Surgery – Instruments – Orthopedic instrumentation
Reexamination Certificate
1999-11-05
2001-10-09
Mancene, Gene (Department: 3732)
Surgery
Instruments
Orthopedic instrumentation
C606S064000
Reexamination Certificate
active
06299616
ABSTRACT:
BACKGROUND OF THE INVENTION
The invention relates to an endoscopic insertion apparatus for a spinal column implant system. The spinal column implant system essentially comprises at least one anchoring element, a bone plate (also referred to herein as “vertebra plate”) connected to the anchoring element, and at least one connection element for connecting at least two bone plates. A screwing-in tool is provided for screwing the anchoring element into a bone part to secure the bone plate in place and an elongated holding device is provided for holding the bone plate.
Spinal column implant systems of the type mentioned in the introduction can be used to fix various bone parts relative to one another; in particular, such an implant can be used for fixing adjacent vertebrae of the spinal column. Such an implant system is attached to the bone parts using a plurality of insertion instruments. Particularly where restricted access points are involved, for example in endoscopic operations, endoscopic insertion apparatus of the type mentioned in the introduction is used. A holding device associated with the insertion apparatus is used to hold the bone plate and the connection element connected to the bone plate and to introduce them into the body. The screwing-in tool is then used to screw the anchoring element into the bone part, for example. A similar procedure is carried out with a second anchoring element and a bone plate associated therewith. A connection element, for example a connection rod or a connection plate, is then brought up to the bone plate. The connection element is then fixed relative to the bone plate. In particular, a clamp element can be used to fix the connection element to the bone plate. Such a clamp element is generally very small, and hence there is a risk of losing it in the operating area. It is also difficult to position the clamp element properly relative to the bone plate. In order to simplify positioning the clamp element, centering pieces are used. The centering pieces are arranged (for example screwed on or latched) on the unit comprising the bone plate, the anchoring element and the connection element before the clamp element is introduced. Only when the centering piece has been positioned properly is the clamp element introduced using the clamp element guide tool.
In this procedure, it is disadvantageous that the centering piece has to be introduced as an independent instrument after the anchoring element and the bone plate have already been fixed on the bone part. In addition, a separately attached centering piece requires at least one actuation unit with which it can be introduced and removed again.
SUMMARY OF THE INVENTION
Accordingly, it is an object of the present invention to improve endoscopic insertion apparatus of the type described in the introduction in such a manner that the number of parts used in the apparatus is reduced and that handling, particularly of the centering piece, is simplified.
The invention achieves this object in endoscopic insertion apparatus of the type described in the introduction in that the holding device comprises an insertion sleeve and a centering element. The centering element and the insertion sleeve can be connected to one another in a screwing-in position by a coupling mechanism in the direction of a longitudinal axis of the holding device, and the centering element and the insertion sleeve can be separated from one another in a centering position.
Such a holding device makes it possible to hold the bone plate and the connection element and bring them to the bone part to which the spinal column implant system is to be attached. After the anchoring element has been attached to the bone part using the screwing-in tool, it is no longer necessary to remove the holding device completely and then to use a centering piece. According to the present invention, it is possible to separate the holding device after the anchoring element has been attached. The centering element remains on the unit which comprises the anchoring element and the bone plate and is attached to the bone part, while the insertion sleeve is detached from the centering element. The centering element and the insertion sleeve are connected by a coupling mechanism. This coupling mechanism ensures that the two parts cannot be separated from one another in the axial direction when the anchoring element is attached to the bone part, that is to say that when the holding device is in the screwing-in position. The centering position for introducing the clamp element and the connection element is obtained by separating the insertion sleeve from the centering element. The centering element remains on the spinal column implant system and, in this position, is used for centering of the connection element which is to be introduced and of the clamp element.
It is beneficial if the centering element is formed by an elongated sleeve, at one end of which there is a part of the coupling mechanism. In contrast to centering pieces which are already known, the fact that the centering element of the present invention is designed as a sleeve means that it can perform a centering function both internally and externally. For example, the screwing-in tool can be guided inside the centering element, whereas the clamp element can be guided in the axial direction along the outer peripheral wall of the sleeve in the direction of the spinal column implant. By arranging that part of the coupling mechanism which is located on the centering element at one end of the centering element, the physical size can be significantly reduced. At the same time, the accessibility and functionality of the coupling mechanism between the insertion sleeve and the centering element are simplified.
According to one preferred embodiment of the present invention, provision may be made for the coupling mechanism to be formed by a latch connection having at least one latching lug, formed as a projection, and at least one latching edge, formed as a projection. The latching lug is arranged on a first part of the holding device and the latching edge is arranged on a second part of the holding device. The refinement of the coupling mechanism as a latch connection significantly simplifies handling of the holding device. For release, all that is required is for the latching edge to be moved relative to the latching lug to enable the insertion sleeve to be removed from the centering element. On the other hand, connecting the two parts is particularly easy as they need merely be plugged together. Further the two parts can also be heard to latch when the latching lug slides past the latching edge and engages behind it.
It is particularly advantageous if the latching lug is arranged resiliently on a part of the holding device in the radial direction in relation to the longitudinal axis of the holding device. Although the latching edge could be arranged resiliently in the same way, it suffices if the latching lug is arranged resiliently. This reduces the number of moving parts and increases the lifetime of the instrument.
Although various types of resilient arrangements of the latching lug on the holding device are conceivable, it is particularly beneficial when the latching lug is arranged on a leaf spring, arranged in the peripheral wall of the insertion sleeve, so as to point in the direction of the longitudinal axis of the holding device. The latching lug is thus situated on the inner peripheral wall of the insertion sleeve. In this arrangement, it does not matter whether the leaf spring is integral with the insertion sleeve or is arranged on the insertion sleeve as a separate component, for example.
According to one preferred embodiment of the present invention, provision may be made for a part of the latch connection to be operationally connected to a release projection for releasing the latch connection. With the present invention, it is crucial that the centering element can be separated from the insertion sleeve. Separation can be induced particularly simply if a projection is provided which is operationally
Aesculap AG & Co. KG
Bumgarner Melba
Lipsitz Barry R.
Mancene Gene
McAllister Douglas M.
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