IPC분류정보
국가/구분 |
United States(US) Patent
등록
|
국제특허분류(IPC7판) |
|
출원번호 |
US-0957589
(2013-08-02)
|
등록번호 |
US-8721692
(2014-05-13)
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발명자
/ 주소 |
- Anderson, David Greg
- Ross, George Joseph
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출원인 / 주소 |
- DePuy Synthes Products LLC
|
대리인 / 주소 |
Nutter McClennen & Fish LLP
|
인용정보 |
피인용 횟수 :
7 인용 특허 :
80 |
초록
▼
Minimally invasive methods and devices are provided for positioning a spinal fixation element in relation to adjacent spinal anchors. In an exemplary embodiment, the device is a percutaneous access device that can be coupled to a spinal anchor, and the method includes the step of positioning a spina
Minimally invasive methods and devices are provided for positioning a spinal fixation element in relation to adjacent spinal anchors. In an exemplary embodiment, the device is a percutaneous access device that can be coupled to a spinal anchor, and the method includes the step of positioning a spinal fixation element through at least one sidewall opening of at least two percutaneous access devices such that the spinal fixation element extends in a lengthwise orientation that is substantially transverse to the longitudinal axis of each percutaneous access device. The spinal fixation element can then be advanced in the lengthwise orientation to seat the spinal fixation element in or adjacent to the receiver heads of at least two adjacent spinal anchors. A fastening element or other closure mechanism can then be applied to each spinal anchor to engage the spinal fixation element within the receiver heads of the adjacent anchors.
대표청구항
▼
1. A method for introducing a spinal fixation element into a patient's spinal column, comprising: providing at least two percutaneous access devices, each device having a proximal end positioned outside a patient's body,a distal end coupled to a spinal anchor,a lumen extending between the proximal a
1. A method for introducing a spinal fixation element into a patient's spinal column, comprising: providing at least two percutaneous access devices, each device having a proximal end positioned outside a patient's body,a distal end coupled to a spinal anchor,a lumen extending between the proximal and distal ends of the percutaneous access device and defining a longitudinal axis, andat least one sidewall opening extending from the distal end through at least a portion of the percutaneous access device;positioning opposed terminal ends of a spinal fixation element through the at least one sidewall opening of the at least two percutaneous access devices with the spinal fixation element being located above a skin surface of the patient and extending in an orientation substantially parallel to the device spinal column of the patient; andadvancing the spinal fixation element in the substantially parallel orientation to seat the spinal fixation element in a receiver head of at least two adjacent spinal anchors. 2. The method of claim 1, wherein each percutaneous access device includes first and second opposed sidewall openings. 3. The method of claim 1, wherein the at least one sidewall opening extends from the distal end and terminates at a position distal to the proximal end. 4. The method of claim 1, wherein each percutaneous access device includes a sleeve disposed therearound and effective to prevent removal of each percutaneous device from the spinal anchor coupled thereto, the sleeve including at least one sidewall opening formed therein that is adapted to align with the at least one sidewall opening in the percutaneous access device. 5. The method of claim 1, wherein each percutaneous access device is threadably coupled to the receiver head of each spinal anchor. 6. The method of claim 1, wherein each percutaneous access device and spinal anchor are mating together by a twist-lock closure mechanism. 7. The method of claim 1, wherein each percutaneous access device is coupled to the receiver head of a spinal anchor, and the at least one opening in the percutaneous access device is adapted to align with a seating portion formed in each receiver head. 8. The method of claim 1, further comprising providing a pusher mechanism adapted to advance the spinal fixation element into the receiver head of adjacent spinal anchors. 9. The method of claim 1, further comprising providing a compression tool, and engaging at least two adjacent percutaneous access devices to compress the devices toward one another while maintaining relative spacing therebetween. 10. The method of claim 9, wherein the compression tool comprises first and second opposed arms that are pivotally mated to one another. 11. The method of claim 1, further comprising delivering a closure mechanism through each percutaneous access device and applying the closure mechanism to each spinal anchor to lock the spinal fixation element in the receiver heads of the anchors. 12. A method for introducing a spinal fixation element into a receiver head of adjacent spinal anchors, comprising: positioning a spinal fixation element through openings formed in at least two adjacent percutaneous access devices such that the spinal fixation element extends between the at least two adjacent percutaneous access devices in an orientation substantially parallel to a spine of a patient;subsequently advancing the spinal fixation element in a distal direction from a location above a skin surface, through tissue, to seat the spinal fixation element in the receiver heads of the adjacent spinal anchors. 13. The method of claim 12, wherein the spinal fixation element is advanced between muscles. 14. The method of claim 12, wherein the each spinal anchor is coupled to a percutaneous access device. 15. The method of claim 12, wherein each percutaneous access device includes opposed openings formed therethrough and extending along a length thereof. 16. The method of claim 15, wherein the openings comprise slots that extend from a distal end and terminate at a position distal to the proximal end of each percutaneous access device. 17. The method of claim 12, further comprising providing a pusher mechanism adapted to advance the spinal fixation element into the receiver head of adjacent spinal anchors. 18. The method of claim 12, further comprising providing a compression tool, and engaging at least two adjacent percutaneous access devices to compress the devices toward one another. 19. The method of claim 18, wherein the compression tool comprises first and second opposed arms that are pivotally mated to one another. 20. The method of claim 12, further comprising providing and applying a closure mechanism to each spinal anchor to lock the spinal fixation element in the receiver heads of the anchors. 21. A method for implanting a spinal fixation element, comprising: advancing a first end of a spinal fixation element through a sidewall opening in a first second percutaneous access device coupled to a first bone anchor implanted in a first vertebra, and advancing a second end of a spinal fixation element through a sidewall opening in a second percutaneous access device coupled to a second bone anchor implanted in a second vertebra such that the spinal fixation element is positioned above a skin surface and extends between the first and second percutaneous access devices; andwith the spinal fixation element extending between the first and second percutaneous access devices and in an orientation substantially parallel to a spine of the patient, advancing the spinal fixation element distally through tissue to position the spinal fixation element within receiver members of the first and second bone anchors. 22. The method of claim 21, further comprising, prior to advancing, implanting the first bone anchor with the first percutaneous access device coupled thereto in a first vertebra, and implanting the second bone anchor with the second percutaneous access device coupled therein in a second vertebra. 23. A method for implanting a spinal fixation element, comprising: implanting a first bone anchor in a first vertebra, the first bone anchor having a first percutaneous access device coupled thereto and defining a lumen extending from a skin surface to the first bone anchor;implanting a second bone anchor in a second vertebra, the second bone anchor having a second percutaneous access device coupled thereto and defining a lumen extending from a skin surface to the second bone anchor;advancing the spinal fixation element along the first and second percutaneous access devices in an orientation substantially perpendicular to a longitudinal axis of the first and second percutaneous access devices such that the spinal fixation element passes through tissue located between the skin surface and the first and second bone anchors; andcoupling the spinal fixation element to the first and second bone anchors. 24. A method for implanting a spinal fixation element, comprising: forming an incision in a skin surface at a location adjacent to a first target implant site in a first vertebra and a second target implant site in a second vertebra:advancing a first k-wire through the incision and into the first vertebra at the first target implant site;advancing at least one dilator over the first k-wire to dilate tissue between the incision and the first target implant site;advancing a first spinal anchor having a first percutaneous access device mated thereto over the first k-wire to position the first spinal anchor at the first target implant site;inserting a driver tool through the first percutaneous access device to drive the first spinal anchor into the first vertebra;advancing a first sleeve over the first percutaneous access device;advancing a second k-wire through the incision and into the second vertebra at the second target implant site;advancing at least one dilator over the second k-wire to dilate tissue between the second incision and the second target implant site;advancing a second spinal anchor having a second percutaneous access device mated thereto over the second k-wire to position the second spinal anchor at the second target implant site;inserting a driver tool through the second percutaneous access device to drive the second spinal anchor into the second vertebra;advancing a second sleeve over the second percutaneous access device to prevent disengagement of the tube from the spinal anchor;forming a pathway between the first and second target implant sites for a percutaneous access device, the pathway being formed by separating tissue from the skin incision down to and between the first and second target implant sites;inserting a spinal fixation element through at least one sidewall opening in each of the first and second percutaneous access devices such that the spinal fixation element extends in an orientation substantially transverse to a longitudinal axis of the first and second percutaneous access devices, and such that at least a portion of the spinal fixation element is located above a skin surface of the patient; andadvancing the spinal fixation element along the pathway to position the spinal fixation element within receiver members on each of the first and second bone anchors; andcoupling the spinal fixation element to the first and second bone anchors.
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