U.S. patent application number 14/853774 was filed with the patent office on 2016-08-18 for minimally invasive surgical tower access devices and related methods.
The applicant listed for this patent is Spinal USA, Inc.. Invention is credited to John Franklin Cummins, John Lawrence Walker.
Application Number | 20160235450 14/853774 |
Document ID | / |
Family ID | 45494233 |
Filed Date | 2016-08-18 |
United States Patent
Application |
20160235450 |
Kind Code |
A1 |
Walker; John Lawrence ; et
al. |
August 18, 2016 |
MINIMALLY INVASIVE SURGICAL TOWER ACCESS DEVICES AND RELATED
METHODS
Abstract
Devices and methods are provided for assisting in spinal
stabilization. An access device is provided that includes an outer
sleeve, inner sleeve, spring latch and lock nut. The inner sleeve
includes compressible grasping elements. The access device can be
coupled to a screw head by sliding the outer sleeve relative to the
inner sleeve and compressing the grasping elements. The coupled
access device and screw can then be delivered to a target location
in a patient. After providing two or more access devices, a rod
member can be delivered using a rod insertion device. The rod
member can serve as a connection between the two screws, and can
provide spinal stabilization. An anti-torque device and a
persuading device can be used to help ensure that the rod member is
placed and secured in a proper location within a patient.
Inventors: |
Walker; John Lawrence;
(Madison, MS) ; Cummins; John Franklin;
(Kosciusko, MS) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Spinal USA, Inc. |
Parsippany |
NJ |
US |
|
|
Family ID: |
45494233 |
Appl. No.: |
14/853774 |
Filed: |
September 14, 2015 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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14097595 |
Dec 5, 2013 |
9220543 |
|
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14853774 |
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|
12843839 |
Jul 26, 2010 |
8603094 |
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14097595 |
|
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 2017/349 20130101;
A61B 17/0218 20130101; A61B 17/708 20130101; A61B 17/3423 20130101;
A61B 17/8875 20130101; A61B 17/7001 20130101; A61B 2090/031
20160201; A61B 17/7086 20130101; A61B 2017/347 20130101; A61B
17/7083 20130101; A61B 17/86 20130101; A61B 2017/564 20130101; A61B
17/7091 20130101 |
International
Class: |
A61B 17/70 20060101
A61B017/70; A61B 17/86 20060101 A61B017/86; A61B 17/88 20060101
A61B017/88; A61B 17/34 20060101 A61B017/34; A61B 17/02 20060101
A61B017/02 |
Claims
1. (canceled)
2. A system for spinal stabilization, comprising: an access device
comprising a proximal section and a distal section, wherein the
proximal section comprises a threaded portion and the distal
section is configured to grasp a screw; an anti-torque device, the
anti-torque device including a handle connected to a cannula
configured to be placed over the access device; and a persuader
device having a hollow interior and internal threads, wherein the
persuader device is configured to be threaded onto the threaded
portion of the access device such that the persuader device is in
contact with the anti-torque device in use; wherein the anti-torque
device is configured to be forced against a rod member configured
to be positioned in the screw by the persuader device in use,
wherein the persuader device and the anti-torque device are
configured to move distally relative to the access device.
3. The system of claim 2, wherein the access device comprises an
inner sleeve and an outer sleeve and relative movement between the
inner and outer sleeves causes the distal section of the access
device to grasp the screw in use.
4. The system of claim 3, wherein the distal section of the access
device comprises two compressible grasping elements configured to
grasp the screw.
5. The system of claim 4, wherein the grasping elements comprise
one or more longitudinal slits configured to enhance
compressibility of the grasping elements.
6. The system of claim 5, wherein each grasping element comprises
two longitudinal slits extending from a distal end of the distal
section of the access device toward a proximal end such that each
grasping element is divided into three sections.
7. The system of claim 3, wherein the outer sleeve is configured to
slidably receive the inner sleeve.
8. The system of claim 4, wherein when the inner sleeve is slidably
received within the outer sleeve, distal movement of the outer
sleeve relative to the elongate sleeve causes compression of the
grasping elements.
9. The system of claim 3, comprising a lock nut having internal
threads, wherein the lock nut is configured to be threaded onto the
threaded portion of the access device to cause relative movement
between the inner sleeve and the outer sleeve in use.
10. The system of claim 2, wherein the persuader device includes a
handle.
11. The system of claim 2, wherein the cannula includes a side slot
for engaging the rod member.
12. The system of claim 2, wherein the persuader device includes
rod engaging members.
13. A method of spinal stabilization, comprising: providing an
access device comprising an elongate sleeve having a proximal
section and a distal section, the proximal section includes a
threaded portion, the distal section includes a slot, wherein the
slot extends from a distal end toward a proximal end of the
elongate sleeve, wherein the slot is configured to allow passage of
a rod member therethrough; grasping a screw with a distal end of
the elongate sleeve; positioning a cannula of an anti-torque device
over the access device, wherein a distal end of the cannula
includes a side slot for engaging the rod member; and positioning a
persuader device such that internal threads of the persuader device
engage the threaded portion of the access device, and such that the
persuader device is in contact with the anti-torque device; and
rotating the persuader device relative to the anti-torque device
and the access device to apply a downward force on the anti-torque
device.
14. The method of claim 13, wherein the access device comprises an
outer sleeve and relative movement between the elongate sleeve and
the outer sleeve causes the distal section of the access device to
grasp the screw.
15. The method of claim 14, comprising placing the cannula of the
anti-torque device over the outer sleeve.
16. The method of claim 15, further comprising: providing a lock
nut having internal threads; and threading the lock nut onto the
threaded portion of the elongate sleeve to cause relative movement
between the elongate sleeve and the outer sleeve.
17. The method of claim 13, wherein the persuader device forces a
rod member into a desired position with rod engaging members.
18. The method of claim 13, wherein the persuader device includes a
handle.
19. The method of claim 13, comprising placing the persuader device
within an interior of the elongate sleeve to force the rod member
into a seat of a head of the screw.
Description
[0001] INCORPORATION BY REFERENCE TO ANY PRIORITY APPLICATIONS
[0002] Any and all applications for which a foreign or domestic
priority claim is identified in the Application Data Sheet as filed
with the present application are hereby incorporated by reference
under 37 CFR 1.57. This application is a continuation of U.S.
application Ser. No. 14/097,595, filed Dec. 5, 2013, which is a
divisional application of U.S. application Ser. No. 12/843,839,
filed Jul. 26, 2010, the entireties of which are incorporated by
reference herein.
BACKGROUND OF THE INVENTION
[0003] 1. Field of the Invention
[0004] The present application relates to devices and methods for
providing spinal stabilization. In particular, the present
application relates to minimally invasive devices and methods for
delivering fixation devices and implants into a spine.
[0005] 2. Description of the Related Art
[0006] Spinal bone degeneration can occur due to trauma, disease or
aging. Such degeneration can cause abnormal positioning and motion
of the vertebrae, which can subject nerves that pass between
vertebral bodies to pressure, thereby causing pain and possible
nerve damage to a patient. In order to alleviate the pain caused by
bone degeneration, it is often helpful to maintain the natural
spacing between vertebrae to reduce the pressure applied to nerves
that pass between vertebral bodies.
[0007] To maintain the natural spacing between vertebrae, spinal
stabilization devices are often provided to promote spinal
stability. These spinal stabilization devices can include fixation
devices, such as spinal screws, which are implanted into vertebral
bone. The fixation devices work in conjunction with other implanted
members, such as rod members, to form stabilization systems.
[0008] Conventional stabilization systems often require open
surgeries and other invasive procedures in order to deliver the
implants into the body. These invasive procedures often cause a
great deal of pain and trauma to the patient, and require a
substantial recovery time. Thus, there exists a need for minimally
invasive devices and methods that can assist in providing spinal
stabilization.
SUMMARY OF SOME EMBODIMENTS
[0009] Devices and methods are provided for assisting in spinal
stabilization. In some embodiments, a system for spinal
stabilization is provided. The system comprises a percutaneous
access device including an outer sleeve having a proximal slot and
a distal slot. The access device also includes an inner sleeve
having a proximal section and a distal section, the proximal
section being operably connected to a spring latch having a tab
member and including a threaded portion, the distal section
including a slot and a pair of compressible grasping elements, each
of the grasping elements including slits, an internal tapered
surface, and an internal protruding member capable of being
received in an aperture in a head of a screw member, wherein the
inner sleeve is configured to be slidably received into the outer
sleeve such that the spring latch is located within the proximal
slot of the outer sleeve and the slot of the inner sleeve is
aligned with the distal slot of the outer sleeve. In addition, the
access device can include a lock nut having an internal engagement
surface for engaging the threaded portion of the inner sleeve,
wherein placement of the lock nut at a bottom section of the
threaded portion of the inner sleeve results in compression of the
grasping elements, and wherein the internal engagement surface is
configured to interact with the tab member via depressions to limit
counter rotation of the lock nut during use.
[0010] The system can also include a cannulated screw member that
is attachable to the inner sleeve. The cannulated screw member
comprises a head portion coupled to a shaft, wherein the head
portion includes a seat for receiving a rod implant, one or more
apertures for receiving an internal protruding member of the inner
sleeve, and at least one slot for interacting with the internal
tapered surface of the inner sleeve. A screw driver for rotating
and driving the screw member into bone can also be provided, as
well as a rod insertion device including a handle and a distal
gripping end for gripping and delivering a rod member.
[0011] The system can also include an anti-torque device including
a handle connected to a cannula, wherein the cannula is configured
to be placed over the outer sleeve, and wherein the cannula
includes a side slot for engaging the rod member. A persuader
device including internal threads can also be provided that can
interact with the anti-torque device and assist in forcing the rod
member into the seat of the screw member.
[0012] In other embodiments, an alternative spinal stabilization
system is provided. The system comprises an outer sleeve having a
distal slot. The system also comprises an inner sleeve having a
proximal section and a distal section, the proximal section
including a threaded portion, the distal section including a slot
and a pair of compressible grasping elements, each of the grasping
elements including an internal protruding member. The inner sleeve
can be configured to be slidably received into the outer sleeve
such that the slot of the inner sleeve is aligned with the distal
slot of the outer sleeve, and wherein sliding the outer sleeve
relative to the inner sleeve actuates compression of the grasping
elements of the inner sleeve.
[0013] In other embodiments, a method of spinal stabilization is
provided. A first access device can be provided that includes a
first outer sleeve and a first inner sleeve, wherein the first
inner sleeve includes a pair of compressible grasping elements
actuated by sliding the first inner sleeve relative to the first
outer sleeve. A first screw member can be provided within the first
pair of compressible grasping elements. The first pair of
compressible grasping elements can be compressed to couple the
first access device to the first screw member. The first access
device and first screw member can be delivered to a first location
within a patient. The first screw member can be inserted into a
first bone member of the patient. A second access device can be
provided that includes a second outer sleeve and a second inner
sleeve, wherein the second inner sleeve includes a pair of
compressible grasping elements actuated by sliding the second inner
sleeve relative to the second outer sleeve. A second screw member
can be provided within the second pair of compressible grasping
elements. The second pair of compressible grasping elements can be
compressed to couple the second access deice to the second screw
member. The second access device and second screw member can be
delivered to a second location within a patient. The second screw
member can be inserted into a second bone member of the patient. A
rod member can be delivered to connect between the first screw
member and second screw member.
BRIEF DESCRIPTION OF THE DRAWINGS
[0014] FIG. 1 illustrates a side view of an assembled minimally
invasive tower access device according to embodiments of the
present application.
[0015] FIG. 2 illustrates an exploded view of different components
of the tower access device of FIG. 1 according to embodiments of
the present application.
[0016] FIGS. 3A-3G illustrate several views of an outer sleeve
member according to embodiments of the present application.
[0017] FIGS. 4A-4G illustrate several views of an inner sleeve
member according to embodiments of the present application.
[0018] FIGS. 5A-5G illustrate several views of a spring latch
member according to embodiments of the present application.
[0019] FIGS. 6A-6E illustrate several views of a lock nut according
to embodiments of the present application.
[0020] FIGS. 7A-7D illustrate several views of a screw member for
using with a spring latch according to embodiments of the present
application.
[0021] FIGS. 8A-8G illustrate a procedure for assembling and
operating a tower device according to embodiments of the present
application.
[0022] FIGS. 9A and 9B illustrate a rod insertion device according
to embodiments of the present application.
[0023] FIGS. 10A and 10B illustrate a rod persuader device and
anti-torque device in use according to embodiments of the present
application.
[0024] FIGS. 11A-11G illustrate different views of an anti-torque
device according to embodiments of the present application.
[0025] FIGS. 12A and 12B illustrate different views of a rod
persuader device according to embodiments of the present
application.
[0026] FIGS. 13A-13C illustrate a break-away screw delivery device
according to embodiments of the present application.
[0027] FIGS. 14A-14H illustrate different views a persuader system
according to embodiments of the present application.
DETAILED DESCRIPTION OF EMBODIMENTS
[0028] The present application relates to minimally invasive
devices and methods for assisting in the delivery of fixation
devices and other implants in a patient. While the minimally
invasive devices described herein can be used to assist various
treatments, in some embodiments, they are used to assist in
delivering fixation devices and other implants to help stabilize
the spine.
[0029] In some embodiments, a minimally invasive tower access
device is provided. The access device includes an outer sleeve and
an inner sleeve that telescopingly or slidably engage with one
another. The inner sleeve includes one or more grasping elements
that can grasp a fixation device (e.g., a pedicle screw) for
delivery into a bone member of a spine. Once the access device is
coupled to the spinal screw, the access device and spinal screw can
be delivered either through an incision in an open surgery, or
minimally invasively through a relatively smaller incision, such as
percutaneously. Once through the incision, the spinal screw can be
brought to a location proximate to a bone member where it can be
inserted. The access device can serve as a portal or opening that
extends from the bone member to outside of the patient. Instruments
can be delivered through the access device. For example, a screw
driver can be provided through the access device to secure the
spinal screw to the bone member. In addition, implants can be
delivered adjacent the side of the access device. For example, a
rod implant can be delivered along the side of the access device
which can connect in between the implanted screws. By using one or
more access devices to deliver screws or other implants as
described herein, a spinal stabilization system can be formed. The
one or more access devices advantageously allow screws and other
implants to be inserted in a specific location with ease, and allow
for a surgeon to comfortably maintain external control of the screw
from outside of a patient's body.
[0030] A number of additional instruments can be used with the
access device to provide spinal stabilization. Among the
instruments that can be used include a screw driver, a rod
insertion device, an anti-torque device, and a rod persuader
device. These instruments, as well as the access device, will be
discussed in greater detail below.
Minimally Invasive Tower Access Device
[0031] FIG. 1 illustrates a side view of an assembled minimally
invasive tower access device according to embodiments of the
present application. The access device 5 includes an elongated
outer sleeve 21 and an elongated inner sleeve 22 that are slidably
engaged with each other. The access device 5 also includes a spring
latch 60 (shown in FIGS. 2 and 5). A lock nut 80 is also provided
that engages with a threaded portion of the inner sleeve 22. When
all of the components are assembled as shown in FIG. 1, they form
an access device 5 that can couple to a fixation device, such as a
screw. The coupled access device and screw can be delivered to a
target location of a patient. In some embodiments, the access
device and screw member are delivered percutaneously.
[0032] FIG. 2 illustrates an exploded view of different components
(e.g., the outer sleeve, inner sleeve, and lock nut) of the tower
access device of FIG. 1 according to embodiments of the present
application. Each of these components will be discussed in greater
detail below.
[0033] FIGS. 3A-3G illustrate several views of an outer sleeve
member 21 according to embodiments of the present application. The
outer sleeve 21 includes two slots, a proximal slot 27 and a distal
slot 28. In other embodiments, the outer sleeve 21 can have a
single distal slot. Within the outer sleeve member 21 is a hollow
cylindrical body through which an inner sleeve can be received.
[0034] The proximal slot 27 and distal slot 28 are formed on
opposite ends of the outer sleeve 21--the proximal slot 27 is
formed on a proximal end of the outer sleeve 21 while the distal
slot 28 is formed on a distal end of the outer sleeve 21. As used
herein, the term "proximal end" refers to the end of the access
device that is closer to the end exposed during surgery, while the
term "distal end" refers to the end of the access device that is
closer to a target location within a patient for delivering a
fixation device or implant. While both the proximal slot 27 and the
distal slot 28 are formed along an edge of the outer sleeve 21, in
some embodiments, either one or both slots can be formed within the
body of the outer sleeve 21 instead of along an edge.
[0035] In some embodiments, the proximal slot 27 opens along one
side of the outer sleeve 21, while the distal slot 28 opens along
two sides of the outer sleeve 21 (as shown in FIG. 3A). The
proximal slot 27 can be located in between the two openings that
form the distal slot 28. While a center longitudinal axis of the
proximal slot 27 is shown at about a 90 degree angle from the a
center longitudinal axis of the distal slot 28, the proximal slot
27 can be located at any angle relative to the openings of the
distal slot 28, such as between 0 and 90 degrees. While the
proximal slot 27 is smaller in both width and length than the
distal slot 28 in the illustrated embodiment, the two slots need
not be limited to these relative dimensions.
[0036] Both the proximal slot 27 and the distal slot 28 of the
outer sleeve 21 can serve particular functions. In some
embodiments, the proximal slot 27 can serve to receive the spring
latch 60, which can be fixed to the inner sleeve 22. The proximal
slot 27 can work in conjunction with the spring latch 60 to
identify the current mode of operation of the access device 5
(e.g., "locked" or "unlocked" mode) as best shown in FIG. 8E. The
spring latch 60 can include a marker 69 (shown in FIG. 8E) that can
help identify the particular mode of operation. The different modes
of operation will be discussed below. With the spring latch 60, the
mode of operation of the access device will be easily visible to
the surgeon. In addition, having the proximal slot 27 work in
conjunction with the spring latch 60 advantageously allows for
proper placement of the outer sleeve 21 relative to the inner
sleeve 22, such that they can have aligning distal slots when the
spring latch 60 is inserted in the proximal slot 27 of the outer
sleeve.
[0037] In some embodiments, the distal slot 28 can serve to receive
one or more stabilization implants therethrough. For example, in
some embodiments, a stabilizing rod member can be delivered along
the side of the access device 5 and angled through the distal slot
28. Once the rod member is angled through the distal slot 28, it
can be forced downward onto the head of the screw. Then, one end of
the rod member can be fixed to a first screw, while the second end
of the rod member is fixed to a second screw, thereby providing
spinal stabilization.
[0038] The distal slot 28 of the outer sleeve 21 can have a length
between 4 cm and 8 cm, or a length between 6 cm and 7 cm. In some
embodiments, the length of the distal slot 28 is much longer (e.g.,
at least 5.5 cm) than slots in conventional access devices. In some
embodiments, the length of the distal slot 28 of the outer sleeve
21 is between 1/3 and 3/4, or approximately 1/2 in some instances,
the length of the entire body of the outer sleeve. In some
embodiments, as shown in FIGS. 8H'-8J', the distal slot 28 of the
outer sleeve can be even longer, and can extend almost the entire
length of the outer sleeve 21. The advantage of the longer slot is
that a rod implant can be more easily delivered through the slot to
provide spinal stabilization. In addition, providing a longer slot
length makes the instrument lighter by removing material from the
system. A challenge, however, is that with the longer slot, the
sidewalls that form the slot may need to be stronger in order to
withstand forces on the sidewalls in some embodiments. Accordingly,
in some embodiments, the thickness of the sidewalls that form the
longer distal slot 28 of the outer sleeve 21 is preferably
increased relative to conventional sleeves to withstand forces on
the sidewalls. In some embodiments, the thickness of the sidewalls
that form the longer distal slot 28 is between about 0.05 cm and
0.4 cm, or between about 0.2 cm and 0.3 cm.
[0039] FIGS. 4A-4G illustrate several views of an inner sleeve
member 22 according to embodiments of the present application. The
inner sleeve 21 includes a proximal section 31 and a distal section
33. The distal section 33 includes a distal slot 23 and a pair of
grasping elements 38. The inner sleeve 22 can be slidably received
within the outer sleeve 21, and in some embodiments, can be secured
in a position relative to the outer sleeve 21 by using the lock nut
80. Like the outer sleeve 21, the inner sleeve 22 includes a hollow
cylindrical body. In some embodiments, the inner sleeve has an
interior diameter of between about 0.5 cm and 2 cm, or between
about 1.0 cm and 1.1 cm.
[0040] In some embodiments, the proximal section 31 of the inner
sleeve 22 includes an exposed threaded portion 34, as shown in FIG.
1. A lock nut 80 having internal threads can engage with the
exposed threaded portion 34 of the inner sleeve. By rotating the
lock nut 80 in a clockwise direction until it is at a bottom
section of the exposed threaded portion 34, the outer sleeve 21 can
be secured with the inner sleeve 22 in a "locked" mode in which the
compressible grasping elements 38 of the inner sleeve 21 are
compressed (discussed below).
[0041] Below the proximal section 31 of the inner sleeve 22 is the
distal section 33 including a distal slot 23 and compressible
grasping elements 38. Like the distal slot 28 of the outer sleeve
21, the distal slot 23 of the inner sleeve 22 can open on two sides
of the inner sleeve 22. In some embodiments, the distal slot 23 of
the inner sleeve 22 is approximately the same size (e.g., similar
width and height) of the distal slot 28 of the outer sleeve 21. One
skilled in the art will appreciate that the dimensions of both the
distal slot 28 of the outer sleeve 21 and slot 23 of the inner
sleeve 22 can vary with respect to one another. The distal slot 23
of the inner sleeve 22 can be placed in part or in complete
alignment with the distal slot 28 of the outer sleeve 21. In some
embodiments, when the distal slot 23 of the inner sleeve 22 is
aligned with the distal slot 28 of the outer sleeve 21, a rod
implant that is delivered into the patient can pass through both of
the slots. The rod implant can be angled through the slots such
that each end of the rod implant makes contact with a screw head
within the access device.
[0042] The distal slot 23 of the inner sleeve 22 can have a length
between about 4.0 cm and 8.0 cm, or between about 6.0 cm and 7.0
cm. In some embodiments, the length of the distal slot 23 is much
longer (e.g., at least 5.5 cm) than slots in conventional access
devices. In some embodiments, the length of the distal slot 23 of
the inner sleeve 22 is between 1/3 and 3/4, or approximately 1/2 in
some instances, the length of a non-threaded body of the inner
sleeve 22.
[0043] In some embodiments, the pair of grasping elements 38
comprise a pair of compressible arms or tines for receiving a screw
head, as shown in FIG. 4A. One skilled in the art will appreciate
that the shape of the grasping elements 38 need not be limited to
the description described herein. In some embodiments, the distance
from one grasping element to another is slightly greater than the
diameter of the hollow interior of the outer sleeve 21 in an
uncompressed state. In these embodiments, in order for the inner
sleeve 22 to be received through the proximal end of the outer
sleeve 21, the grasping elements 38 should be slightly compressed.
When the grasping elements 38 exit the distal end of the outer
sleeve 21, the grasping elements 38 can return to their
uncompressed state, thereby advantageously helping to secure the
inner sleeve 22 to the outer sleeve 21 by limiting the inner sleeve
22 from unintentionally backing out of the outer sleeve 21.
[0044] In some embodiments, the grasping elements 38 are flat,
while in other embodiments (as shown in FIG. 4A), the grasping
elements 38 can include some curvature so as to accommodate a screw
head of a particular shape. In some embodiments, the grasping
elements 38 include protruding members 45 that can be received in
an aperture of the screw head to secure the screw to the inner
sleeve. The protruding members 45 can be rigid or somewhat
flexible, and are configured to be inserted into two or more holes
or apertures formed on the head of a screw upon compression of the
grasping elements 38 of the inner sleeve 22. While the protruding
members 45 can have a smooth surface finish, in some embodiments,
the protruding members 45 have a roughened surface finish that can
provide a frictional force between the protruding members 45 and
surfaces of the screw head that form the receiving apertures 45.
The protruding members 45 can have a cross-sectional area that is
circular, rectangular, trapezoidal or any other shape, so long as
they are securely receivable in a corresponding aperture of the
head of the screw. In some embodiments, rather than have protruding
members that resemble pins, the inner sleeve 22 can include flanges
that extend from a bottom surface of the distal end of the inner
sleeve 22. The flanges can be compressible such that when
compressed, the flanges surround and secure a portion of the head
of the screw (such as a bottom portion), thereby coupling the inner
sleeve 22 to the screw.
[0045] In some embodiments, the compressible grasping elements 38
of the inner sleeve 22 also include an internal surface 47 (shown
in FIG. 4A) for engaging a slot on the screw head. The purpose of
the internal surface 47 is to absorb axial force that is
transferred to the grasping elements 38 of the inner sleeve 22 from
the screw head when the screw head is under compression. The
internal surface 47 can engage one or more slots located on the
screw head, and can comprise a substantially triangular tapered
surface proximal from the protruding member 45. In some
embodiments, the substantially triangular tapered surface 47 can be
located below a ledge 49 that forms an indentation in the interior
of the grasping elements 38. The ledge 49 can advantageously
provide a surface for the screw to stop against once the screw is
inserted to its proper depth within the inner sleeve 22.
[0046] In some embodiments, the grasping elements 38 include
optional slits 41, which advantageously assist to provide
compressibility to the grasping elements 38. The compressibility of
the grasping elements 38 is advantageous as it allows the inner
sleeve to be received in the outer sleeve, and also helps the
grasping elements 38 to couple with a screw head. As shown in FIG.
4A, in some embodiments, each of the grasping elements 38 can
include a pair of slits 41 such that each grasping element is
divided into three sections--two side sections and a middle
section. In these embodiments, the middle section can include a
protruding member 45 and internal tapered surface 47, as discussed
above.
[0047] The inner sleeve 22 can be slidably received in the outer
sleeve 21 such that the grasping elements 38 of the inner sleeve 22
can extend beyond the distal end of the outer sleeve 21. In some
embodiments, the inner sleeve 22 can be slidably received in the
outer sleeve 21 such that in a first position, the grasping
elements 38 are uncompressed. Sliding the inner sleeve 22 relative
to the outer sleeve 21 in a second position can result in
compression of the grasping elements 38. For example, the outer
sleeve 21 can be slid down the inner sleeve 22 such that a bottom
of the outer sleeve 21 helps to compress the grasping elements 38.
In some embodiments, the outer sleeve 21 can completely cover the
grasping elements 38 to compress the grasping elements, while in
other embodiments, the outer sleeve 21 only covers a portion of the
grasping elements 38 to result in compression. The compression
mechanism provided by the outer sleeve 21 sliding over the
compressible grasping elements 38 of the inner sleeve 21 is
advantageous over conventional screw delivery devices, as the body
of the outer sleeve 21 helps to reduce the risk of the protruding
members 45 becoming accidentally loose from the head of the screw.
Moreover, having a slidably engaged outer sleeve 21 and inner
sleeve 22 reduces the need for extra tools that might be used in
conventional screw delivery devices for securing an access device
to a screw member. In some embodiments, the inner sleeve 22 and
outer sleeve 21 can work in conjunction with a lock nut 80 to
secure the inner sleeve 22 and outer sleeve 21 in a position such
that the grasping elements are compressed. The inner sleeve 22 and
outer sleeve 21 can also work in conjunction with a spring latch
60.
[0048] FIGS. 5A-5G illustrate several views of a spring latch
member 60 according to embodiments of the present application. The
spring latch 60 includes an upper raised surface 64 and a lower
raised surface 66, as well as a tab member 68 extending from a
proximal end. The spring latch 60 can also include holes 76 for
receiving one or more fixation members (e.g., screws) for attaching
the spring latch 60 to the inner sleeve 22.
[0049] In some embodiments, and as shown in FIG. 8E, the spring
latch 60 can be attached to the inner sleeve 22. The spring latch
60 can serve multiple functions. In some embodiments, the spring
latch 60 (when fixed to the inner sleeve 22) can fit within the
proximal slot 27 of the outer sleeve 21 and can serve to identify
the current mode of operation of the access device 5 when the inner
sleeve 22 and outer sleeve 21 are slid relative to one another. For
example, the spring latch 60 can include a marker that can identify
when the outer sleeve and inner sleeve are in an "unlocked"
position in which the two sleeves remain slidable relative to one
another. Or the spring latch 60 can identify when the outer sleeve
and inner sleeve are in a "locked" position in which the two
sleeves are secured in a position with the lock nut 80. In
addition, the spring latch 60 can advantageously help to ensure
that the inner sleeve 22 and outer sleeve 21 are in proper
alignment, by having the spring latch 60 fit within the proximal
slot 27 of the outer sleeve 21.
[0050] In some embodiments, the tab member 68 of the spring latch
can interact with lock nut 80 when the lock nut 80 is rotated to a
distal section of the external threaded portion 34 of the inner
sleeve. For example, the tab member 68 can interact with an inner
engagement surface 83 (e.g., one or more depressions 88 as shown in
FIG. 6B) of the lock nut 80. By fitting in one of the depressions
88, the tab member 68 can advantageously limit unintentional
counter or back rotation of the lock nut 80 when in use.
[0051] FIGS. 6A-6E illustrate several views of a lock nut 80
according to embodiments of the present application. The lock nut
80 includes an inner engagement surface 83 that can engage the
external threaded portion of the inner sleeve 22. In some
embodiments, the inner engagement surface 83 comprises a threaded
portion (not shown) that complements the external threads of the
inner sleeve 22. In some embodiments, the inner engagement surface
83 can also include a series of depressions 88 for interacting with
the tab member 68 of the spring latch 60. When the lock nut 80 is
placed in a downward section of the threaded portion of the inner
sleeve 22 fixed to a spring latch 60, a tab member 68 of the spring
latch can interact and fit into one of the depressions 88, thereby
advantageously limiting unintentional back or counter-clockwise
rotation of the lock nut 80. On the exterior of the lock nut 80, a
knurled surface is advantageously provided for easy grasping during
use.
[0052] The lock nut 80 can be used to secure the inner sleeve 22
and outer sleeve 21 in a locked mode by adjusting the lock nut 80
in a clockwise direction down the threaded portion of the inner
sleeve 22 until it can no longer turn clockwise. In the locked
mode, the inner sleeve 22 is secured in position with the outer
sleeve 21, and the grasping elements 38 of the inner sleeve are
compressed (as shown in FIG. 8G). In this mode, a screw head or
other fixation device can be grasped and secured by the compressed
grasping elements 38.
[0053] FIGS. 7A-7D illustrate several views of a screw member 90
for use with a spring latch according to embodiments of the present
application. The screw member 90 can be inserted into the holes 76
of the spring latch 60 to secure the spring latch 60 to the inner
sleeve 22, as shown in FIG. 8E.
[0054] FIGS. 8A-8G illustrate a procedure for assembling and
operating a tower device according to embodiments of the present
application.
[0055] FIG. 8A illustrates the inner sleeve 22, outer sleeve 21 and
lock nut 80 as separate components.
[0056] FIGS. 8B and 8C illustrate the inner sleeve 22 inserted into
the outer sleeve 21. The inner sleeve 22 is slidable relative to
the outer sleeve 21 such that the distal, compressible grasping
elements 38 of the inner sleeve extend from a distal end of the
outer sleeve 21. In addition, in order to properly orient the inner
sleeve 22 relative to the outer sleeve 21, the spring latch 60
(fixed to the inner sleeve) can be aligned with the proximal slot
27 of the outer sleeve 21. In some embodiments, the inner sleeve 22
and outer sleeve 21 are slidable relative to one another until the
lock nut 80 is secured in place.
[0057] FIG. 8D illustrates a close-up view of the grasping elements
38 upon insertion of the inner sleeve 22 in the outer sleeve 21
without the lock nut 80. The inner sleeve 22 can be moved relative
to the outer sleeve 21 such that the grasping elements 38 are open
and in an uncompressed state, as shown in FIG. 8D. In the
uncompressed state, the grasping elements 38 can easily fit over an
object, such as a screw head. The grasping elements 38 can
subsequently be compressed (as shown in FIG. 8G) to grasp a screw
member with the assistance of the lock nut 80.
[0058] FIG. 8E illustrates a close-up view of the lock nut 80 in
the process of moving down the threaded portion 34 of the inner
sleeve 22. In some embodiments, the lock nut 80 can be rotated
clockwise until it is pressed firmly against the surface of the
outer sleeve 21. When the lock nut 80 is no longer able to rotate
clockwise down the threaded portion 34, the access device 5 will be
in locked mode, as indicated by the marker 69 on the spring latch
60. In locked mode, the inner sleeve 22 is secured in a position
relative to the outer sleeve 21, and the grasping elements 38 are
compressed. In addition, in this mode, the tab member 68 of the
spring latch 60 engages an inner portion of the lock nut 80 and
limits counter-rotation of the lock nut. Compression of the
grasping elements 38 helps to secure the access device to a screw
member (e.g., via apertures in the screw head that receive internal
protruding members of the grasping elements).
[0059] FIG. 8F illustrates a side view of the fully-assembled
access device 5 in locked mode. As shown in the figure, the lock
nut 80 has been rotated completely clockwise down the threaded
portion 34 of the inner sleeve. The tab member 68 of the spring
latch is now hidden from view, as it is engaged with an inner
portion of the lock nut 80. In the locked mode, the grasping
elements 38 are compressed (as shown in FIG. 8G) and capable of
securing a screw head therein.
[0060] The access device 5 can be coupled to a screw 90 having a
head member 92 and threaded shaft portion 94, as shown in FIGS. 10A
and 10B. In some embodiments, the head member 92 can be
tulip-shaped. The head member 92 can have a U-shaped seat for
receiving an implant, such as a stabilizing rod member. The head
member 92 can include holes or apertures for receiving one or more
protruding members (e.g., from the distal end of the access
device). In some embodiments, the surface of the head member 92
also includes one or more slots that interact with the internal
tapered surface 47 of the inner sleeve to assist in the absorption
of axial loads.
[0061] An elongated, threaded shaft member 94 can extend from the
bottom of the head member 92. In some embodiments, the head member
92 and shaft member 94 are separate components that are coupled,
while in other embodiments, the head member 92 and shaft member 94
form a single unitary member. In some embodiments, the head member
92 of the screw 90 can comprise a break-away portion that is easily
separated from the shaft member 94 by a snapping motion. The screw
90 can be cannulated such that it can include a hollow body through
which a guidewire or k-wire can be received, as discussed below.
Various types of screws can be used with the access device,
including different kinds of pedicle screws.
[0062] In some embodiments, once the access device 5 and screw 90
are coupled, a screw driver (not shown) can be inserted into the
access device. The screw driver, which includes a handle and a
shaft, can engage the head of the screw 90 (e.g., a hex portion of
the screw). The screw driver can be cannulated such that it too can
receive a guidewire or k-wire that passes through the cannulated
screw.
[0063] The coupled access device 5 and screw 90 (along with the
screw driver) can be inserted percutaneously to a target location
within the patient (e.g., a portion of a spine) wherein the screw
is to be delivered. The coupled access device 5 and screw 90 can be
guided using a guide-wire or k-wire that is insertable through the
hollow body of the screw 90. Once the screw 90 is placed proximal
to a target location, the screw 90 can be driven into the location
by using the screw driver to provide rotational and axial force. In
some embodiments, rotation of the screw driver causes rotation of
the screw 90, as well as rotation of the access device 5 to which
it is coupled.
[0064] One or more screws can be fixed into bone using the devices
described above. For example, in one embodiment, a first screw
attached to a first access device can be delivered into a first
vertebrae, while a second screw attached to a second access device
can be delivered into a second vertebrae. Once the screws are fixed
into bone, an implant, such as a connecting rod member (not shown),
can be delivered in the patient and connected between the two
screws. In some embodiments, the rod member is delivered via a
mini-open procedure, in which an incision is made between the first
and second screw. In other embodiments, the rod member is delivered
percutaneously along the side of either the first and second access
devices. One end of the rod member can be fixed to the first screw,
while the opposite end of the rod member can be fixed to the second
screw, thereby forming a stabilizing connection between the screws.
To enclose and secure the ends of the rod member to the screws, cap
screws (not shown) can be provided through the access devices and
over the rod ends. In some embodiments, the cap screws are
threaded. Each cap screw can provide a downward force on a rod end,
and this downward force can be transferred from the rod end to the
screw head, thereby providing a secure locking mechanism for the
system.
[0065] To assist in providing and securing the ends of the rod
member to the screw heads, a number of different components can be
provided. Among the components are a rod insertion device, an
anti-torque device and a persuader device, examples of which are
described below.
Rod Insertion System--Rod Insertion Device, Anti-Torque Device and
Persuader Device
[0066] A rod insertion system is provided that can assist in the
delivery of a rod implant to a desired location within a patient.
The rod insertion system can include a rod insertion device 110, an
anti-torque device 142, and a persuader device 131.
[0067] FIGS. 9A and 9B illustrate a rod insertion device 110
according to embodiments of the present application. The rod
insertion device 110 includes a distal gripping end 115, a sliding
sleeve 118, a torque driven locking cap 121 and a handle 130.
[0068] The rod insertion device 110 includes a distal gripping end
115 for gripping a rod member so that it can be delivered into a
patient. The gripping end 115 can be affixed to a shaft member of
the rod insertion device 110. The shaft member can have a
longitudinal axis that runs a length between the gripping end 115
and the handle 130. The distal gripping end 115 comprises two or
more gripping elements (e.g., fingers or tines) that can be used to
grip and hold a rod member. The gripping elements can be tapered.
The gripping elements can also be compressible so as to securely
grip a rod member to allow for delivery of the rod member into a
patient. In some embodiments, the gripping elements are compressed
by sliding the sliding sleeve 118 downward over a portion of the
gripping end 115.
[0069] The sliding sleeve 118 can be located over a portion of the
shaft member attached to the gripping end 115. The sliding sleeve
118 can be slidable relative to the inner shaft member. In some
embodiments, upon sliding the sleeve 118 distally over a portion of
the gripping end 115, the gripping end 115 can be compressed. When
the gripping end 115 is compressed, it can grip or grasp a rod
member or other implant. In some embodiments, the sliding sleeve
118 is actuated by rotating an adjacent torque driven locking cap
121.
[0070] The torque driven locking cap 121 is provided adjacent the
sliding sleeve 118 on the rod insertion device 110. The torque
driven locking cap 121 can work similar to the lock nut 80; that
is, it can be rotated clockwise until it contacts and secures the
sliding sleeve 118 in a position whereby the gripping end 115 is
compressed. In some embodiments, the torque driven locking cap 121
includes a knurled exterior surface that allows for easier
gripping.
[0071] At the proximal end of the rod insertion device 110 is a
handle 130. The handle can include dimples or grooves to allow for
easy handling of the rod insertion device 110.
[0072] In some embodiments, the rod insertion device 110 in FIGS.
9A and 9B can be used to deliver a rod implant adjacent to the
sidewalls of an access device 5. In other embodiments, the rod
insertion device 110 can be used to deliver a rod implant through
an incision in a mini-open procedure between two access
devices.
[0073] FIGS. 10A and 10B illustrate an anti-torque device 142 and
rod persuader device 131 in use together according to embodiments
of the present application. As shown in the figures, the
anti-torque device 142 can be placed over the outer sleeve of the
access devices, while the rod persuader device 131 can be placed
above the anti-torque device and over a proximal threaded portion
of the inner sleeve 21. In some embodiments, either one or both of
these instruments are optional.
[0074] FIGS. 11A-11G illustrate different views of an anti-torque
device 142 according to embodiments of the present application. The
anti-torque device 142 comprises a handle 143 operably connected to
a cannula 145. In some embodiments, the cannula 145 is configured
to operate over the outer sleeve 21 of the access device 5. At the
distal end of the cannula 145 is a slot 149 that can interact with
a rod member that has been inserted in a patient but is not in a
proper position. In some embodiments, the slot 149 of the
anti-torque device can press down against the rod member, thereby
helping to force the rod member into a desired position within a
patient. In some embodiments, the slot forms a half-circle with a
radius of between about 0.1 cm and 0.5 cm, or between about 0.3 cm
and 0.4 cm.
[0075] The anti-torque device 142 can provide a number of
advantages. One advantage of the anti-torque device 142 is that it
can act as a persuader to force a rod member into a desired
position within a patient, as noted above. Another advantage of the
anti-torque device 142 is that it can provide an anti-torque
mechanism that resists rotation of the access device 5 when
adjusting the position of a rod member. For example, when trying to
adjust the rod member into a desirable position, the anti-torque
device 142 can help to ensure that the access device 5 is not
rotated. In addition, in some embodiments, the distal end of the
anti-torque device 142 preferably helps to hold the screw 90 in a
secure position while a cap screw is tightened over a rod member
and screw head.
[0076] FIGS. 12A and 12B illustrate different views of a rod
persuader device 131 that is configured to fit above the
anti-torque device 142 and over a threaded portion of the inner
sleeve 22 of the access device 5. In some embodiments, the rod
persuader device 131 comprises a substantially cylindrical member
that includes a hollow interior 136. In some embodiments, the rod
persuader device 131 can included internal threads (not shown)
which are capable with mating with the threaded portion of the
inner sleeve 22. The rod persuader device 131 can be configured to
be placed in contact with the anti-torque device 142 by rotating
the persuader device 131 clockwise down the exposed threaded
portion of the inner sleeve 22. The rod persuader device 131 can
apply a downward force on the anti-torque device 142, which can
then transfer to a rod member. This force helps to advantageously
stabilize the rod member and place it in a desirable position
within the patient's body. The rod persuader device 131 is also
advantageous in that it is clearly visible outside of the patient's
body, and provides a comfortable means to transmit force to
stabilize and position the rod member.
[0077] In some embodiments, the persuader device 131 is optional,
and can be used on its own or with the anti-torque device 142 to
force a rod member into a desired location within an access device
5 (e.g., onto a seat of a screw head). In some embodiments, the
anti-torque device 142 and/or persuader device 131 can be used to
displace blocking tissue that may prevent the rod member from being
placed in a desired location. Both the anti-torque device 142 and
persuader device 131 are uniquely configured such that they can be
used on top of the access device 5. This configuration allows a
user (e.g., surgeon) of the anti-torque device and/or persuader
device 131 to displace tissue and deliver the rod member into its
proper position with ease, as the user would only have to apply
relatively minor force to rotate the persuader device to interact
with the anti-torque device. In addition, in some embodiments, the
anti-torque device 142 and/or persuader device 131 includes an
upper viewing window, such that the user can easily visualize
tissue and rod member position within the access device 5.
Methods of Using the Access Device and Rod Insertion System
[0078] A procedure for using the minimally invasive access device
according to embodiments of the present application will now be
described. The procedure makes use of a first minimally invasive
tower access device and a second minimally invasive tower access
device. The access device includes an outer sleeve slidable
relative to an inner sleeve, as well as a lock nut. The inner
sleeve includes a pair of compressible grasping elements each
having an internal protruding member to be received in an aperture
of a screw head.
[0079] The first access device is provided with its distal grasping
elements in an uncompressed state. A first screw having a screw
head with apertures is also provided. The first screw can be placed
such that its screw head is in between the uncompressed grasping
elements. The access device can be attached to the screw head by
compressing the grasping elements. The grasping elements are
compressed by sliding the outer sleeve relative to the inner
sleeve, and rotating the lock nut clockwise down a threaded portion
of the inner sleeve. Upon compression of the grasping elements, the
internal protruding members of the inner sleeve will be inserted
into corresponding apertures of the screw head, thereby coupling
the access device to the screw.
[0080] After coupling the access device to the screw, a screw
driver can be provided. The screw driver, which includes a handle
portion and a shaft portion, can be delivered down the access
device until the shaft portion is in contact with the head of the
screw. The coupled access device and screw, as well as the screw
driver, are ready to be delivered through an incision.
[0081] In some embodiments, an incision of a desirable size is
formed by providing a k-wire or guidewire that guides a dilator.
The dilator includes one or more expandable sleeves, and can assist
in providing an opening of a desirable size for inserting the
coupled access device and screw into a patient.
[0082] The coupled access device and screw can be percutaneously
delivered to a location (e.g., using a k-wire) such that the screw
can be driven into a bone (e.g., a pedicle). The screw driver can
provide rotational and axial driving forces to drive the screw into
bone. Once the screw is driven into the bone, the screw driver can
be removed. The access device remains coupled to the screw such
that a portion of the access device remains accessible to a surgeon
from outside of the patient.
[0083] A second access device can now be provided, along with a
second screw. All of the steps above--coupling the access device to
the screw, inserting a screw driver in the access device,
delivering the coupled access device and screw to a location within
a patient through an incision, driving the screw into a bone
member, and removing the screw driver to leave only the coupled
access device and screw--can be repeated with respect to the second
access device.
[0084] A rod member can now be provided which will serve as a
connecting, stabilizing member between the first and second screws.
The rod member can be delivered using a rod insertion device. The
rod member can be delivered along the outer sidewall of the first
access device. The rod member can be delivered at an angle such
that its first end is received into a distal slot of the first
access device. The rod member can then be directed such that its
second end is received into a distal slot of the second access
device. The first end of the rod member can then be connected to
the first screw within the first access device, while the second
end of the rod member can then be connected to the second screw
within the second access device. A screw cap can then be delivered
down each of the access sleeves, and can be used to impart a
downward force on the rod member to secure the rod member in the
spinal stabilization system.
[0085] To ensure proper placement of the rod member within the
access sleeves, an optional anti-torque device can be provided. The
anti-torque device includes a cannula having a slot. The cannula
can be placed over either the first or second access devices, and
the slot on the cannula can be used as a persuader to force the rod
member into a desired position within the patient. Simultaneously,
while serving as a persuader, the anti-torque device can also limit
undesirable rotation of the access devices that can be caused
during adjustment of the rod member. In some embodiments, the
anti-torque device helps to secure the screw in position while a
screw cap imparts a downward force on the rod member that transfers
to the screw head.
[0086] In addition to the anti-torque device, an optional rod
persuader device can also be provided to interact with the
anti-torque device. The rod persuader device can be placed above
the anti-torque device, and can be inserted over a threaded portion
of the inner sleeve. The anti-torque device and persuader device
can help to displace tissue that may block the proper placement of
the rod member within an access device. The anti-torque device and
persuader device can help to force the ends of the rod members into
a seat of the first and second screw heads, thereby creating a
spinal stabilization member between the two screws.
[0087] Once the rod member is placed in a desired position between
the two screws (e.g., either with or without the anti-torque device
and/or persuader device), screw caps can be provided down the
access devices that secure the ends of the rod member to the heads
of the screws. Once the screw caps are provided, the first and
second access devices can be removed. Alternatively, the first or
second access devices can be kept in place so that the steps above
can be repeated using additional devices. It would then be possible
to provide additional rod implants across bone members, thereby
creating a spinal stabilization system. In some embodiments, a
spinal stabilization system comprises two, three, four, or more rod
implants.
[0088] Once the access devices are removed, the patient can then be
allowed to heal. Advantageously, with the use of the access devices
described herein, the recovery time is reduced compared to
conventional surgeries due to the relatively minimal incisions
needed to perform the surgery.
Additional Embodiments of Devices
[0089] In addition to the embodiments of devices described above
that can be used with minimally invasive surgeries, other devices
are described that can also be used to assist in spinal
stabilization. Many of these devices can be used with open or
mini-open surgeries, as will be discussed below.
[0090] FIGS. 13A and 13B illustrate a break-away screw delivery
device according to embodiments of the present application. The
break-away screw delivery device 200 comprises an elongated portion
205 having an elongated slot 228. Along the length of the device
200 are grooves or indentations 209 that help to identify and
facilitate break-away points as will be discussed below. The
elongated portion 205 is connected to a screw portion 290 which
includes a shaft 294.
[0091] In some embodiments, the break-away screw delivery device
200 can be used on its own to deliver a screw portion 290 into a
bone member. While it is possible that the device 200 can be used
percutaneously, the device 200 can also be used in an open surgery
or mini-open surgical procedure. In operation, the device 200 can
be delivered to a location within a patient's body. When the device
200 is at a desirable location, the screw portion 290 can be driven
into a bone member. In some embodiments, the screw portion 290 is
driven into a bone member by providing a screw driver through the
interior of the delivery device 200. Once the screw portion 290 is
driven into a bone member, a rod member can be inserted into the
delivery device 200. The rod member can be used as a connection in
between two or more delivery devices 200. Afterwards, a screw cap
can be provided to secure the rod member.
[0092] Advantageously, at any time, a portion of the elongated
portion 205 of the delivery device 200 can be broken off or snapped
off, for example, proximate to the indentation 209. When a portion
of the elongated portion 205 is snapped off, a distal end 211 of
the elongated portion 205 remains. The distal end 211 resembles the
head of a screw and can securely receive a stabilizing rod implant.
In some embodiments, a portion of the elongated portion 205 is
snapped off after driving the screw portion 290 into a bone,
delivering a rod member and providing a secure screw cap. The
snapped off portion of the elongated portion 205 can be removed,
thereby leaving within the patient a part of a bone stabilizing
system.
[0093] FIGS. 14A-14H illustrate different views of an alternate
persuader system according to embodiments of the present
application. Like the break-away screw delivery device 200, the
persuader system 231 can be used in an open procedure or mini-open
procedure. The persuader system 231 includes a persuader sleeve 233
that is operably connected to an inner sleeve 222 having grasping
elements 238 and an outer sleeve 221. The inner sleeve 222 and
outer sleeve 221 can be slidable relative to one another. The
persuader sleeve 233 further includes a proximal portion 235 having
a handle 237 that serves as an actuating element and a distal
portion 232 having a cut-out portion 234.
[0094] In some embodiments, the persuader system 231 can be used to
deliver an implant, such as a rod member, to a desirable location
in a patient during open surgery. The persuader system 231 can
include an inner sleeve 222 and outer sleeve 221 that are slidable
relative to one another. The sleeves can operate similarly to the
inner sleeve and outer sleeve of the access device described above
in that sliding the sleeves relative to one another can result in
compression of the grasping elements 238, thereby allowing a rod
implant to be grasped therebetween. Once a rod implant is grasped,
the persuader system 231 can be delivered to a desirable location
within a patient. In some embodiments, by actuating the handle 237
of the persuader system (e.g., by rotation), the distal portion 232
of the persuader system can be extended until the cut-out portion
234 is in contact with the rod member. Advantageously, the cut-out
portion 234 can help to stabilize and secure the rod member in a
desirable position within the patient.
[0095] It will be apparent to those skilled in the art that various
modifications and variations can be made in the present embodiments
without departing from the scope or spirit of the advantages of the
present application. Thus, it is intended that the present
application cover the modifications and variations of these
embodiments and their equivalents.
* * * * *