic instrumentation
C606S075000
Reexamination Certificate
active
06179838
ABSTRACT:
This invention relates to bone fixation apparatus for immobilizing the spine, and more particularly, to apparatus of posterior internal fixation of the spine and to a method for affecting such fixation.
Spinal fixation apparatuses are widely employed in surgical processes for correcting for spinal injury and diseases. These apparatuses employ longitudinal link rods secured to coupling elements which elements in turn are secured to the bone such as vertebrae by spinal bone fixation fasteners such as pedicle screws, hooks and others. Transverse bridge elements connect parallel rods which extend along the spinal column, the rods being connected by the bridge elements to opposing sides of the spinal column portion being corrected. These apparatuses are supplied for posterior internal use and require flexibility in surgical implantation to facilitate the surgery and maximize the corrective action with minimum patient discomfort.
U.S. Pat. No. 5,522,816 to Dinello et al. discloses an apparatus for interconnecting a pair of longitudinal members for fixation to vertebrae including connector members connected to the longitudinal members. An elongate plate extends transverse to the longitudinal members and interconnects the connector members. A set screw clamps a hook to a longitudinal member. A nut engages the set screw to clamp the plate to the connector member. The plate has a recess for receiving the connector member to prevent pivoting of the elongate member.
U.S. Pat. No. 5,624,442 to Mellinger et al. discloses a transverse connector member to connect two parallel spinal implant rods. The connector member includes a clamp comprising a rod receiving recess and a top-loaded set screw which causes a horizontal and vertical loading of the rod to bias the rod into contact with the recess. In one embodiment, an adjustable distance is provided between clamping members. In another embodiment, the connector is a single unit in which the clamping members have openings in the same direction to facilitate loading the connector onto the rods.
In U.S. Pat. No. 5,380,325 to Lahille et al. a consolidation rod, pedicle screws and vertebrae claws are disclosed with threaded sections fitted with a nut for clamping to the rod. The fastener comprises a first bore sliding on the rod, a first opening into the first bore and narrowed by nut screwing, and a second bore passing through the slit and passed through by the threaded section. An indented plate, or a bar with threaded ends fitted with hooks transversely stabilizes the two consolidation rods. A connector longitudinally stabilizes the two consolidation rods.
U.S. Pat. No. 5,466,241 discloses a further support device for a human vertebrae column. The head of two pedicle screws are mounted on a holding device pivotally about an axis normal to the screw shank axis. A securing device fixes the screws in a fixed angular position and at desired axial intervals, the holding device including two bolts cooperating with a threaded sleeve including a clamping surface. For each bolt a screw connection is provided which clamp fixes with respect to each other in their position the clamping surfaces of the bolts and pedicle screws or of the two bolts.
U.S. Pat. No. 5,651,789 to Cotrel discloses two fixation hooks which move along a rigid bar in sliding manner and are equipped with means for locking on the bar. A body has a hook extending therefrom. The body has a first bearing surface for engaging a first elongate member. The first surface conforms to a portion of the elongate member outer surface. The body has a second bearing surface transverse the first surface. The first bearing surface which abuts a portion of a second elongate member when the second elongate member is transverse to the first elongate member. A plug bears against the second elongate member to clamp the second elongate member against the first elongate member when the first elongate member is engaged with the first bearing surface.
Still other fixation devices are disclosed in U.S. Pat. Nos. 5,498,262, 4,483,334, 5,254,118, 5,306,275, 5,344,422, 4,474,551, 5,645,544, 5,129,900, 4,648,388, 4,719,905, 5,000,165, 5,053,034, 5,084,049, 5,129,900, 5,312,404, 5,344,422, 5,487,744, 5,545,228 and 5,562,661. These all disclose various arrangements of couplers and fixation devices for securing a bone fixation element to an elongated bone fixation rod.
The present invention is in recognition of a need for a bone fixation coupler and bone fixation assembly method that uses a minimum of components and is simple to implement.
A bone fixation coupler according to the present invention for securing a bone fixation link rod to a bone fixation member comprises first and second elements each having a body and a flange extending from the body, the bodies and flanges being juxtaposed and secured for relative pivoting displacement, the bodies each having an opening for receiving the rod on an axis, the openings being offset relative to each other along the axis in the juxtaposed relation. The juxtaposed flanges have aligned bores for receiving a portion of the fixation member, the received member portion for clamping the juxtaposed flanges together, the offset openings being dimensioned relative to the flanges and to each other for clamping the received rod to the bodies in response to the clamping of the flanges.
In one aspect, the opening in one body is a circular cylindrical bore and the opening in the other body is a hook.
In another aspect, each body has a further bore and further includes a pivot pin in the further bore of each body for hinging the elements about the pivot pin.
In another aspect, the body of one of the elements is bifurcated forming a slot, the body of the other of the elements being located in the slot.
In a further aspect, the flanges of each element are planar and parallel to a first plane, the bodies each being planar and parallel to a second plane, the first and second planes being normal.
In a further aspect, the bone fixation device comprises a bone fixation member having opposing first and second ends and includes first means for fixation to a bone at the first end and second means for receiving a fastener at the second end. Tool guide receiving means are at the second end for receiving a tool guiding device for guiding a tool for fastening the fastener to the second means. Securing means are intermediate the ends and cooperate with the fastener for securing the element to a link rod coupling device. A tool guide is secured to the tool guide receiving means.
In a further aspect, the guide receiving means is a threaded bore and the guide is an elongated shaft.
In a further aspect, the second end has external threads and the fastener is a nut mating with the threads.
In a further aspect, the first means comprises one of a threaded shank and hook for engaging a bone.
A method of attaching a link rod to a bone fixation element according to an aspect of the present invention comprises securing the link rod in fixed spaced relation to a bone; attaching a bone fixation member to the bone; attaching a coupler element to the link rod; and guiding and simultaneously fastening a fastener to the bone fixation member and to the coupler while simultaneously pulling the fixation member and the bone toward the link rod and coupler during the fastening.
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patent: 54
Buiz Michael
Carella Byrne et al.
Gilfillan III John G.
Reip David O.
Squire William
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