U.S. patent application number 17/208590 was filed with the patent office on 2022-09-22 for screw shank based tissue retraction.
This patent application is currently assigned to Warsaw Orthopedic, Inc.. The applicant listed for this patent is Warsaw Orthopedic, Inc.. Invention is credited to Cristian A. Capote, ANTHONY J. MELKENT.
Application Number | 20220296283 17/208590 |
Document ID | / |
Family ID | 1000006575825 |
Filed Date | 2022-09-22 |
United States Patent
Application |
20220296283 |
Kind Code |
A1 |
MELKENT; ANTHONY J. ; et
al. |
September 22, 2022 |
SCREW SHANK BASED TISSUE RETRACTION
Abstract
A surgical instrument configured to enable simultaneously
driving a bone screw into a boney structure of a patient and
delivering of a blade within the patient adjacent the bone screw is
disclosed. The surgical instrument may include an elongated
outer-sheath extending in a longitudinal direction from a proximal
end to a distal end, for example The elongated outer-sheath may
include an interior cavity that defines a centrally disposed
longitudinal axis that extends in the longitudinal direction, for
example. The surgical tool may include a central-sheath disposed
within the interior cavity that extends in the longitudinal
direction, for example. The surgical instrument may further include
an inner-shaft rotatably supported by the central-sheath that
extends in the longitudinal direction, for example. The inner-shaft
may include a driver configured to selectively drive a bone screw
upon rotation of the inner-shaft about the longitudinal axis, for
example.
Inventors: |
MELKENT; ANTHONY J.;
(Germantown, TN) ; Capote; Cristian A.; (Memphis,
TN) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Warsaw Orthopedic, Inc. |
Warsaw |
IN |
US |
|
|
Assignee: |
Warsaw Orthopedic, Inc.
Warsaw
IN
|
Family ID: |
1000006575825 |
Appl. No.: |
17/208590 |
Filed: |
March 22, 2021 |
Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 2017/0256 20130101;
A61B 17/025 20130101; A61B 17/7082 20130101 |
International
Class: |
A61B 17/70 20060101
A61B017/70; A61B 17/02 20060101 A61B017/02 |
Claims
1. A surgical instrument, comprising: an elongated outer-sheath
extending in a longitudinal direction from a proximal end to a
distal end, the elongated outer-sheath having an interior cavity
defining a centrally disposed longitudinal axis extending in the
longitudinal direction; the elongated outer-sheath having a
coupling rail disposed proximate to the distal end; a blade
configured to couple to and uncouple from the elongated
outer-sheath via the coupling rail, wherein a distal end of the
blade comprises an indented arcuate channel configured to rotatably
support about 15% to about 50% of an underside of a head portion of
a bone screw; a central-sheath disposed within the interior cavity
and extending in the longitudinal direction; and an inner-shaft
rotatably supported by the central-sheath and extending in the
longitudinal direction, the inner-shaft including a driver disposed
proximate the distal end, the inner-shaft being rotatable about the
longitudinal axis, wherein the surgical instrument is configured to
enable simultaneously driving the bone screw into a boney structure
of a patient in an installed position and delivery of the blade
within the patient adjacent the installed position.
2. The surgical instrument of claim 1, wherein: the elongated
outer-sheath comprises a generally cylindrical shape having an
outer surface, and the blade comprises an interior side surface
that corresponds in size and shape to the outer surface of the
elongated outer-sheath.
3. The surgical instrument of claim 1, wherein: the blade comprises
a coupling channel disposed at a proximal end of the blade that is
indented with respect to an interior surface of the blade, the
coupling rail of the elongated outer-sheath is outdented with
respect to an outer surface of the outer-sheath, and the coupling
rail is slidably connected with the coupling channel.
4. The surgical instrument of claim 3, wherein the blade extends
from the coupling rail of the elongated outer-sheath such that a
distal end of the blade extends distally farther than the distal
end of the elongated outer-sheath.
5. (canceled)
6. (canceled)
7. (canceled)
8. The surgical instrument of claim 1, wherein: the arcuate channel
of the bone screw receiving portion is sloped with respect to the
longitudinal direction and directly contacts a bottom dome shaped
surface of the head portion of the bone screw while the bone screw
is being driven due to rotation of the inner shaft about the
longitudinal axis, and when the bone screw is being driven, the
bottom dome shaped surface is partially nested with the arcuate
channel.
9. The surgical instrument of claim 8, wherein the blade comprises
a fastener disposed at a proximal end of the blade for coupling to
a retractor.
10. The surgical instrument of claim 1, wherein the central-sheath
includes an enlarged proximal end extending proximally farther than
the proximal end of the elongated outer-sheath and having a cross
sectional width that is greater than an average cross sectional
width of the elongated outer-sheath.
11. The surgical instrument of claim 10, wherein: a proximal end of
the inner shaft extends into the enlarged proximal end of the
central sheath, the enlarged proximal end of the central sheath
comprises a spring that biases the inner-shaft towards the distal
end of the elongated outer-sheath, and the inner-shaft is movable
forward and backward in the longitudinal direction.
12. The surgical instrument of claim 11, wherein the inner-shaft
includes an end portion connectable to a powered drive instrument,
the end portion extending proximally farther than the proximal end
of the elongated outer-sheath.
13. A surgical system, comprising: a blade including an indented
arcuate channel at a distal end thereof; a bone screw having a
spherical head comprising an upper dome shaped surface and a lower
dome shaped surface; and a surgical instrument configured to enable
simultaneously driving the bone screw into a boney structure of a
patient in an installed position and delivering the blade within
the patient adjacent the installed position, wherein the surgical
instrument comprises: an elongated outer-sheath extending in a
longitudinal direction from a proximal end to a distal end, the
elongated outer-sheath having an interior cavity defining a
centrally disposed longitudinal axis extending in the longitudinal
direction, the elongated outer-sheath having a coupling rail
disposed proximate to the distal end; and a rotatable driver
disposed within the interior cavity and extending in the
longitudinal direction and rotatable about the longitudinal axis,
wherein the blade is configured to selectively couple to and
uncouple from the elongated outer-sheath; and wherein the indented
arcuate channel is configured to--directly contact about 15% to
about 50% of the lower dome shaped surface of the bone screw while
the surgical instrument drives the bone screw into the boney
structure of the patient.
14. The surgical system of claim 13, wherein: the elongated
outer-sheath comprises a generally cylindrical shape having an
outer surface, and the blade comprises an interior side surface
that corresponds in size and shape to the outer surface of the
elongated outer-sheath.
15. The surgical instrument of claim 13, wherein the blade extends
in the longitudinal direction and the indented arcuate channel is
sloped with respect to the longitudinal direction.
16. The surgical instrument of claim 15, wherein the indented
arcuate channel of the bone screw receiving portion is configured
to rotatably support the bone screw such that the lower dome shaped
surface of the bone screw slides across the indented arcuate
channel when the bone screw is being driven by the rotatable
driver.
17. The surgical instrument of claim 13, further comprising a
retractor, and wherein the blade comprises a fastener disposed at a
proximal end of the blade, the fastener being configured to
selectively couple to the retractor.
18. A method for simultaneously delivering a blade and a bone
screw, comprising: providing a surgical instrument comprising: an
elongated outer-sheath extending in a longitudinal direction from a
proximal end to a distal end, the elongated outer-sheath having an
interior cavity defining a centrally disposed longitudinal axis
extending in the longitudinal direction; the elongated outer-sheath
having a coupling rail disposed proximate to the distal end; a
central-sheath disposed within the interior cavity and extending in
the longitudinal direction; and an inner-shaft rotatably supported
by the central-sheath and extending in the longitudinal direction,
the inner-shaft including a driver disposed proximate the distal
end; providing a blade comprising a bone screw receiving portion,
the bone screw receiving portion comprises an indented arcuate
channel; coupling the blade to the elongated outer-sheath via the
coupling rail; providing a bone screw having a head portion
including a lower dome shaped surface generally corresponding in
size and shape to the bone screw receiving portion; coupling the
bone screw to the driver; supporting about 15% to about 50% of the
lower dome shaped surface of the bone screw with the indented
arcuate channel; installing, simultaneously, the bone screw in a
boney structure of a patient in an installed position and the blade
in the patient, wherein the bone screw is installed by rotating the
driver such that the lower dome shaped surface of the bone screw
slides across the indented arcuate channel.
19. The method of claim 18, wherein: the indented arcuate channel
is sloped with respect to the longitudinal direction, and when the
bone screw is in the installed position a bottom surface of a head
portion of the bone screw directly contacts the indented arcuate
channel.
20. The method of claim 19, comprising: positioning an arm of a
retractor adjacent the installed bone screw and blade; and coupling
a fastener of the blade to the arm of the retractor; and
uncoupling, after completing the coupling the fastener step, the
blade from the outer-sheath.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application hereby incorporates by reference each of
the following U.S. Patent Applications. U.S. Pat. No. 10,456,122,
filed Mar. 13, 2013 and titled SURGICAL SYSTEM INCLUDING POWERED
ROTARY-TYPE HANDPIECE; U.S. patent application Ser. No. 16/560,587,
filed Sep. 4, 2019 and titled SURGICAL INSTRUMENT AND METHOD; U.S.
patent application Ser. No. 14/645,232 filed Mar. 11, 2015, titled
"SURGICAL INSTRUMENT AND METHOD" now U.S. Pat, No. 10,285,740
granted May 14, 2019; U.S. patent application Ser. No. 16/395,574,
filed Apr. 26, 2019 and titled Surgical instrument and method; and
U.S. patent application Ser. No. 17/166,265, filed Feb. 3, 2021 and
titled "MODULAR SURGICAL INSTRUMENT SYSTEM AND METHOD FOR
SHANK-BASED RETRACTION AND DISTRACTION."
FIELD
[0002] In one aspect, the present disclosure generally relates to
medical devices and more particularly to a system and method for
delivery of a blade and bone screw for retraction of patient
tissue. In another aspect, the present disclosure is generally
related to systems and methods using a modular retractor blade and
various distractors and/or retractors to provide retraction and
distraction for use in a mini-open transforaminal lumbar interbody
fusion (TLIF) spine surgery. The associated systems and methods
disclosed herein may be used for other surgeries and are not
limited to the specific examples disclosed herein.
BACKGROUND
[0003] Spinal disorders such as degenerative disc disease, disc
herniation, osteoporosis, spondylolisthesis, stenosis, scoliosis
and other curvature abnormalities, kyphosis, 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 pain, nerve damage, and partial or
complete loss of mobility.
[0004] 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. As part of
these surgical treatments, spinal constructs, which include
implants such as bone fasteners, connectors, plates and vertebral
rods are often used to provide stability to a treated region. These
implants can redirect stresses away from a damaged or defective
region while healing takes place to restore proper alignment and
generally support the vertebral members. Surgical instruments are
employed, for example, to engage the fasteners for attachment to
the exterior of two or more vertebral members.
[0005] Spinal disorders may result in pain, nerve damage, and loss
of mobility. While, non-surgical treatments may be effective to
treat some spine disorders, others will require surgical
treatments, such as without limitation, spinal fusions. During, a
mini-open transforaminal lumbar interbody fusion (TLIF) spine
surgery, an incision can be made off the midline to access both
disc space and pedicles. Other spine surgeries may place the
incision in a different location. Various tools are used to perform
retraction with blades to expose a portion of the spine or boney
structures through the incision. Other instruments are used to
perform distraction. The interchange of these different instruments
may increase the length of time required to perform the surgery.
This disclosure describes methods and systems directed to
addressing the problems described above, and/or other issues.
SUMMARY
[0006] The techniques of this disclosure generally relate to, for
example, a modular surgical instrument system for delivery of a
modular retractor blade and a bone screw for use with various
distractors to provide retraction and/or distraction of patient
tissue. The systems and methods may be discussed in relation to,
for example, in an open, mini-open transforaminal lumbar interbody
fusion (TLIF) spine surgery, although they are of course equally
applicable to any other surgical procedure in which it may be
advantageous to deliver a retractor blade and a bone screw
simultaneously.
[0007] Various embodiments in accordance with the principles of
this disclosure describe a surgical instrument having an elongated
outer-sheath extending in a longitudinal direction from a proximal
end to a distal end, for example. The surgical instrument may
include an elongated outer-sheath that has an interior cavity that
defines a centrally disposed longitudinal axis that extends in the
longitudinal direction, for example. The surgical tool may include
a blade configured to couple to and uncouple from the elongated
outer-sheath via a coupling portion. The surgical tool may include
a central-sheath disposed within the interior cavity and extending
in the longitudinal direction, for example The surgical instrument
may further include an inner-shaft rotatably supported by the
central-sheath and that extends in the longitudinal direction, for
example The inner-shaft may include a driver disposed proximate the
distal end, and the inner-shaft may be rotatable about the
longitudinal axis. Additionally, in various embodiments, the
surgical instrument may be configured to enable simultaneously
driving the bone screw into a boney structure of a patient in an
installed position and delivering of the blade within the patient
adjacent the installed position, for example.
[0008] Various embodiments in accordance with the principles of
this disclosure describe a surgical system. The surgical system may
include a blade, a bone screw, and a surgical instrument, for
example. The surgical instrument may be configured to enable
simultaneously driving the bone screw into a boney structure of a
patient in an installed position and delivering the blade within
the patient adjacent the installed position, for example In various
embodiments, the surgical instrument may include an elongated
outer-sheath extending in a longitudinal direction from a proximal
end to a distal end, and the elongated outer-sheath may have an
interior cavity defining a centrally disposed longitudinal axis
extending in the longitudinal direction, for example. Additionally,
the surgical instrument may include a rotatable driver disposed
within the interior cavity and that extends in the longitudinal
direction, for example. In various embodiments, the blade may be
configured to selectively couple to and uncouple from the elongated
outer-sheath, and directly contact a head portion of the bone screw
while the surgical instrument drives the bone screw into the boney
structure of the patient, for example.
[0009] Various embodiments describe a method for simultaneously
delivering a blade and a bone screw. The method may include the
step of providing a surgical instrument that includes an elongated
outer-sheath extending in a longitudinal direction from a proximal
end to a distal end, for example. The elongated outer-sheath may
have an interior cavity defining a centrally disposed longitudinal
axis extending in the longitudinal direction, and the elongated
outer-sheath may have a coupling portion disposed proximate to the
distal end, for example The surgical tool may include a
central-sheath disposed within the interior cavity and extending in
the longitudinal direction and an inner-shaft rotatably supported
by the central-sheath and extending in the longitudinal direction,
for example. In various embodiments, the inner-shaft may also
include a driver disposed proximate the distal end, for example.
The method may further include the steps of providing a blade
comprising a bone screw receiving portion and coupling the blade to
the elongated outer-sheath via the coupling portion, for example
The method may further include the steps of providing a bone screw
having a head portion generally corresponding in size and shape to
the bone screw receiving portion, and coupling the bone screw to
the driver, for example. The method may further include the steps
of installing, simultaneously, the bone screw in a boney structure
of a patient in an installed position and the blade in the patient,
for example.
[0010] The details of one or more aspects of the disclosure are set
forth in the accompanying drawings and the description below. Other
features, objects, and advantages of the techniques described in
this disclosure will be apparent from the description and drawings,
and from the claims.
BRIEF DESCRIPTION OF DRAWINGS
[0011] FIG. 1 is a perspective view of a surgical tool.
[0012] FIG. 2 is a perspective view of a retractor in use with the
surgical tool of FIG. 1.
[0013] FIG. 3 is an exploded parts view of the surgical tool of
FIG. 1.
[0014] FIG. 4 is a cross section of the surgical tool of FIG.
1.
[0015] FIG. 5 is an enlarged perspective view of a portion of a
surgical tool and a modular blade.
[0016] FIG. 6 is an alternate perspective view of a portion of a
surgical tool and a modular blade.
[0017] FIG. 7A is a perspective view of a blade for use with a
surgical tool.
[0018] FIG. 7B is an alternate perspective view of a blade for use
with a surgical tool.
[0019] FIG. 8 is a perspective view of a retractor.
[0020] FIG. 9 is an alternate perspective view of the retractor of
FIG. 8.
[0021] FIG. 10 is a top down view of the retractor of FIGS. 8 and
9.
[0022] FIG. 11 is a perspective view of a retractor and an
extension member.
DETAILED DESCRIPTION
[0023] Embodiments of the present disclosure relate generally, for
example, to spinal stabilization systems, and more particularly, to
surgical instruments for use with spinal stabilization systems.
Embodiments of the devices and methods are described below with
reference to the Figures.
[0024] The following discussion omits or only briefly describes
certain components, features and functionality related to spinal
stabilization systems, which are apparent to those of ordinary
skill in the art. It is noted that various embodiments are
described in detail with reference to the drawings, in which like
reference numerals represent like parts and assemblies throughout
the several views, where possible. Reference to various embodiments
does not limit the scope of the claims appended hereto because the
embodiments are examples of the inventive concepts described
herein. Additionally, any example(s) set forth in this
specification are intended to be non-limiting and set forth some of
the many possible embodiments applicable to the appended claims.
Further, particular features described herein can be used in
combination with other described features in each of the various
possible combinations and permutations unless the context or other
statements clearly indicate otherwise.
[0025] Terms such as "same," "equal," "planar," "coplanar,"
"parallel," "perpendicular," etc. as used herein are intended to
encompass a meaning of exactly the same while also including
variations that may occur, for example, due to manufacturing
processes. The term "substantially" may be used herein to emphasize
this meaning, particularly when the described embodiment has the
same or nearly the same functionality or characteristic, unless the
context or other statements clearly indicate otherwise.
[0026] Referring generally to FIGS. 1-11 a surgical tool 100 is
disclosed. Surgical tool 100 may be referred to as blade and screw
delivery tool in some embodiments. For example, as illustrated in
FIGS. 1 and 2, surgical tool 100 may concurrently deliver (i) a
bone screw 12 or other anchoring member into a boney structure and
(ii) a modular blade 110 for tissue retraction of surrounding soft
tissue of a patient. Surgical tool 100 may include a proximal end
100p and a distal end 100d, for example. Surgical tool 100 may be
coupled to a rotational drive instrument at the proximal end 100p
and a bone screw 12 or other anchoring member may be coupled at the
distal end 100d. At least one rotational drive instrument may be
the POWEREASETM System sold by Medtronic and/or the powered
rotary-type handpiece described in U.S. Pat. No. 10,456,122, the
disclosure of which is incorporated herein by reference in its
entirety.
[0027] It shall be understood that in some embodiments and surgical
procedures surgical tool 100 may be inserted through a previously
established surgical path such as an incision in a patient to
enable bone screw 12 to reach the target location. Various exterior
and interior sheaths, shafts, and functional attributes of surgical
tool 100 are disclosed in detail below.
[0028] As shown in FIG. 2, and in some surgical procedures, it may
be advantageous to utilize two surgical tools 100 for securing a
bone screw 12 into a superior vertebrae and an inferior vertebrae,
for example. Concurrently with delivering bone screw 12 into the
respective vertebrae, a respective blade 110 may also be delivered
into an incision in the patient for preventing adjacent soft tissue
form covering up bone screw 12 and/or subsequent retraction of
surrounding soft tissue with a retractor, for example. Each blade
110 may be securely and removably coupled to a retractor 200 as
will be explained in further detail below. It shall be understood
that although retractor 200 is illustrated with only two blades
110, retractor 200 may be configured to couple to any number of
blades 110 and manipulate blades 110 in any appropriate manner. For
example, retractor 200 may articulate blades 110, move blades 110
upwards and downwards, move blades 110 side to side, and or couple
to additional blades, shims, extension blades, etc. (not
illustrated in FIG. 2).
[0029] FIG. 3 is an example exploded parts view of the surgical
tool 100 and a modular blade 110. In the example illustration,
surgical tool 100 may be composed of an outer-sheath 120 having a
generally cylindrical shape and an open void space inside the
interior of outer-sheath 120. Outer-sheath 120 may include various
coupling portions such as lower coupling portion 122 and upper
coupling portion 124, for example. Coupling portions 122 and 124
may be utilized to securely and removably connect with various
blades 110 to outer-sheath 120, for example. Outer-sheath 120 may
extend lengthwise in a longitudinal direction from a proximal end
120p to a distal end 120d and define a centrally disposed
longitudinal axis projecting through the interior of outer-sheath
120 in a direction from the proximal end 120p to the distal end
120d, for example The interior of outer-sheath 120 may comprise an
inner diameter void space configured to house a tool for driving
bone screw 112, for example Central-sheath 130 may be disposed
within the inner diameter portion (central void space) of
outer-sheath 120, for example In some embodiments, central-sheath
130 may be secured to outer-sheath 120 by pins, screws, locking
channels, dovetail configuration, etc. In other embodiments,
central-sheath 130 may be snug fit and not necessarily rigidly
secured as explained in the immediately prior sentence.
Central-sheath 130 may include a proximal end 130p and a distal end
130d. In use, when central-sheath 130 is nested in a coaxial
relationship with outer-sheath 120 a portion of the proximal end
130p of central-sheath 130 may extend beyond a portion of the
proximal end 120p of outer-sheath 120, for example. In various
embodiments, the proximal end 130p of central-sheath 130 may be
configured to couple to a drive instrument (not illustrated) and/or
house a proximal end 125p of inner-shaft 125, for example.
[0030] In various embodiments, inner-shaft 125 may extend in a
longitudinal direction from a proximal end 125p to a distal end
125d. The proximal end may include a spring 126 to enable inner
drive shaft 125 to move forward and backward in the longitudinal
direction within central-sheath 130, for example. The proximal end
may be configured to connect and disconnect with a powered driver,
for example The distal end 125d may include a drive portion 127 to
securely couple to a head portion of a bone screw 112, for example
In various embodiments, inner-shaft 125 may rotate clockwise and/or
counter clockwise within central-sheath 130 and outer-sheath 120,
for example For example still, inner-shaft 125 may rotate clockwise
and counterclockwise around the longitudinal axis defined by
outer-sheath 120. Additionally, in various embodiments,
outer-sheath 120 may be configured to house the same, similar, or
substantially the same instrument as the various surgical
instruments disclosed in U.S. patent application Ser. No.
16/560,587, and U.S. patent application Ser. No. 16/395,574, the
disclosure of each is incorporated herein in entirety. For example,
the various surgical systems, and tools may be inserted within the
interior void space of outer-sheath 120 and utilized to drive a
bone screw in the same, substantially the same, and/or similar
manner as would be readily apparent to a person having ordinary
skill in the art unless the arrangement of parts and context
clearly indicates otherwise. Additionally, in some embodiments,
central-sheath 130 and inner-shaft 125 may be referred to as a
single instrument, for example a rotatable driver.
[0031] FIG. 4 is a cross section of a surgical tool 100 coupled to
a blade 110 after driving a bone screw 12 within a vertebrae of a
patient. In the example illustration, surgical tool 100 includes an
outer-sheath 120 housing a central-sheath 130 that in turn houses
an inner-shaft 125. For example, outer-sheath 120, central-sheath
130, and inner-shaft 125 are in a coaxial relationship where
inner-shaft 125 may freely rotate within outer-sheath 120.
Additionally, drive portion 127 of inner-shaft 125 may be coupled
to bone screw 12 to facilitate rotation of bone screw 12 and the
driving of bone screw 12 into the vertebrae of a patient, for
example. Furthermore, blade 110 may be removably coupled to
outer-sheath 120, for example via lower coupling portion 122. In
this way, it is shown that surgical tool 100 may concurrently
(simultaneously) install a bone screw 12 into a boney structure and
deliver a blade 110 into the same vicinity for retaining patient
tissue.
[0032] FIG. 5 and FIG. 6 are enlarged perspective views of a
portion of a surgical tool 100 and a modular blade 110. Modular
blade 110 may extend from a proximal end 110p to a distal end 110d,
for example. The proximal side 110p may include a fastener 116 for
coupling blade 110 to a retractor 200, for example As illustrated,
modular blade 110 may include an exterior lateral sidewall 110a
(tissue facing side 110a) and an interior lateral sidewall 110b
(screw facing side 110b). In the illustrated embodiment, sidewalls
110a, 110b comprise a non-planar curved surface generally
corresponding in size and shape to the outer diameter of
outer-sheath 120. However, in other embodiments outer-sheath 120
may be alternately shaped, and blades 110 may be correspondingly
shaped. For example, a pentagon shape, hexagon shape, rectangular
shape, etc. In various embodiments, blade 110 may removably couple
to outer-sheath 120 via coupling portion 122, for example.
Referring to FIG. 6, it is shown that blade 110 may include a
coupling channel 114 for securely attaching blade 110 to the
coupling portion 122. Coupling channel 114 may comprise an indented
portion and coupling portion 122 may comprise an outdented portion,
at least with respect to their associated surfaces, for
example.
[0033] In operation, an end user may move outer-sheath 120 and/or
blade 110 such that coupling portion 122 may be slid into coupling
channel 114, for example in a downward direction with respect to
FIG. 6. The coupling portion 122 may nest within coupling channel
114. In various embodiments, the coupling portion 122 may
disconnect from coupling channel 114 by lifting upward with
sufficient force, i.e., coupling portion 122 and coupling channel
114 are attached by a connecting force that can be disassociated
merely by pulling the outer-sheath 120 away from the blade 110 with
a sufficient force to overcome the connecting force. For example
still, the coupling channel 114 and coupling portion 122 may be
connected by a spring loaded force or spring loaded tab comprising
a biasing element and tabs. In other embodiments, a locking portion
or actuator may secure blade 110 to outer-sheath 120 in similar
manner as explained above. In those embodiments including a locking
portion, an end user may first unlock the locking portion or
actuator before disconnecting the surgical tool 100 from blade
110.
[0034] FIGS. 7A and 7B are perspective views of a blade 110 for use
with a surgical tool 100 as disclosed herein. Blade 110 may include
a screw receiving portion 112, for example In the example
embodiment, screw receiving portion 112 may comprise an indented
arcuate channel disposed at a distal end 110d of blade 110 for
example In other embodiments, screw receiving portion 112 may be
alternately shaped depending on the head portion of bone screw 12,
for example. In the disclosed embodiment, screw receiving portion
112 may be configured to surround a portion of the head of a bone
screw 112, for example The screw receiving portion 112 may have a
size, shape, and general geometry that corresponds to the size,
shape, and general geometry of the head portion of bone screw 12.
For example, approximately 15%-50% of the underside of the head of
bone screw 12 may nest within an arcuate and sloped surface of
screw receiving portion 112. In at least one embodiment, screw
receiving portion 112 is configured to rotatably support about 25%
of the bottom half surface of a head of a bone screw 12 and bone
screw 12 may have a generally dome shaped head portion. It shall be
understand that the dome shaped head portion as immediately
described may be understand as being severable into a top half and
a bottom half. For example, the head portion of a bone screw 12 may
include a top dome surface and a bottom dome surface. The bottom
dome surface may adjoin a threaded portion there below. The head
portion of the bone screw 12 may also include a planar side surface
portion in some embodiments. Those with skill in the art will
appreciate that the precise size, geometry, and structural
attributes of screw receiving portion 112 may be designed in view
of the particular size, geometry, and structural attributes of the
head portion of a bone screw 12 or other anchoring member, implant,
tool, probe, or the like. For example, a bone screw having a hex
shaped head, a hexalobular shaped head, a cylindrical shaped head,
etc. may suggest an alternately and correspondingly shaped screw
receiving portion 112.
[0035] FIGS. 8 and 9 are example perspective views of an example
retractor 200 including three blades 110, 110z. The example
retractor 200 may include two modular blades 110 that each have or
include a screw receiving portion 112 at a distal portion 110d
similarly as described above, for example. Blades 110 may include a
curved outer surface 110a and a curved inner surface 110b, for
example. Distinct from blades 110, supplemental blade 110z may not
include curved surfaces and/or a screw receiving portion 112. For
example, supplemental blade 110z is substantially planar and is not
configured for resting against a bone screw 12. However, in other
embodiments, supplemental blade 110z may be configured in a similar
manner as blades 110 and include a screw receiving portion 112 or
the like with or without curved surfaces, for example.
[0036] In practice, an end user such as a surgeon may install
blades 110 and bone screw 12 concurrently as described above. Next,
the surgeon may secure retractor 200 to a table via a table mount.
Next, the surgeon may position respective arms of retractor 200
adjacent a respective blade 110 while surgical tool 100 remains
connected to blade 110, for example. Next, the surgeon may secure
blades 110 to the respective arms of retractor 200 via fastener
116, for example. Next, the surgeon may uncouple each surgical tool
100 from each respective blade 110. For example, the surgeon may
move surgical tool 100 upward and away from bone screw 12 with
sufficient force to overcome the connection force between 114 and
122. It shall be understood that retractor 200 may be secured to a
table (not illustrated) such that the relative position of blades
110 may not change and the force required to uncouple surgical tool
100 from blades 110 may be overcome with relative ease due to the
table anchoring the retractor 200 in place.
[0037] FIG. 10 is an example top down view of a retractor 200
including two blades 110 and a supplemental blade 110z. As
illustrated, blades 110, 110z define a surgical opening 50, for
example. The retractor 200 may securely position the proximal end
110p of blades 110 such that blades 110 are restrained from moving
upward, downward, and side to side, for example. Additionally, due
to a head of bone screw 12 directly contacting and/or being nested
within the screw receiving portion 112, blades 110 may act against
bone screw 12 at a distal end 110d. For example, a force of a
patients tissue (schematically shown via arrow F.sub.1 and arrow
F.sub.2) may act against blades 110 pushing them towards a center
of surgical opening 50 and the distal end 110d may remain in place
relative to bone screw 12. For example still, head portion 12 may
provide a fixed fulcrum point resisting the tendency for the distal
end 110d of blades 110 to pivot inwards towards a center of
surgical opening 50. In this way, an inward articulation of blades
110 may be suppressed and/or prevented.
[0038] FIG. 11 is a perspective view of a retractor 200 and an
internal brace 210. Internal brace 210 may be positioned between
bone screws 12 and mobile blades 110 such that it acts against bone
screws 12 and/or mobile blades 110. The internal brace 210 may be
utilized to suppress and/or prevent inward shrinkage of surgical
opening 50 due to, for example, inward pressure from a patient's
tissue such as forces F.sub.1 and F.sub.2. Additionally, internal
brace 210 may be expanded to actively apply pressure against bone
screws 12 and/or blades 110, for example In various embodiments,
retractor 200 may be the same as the modular surgical instrument
system described in U.S. patent application Ser. No. 17/166,265,
the entire disclosure of which is incorporated herein by reference
in its entirety. For example, the surgical tool 100 and
corresponding blades 110 of the present application may be used
with the modular surgical instrument system of U.S. patent
application Ser. No. 17/166,265 as would be readily apparent to a
person having ordinary skill in the art.
[0039] It should be understood that various aspects disclosed
herein may be combined in different combinations than the
combinations specifically presented in the description and
accompanying drawings. For example, features, functionality, and
components from one embodiment may be combined with another
embodiment and vice versa unless the context clearly indicates
otherwise Similarly, features, functionality, and components may be
omitted unless the context clearly indicates otherwise. It should
also be understood that, depending on the example, certain acts or
events of any of the processes or methods described herein may be
performed in a different sequence, may be added, merged, or left
out altogether (e.g., all described acts or events may not be
necessary to carry out the techniques).
[0040] Unless otherwise specifically defined herein, all terms are
to be given their broadest possible interpretation including
meanings implied from the specification as well as meanings
understood by those skilled in the art and/or as defined in
dictionaries, treatises, etc. It must also be noted that, as used
in the specification and the appended claims, the singular forms
"a," "an" and "the" include plural referents unless otherwise
specified, and that the terms "comprises" and/ or "comprising,"
when used in this specification, specify the presence of stated
features, elements, and/or components, but do not preclude the
presence or addition of one or more other features, steps,
operations, elements, components, and/or groups thereof.
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