U.S. patent application number 14/920225 was filed with the patent office on 2016-02-11 for extender collar system.
The applicant listed for this patent is Warsaw Orthopedic, Inc.. Invention is credited to Richard Quinn Brown, Kevin T. Foley, Gregory C. Marik, Joseph D. Shine, Daniel Paxton Wall.
Application Number | 20160038189 14/920225 |
Document ID | / |
Family ID | 48086503 |
Filed Date | 2016-02-11 |
United States Patent
Application |
20160038189 |
Kind Code |
A1 |
Wall; Daniel Paxton ; et
al. |
February 11, 2016 |
EXTENDER COLLAR SYSTEM
Abstract
A collar for extenders and an extender assembly including a
collar is disclosed. The collar is configured to receive extenders
and maintain the extenders in a parallel orientation so as to
prevent splaying and premature beak-off of the extenders from the
spine. Methods of use are disclosed.
Inventors: |
Wall; Daniel Paxton;
(Medina, TN) ; Brown; Richard Quinn;
(Collierville, TN) ; Foley; Kevin T.; (Germantown,
TN) ; Shine; Joseph D.; (Germantown, TN) ;
Marik; Gregory C.; (Collierville, TN) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Warsaw Orthopedic, Inc. |
Warsaw |
IN |
US |
|
|
Family ID: |
48086503 |
Appl. No.: |
14/920225 |
Filed: |
October 22, 2015 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
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13274702 |
Oct 17, 2011 |
|
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14920225 |
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Current U.S.
Class: |
606/86A |
Current CPC
Class: |
A61B 90/92 20160201;
A61B 2090/061 20160201; A61B 17/7091 20130101; A61B 17/708
20130101; A61B 17/7079 20130101; A61B 17/8875 20130101; A61B
2090/062 20160201; A61B 17/7085 20130101; A61B 2090/037 20160201;
A61B 2090/067 20160201; A61B 17/7076 20130101 |
International
Class: |
A61B 17/70 20060101
A61B017/70; A61B 19/00 20060101 A61B019/00 |
Claims
1-20. (canceled)
21. A collar configured for connection to a proximal end of an
extender comprising: a body extending between opposite proximal and
distal end surfaces, the body defining a first cavity, a second
cavity and an intermediate cavity disposed therebetween, the
cavities each extending through each of the end surfaces, wherein
the first and second cavities are configured to receive the
proximal end of the extender and the intermediate cavity is
configured for disposal of a surgical instrument; and a stop member
positioned in at least one of the first and second cavities such
that the stop member forms a portion of the proximal end surface,
the stop member being configured to block at least a portion of a
respective one of the first and second cavities to prevent the
extender from protruding past the proximal end of at least one of
the first and second cavities.
22. The collar of claim 21 wherein the first cavity is separated
from the intermediate cavity by a first wall that extends from the
proximal end surface to the distal end surface and the second
cavity is separated from the intermediate cavity by a second wall
that extends from the proximal end surface to the distal end
surface.
23. The collar of claim 21 wherein the first cavity spaced apart
from the intermediate cavity by a first wall such that the first
cavity is not in communication with the intermediate cavity and the
second cavity is spaced apart from the intermediate cavity by a
second wall such that the second cavity is not in communication
with the intermediate cavity.
24. The collar of claim 21 wherein the first cavity is completely
spaced apart from the intermediate cavity by a first wall and the
second cavity is completely spaced apart from the intermediate
cavity by a second wall.
25. The collar of claim 21 wherein the first and second cavities
are each in communication with the intermediate cavity.
26. The collar of claim 21 wherein the proximal end surface is
configured to mate with at least a portion of a surgical instrument
disposed in the intermediate cavity thereby aligning the surgical
instrument with the intermediate cavity.
27. The collar of claim 21 wherein the stop member is a protrusion
configured to contact the proximal end of the extender.
28. The collar of claim 21 wherein the stop member is a solid block
configured to contact the proximal end of the extender.
29. The collar of claim 21 wherein the proximal end surface is
flat.
30. The collar of claim 21 wherein the portion of the proximal end
surface is a flat portion of the proximal end surface.
31. The collar of claim 21 wherein the stop member is coupled to an
inner surface of the body that defines one of the first cavity and
the second cavity.
32. The collar of claim 21 wherein: the body comprises an opening
extending through an inner surface of the body that defines at
least one of the cavities and an opposite outer surface of the
body, the opening being in communication with one of the first and
second cavities; and the body comprises an actuator arm pivotally
mounted to the outer surface such that the actuator arm moves
between a first position in which the actuator arm is spaced apart
from the opening a second position in which at least a portion of
the actuator arm is disposed in the opening.
33. The collar of claim 32 wherein the actuator arm is biased to
the first position.
34. The collar of claim 32 wherein the body extends along a
longitudinal axis between the proximal and distal end surfaces, the
actuator arm being pivotable about a pivot point that extends
transverse to the longitudinal axis.
35. The collar of claim 32 wherein the actuator arm has a thickness
that is uniformly decreasing.
36. The collar of claim 32 wherein the actuator arm is
flexible.
37. The collar of claim 32 wherein the body extends along a
longitudinal axis between the proximal and distal end surfaces, the
opening extending transverse to the longitudinal axis.
38. A collar configured for connection to a proximal end of an
extender comprising: a body extending between opposite proximal and
distal end surfaces, the body defining a first cavity, a second
cavity and an intermediate cavity disposed therebetween, the
cavities each extending through each of the end surfaces, wherein
the first and second cavities are configured to receive the
proximal end of the extender and the intermediate cavity is
configured for disposal of a surgical instrument; and a stop member
enclosed within one of the first and second cavities, the stop
member being configured to block at least a portion of a respective
one of the first and second cavities to prevent the extender from
protruding past the proximal end of at least one of the first and
second cavities.
39. The collar of claim 38 wherein: the body includes an inner
surface that defines at least one of the cavities and an opposite
outer surface; and the stop member is coupled to the inner surface
and does not extend through the outer surface.
40. A collar configured for connection to a proximal end of an
extender comprising: a body extending between opposite flat
proximal and distal end surfaces, the body defining a first cavity,
a second cavity and an intermediate cavity disposed therebetween,
the cavities each extending through each of the end surfaces,
wherein the first and second cavities are configured to receive the
proximal end of the extender and the intermediate cavity is
configured for disposal of a surgical instrument; a stop member
positioned in at least one of the first and second cavities such
that the stop member forms a portion of the proximal end surface,
the stop member being a solid block that is enclosed within one of
the first and second cavities and configured to block at least a
portion of a respective one of the first and second cavities to
prevent the extender from protruding past the proximal end of at
least one of the first and second cavities; an opening extending
through an inner surface of the body that defines at least one of
the cavities and an opposite outer surface of the body, the opening
being in communication with one of the first and second cavities;
and an actuator arm pivotally mounted to the outer surface such
that the actuator arm moves between a first position in which the
actuator arm is spaced apart from the opening a second position in
which at least a portion of the actuator arm is disposed in the
opening.
Description
TECHNICAL FIELD
[0001] The present disclosure generally relates to medical devices
for the treatment of musculoskeletal disorders, and more
particularly to a surgical system for implant delivery to a
surgical site and a method for treating a spine.
BACKGROUND
[0002] Spinal pathologies and disorders such as scoliosis and other
curvature abnormalities, kyphosis, degenerative disc disease, disc
herniation, osteoporosis, spondylolisthesis, stenosis, tumor, and
fracture may result from factors including trauma, disease and
degenerative conditions caused by injury and aging. Spinal
disorders typically result in symptoms including deformity, pain,
nerve damage, and partial or complete loss of mobility.
[0003] Non-surgical treatments, such as medication, rehabilitation
and exercise can be effective, however, may fail to relieve the
symptoms associated with these disorders. Surgical treatment of
these spinal disorders includes correction, fusion, fixation,
discectomy, laminectomy and implantable prosthetics. Surgical
treatments used for positioning and alignment may employ
implantable rods and fasteners. Surgical instruments, such as, for
example, extenders are employed to position and align the
implantable rods and fasteners with a spine. This disclosure
describes an improvement over these prior art technologies.
SUMMARY OF THE INVENTION
[0004] Accordingly, a collar configured to attach to the proximal
end of extenders so as to prevent splaying of the extenders and
provide a passageway for surgical instruments, such as screwdrivers
and measuring devices, is provided. An extender system that
contains both extenders and the collar is provided for delivery of
an implant, such as bone fasteners and rods, to a surgical site for
treatment of spine related conditions. The collar is configured to
connect to a proximal end of an extender and includes a body
defining a longitudinal axis. The body also includes an outer
surface and an inner surface configured to define a first cavity, a
second cavity and an intermediate cavity disposed therebetween. The
inner surface including at least one wall projecting therefrom and
being disposed about the intermediate cavity, wherein the first and
second cavities receive the proximal end of the extenders to
prevent splaying and the intermediate cavity includes a passageway
configured for disposal of a surgical instrument.
[0005] In an embodiment in accordance with the principles of the
present disclosure, an extender system including first and second
extenders extending between a proximal end and a distal end along a
longitudinal axis is provided. The first and second extenders are
positioned so as to form an inner cavity along the longitudinal
axis with openings at the proximal and distal ends. The distal end
of the first and second extenders are configured to attach to
anchors engageable to a spinal column of a patient and the proximal
end includes at least one detent. Also included in the extender
system is a collar having a body defining a longitudinal axis, an
outer surface and an inner surface configured to define a first
cavity, a second cavity and an intermediate cavity disposed
therebetween. The inner surface including at least one wall
projecting therefrom and being disposed about the intermediate
cavity wherein the first and second cavities receive the proximal
end of the extenders to prevent splaying and the intermediate
cavity includes a passageway that aligns with the inner cavity
formed by the first and second extenders that is configured for
disposal of a surgical instrument.
[0006] In an embodiment in accordance with the principles of the
present disclosure, a surgical kit including a collar configured
for connection to a proximal end of an extender is provided. The
kit also includes at least two extenders extending between a
proximal end and a distal end along a longitudinal axis forming an
inner cavity along the longitudinal axis. The inner cavity having
openings at the proximal and distal ends and the distal end of the
extenders configured to attach to anchors engageable to a spinal
column of a patient. Hardware to be used with the extender system
of the kit such as bone fasteners, screws, and capped rods are also
included. The kit may also include instruments used with the
extender system such as screwdrivers and measuring devices, for use
in surgical procedures for the spine.
[0007] The extender kit provided in accordance with the principles
of the disclosure may be used for surgical procedures of the spine.
The kit provides the tools for placement of an implant, for example
capped rods or bone fasteners, in the spine of a patient. One
method in which the extenders system can be used includes attaching
the distal end of the extenders to fasteners positioned in the
spine of a patient so as to secure the distal ends of the extender
to the spine of a patient. Once the extenders are in place the
collar is attached to the proximal end of the extenders in order to
stabilize the extenders and keep them substantially to each other
so as to prevent splaying and to provide an inner cavity between
the extenders for the passage of implants and surgical instruments.
The collar can be attached to the extenders either before or after
the implant is introduced into the inner cavity of the extenders.
Once the implant is positioned within the inner cavity along the
longitudinal axis of the extenders, the implant is advanced towards
the spine of a patient for attachment. Throughout the procedure,
the collar keeps the extenders parallel to one another so as to
prevent splaying and stabilize the extenders.
BRIEF DESCRIPTION OF THE DRAWINGS
[0008] The present disclosure will become more readily apparent
from the specific description accompanied by the following
drawings, in which:
[0009] FIG. 1 is a perspective view of one particular embodiment of
the collar showing the proximal end in accordance with the
principles of the present disclosure;
[0010] FIG. 2 is a perspective view of the collar shown in FIG. 1
showing the distal end in accordance with the principles of the
present disclosure;
[0011] FIG. 3 is a perspective view of the collar shown in FIG. 1
showing three separate cavities in accordance with the principles
of the present disclosure;
[0012] FIG. 4 is a perspective view of an extender configured to
mate with the collar shown in FIG. 1 in accordance with the
principles of the present disclosure;
[0013] FIG. 5 is a prospective view of the proximal end of the
extender shown in FIG. 4 in accordance with the principles of the
present disclosure;
[0014] FIG. 6 is a perspective view of a collar cap and two
extenders attached to a screw assembly in accordance with the
principles of the present disclosure;
[0015] FIG. 7 is a perspective view of the proximal end of the
extender and collar shown in FIG. 6 aligned for attachment in
accordance with the principles of the present disclosure;
[0016] FIG. 8 is a perspective view of the proximal end of the
extender and collar shown in FIG. 7 with the collar in the process
of attachment in accordance with the principles of the present
disclosure;
[0017] FIG. 9 is a cross-sectional view of the proximal end of the
extender and collar shown in FIG. 8 with the collar attached in
accordance with the principles of the present disclosure;
[0018] FIG. 10 is a perspective view of the surgical instrument
with the collar engaged in accordance with the principles of the
present disclosure;
[0019] FIG. 11 is a perspective view of the surgical instrument of
FIG. 10 aligned with a screwdriver in accordance with the
principles of the present disclosure;
[0020] FIG. 12 is a perspective view of the surgical instrument of
FIG. 10 aligned with a rod measuring device in accordance with the
principles of the present disclosure;
[0021] FIG. 13 is a perspective view of the surgical instrument of
FIG. 10 aligned with a Break-Off Set Screw Driver in accordance
with the principles of the present disclosure; and
[0022] FIG. 14 is a perspective view of the surgical instrument of
FIG. 10 with capped rods placed in between the parallel extenders
in accordance with the principles of the present disclosure.
[0023] Like reference numerals indicate similar parts throughout
the figures.
DETAILED DESCRIPTION OF THE INVENTION
[0024] The exemplary embodiments of the collar, and the extender
system including the collar, are discussed in terms of medical
devices for the treatment of musculoskeletal disorders and more
particularly, in terms of extenders and surgical instruments for
implant delivery to a surgical site for treating a spine. It is
envisioned that the collar attaches to the proximal end of the
extenders so as to keep the extenders parallel to one another so as
to prevent splaying and premature break-off of the extenders. The
extender system can be used to introduce an implant, such as a rod
or a bone fastener, for attachment to a spine. In one embodiment, a
kit is provided that includes the extenders, collar, implants, such
as rods and fasteners, and may also include specific surgical
instruments to be used with the extender system for attachment of
the implants to the spine of a patient. One or all of the
components of the extender system can be disposable, peel-packed,
pre-packed sterile devices, or reusable.
[0025] It is envisioned that the present disclosure may be employed
to treat spinal disorders such as, for example, degenerative disc
disease, disc herniation, osteoporosis, spondylolisthesis,
stenosis, scoliosis and other curvature abnormalities, kyphosis,
tumor and fractures. It is contemplated that the present disclosure
may be employed with other osteal and bone related applications,
including those associated with diagnostics and therapeutics. It is
further contemplated that the disclosed surgical system and methods
may be alternatively employed in a surgical treatment with a
patient in a prone or supine position, and/or employ various
surgical approaches to the spine, including anterior, posterior,
posterior mid-line, postero-lateral, and/or antero-lateral
approaches, and in other body regions. The present disclosure may
also be alternatively employed with procedures for treating the
lumbar, cervical, thoracic and pelvic regions of a spinal column.
The system and methods of the present disclosure may also be used
on animals, bone models and other non-living substrates, such as,
for example, in training, testing and demonstration.
[0026] The present invention may be understood more readily by
reference to the following detailed description of the invention
taken in connection with the accompanying drawing figures, which
form a part of this disclosure. It is to be understood that this
invention is not limited to the specific instruments, devices,
methods, conditions or parameters described and/or shown herein,
and that the terminology used herein is for the purpose of
describing particular embodiments by way of example only and is not
intended to be limiting of the claimed invention. Also, as used in
the specification and including the appended claims, the singular
forms "a," "an," and "the" include the plural, and reference to a
particular numerical value includes at least that particular value,
unless the context clearly dictates otherwise. Ranges may be
expressed herein as from "about" or "approximately" one particular
value and/or to "about" or "approximately" another particular
value. When such a range is expressed, another embodiment includes
from the one particular value and/or to the other particular value.
Similarly, when values are expressed as approximations, by use of
the antecedent "about," it will be understood that the particular
value forms another embodiment. It is also understood that all
spatial references, such as, for example, horizontal, vertical,
top, upper, lower, bottom, left and right, are for illustrative
purposes only and can be varied within the scope of the disclosure.
For example, the references "upper" and "lower" are relative and
used only in the context to the other, and are not necessarily
"superior" and "inferior".
[0027] Further, as used in the specification and including the
appended claims, "treating" or "treatment" of a disease or
condition refers to performing a procedure that may include
administering one or more drugs to a patient (human, normal or
otherwise or other mammal), in an effort to alleviate signs or
symptoms of the disease or condition. Alleviation can occur prior
to signs or symptoms of the disease or condition appearing, as well
as after their appearance. Thus, treating or treatment includes
preventing or prevention of disease or undesirable condition (e.g.,
preventing the disease from occurring in a patient, who may be
predisposed to the disease but has not yet been diagnosed as having
it). In addition, treating or treatment does not require complete
alleviation of signs or symptoms, does not require a cure, and
specifically includes procedures that have only a marginal effect
on the patient. Treatment can include inhibiting the disease, e.g.,
arresting its development, or relieving the disease, e.g., causing
regression of the disease. For example, treatment can include
reducing acute or chronic inflammation; alleviating pain and
mitigating and inducing re-growth of new ligament, bone and other
tissues; as an adjunct in surgery; and/or any repair procedure.
Also, as used in the specification and including the appended
claims, the term "tissue" includes soft tissue, ligaments, tendons,
cartilage and/or bone unless specifically referred to
otherwise.
[0028] The following discussion includes a description of a collar
configured for attachment to the proximal end of extenders, an
extender system containing the collar, a kit containing the
extender system and implants and surgical instruments used with the
extender system. Alternate embodiments are also disclosed.
Reference will now be made in detail to the exemplary embodiments
of the present disclosure, which are illustrated in the
accompanying figures. Turning now to FIGS. 1-14, there is
illustrated components of a collar and an extender system including
the collar in accordance with the principles of the present
disclosure.
[0029] The components of the collar and extender system can be
fabricated from biologically acceptable materials suitable for
medical applications, including metals, synthetic polymers,
ceramics and bone material and/or their composites, depending on
the particular application and/or preference of a medical
practitioner. For example, the components of the collar and
extender system, individually or collectively, can be fabricated
from materials such as stainless steel alloys, commercially pure
titanium, titanium alloys, Grade 5 titanium, super-elastic titanium
alloys, cobalt-chrome alloys, stainless steel alloys, superelastic
metallic alloys (e.g., Nitinol, super elasto-plastic metals, such
as GUM METAL.RTM. manufactured by Toyota Material Incorporated of
Japan), ceramics and composites thereof such as calcium phosphate
(e.g., SKELITE.TM. manufactured by Biologix Inc.), thermoplastics
such as polyaryletherketone (PAEK) including polyetheretherketone
(PEEK), polyetherketoneketone (PEKK) and polyetherketone (PEK),
carbon-PEEK composites, PEEK-BaSO.sub.4 polymeric rubbers,
polyethylene terephthalate (PET), fabric, silicone, polyurethane,
silicone-polyurethane copolymers, polymeric rubbers, polyolefin
rubbers, hydrogels, semi-rigid and rigid materials, elastomers,
rubbers, thermoplastic elastomers, thermoset elastomers,
elastomeric composites, rigid polymers including polyphenylene,
polyamide, polyimide, polyetherimide, polyethylene, epoxy, bone
material including autograft, allograft, xenograft or transgenic
cortical and/or corticocancellous bone, and tissue growth or
differentiation factors, partially resorbable materials, such as,
for example, composites of metals and calcium-based ceramics,
composites of PEEK and calcium based ceramics, composites of PEEK
with resorbable polymers, totally resorbable materials, such as,
for example, calcium based ceramics such as calcium phosphate,
tri-calcium phosphate (TCP), hydroxyapatite (HA)-TCP, calcium
sulfate, or other resorbable polymers such as polyaetide,
polyglycolide, polytyrosine carbonate, polycaroplaetohe and their
combinations. Various components of the system may have material
composites, including the above materials, to achieve various
desired characteristics such as strength, rigidity, elasticity,
compliance, biomechanical performance, durability and radiolucency
or imaging preference. The components of the collar and surgical
instrument, individually or collectively, may also be fabricated
from a heterogeneous material such as a combination of two or more
of the above-described materials. The components of the collar and
surgical instrument may be monolithically formed, integrally
connected or include fastening elements and/or instruments, as
described herein.
[0030] The extender system of the disclosure includes a collar as
shown in FIGS. 1-14. The collar includes a body 11 having a
proximal end 14 and a distal end 13 that defines the shape of the
collar 10. It is envisioned that the body may have alternate cross
section configurations, such as, for example, oval, oblong,
triangular, rectangular, square, polygonal, winged, irregular,
uniform, non-uniform, c-shaped, variable and/or tapered as long as
it is configured to fit on the proximal end of an extender so as to
prevent splaying of the extenders. Body 11 has an inner surface
configured to define a first cavity 21, a second cavity 22 and an
intermediate cavity 23 disposed therebetween. The intermediate
cavity 23 extends along the longitudinal axis from a proximal end
14 to a distal end 13 of the collar 10. The intermediate cavity 23
is configured to receive instruments and/or implants used in the
surgical procedure.
[0031] First and second cavities 21, 22 extend from the proximal
end 14 to the distal end 13 of collar 10 and are configured to
receive the proximal ends of extenders. That is, the first and
second cavities 21, 22 have a width and height greater than the
width and height of the extender it is configured to receive. The
width and height of first and second cavities 21, 22 can vary from
collar to collar depending on the width and height of the extenders
to be received. For example, the height of first and second
cavities 21, 22 ranges from about 4.0 mm to about 7.5 mm and the
width of first and second cavities 21, 22 ranges from about 1.0 mm
to about 3.25 mm. The depth of first and second cavities 21, 22 can
also vary depending on the desired overall length of the collared
extenders. Since the extender system including the collar is used
in open surgery, mini-open surgery and minimally invasive surgery,
the surgeon may use the proximal end of the collar 14 positioned on
an extender to gauge whether a surgical instrument in the
passageway 12 of the intermediate cavity 23 is fully seated. That
is, the proximal end 14 of the collar 10 can be used by a surgeon
as a reference point to line up a mark on the inserted instrument
to determine whether the instrument is properly seated in the
spine.
[0032] In an embodiment, in accordance with the principles of the
present disclosure, one or both of first and second cavities has a
stop member 29 positioned at the proximal end 14 of the cavity.
Stop member 29 can be a separate insert that fits in first and/or
second cavities, or can be a protrusion or solid block configured
to contact the proximal end 32 of an extender 39 received within
the first and/or second cavities. Contact of extender 39 with stop
member 29 prevents extender 39 from extending pass the proximal end
14 of collar 10. This assures proper placement of the extenders 39
within the collar 10 and defines a reproducible overall length of
the surgical instrument having the extenders 39 positioned within
collar 10. Stop member 29 prevents extenders 39 from extending pass
the proximal end 14 of cap 10 and sliding down the extenders
39.
[0033] In one embodiment, in accordance with the principles of the
present disclosure first and second cavities 21, 22 are at least
partially separated from intermediate cavity 23 by ridges formed in
inner surface 20. That is, first cavity 21 is defined on one side
by a portion of the inner surface 20 that spans along a first side
16 and on the other side by a partial wall formed by an upper ridge
26 positioned across from lower ridge 25 on the inner surface 20.
Ridges 24, 25 together partially separate first cavity 21 from
intermediate cavity 23 and provide an area configured to receive
and retain extenders 39 in a parallel configuration. Similarly,
second cavity 22 is defined on one side by a portion of the inner
surface 20 that spans along a second side 15 and on the other side
by a partial wall formed by an upper ridge 26 positioned across
from lower ridge 27 on the inner surface 20. Ridges 26, 27 together
partially separate second cavity 22 from intermediate cavity 23 and
provide an area configured to receive and retain extenders 39 in a
parallel configuration.
[0034] In an alternative embodiment, in accordance with the
principles of the present disclosure first and second cavities 21,
22 are completely separated from intermediate cavity 23 by left and
right walls 28 extending from an upper portion of inner surface 20
to a lower portion of inner surface 20. Walls 28 completely
separate first and second cavities 21, 22 from intermediate cavity
23 and as formed first and second cavities 21, 22 are configured to
receive and retain extenders 39 so as to maintain the extenders in
a parallel orientation to one another. The width of first and
second cavities 21, 22 may vary, however in order to accommodate
the proximal ends of the extenders they must be at least as wide as
the width of extenders 39.
[0035] Body 11 includes at least one notch 30 configured to receive
at least one detent 43 located on the proximal end 32 of extenders
39. Notch 30 can be configured to extend through body 11 from the
inner surface 20 to the outer wall 19. In this configuration,
detent 43 positioned within notch 30 is visible from outer wall 19.
In an alternative embodiment, notch 30 can be configured so as to
not breach outer wall 19 of body 11. In this configuration, detent
43 is not visible from the outer wall. In either configuration, it
is envisioned that notch 30 is located in either one or each of
first and second cavities 21, 22 and are configured to mate with
detent 43 located on the proximal end 32 of extenders 39. Once the
extenders 39 are slid into first and second cavities 21, 22 the
detents 43 located on the proximal end 32 of the extenders 39 snap
into notch 30. This mating relationship retains the extenders 39
within first and second cavities 21, 22 in a parallel orientation
to one another so as to prevent splaying. Preventing splaying of
the extenders assures that the extenders 39 do not prematurely
break off from the fasteners.
[0036] Extenders 39 extend between a proximal end 32 and a distal
end 38 along longitudinal axis. It is contemplated that the
thickness of extenders 39 may be uniformly increasing or
decreasing, or have alternate diameter dimensions along
longitudinal axis. It is further contemplated that all or only a
portion of extenders 39 have a uniform width along the longitudinal
axis. In one embodiment, extenders 39 have a reduced width at the
proximal end 32 as compared to the rest of extenders 39. It is
contemplated that the transition between the two different widths
can be gradual, abrupt or can be defined by shoulder 37 that
gradually flares outwardly from the narrower width to the greater
width over a relatively short distance. The proximal end 32 of
extenders 39 having the reduced width contains first and second
tongs 36, 37 having one or more detents 43 that are, as stated
herein, configured to mate with notch 30. It is contemplated that
detent 43 can have various shapes, such as, curved, rectangular,
square, pointed, uniform or irregular shaped and protrudes away
from the surface of tongs 36, 37. The shape of detent 43 is
configured so that it snaps into notch 30 and extenders 39 are
retained within the first and second cavities.
[0037] In one embodiment, proximal end 32 contains a first tong 36
and a second tong 37 separated by a space 35. Space 35 is defined
by inner walls between first and second tongs 36, 37 and extends
distally from proximal end 32. Space 35 positioned between tong 36
and tong 37 provides a flexing area in which the tongs can extend
into when depressed towards one another. Once the force placed on
first and second tongs 36, 37 are released, the tongs naturally
spring back to their original position and space 35 is
re-established. It is contemplated that first and second cavities
21, 22 of the collar 10 are configured so that first and second
tongs 36, 37 are compressed together as the extenders are advanced
into first and second cavities 21, 22. Once detents 43 on tongs 36,
37 mate with notch 30, tongs 36, 37 snap back to their original
position releasably locking the extenders 39 to the collar 10.
[0038] In one embodiment, the cross section of first and second
cavities 21, 22 gradually tapers from the distal end 13 to the
proximal end 14 so that when extender 39 is advanced into first and
second cavities 21, 22, detents 43 on first and second tongs ride
along the inner surface and are gradually compressed towards each
other. Once detents 43 come in contact with notches 30 they snap
into notches 30 and first and second tongs 36, 37 flex back towards
their original position and extenders 39 are locked in place.
Pulling the collar 10 away from the distal end of the extenders
causes the detents to release from the notches 30 and disconnects
collar 10 from the extenders. That is, by pulling collar 10 away
from the extenders or by directly depressing detents 43 inwardly,
detents 43 release from notches 30 and the extenders can be
disconnected from the collar 10. Once disconnected, the extenders
39 can be removed from the patient one by one, sterilized and used
again or discarded.
[0039] It is contemplated that collar 10 can include a quick
release system that facilitates release of the collar 10 from
extenders 39. In one embodiment, the quick release system includes
a first actuator arm 70 and a second actuator arm 71 that are each
attached to outside surface 19 of collar 10 at one end 72 and have
a contact surface configured to contact detent 43 at an opposite
end 71. Each actuator arm is flexible and can move from a first
position to a second position such that in the first position the
contact end 71 is not engaged with detent 43 and in a second
position contact end 71 comes in contact with the detents 43.
Actuator arms 70, 71 move from the first position to the second
position by compressing each actuator arm inwardly towards the
outer surface 19 of collar 10 so that contact end 71 comes in
contact with detents 43 extending to the outside surface of the
collar. Once detents 43 are pushed back out of notches 30 and the
compression force exerted on each arm is released, the arms return
back to their original position and collar 10 can be detached from
extenders 39. It is contemplated that the thickness of actuator
arms 70, 71 may be uniformly increasing or decreasing, or have
alternate diameter dimensions along the longitudinal axis. It is
further contemplated that all or only a portion of the surfaces of
contact end 71 may have alternate surface configurations, such as,
for example, those alternatives described herein. It is envisioned
that actuator arms 70 may have alternate cross section
configurations, such as, for example, oval, oblong, triangular,
rectangular, square, polygonal, irregular, uniform, non-uniform,
variable and/or tapered.
[0040] It is also contemplated that detents 43 can be color coated
so that once they are snapped into notches 30 that extend to the
outside surface, the color coated detents 43 are readably visible
from the outside surface. This would allow a surgeon to quickly
confirm that the detents are positioned within the notches and that
the collar is properly seated on the extenders 39. The color used
to coat the detents should contrast the color of the outside
surface of the collar so that it is easily noticed from the outside
surface.
[0041] Collar 10 has a top surface 17 at the proximal end 14 and a
bottom surface 18 located at the distal end 13. The top surface 17
is configured to seat instruments used with the collared extender
system. It is contemplated that the top surface 17 can be flat as
shown in FIG. 1 or can be configured to align and lock an
instrument that is used with the collared extender system, such as
a rod measuring device, in place. This seating assures alignment of
the instrument in the intermediate cavity of the collar and the
inner cavity of the extenders and acts as a stop so as to indicate
that the instrument is fully seated in the surgical site. The top
surface 17 can also act as a marking point that when aligned with
markings on the instrument being advanced indicates proper seating
of the instrument. For example, if a mark on an instrument being
advanced is not visible over the top surface 17 of the collar, it
is not properly seated and the surgeon will have to adjust the
instrument until the marking becomes visible.
[0042] It is contemplated that a kit including the collar 10 and
extenders 39 described herein is provided. The kit includes a
collar 10 configured for connection to a proximal end of an
extender and at least two extenders extending between a proximal
end and a distal end along a longitudinal axis. The kit also
includes hardware to be used with the extender system and may
include instruments used with the system. The first and second
extenders in accordance with the disclosure are configured so as to
form an inner cavity along the longitudinal axis with openings at
the proximal and distal ends when assembled. The distal ends of the
extenders are configured to attach to anchors engageable to a
spinal column of a patient and the kit includes such anchors. As
stated herein hardware and implants that can be implanted into the
spine in a procedure using the extender assembly described herein
are also included. Examples of implants that can be included in the
kit are selected from the group consisting of bone fasteners,
screws, and capped rods as well other fasteners, implants and
hardware for use with the assembly. It is also contemplated that
the kit may include particular instruments that are used with the
assembly such as screwdrivers, MAS screwdrivers, breakaway
screwdrivers, rod measuring devices, as well as, other instruments
that can be used with the assembly. The kit can be provided in a
sterilized package ready fro use or can be in an autoclavable
packaging to be sterilized prior to using the kit in surgery.
[0043] In operation, collar 10 is manipulated so that first and
second cavities 21, 22 are positioned on the proximal portion of
extenders 39. As collar 10 is advanced onto the extenders 39, tongs
36, 37 contact the inner surface 20 of first and second cavities
21, 23 and ride along the inner surface flexing inwardly towards
each other. When detents 43 reach notches 30 in the inner surface
20 of first and second cavities 21, 22, the detents snap into place
as the tongs 36, 37 return back to their original configuration.
The collar 10 is then attached to the extenders 39 and the
extenders are secured in a parallel orientation. Retaining the
extenders parallel to one another prevents splaying which can lead
to premature break away of the extenders from the spine. Once the
procedure is completed and the extenders need to be removed, the
collar can be removed by pulling the collar away from the extenders
so that detents 43 release from notches 30 and the collar 10 can be
slipped off of the extenders 39. It is also contemplated that the
collar can remain on the extenders and the entire extender system
can be removed with the collar attached.
[0044] As shown in FIGS. 10-14 different instruments can be used
with the collar-extender assembly. A completed collar-extender
assembly can be used to place a screw advanced down the inner
cavity of the extenders and into the spine of a patient. A
screwdriver 50 can be aligned within the inner cavity so as to
advance the screw into the spine. Collar 10 aids in keeping the
assembly aligned and the extenders from splaying as the screw is
advanced. This feature is especially useful when the
collar-extender assembly is used with a rod-measuring device 51 as
shown in FIG. 13.
[0045] As shown in FIG. 13, the inserted rod-measuring device 51 is
equipped with a shoulder 53 that abuts the top surface 17 of the
proximal end of the collar 10. Here, the collar 10 not only keeps
everything in alignment but also serves as a stop that indicates to
the surgeon that the rod-measuring device is fully seated into the
implants. The top surface 17 of collar 10 can also be used as a
reference point for the surgeon when using instruments that do not
have a shoulder to abut the collar but instead is equipped with
markings on the device indicating the depth in which the instrument
is inserted. When a marked instrument is used with the extender
assembly of the present disclosure the surgeon can advance the
instrument, such as a break-off set screw driver, into the inner
cavity of the collar-extender assembly and when the line marked on
the instrument is visible over or aligned with the proximal end of
the collar, the device is fully seated. If the line on the device
is not visible in relation to the proximal surface of the collar,
then the device is fully seated. In this situation the collar not
only keeps everything aligned but also serves as a reference point
to align markers on instruments used with the extender
assembly.
[0046] The collar-extender assembly can also be used to place
implants into the spine of a patient. For example, as shown in FIG.
14, a capped rod 60 having capped ends 61 is positioned within the
inner cavity of the extenders and is advanced towards the spine.
The collar keeps the extenders parallel to one another as the
implant is advanced so that the extenders serve as guide rails
preventing the capped rod from coming out of the extenders as it is
advanced. The collar-extender assembly also prevents splaying as
the rod is advanced towards the spine thereby preventing premature
splaying. It is contemplated that other surgical instruments can be
used with the collar-extender assembly disclosed herein and the
collar may serve additional roles in improving use of the
instrument over assemblies without a collar.
[0047] In assembly, operation and use, the collar and
collar-extender assembly is employed with a surgical procedure, in
accordance with the principles of the present disclosure, for
treatment of a spinal disorder affecting a section of a spine of a
patient, as discussed herein. The collar-extender assembly is
employed with a surgical procedure for treatment of a condition or
injury of an affected section of the spine including cervical,
thoracic, lumbar and pelvis regions of the spine.
[0048] In use, to treat the affected section of the spine, a
medical practitioner obtains access to a surgical site in any
appropriate manner, such as through incision and retraction of
tissues in an open or mini-open surgical technique. It is
envisioned that the collar-extender assembly may be used in any
existing surgical method or technique including open surgery,
mini-open surgery and minimally invasive surgery, whereby the
spinal region is accessed through a micro-incision, or sleeve that
provides a protected passageway to the area. Once access to the
surgical site is obtained, the particular surgical procedure is
performed for treating the spinal disorder.
[0049] It will be understood that various modifications may be made
to the embodiments disclosed herein. Therefore, the above
description should not be construed as limiting, but merely as
exemplification of the various embodiments. Those skilled in the
art will envision other modifications within the scope and spirit
of the claims appended hereto.
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