WO2006028537A2 - Cervical plate with backout protection - Google Patents
Cervical plate with backout protection Download PDFInfo
- Publication number
- WO2006028537A2 WO2006028537A2 PCT/US2005/020909 US2005020909W WO2006028537A2 WO 2006028537 A2 WO2006028537 A2 WO 2006028537A2 US 2005020909 W US2005020909 W US 2005020909W WO 2006028537 A2 WO2006028537 A2 WO 2006028537A2
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- bushing
- channel
- bone screw
- protrusion
- shape
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/8033—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers
- A61B17/8047—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers wherein the additional element surrounds the screw head in the plate hole
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7059—Cortical plates
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/92—Impactors or extractors, e.g. for removing intramedullary devices
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/809—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with bone-penetrating elements, e.g. blades or prongs
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/025—Joint distractors
- A61B2017/0256—Joint distractors for the spine
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4601—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for introducing bone substitute, for implanting bone graft implants or for compacting them in the bone cavity
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/28—Bones
- A61F2002/2835—Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
Definitions
- the present invention relates to implantable devices useful in bone fusion and, more particularly, to cervical plates having backout protection.
- the vertebrae of the human spine are arranged in a column with one vertebra on top of the next. Between each vertebra exists an intervertebral disc that transmits force between adjacent vertebrae and provides a cushion between the adjacent vertebrae.
- FIG. 1 shows two adjacent vertebrae 102 and 104. Located between vertebrae 102 and 104 is an intervertebral space 106 partially filled by an implant 108.
- the implant 108 is first inserted into the intervertebral space 106, the adjacent vertebrae 102 and 104 are manually kept apart by the surgeon using, for example, a retracting device (not shown).
- a retracting device not shown.
- FIG. 2 once the implant 108 is placed, the surgeon releases the adjacent vertebrae 102 and 104 allowing them to squeeze the implant 108 and hold the implant 108 in place.
- Cervical plate 202 may have a central viewing window 204 and one or more screw holes 206, in this example four screw holes 206a-206d are shown.
- Four bone screws (which will be identified by reference numerals 208a-208d) would be screwed into the vertebrae using the screw holes 206 to anchor the cervical plate to the vertebrae and immobilize the vertebrae with respect to one another.
- the bone screws 208a-208d absent a locking mechanism tend to reverse thread, which is also known as backing out. Locking mechanisms have been developed to inhibit the bone screws from backing out. Some of the devices included caps or plates that extend over the screw holes 206to inhibit upwards movement of bone screws 208a-208d. Other devices include a frictional engagement between a bushing and the bone screws 208a-208d.
- a cervical plate having backout protection comprises a plurality at through holes.
- Each through hole includes a channel in which a bushing resides.
- the bushing has a bottom edge that can align with a protrusion on a screw head that inhibits the screw from backing out.
- FIG. 1 shows adjacent vertebrae with a bone graft
- FIG. 2 shows adjacent vertebrae with a bone graft and cervical plate
- FIG. 3 shows a perspective and cross-sectional view of a cervical plate with backout protection consistent with the present invention
- FIG. 4 shows a perspective view of a fixed angle bone screw
- FIG. 5 shows a perspective view of a variable angle bone screw
- FIG. 6 shows a perspective view of an embodiment of one possible bushing consistent with the present invention
- FIG. 7 shows a cross-sectional view of the bone screw and bushing as it would exist if the bone screw was threaded in the vertebral body; and
- FIG. 8 shows a cross-section view similar to FIG. 7 but prior to complete engagement.
- FIG. 3 a perspective and cross-sectional view of a cervical plate 300 illustrative of an embodiment of the present invention is shown.
- Cervical plate 300 is shown with a construct that could span two intervertebral spaces (a.k.a. a two level cervical plate); however, cervical plate 300 could be constructed to span more or less intervertebral spaces.
- cervical plate 300 is shown with two viewing windows 302. More or less viewing windows 302 could be provided. For example, for a construct that spanned one intervertebral space, only one viewing window may be used. Moreover, for a construct that spanned three intervertebral spaces, three viewing windows may be provided.
- each viewing window 302 could be split into several smaller viewing windows as a matter of design choice.
- Cervical plate 300 comprises a bone facing side 304, a top side 306 opposite bone facing side 304, and a plurality of through holes 308.
- Through holes 308 generally have a diameter dl, at least at bone facing side 304 and top side 306.
- Each of the plurality of through holes 308 has a channel 310 traversing a perimeter of through hole 308.
- Channel 310 resides between bone facing surface 304 and top side 306.
- channel 310 has a concave shape with a maximum diameter of diameter d2 greater than dl. While described separately, channel 310 may simply be a bowing or gradual increase in diameter along the sidewalls associated with through holes 308.
- a bushing 312 resides in channel 310, as will be explained further below.
- Bone screws 314 extend through through holes 308 such that bone screws 314 are threaded to vertebral bodies.
- a head 316 of bone screws 314 engage bushings 312, as will be explained further below, inhibiting bone screws 314 from reverse threading or
- fixed angle bone screw 400 and variable angle bone screw 500 are shown.
- bone screws 314 could be either fixed angle bone screws 400 or variable angle bone screws 500, and both are shown in FIG. 3.
- Fixed angle bone screws 400 and variable angle bone screws 500 are generally known in the art and will not be further explained herein. Head 316 will be explained further below with reference to FIG. 7.
- Bushing 312 comprises a top edge 602, which would be located proximate top side 304, and a bottom edge 604, which would be located proximate bone facing surface 306.
- Sidewall 606 extends between top edge 602 and bottom edge 604.
- Bushing 312 is shown generally cylindrical in shape but generally would have a shape consistent with channel 310 to allow cervical plate 300 and bone screws 314 to align properly during surgery.
- channel 310 has a concave shape to cooperatively engage a convex shape of an outer surface 608 of sidewall 606.
- Inner surface 610 has a shape consistent with heads 316.
- Outer surface 608 has a diameter d2 at its maximum.
- Bushing 312 is compressible such that bushing 312 can be compressed to fit within diameter dl.
- bushing 312 may have a gap 610. Once the compressive force is removed, bushing 312 would expand such that outer surface 608 cooperatively engages channel 310.
- At least a bottom portion 612 of bushing 312 comprises a flexible material that can expand outward when impinged by head 316, which will be explained further below.
- bottom portion 612 may comprises one or more slots 614.
- bottom edge 604 has a diameter d3. Head 316 will be explained in more detail with reference to FIGS. 7 and 8. Head 316 has an internal matting surface 702.
- Internal matting surface 702 is designed to allow a surgical tool to drive bone screw 314 into a vertebral body.
- Head 316 has an external surface 704 that cooperatively engages inner surface 610 of bushing 312.
- inner surface 610 is concave and external surface 704 is convex.
- External surface 704 may extend over a portion or all of head 316, but terminates at a transition edge 706 where a protrusion 708, which may be a ledge or shoulder, extends.
- Transition edge 706 has a diameter d3 and protrusion 708 extends outward from transition edge 706 such that bottom edge 604 abuts protrusion 708.
- bushing 312 inhibits reverse threading of bone screw 314 because bottom edge 604 abutting protrusion 708 inhibits upward movement of bone screw 314. While bottom edge 604 could directly abut protrusion 708, washers or other devices could be implanted as well.
- FIG. 7 shows the implant after bone screw 314 has been threaded in the vertebral bodies
- FIG. 8 shows the implant prior to completion of the threading operation.
- head 316 advances through bushing 312.
- a surface 802 on protrusion 708 tends to impinge on bottom portion 612 as head 316 advances.
- the impingement causes bottom portion 612 to flex.
- protrusion 708 advances past bottom edge 604, bottom portion returns to it pre-flex position such that bottom edge 604 is aligned over protrusion 708.
Abstract
Description
Claims
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/932,272 | 2004-09-01 | ||
US10/932,272 US7175623B2 (en) | 2002-06-24 | 2004-09-01 | Cervical plate with backout protection |
Publications (3)
Publication Number | Publication Date |
---|---|
WO2006028537A2 true WO2006028537A2 (en) | 2006-03-16 |
WO2006028537A3 WO2006028537A3 (en) | 2006-10-05 |
WO2006028537B1 WO2006028537B1 (en) | 2006-11-16 |
Family
ID=36036777
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US2005/020909 WO2006028537A2 (en) | 2004-09-01 | 2005-06-14 | Cervical plate with backout protection |
Country Status (2)
Country | Link |
---|---|
US (1) | US7175623B2 (en) |
WO (1) | WO2006028537A2 (en) |
Cited By (23)
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US7951170B2 (en) | 2007-05-31 | 2011-05-31 | Jackson Roger P | Dynamic stabilization connecting member with pre-tensioned solid core |
US9050139B2 (en) | 2004-02-27 | 2015-06-09 | Roger P. Jackson | Orthopedic implant rod reduction tool set and method |
US9198695B2 (en) | 2010-08-30 | 2015-12-01 | Zimmer Spine, Inc. | Polyaxial pedicle screw |
US9629669B2 (en) | 2004-11-23 | 2017-04-25 | Roger P. Jackson | Spinal fixation tool set and method |
USRE46431E1 (en) | 2003-06-18 | 2017-06-13 | Roger P Jackson | Polyaxial bone anchor with helical capture connection, insert and dual locking assembly |
US9743957B2 (en) | 2004-11-10 | 2017-08-29 | Roger P. Jackson | Polyaxial bone screw with shank articulation pressure insert and method |
US9907574B2 (en) | 2008-08-01 | 2018-03-06 | Roger P. Jackson | Polyaxial bone anchors with pop-on shank, friction fit fully restrained retainer, insert and tool receiving features |
US9918751B2 (en) | 2004-02-27 | 2018-03-20 | Roger P. Jackson | Tool system for dynamic spinal implants |
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Also Published As
Publication number | Publication date |
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WO2006028537A3 (en) | 2006-10-05 |
WO2006028537B1 (en) | 2006-11-16 |
US20050027296A1 (en) | 2005-02-03 |
US7175623B2 (en) | 2007-02-13 |
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