U.S. patent application number 11/954562 was filed with the patent office on 2008-06-12 for polyaxial bone screw.
This patent application is currently assigned to DEPUY SPINE, INC.. Invention is credited to Niall Casey, Thomas Vincent Doherty, Mark Hall, David D. Konieczynski, Dale Whipple.
Application Number | 20080140135 11/954562 |
Document ID | / |
Family ID | 33540712 |
Filed Date | 2008-06-12 |
United States Patent
Application |
20080140135 |
Kind Code |
A1 |
Konieczynski; David D. ; et
al. |
June 12, 2008 |
POLYAXIAL BONE SCREW
Abstract
The present invention generally provides a polyaxial fixation
device having a shank with a spherical head formed on a proximal
end thereof, and a receiver member having an axial passage formed
therein that is adapted to polyaxially seat the spherical head of
the shank. The polyaxial bone screw further includes an engagement
member that is adapted to provide sufficient friction between the
spherical head and the receiver member to enable the shank to be
maintained in a desired angular orientation before locking the
spherical head within the receiver member.
Inventors: |
Konieczynski; David D.;
(Needham, MA) ; Doherty; Thomas Vincent; (Latham,
NY) ; Whipple; Dale; (East Taunton, MA) ;
Casey; Niall; (Boston, MA) ; Hall; Mark;
(Bridgewater, MA) |
Correspondence
Address: |
NUTTER MCCLENNEN & FISH LLP
WORLD TRADE CENTER WEST, 155 SEAPORT BOULEVARD
BOSTON
MA
02210-2604
US
|
Assignee: |
DEPUY SPINE, INC.
Raynham
MA
|
Family ID: |
33540712 |
Appl. No.: |
11/954562 |
Filed: |
December 12, 2007 |
Related U.S. Patent Documents
|
|
|
|
|
|
Application
Number |
Filing Date |
Patent Number |
|
|
11381048 |
May 1, 2006 |
|
|
|
11954562 |
|
|
|
|
10608904 |
Jun 27, 2003 |
7087057 |
|
|
11381048 |
|
|
|
|
Current U.S.
Class: |
606/309 ;
606/301; 606/305 |
Current CPC
Class: |
A61B 17/7037 20130101;
A61B 17/7035 20130101; A61B 17/8605 20130101; A61B 17/7032
20130101 |
Class at
Publication: |
606/309 ;
606/301; 606/305 |
International
Class: |
A61B 17/56 20060101
A61B017/56 |
Claims
1-31. (canceled)
32. A method of producing an apparatus for retaining bone portion
in a desired spatial relationship, comprising: providing a fastener
having a longitudinal axis, a first threaded end portion engageable
with a bone portion and a second end portion; providing a housing
having a first passage capable of receiving a longitudinal member
and a second passage for receiving the fastener, the second passage
having a longitudinal axis; extending the fastener through an
opening in the housing into the second passasge so that the
fastener is pivotable relative to the housing and the longitudinal
axis of the fastener is positionable in any one of a plurality of
angular positions relative to the longitudinal axis of the second
passage; and limiting relative movement between the fastener and
the housing by creating a frictional engagement that holds the
position of the housing relative to the fastener when the
longitudinal member is not recieved in the first passage of the
housing.
33. The method of claim 32, wherein the first passage is transverse
to the second passage.
34. The method of claim 32, wherein the first passage and the
second passage intersect.
35. The method of claim 32, wherein the frictional engagement is
created between the second end portion of the fastener and an inner
surface of the housing.
36. The method of claim 32, further comprising inserting a spacer
into the second passage of the housing, the spacer applying an
axial force toward the fastener to create the frictional engagement
between the second end portion of the fastener and the inner
surface of the housing.
37. The method of claim 32, further comprising inserting a spring
member into the second passage of the housing, the spring member
compressing to apply an axial force to the spacer and urging the
spacer axially toward the fastener to create the frictional
engagement that holds the position of the housing relative to the
fastener when the longitudinal member is not received in the first
passage of the housing.
38. A method of producing an apparatus for retaining bone portions
in a desired spatial relationship, comprising: providing a fastener
having a longitudinal axis, a first threaded end portion engageable
with a bone portion and a second end portion; providing a housing
having a first passage capable of receiving a longitudinal member
and a second passage, the second passage having a longitudinal axis
extending transverse to the first passage; extending the fastener
through an opening in the housing into the second passage so that
the second end portion of the fastener engages an inner surface of
the housing and the fastener is pivotable relative to the housing
so that the longitudinal axis of the fastener is positionable in
any one of a plurality of angular positions relative to the
longitudinal axis of the second passage; and inserting a spacer in
the housing, the spacer configured to engage the longitudinal
member, wherein the spacer applies an axial force toward the
fastener to create a frictional engagement between the second end
portion of the fastener and the inner surface of the housing;
wherein the frictional engagement holds the position of the housing
relative to the fastener when the longitudinal member is disengaged
from the spacer, and the fastener and the housing are manually
moveable relative to each other when the longitudinal member is
disengaged from the spacer and the spacer applies the axial
force.
39. The method of claim 38, wherein the second end portion of the
fastener comprises a part spherical surface.
40. The method of claim 39, wherein the part spherical surface of
the fastener engages a concave part spherical surface of the
housing.
41. The method of claim 38, wherein the spacer engages the
fastener.
42. The method of claim 41, further comprising inserting a spring
member in the housing and compressing the spring member to urge the
spacer axially toward the fastener to prevent relative movement
between the fastener and the housing when the longitudinal member
is disengaged from the spacer and the spacer engages the
fastener.
43. The method of claim 41, wherein the spacer has a concave part
spherical surface that engages a part spherical surface of the
fastener.
44. The method of claim 38, further comprising providing a cap
screw, the cap screw configured to threadably engage the housing
and apply a force to a longitudinal member positioned in the first
passage of the housing to press the longitudinal member against the
spacer.
45. A method of producing an apparatus for retaining bone portions
in a desired spatial relationship, comprising: providing a fastener
having a longitudinal axis, a first threaded end portion engageable
with a bone portion and a second end portion; providing a housing
having a first passage capable of receiving a longitudinal member
and a second passage for receiving the fastener, the second passage
having a longitudinal axis, wherein the fastener extends through an
opening in the housing into the second passage so that the fastener
is pivotable relative to the housing and the longitudinal axis of
the fastener is positionable in any one of a plurality of angular
positions relative to the longitudinal axis of the second passage;
connecting the fastener to a vertebra, wherein a frictional
engagement holds the position of the housing relative to the
fastener prior to the longitudinal member being received in the
first passage of the housing; positioning the longitudinal member
in the first passage of the housing; and threadably engaging a set
screw in the housing, the set screw engaging and applying a force
to the longitudinal member.
46. The method of claim 45, wherein the frictional engagement is
created between the second end portion of the fastener and an inner
surface of the housing.
47. The method of claim 46, wherein the housing is provided with a
spacer positioned within the second passage, and the longitudinal
member engages the spacer.
48. The method of claim 47, wherein the housing is provided with a
spring member that urges the spacer axially toward the fastener and
the inner surface of the housing against the second end portion of
the fastener.
49. The method of claim 45, further comprising, prior to
positioning the longitudinal member in the first passage of the
housing, moving the fastener relative to the housing to overcome
the frictional engagement.
50. The method of claim 45, wherein the first passage is transverse
to and intersects the second passage.
51. The method of claim 45, wherein the second end portion of the
fastener is part spherical, and the part spherical end portion of
the fastener engages a concave inner surface of the housing.
52. An apparatus comprising: a housing having a top end, a bottom
end, and first and second side walls; the first and second walls
defining an opening in the top end of the housing and a channel
extending through the housing having a longitudinal axis defining a
passageway for receiving a spinal rod; and a fastener configured to
engage to bone, the fastener having a longitudinal axis, the
fastener extending from the bottom end of the housing; wherein each
of the first and second side walls includes a downwardly facing
horizontal surface and at least a partially cylindrical inwardly
extending recess on an exterior surface thereof.
53. The apparatus of claim 52, wherein the first and second side
walls have an exterior side surface that is substantially
arcuate.
54. The apparatus of claim 52, wherein each of the first and second
side walls define an interior side surface and an exterior side
surface, the interior side surface further defining the channel and
the exterior side surface located opposite the internal
surface.
55. The apparatus of claim 52, further comprising a rod positioned
in the channel.
56. The apparatus of claim 55, further comprising a clamping
mechanism that clamps said rod and housing to said fastener to
prevent movement of said fastener relative to said housing.
57. The apparatus of claim 56, wherein the housing is internally
threaded, and the clamping mechanism is a set screw.
58. The apparatus of claim 52, wherein said fastener extends
through an opening in the bottom end of the housing and is movable
in any one of a plurality of angular positions relative to said
housing.
59. The apparatus of claim 52, wherein the recess extends partially
through the housing.
60. An apparatus comprising: a housing having a top end, a bottom
end, and first and second side walls; the first and second walls
defining an opening in the top end of the housing and a channel
extending through the housing having a longitudinal axis defining a
passageway for receiving a spinal rod; and a fastener configured to
engage to bone, the fastener having a longitudinal axis, the
fastener extending from the bottom end of the housing; wherein each
of the first and second side walls includes a downwardly facing
horizontal surface extending along substantially the entirety of an
exterior surface of each of the first and second side walls.
61. An apparatus comprising: a fastener having a longitudinal axis
and engageable with a bone portion; a housing having a passage with
a first transverse dimension, said fastener extending through an
opening in said housing into said passage and being movable
relative to said housing, said longitudinal axis of said fastener
being positionable in any one of a plurality of angular positions
relative to said longitudinal axis of said passage; a spacer
received in said passage of said housing and engageable with said
fastener, said spacer having an upper end and a lower end; and a
retaining structure having a second transverse dimension greater
than the first transverse dimension; wherein the retaining
structure is configured to be press-fit into the passage, the
distance between the retaining structure and the spacer determining
an adjustable force applied by the spacer to the fastener to
prevent relative movement between said fastener and said housing
when the spacer engages the fastener; and wherein an inner surface
of the housing is substantially continuous at least from a location
engaging the retaining structure to a location adjacent the lower
end of the spacer.
62. An apparatus as defined in claim 61, wherein the retaining
structure and the spacer are separate members.
63. An apparatus as defined in claim 61, wherein the retaining
structure and the spacer are integral.
64. An apparatus as defined in claim 61, wherein the inner surface
of the housing is substantially continuous at least from a location
engaging the retaining structure to a location within a plane
transverse to the longitudinal axis of the housing, said transverse
plane containing the lower end of the spacer.
65. An apparatus comprising: a fastener having a longitudinal axis
and engageable with a bone portion; a housing having a passage and
being configured to receive a longitudinal member, said fastener
extending through an opening in said housing into said passage and
being movable relative to said housing, said longitudinal axis of
said fastener being positionable relative to said longitudinal axis
of said passage; a spacer having a lower end engaged with said
fastener; and means for preventing relative movement between said
fastener and said housing before a longitudinal member is received
in the housing.
66. An apparatus comprising: a fastener having a longitudinal axis
and engageable with a bone portion; a housing having a passage and
being configured to receive a longitudinal member, said fastener
extending through an opening in said housing into said passage and
being movable relative to said housing, said longitudinal axis of
said fastener being positionable relative to said longitudinal axis
of said passage; and means for preventing relative movement between
said fastener and said housing before a longitudinal member is
received in the housing.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] The present application is a continuation of U.S. patent
application Ser. No. 11/381,048 filed on May 1, 2006 and entitled
"Polyaxial Bone Screw," which is a continuation of U.S. patent
application Ser. No. 10/608,904 filed on Jun. 27, 2003 and entitled
"Polyaxial Bone Screw." These references are hereby incorporated by
reference in their entireties.
FIELD OF THE INVENTION
[0002] The present invention relates to polyaxial bone screws, and
in particular to a polyaxial bone screw assembly in which the bone
screw can be maintained in a desired angular orientation prior to
locking the bone screw with respect to the rod-receiving
member.
BACKGROUND OF THE INVENTION
[0003] Spinal fixation devices are used in orthopedic surgery to
align and/or fix a desired relationship between adjacent vertebral
bodies. Such devices typically include a spinal fixation element,
such as a relatively rigid fixation rod, that is coupled to
adjacent vertebrae by attaching the element to various anchoring
devices, such as hooks, bolts, wires, or screws. The fixation rods
can have a predetermined contour that has been designed according
to the properties of the target implantation site, and once
installed, the instrument holds the vertebrae in a desired spatial
relationship, either until desired healing or spinal fusion has
taken place, or for some longer period of time.
[0004] Spinal fixation devices can be anchored to specific portions
of the vertebra. Since each vertebra varies in shape and size, a
variety of anchoring devices have been developed to facilitate
engagement of a particular portion of the bone. Pedicle screw
assemblies, for example, have a shape and size that is configured
to engage pedicle bone. Such screws typically include a bone screw
with a threaded shank that is adapted to be threaded into a
vertebra, and a rod-receiving element, usually in the form of a
U-shaped slot formed in the head. The shank and rod-receiving
assembly can be provided as a monoaxial screw, whereby the
rod-receiving element is fixed with respect to the shank, or a
polyaxial screw, whereby the rod-receiving element has free angular
movement with respect to the shank. In use, the shank portion of
each screw is threaded into a vertebra, and once properly
positioned, a fixation rod is seated into the rod-receiving element
of each screw. The rod is then locked in place by tightening a
set-screw, plug, or similar type of fastening mechanism into the
rod-receiving element.
[0005] While current spinal fixation systems have proven effective,
it can be difficult to mount rods into the rod-receiving element of
various fixation devices. In particular, it can be difficult to
align and seat a rod into the rod-receiver of a polyaxial implant
since the rod-receiver has polyaxial freedom of movement with
respect to the shank. More particularly, the polyaxial freedom of
movement of the rod-receiver can allow the receiver to "flop,"
thereby requiring the surgeon or an assistant to hold the receiver
in the desired position during rod introduction.
[0006] Accordingly, there remains a need for a polyaxial bone screw
assembly in which the rod-receiving element can be maintained in a
desired angular orientation before locking the shank with respect
to the receiver member.
SUMMARY OF THE INVENTION
[0007] The present invention generally provides a polyaxial spinal
fixation device (e.g., bone screws, hooks, etc.) having a shank
with a spherical head formed on a proximal end thereof, and a
receiver member having an axial passage formed therein that is
adapted to polyaxially seat the spherical head of the shank. The
polyaxial fixation device further includes an engagement member
that is adapted to provide sufficient friction between the
spherical head and the receiver member to enable the shank to be
maintained in a desired angular orientation before locking the
spherical head within the receiver member. The engagement member
can have a variety of configurations, and in one embodiment the
engagement member can be a ring member, such as a snap ring, that
is positioned to engage a portion of the spherical head to provide
frictional engagement between the head and the receiver member. The
ring member can be disposed within a groove formed around an outer
surface of the spherical head of the shank, and/or it can be
disposed within a groove formed around an inner surface of the
receiver member. The groove around the inner surface of the
receiver member preferably has a depth that is equal to or greater
than a thickness of the ring member to allow the ring member to be
completely disposed within the groove. Alternatively, or in
addition, the ring member can be adapted to expand or contract to
be disposed completely within the groove.
[0008] In another embodiment, the engagement member can be a
compression cap that is disposed within the receiver member and
that has a concave distal surface adapted to seat at least a
portion of the spherical head of the shank. The compression cap is
preferably capable of mating with the receiver member such that the
compression cap is effective to retain the spherical head of the
shank in a spherical recess formed in the receiver member. The
compression cap can have a variety of configurations, and in one
embodiment it can include opposed leaf-spring members that are
adapted to contract inward, biasing the cap distally, to
frictionally engage the spherical head of the shank. In another
embodiment, at least a portion of the compression cap has a
diameter that is expandable to frictionally engage the spherical
head. By way of non-limiting example, the compression cap can
include a plurality of distally-extending finger-like members
formed around a distal edge of the compression cap to frictionally
engage the spherical head. In yet another embodiment, the
compression cap can include at least one longitudinally oriented
slot formed therein to allow the compression cap to be contracted
to frictionally engage the spherical head.
[0009] In other aspects, a polyaxial fixation assembly is provided
having a shank with a spherical head formed on a proximal end
thereof, and a receiver member having a first, proximal opening
adapted to receive a spinal fixation rod and a second, distal
opening having a diameter sized to permit passage of the shank
therethrough while maintaining the spherical head therein. The
receiver member further includes a spherical seat adjacent the
second, distal opening to polyaxially seat the spherical head of
the shank. The polyaxial fixation assembly also includes means for
frictionally engaging the spherical head to maintain the shank in a
desired angular orientation such that a force greater than a
frictional engagement force is required to change the angular
orientation of the threaded shank with respect to the receiver
member.
BRIEF DESCRIPTION OF THE DRAWINGS
[0010] The invention will be more fully understood from the
following detailed description taken in conjunction with the
accompanying drawings, in which:
[0011] FIG. 1 is a perspective view of a prior art polyaxial bone
screw;
[0012] FIG. 2A is an enlarged, partially cross-sectional view of a
polyaxial bone screw assembly having a ring member disposed therein
in accordance with one embodiment of the present invention;
[0013] FIG. 2B illustrates several embodiments of a ring member
that can be used with the polyaxial bone screw assembly shown in
FIG. 2A;
[0014] FIG. 2C is an illustration of another embodiment of a bone
screw having a ring member disposed therearound;
[0015] FIG. 3A is a perspective view of a polyaxial bone screw
assembly, in the disassembled state, having a compression cap with
a collet for engaging the head of a bone screw in accordance with
another embodiment of the present invention;
[0016] FIG. 3B is an enlarged, partially cross-sectional view of a
portion of the polyaxial bone screw assembly shown in FIG. 3A;
[0017] FIG. 3C illustrates the polyaxial bone screw assembly of
FIG. 3B with a rod and closure mechanism disposed therein;
[0018] FIG. 4A is a perspective view of another embodiment of a
polyaxial bone screw assembly, in the disassembled state, having a
compression cap with a leaf-spring for engaging the head of a bone
screw in accordance with the present invention;
[0019] FIG. 4B is an enlarged, cross-sectional view of the a
portion of the polyaxial bone screw assembly shown in FIG. 4A;
[0020] FIG. 5A is a perspective view of yet another embodiment of a
polyaxial bone screw assembly, in the disassembled state, having a
compression cap with a slot formed therein to allow the compression
cap to engage the head of a bone screw in accordance with the
present invention; and
[0021] FIG. 5B is an enlarged, partially cross-sectional view of a
portion of the polyaxial bone screw shown in FIG. 5A.
DETAILED DESCRIPTION OF THE INVENTION
[0022] FIG. 1 illustrates a prior art polyaxial bone screw assembly
10 that includes a bone screw 12, a receiver member 18, and a
compression cap 24. As shown, the bone screw 12 generally includes
a threaded shank 14 having a spherical head 16 formed on a proximal
end 14a thereof. An Allen or other female socket 15 is formed in
the head 16 for applying torque along the axis of the shank 14 to
insert the shank 14 into bone. The receiver member 18 is generally
U-shaped and includes opposed side walls or legs 20a, 20b that are
substantially parallel to one another and that define a
rod-receiving portion 22 for seating a spinal fixation rod. A
distal end 18b of the receiver member 18 includes an axial opening
(not shown) formed therein and having a diameter sized to permit
passage of the shank 14 therethrough while maintaining the
spherical head 16 therein. The receiver member 18 further includes
a spherical seat (not shown) adjacent to the distal opening for
polyaxially seating the spherical head 16 of the bone screw 12. The
compression cap 24, which is adapted to be positioned within the
receiver member 18, has a generally cylindrical shape and includes
a rod-receiving proximal surface 26, and a concave distal surface
(not shown) that is adapted to fit around and seat a portion of the
spherical head 16 of the bone screw 12.
[0023] In use, the threaded shank 14 is disposed through the distal
opening in the receiver member 18 and the spherical head 16 of the
bone screw 12 is positioned within the spherical seat in the
receiver member 18. The compression cap 24 is then inserted into
the receiver member 18 such that the concave distal surface of the
compression cap 24 is disposed around and seats a portion of the
spherical head 16 of the bone screw 12. In order to retain the
compression cap 24 within the receiver member 18, the receiver
member 18 includes opposed sides bores (only one side bore 28a is
shown) having a deformable material (not shown) extending there
across on an inner surface of the receiver member 18. The side
bores 28a allow the material to be deformed inward to extend into
and engage opposed detents (only one detent 30a is shown) formed in
the compression cap 24. A tool can be used to deform the material
into the detents 30a once the compression cap 24 is disposed within
the receiver 18. As a result, the compression cap 24 is maintained
within the receiver member 18, thereby preventing removal of the
bone screw 12 from the receiver member 18. The compression cap 24
is also effective to lock the bone screw 12 in a desired angular
orientation with respect to the receiver member 18 once a rod is
disposed and locked within the receiver member 18. A person skilled
in the art will appreciate that a variety of techniques can be used
to retain the compression cap 24 within the receiver member 18, and
that the present invention is not intended to be limited to use
with compression caps 24 having detents for receiving deformable
material disposed within the receiver member. By way of
non-limiting example, the compression cap 24 can be retained within
the receiver 18 using a cross-pin.
[0024] Once the bone screw 12 is implanted within bone, and prior
to insertion of a rod into the receiver member 18, the receiver
member 18 of the prior art assembly is free to rotate and/or be
angularly positioned with respect to the bone screw 12. While this
advantageously allows alignment of the receiver member 18 with a
rod adapted to be disposed therein, such free axial movement of the
receiver member 18 can present challenges during surgery as the
surgeon is required to hold the receiver member 18 in the desired
position during rod introduction.
[0025] Accordingly, the present invention provides mechanisms for
creating friction between the spherical head 16 and the receiver
member 18 to allow the receiver member 18 to be provisionally
maintained in a desired angular orientation prior to locking the
receiver member 18 with respect to the a polyaxial fixation device.
This is particularly advantageous in that it allows a surgeon to
position and maintain the receiver member 18 in a desired
orientation prior to rod introduction, thereby preventing the
receiver member 18 from moving with respect to the bone screw 12
during introduction of a rod. While several different techniques
can be used to create the necessary frictional forces to allow the
angular orientation between the receiver member 18 and the bone
screw 12 to be maintained, FIGS. 2A-5B illustrate several exemplary
embodiments for frictionally engaging the spherical head of a bone
screw with respect to a rod-receiver member. For convenience
purposes, the reference numbers used in the embodiments shown in
FIGS. 2A-5B correspond to the reference numbers used in FIG. 1,
except that a different prefix is added to the reference numbers
for each embodiment. A person skilled in the art will appreciate
that a variety of other techniques can be used to create the
frictional forces necessary to maintain the angular orientation of
the shank with respect to the receiver member. Moreover, the
techniques used to create friction between the spherical head and
the receiver member can be adapted for use with virtually any
polyaxial spinal fixation device in addition to the illustrated
bone screw assembly, and the invention is not intended to be
limited to the specific polyaxial bone screw assembly shown.
[0026] FIG. 2A illustrates one embodiment of a polyaxial bone screw
assembly 210 that utilizes a ring member, e.g., a snap ring 234, to
frictionally engage the spherical head 216 of the bone screw 212.
The snap ring 234 can have a variety of configurations, shapes, and
sizes, but it should be adapted to expand to fit around at least a
portion of the spherical head 216. As shown, the snap ring 234 is
in the shape of a loop with an opening 235 formed therein that
allows the diameter d of the snap ring 234 to expand to fit around
a portion of the spherical head 216 of the bone screw 212. While
the snap ring 234 is shown having a C-shape, the snap ring can 234
can have a variety of other configurations. By way of non-limiting
example, FIG. 2B illustrates a variety of different snap rings
234a, 234b, 234c, 234d, 234e that can be used with the polyaxial
bone screw assembly 210 shown in FIG. 2A. Snap rings 234a and 234c,
for example, each have an irregular shape that allows the snap
rings 234a, 234c to expand to fit around the spherical head 216 of
the bone screw 212. Snap ring 234e, on the other hand, includes
several cut-out portions 235e that allow the snap ring 234e to
expand. In other embodiments, the snap ring 234 can have a variety
of different cross-sectional shapes such as, for example, a
circular cross-sectional shape as shown on snap ring 234d, or a
C-shaped cross-section as shown on snap ring 234b.
[0027] While the snap ring 234 can have a variety of
configurations, the snap ring 234 should be adapted to fit within a
corresponding groove 236 formed around an inner surface of the
receiver member 218. The groove 236 maintains the snap ring 234 at
a particular location with respect to the spherical head 216 of the
bone screw such that the snap ring 234 is expanded around the head
216. More particularly, the groove 236 should be formed in a
proximal portion of the spherical seat 219 formed in the distal end
218b of the receiver member 218. Not only is the groove 236
effective to maintain the position of the snap ring 234 around the
spherical head 216, but it is also effective to fully seat the snap
ring 234 when the head 216 is locked within the receiver 218. As
previously discussed, when a rod is seated within the receiver
member 218, the compression cap 224 is forced distally to lock the
bone screw 216 with respect to the receiver 218. The groove 236
receives the snap ring 234 to prevent the snap ring 234 from
interfering with the locking function of the compression cap 224.
Accordingly, the groove 236 preferably has a depth d.sub.l that is
at least equal to, and more preferably is greater than, a thickness
t.sub.r of the snap ring 234. Alternatively, or in addition, the
snap ring 234 can be adapted to expand or contract to be completely
disposed within the groove 236. By way of non-limiting example, the
snap ring 234 can be formed from a compressible or deformable
material that allows the snap ring 234 to be forced completely into
the groove 236.
[0028] Still referring to FIG. 2A, the bone screw assembly 210 can
be assembled by first placing the snap ring 234 within the groove
236 in the receiver member 218. The threaded shank 214 of the screw
212 can then be inserted through the axial opening 237 formed in
the distal end 218b of the receiver member 218. As a result, the
spherical head 216 will rest on top of the snap ring 234. The
compression cap 224 can then be placed in the receiver 218 and can
be used to push the head 216 into the recess 219, thereby causing
the snap ring 234 to expand around the head 216 to engage the head
216. This can be achieved by using a tool to push the compression
cap 224 in a distal direction. To prevent the compression cap 224
from popping out of the receiver 218, another tool can be inserted
into each of the opposed bores 228a, 228b to deform the deformable
material 232a, 232b, which extends across the inner surface of the
receiver member 218, into the corresponding detents 230a, 230b
formed in the compression cap 224. As a result, the compression cap
224 is prevented from moving in a proximal direction, thereby
preventing the spherical head 216 from moving proximally and
becoming disengaged with the snap ring 234. One skilled in the art
will appreciate that a variety of other techniques and fastening
members are known for use in retaining the spherical head 216 (and
any rod) within the receiver 218.
[0029] Once the device 210 is assembled, the frictional forces
created by the snap ring 234 that act on the spherical head 216 of
the screw 212 will allow the screw 212 to be set at a desired
angular orientation with respect to the receiver member 218, as
shown in FIG. 2A. The frictional forces can simply be overcome by
grasping and moving the bone screw 212 with respect to the receiver
member 218 to change the angular orientation. In other words, a
force greater than the frictional engagement force is required to
change the angular orientation of the bone screw 212 with respect
to the receiver member 218.
[0030] In another embodiment, shown in FIG. 2C, the snap ring 234
can be disposed within a groove 236' formed around the spherical
head 216' of the bone screw 212', rather than in a groove 236
formed within the receiver member 218. In this embodiment, the
groove 236' around the head 216' of the bone screw 212' preferably
extends at an angle .alpha., with respect to a longitudinal axis L
of the screw 212', around the proximal half of the spherical head
216' to allow the head 216' to fit within the spherical recess 219
in the receiver member 218. The angle .alpha. of the groove 236'
also allows the snap ring 234 to bear against the concave inner
surface of the compression cap 224, thereby creating the necessary
frictional forces to allow the angular orientation of the bone
screw 212' to be maintained with respect to the receiver member
218.
[0031] FIGS. 3A-3C illustrate another embodiment of a polyaxial
bone screw assembly 310 that includes an engagement feature that is
effective to maintain the angular orientation of a bone screw 312
with respect to a receiver member 318. In this embodiment, rather
than providing a separate engagement member, such as snap ring 234
shown in FIGS. 2A-2C, the compression cap 324 is modified to
include an expandable portion that is adapted to fit around and
frictionally engage the spherical head 316 of the bone screw 312.
While the expandable portion can have virtually any configuration,
in an exemplary embodiment the distal end 324b of the compression
cap 324 includes a collet 333 formed therearound having several
spaced apart finger-like members 334 that are separated by slots
335 which allow the finger-like members 334 to expand. The collet
333 can include any number of finger-like members 334 that can be
spaced apart at varying distances. Once the cap is retained in
place within the receiver member, the fingers 334 will bear upon
the spherical head 316 of the screw 312. This can be achieved by
deforming the fingers 334 on the cap inward prior to assembly, so
that they contact the spherical head 316 of the screw 312 once
inserted. Alternatively, the concave underside of the cap 324 can
be machined so that the radius is smaller than a radius r of the
spherical head 316 of the screw 312. This interference will also
cause the fingers 334 to bear upon the head 316 of the screw 312.
In use, as the compression cap 324 is moved distally on to the head
316, the collet 333 is forced to expand around the spherical head
316 of the bone screw 312 to engage the head and create the
friction necessary to maintain the angular orientation of the screw
312 with respect to the receiver 318, as shown in FIG. 3B. As
previously indicated, the compression cap 324 can be retained in
this position by deforming the material 332a, 332b in the receiver
member 318 into the corresponding detents 330a, 330b in the
compression cap 324.
[0032] Still referring to FIG. 3B, in a further embodiment, the
receiver member 318 can include an annular groove 336 formed
therein for receiving the expandable fingers 334 of the collet 333.
The groove 336, which is similar to groove 236 shown in FIG. 2A,
prevents the collet 333 from interfering with the locking function
of the compression cap 324. In other words, when a rod 50 is seated
within the rod-receiving recess 326 formed in the compression cap
324, and a closure mechanism 60 is applied to lock the rod 50
within the receiver member 318, as shown in FIG. 3C, the
compression cap 324 locks the position of spherical head 316 within
the receiver member 318. The groove 336 thus receives the collet
333 to prevent the collet 333 from interfering with the locking
forces created between the compression cap 324 and the spherical
head 316.
[0033] FIGS. 4A-4B illustrate yet another embodiment of a polyaxial
bone screw assembly 410 in which a leaf-spring compression cap 424
is used to engage the spherical head 416 of the bone screw 412 to
create the frictional forces necessary to maintain the angular
orientation of the bone screw 412 with respect to a receiver member
418. As shown in FIG. 4A, the compression cap 424 includes a first
pair of slots 431a.sub.1, 431a.sub.2 formed on opposed sides of the
first detent 430a, and a second pair of slots 431b.sub.1,
431b.sub.2 formed on opposed sides of the second detent 430b. Each
pair of slots 431a, 431a.sub.2, 431b.sub.1, 431b.sub.2 extends from
a proximal end 424a of the compression cap 424 toward the distal
end 424b, terminating just proximal to the distal end 424b. As a
result, the slots 431a.sub.1, 431a.sub.2, 431b.sub.1, 431b.sub.2
form sidewall portions 434a, 434b therebetween that are flexible,
thereby forming a leaf spring. In use, as shown in FIG. 4B, when
the deformable material 432a, 432b in the receiver member 418 is
deformed into the corresponding detents 430a, 430b in the
compression cap 424, the sidewall portions 424a, 424b flex inward
thereby contracting around, and preferably creating a downward
pressure on, the spherical head 416 of the bone screw 412. As a
result, friction is created between the compression cap 424 and the
spherical head 416 to maintain the angular orientation of the screw
412 with respect to the receive member 418. A person skilled in the
art will appreciate that a variety of other techniques can be used
to create a spring-like compression cap 424 that is effective to
engage the spherical head 416 of the screw 412.
[0034] FIGS. 5A-5B illustrate yet another embodiment of a polyaxial
bone screw assembly 510. In this embodiment, the compression cap
524 includes an axial slot 534 formed therein to allow the
compression cap 524 to be contracted to engage the spherical head
516 of the bone screw 512. While the slot 534 can be formed
anywhere in the compression cap 524, the slot 534 is preferably
formed in the portion of the sidewall that extends between the
opposed detents 530a, 530b, and more preferably the slot 534 is
equidistant from each detent 530a, 530b to allow the compression
cap 524 to be swaged evenly in a distal direction. FIG. 5B
illustrates the compression cap 524 in the contracted state around
the head 516 of the bone screw. The deformable material 532a, 532b
in the receiver member 518 is deformed into the detents 530a, 530b
in the compression cap 524 to contract the compression cap 524
around the spherical head 516. As a result, the frictional forces
created by the compression cap 524 radially contracting around the
spherical head 516 are effective to allow the bone screw 512 to be
maintained at a desired angular orientation with respect to the
receiver member 518.
[0035] A person skilled in the art will appreciate that a variety
of other techniques can be used to apply friction to the spherical
head of a polyaxial bone screw to allow the bone screw to be
maintained in a desired angular orientation before locking the bone
screw within the receiver member. By way of non-limiting example,
the spherical head of the polyaxial screw can include a coating or
surface treatment thereon to hinder movement of the screw head with
respect to the receiver member. Alternatively, or in addition, the
spherical head, the compression cap, and/or the receiver member can
include one or more protrusions formed thereon to frictionally
engage the spherical head to allow the orientation of the head to
be maintained in a desired configuration. The protrusions can be,
for example, formed from a plastic material that is effective to
interfere with the free rotational movement of the screw within the
receiver.
[0036] A person skilled in the art will appreciate that this design
is application to other polyaxial fixation devices, including other
screws, cross-connectors, hooks, bolts, etc., and it is not
intended to be limited to use with a polyaxial bone screw. A person
skilled in the art will also appreciate further features and
advantages of the invention based on the above-described
embodiments. Accordingly, the invention is not to be limited by
what has been particularly shown and described, except as indicated
by the appended claims. All publications and references cited
herein are expressly incorporated herein by reference in their
entirety.
* * * * *