Revision connectors, systems, and methods thereof

Connector assemblies, systems, and methods thereof. A connector having body having a first end and a second end; a first connecting member at the first end, the first connecting member having a rod supporting member extending away from the first connector and a passage extending between the first connecting member and the rod supporting member; and a rod extending from the second end. The body and the passage extend co-axially, and a space is provided between the first end and the second end, the space being sized such that a spinal implant screw head is insertable in the space.

BACKGROUND

Field of the Invention

The present invention relates to rod connectors, such as spinal hardware connectors.

Description of the Related Art

At times, spinal surgeons are forced to add additional fixation to spinal segments adjacent to previously instrumented levels. In these cases, the hardware from the initial surgery interferes with placement of new fixation for the adjacent level. Therefore, there is a need for connector implants that attach to the existing spinal fusion construct on one end and extend fixation to adjacent levels in need of fusion. Quicker recovery times and lessened discomfort makes minimally invasive surgical (MIS) techniques favorable in these situations.

SUMMARY

The present disclosure relates to components, systems, and methods for connecting one device to another device. For example, one elongate implant, such as a first rod, may be coupled to another elongate implant, such as a second rod. The elongate implants, such as rods, are well known to connect adjacent vertebrae in a spinal fusion procedure. Depending on the configuration of rods or implants, it may be desirable to have one rod connected to another rod or additional implant. In the case of two or more rods, these rods may be interconnected with one or more connectors, for example, in a single given surgery, such as a scoliosis operation, or at a later surgery, for example, in a revision surgery. In a revision surgery, connectors can be used to connect new fixation constructs to existing fixation constructs without the need to remove the original hardware. The different connection modes provided in the following exemplary embodiments offer a range of options to be chosen based on a specific clinical scenario and/or surgeon preference. Although certain configurations are shown herein, it is envisioned that any suitable number, type, and selection of connectors and implants may be chosen and configured by the skilled surgeon.

According to one embodiment, an articulating revision connector assembly may include a connector that is configured to connect a new construct to an existing construct in a patient.

In one embodiment, the articulating revision connector assembly comprises a rod and a connector attached to the rod. The connector includes an open clamp portion having a securing mechanism rotatably connected thereto and a closed clamp portion rotatably connected to the open clamp portion. The closed clamp portion has a passage extending therethrough. The passage is sized to allow passage of the rod therethrough. A locking mechanism is configured to releasably prevent rotation of the closed clamp portion relative to the open clamp portion when the rod is inserted into the passage.

In an alternative embodiment, the articulating revision connector assembly comprises a rod and a connector releasably connected to the rod. The connector includes a first connecting portion extending along a longitudinal axis. The first connecting portion has a first end having an open connection adapted to releasably retain the rod and a second end having a blind passage extending along the longitudinal axis. A second connecting portion is rotatably connected to the second end of the first connecting portion. The second connecting portion has an axial passage extending generally orthogonal to the longitudinal axis.

In still another alternative embodiment, a method of adding a new construct to an existing construct comprises the steps of: providing a connector having a first connecting portion with an open connection and a second connecting portion rotatably connected to the first connecting portion, the second connecting portion having an axial passage extending therethrough; inserting the open connection over a first rod in the existing construct; securing the first connecting portion to the first rod; inserting a second rod through the axial passage; rotating the second connecting portion relative to the first connecting portion to a desired location; and securing the second rod to the second connecting portion, thereby restricting rotation of the second connecting portion with respect to the first connecting portion.

In yet another exemplary embodiment, a spinal revision connector assembly comprises a body having a first end and a second end, a first connecting member at the first end, and a rod extending from the second end.

Another exemplary embodiment of a spinal revision connector assembly comprises an elongate rod having a first end and a second end, a tapered tip at the first end, and a securing structure at the second end.

In still another exemplary embodiment, the spinal revision connector assembly comprises a rod and a connector portion attached to an end of the rod. The connector portion has a space sized to allow the passage of a construct therethrough and a connector distal from the rod.

DETAILED DESCRIPTION

In the drawings, like numerals indicate like elements throughout. Certain terminology is used herein for convenience only and is not to be taken as a limitation on the present invention. The terminology includes the words specifically mentioned, derivatives thereof and words of similar import. The embodiments illustrated below are not intended to be exhaustive or to limit the invention to the precise form disclosed. These embodiments are chosen and described to best explain the principle of the invention and its application and practical use and to enable others skilled in the art to best utilize the invention.

Also for purposes of this description, the terms “couple,” “coupling,” “coupled,” “connect,” “connecting,” or “connected” refer to any manner known in the art or later developed of joining or connecting two or more elements directly or indirectly to one another, and the interposition of one or more additional elements is contemplated, although not required. Conversely, the terms “directly coupled,” “directly connected,” etc., imply the absence of such additional elements.

The present disclosure relates to components, systems, and methods for connecting one elongate implant, such as a first rod, to another elongate implant, such as a second rod. The elongate implants, such as rods, are well known to connect adjacent vertebrae in a spinal fusion procedure. Depending on the configuration of rods or implants, it may be desirable to have one rod connected to another rod or additional implant. In the case of two or more rods, these rods may be interconnected with one or more connectors, for example, in a single given surgery, such as a scoliosis operation, or at a later surgery, for example, in a revision surgery.

For example, connectors can be used to connect new fixation constructs to existing fixation constructs without the need to remove index surgery hardware. A benefit to such direct attachment to existing constructs saves operating time, causes less disruption to the patient, and minimizes patient healing time. The ability of the inventive connectors to maintain connection with existing constructs can maximize utility in cases of varying patient anatomy and existing spinal constructs. The different connection modes provided in the following exemplary embodiments offer a range of options to be chosen based on a specific clinical scenario and/or surgeon preference. Thus, although certain configurations are shown herein, it is envisioned that any suitable number, type, and selection of connectors and implants, such as rods, may be chosen and configured by the skilled surgeon.

While the different connection modes disclosed herein can be used independently, those skilled in the art will recognize that the connection modes can be combined “á la carte” according to patient needs. Further, while the connection modes disclosed herein can be provided separately, kits that include various and multiple combinations of different connection modes can also be provided.

Referring toFIGS. 1-5, an articulating revision connector assembly100(“connector assembly100”) according to a first exemplary embodiment is shown. Connector assembly100is used to attach to a first rod50that is already present in an existing construct. As shown inFIG. 2, first rod50can be supported by and secured to one or more screw heads60(e.g., a tulip assembly connected to a polyaxial pedicle screw). Although not shown, a cap or securing member, such as a threaded cap, may then be engaged with the threaded portion of the tulip to secure the rod50therein. WhileFIG. 2shows connector assembly100as being located between screw heads60, those skilled in the art will recognize that connector assembly100can be located in other places along first rod50. For example, the connector assembly100can positioned such that it is substantially in contact with a portion of the screw heads60(e.g. substantially in contact with an outer portion of the tulip assembly).

Referring backFIG. 1, connector assembly100is an open lateral connector that extends an existing construct an adjacent level. Connector assembly100includes an open clamp portion110rotatably connected to a closed clamp portion130that provides articulation about open clamp portion110to a desired angle. Once the desired rotational position is achieved, closed clamp portion130can be secured to open clamp portion110, locking the articulation.

Open clamp portion110includes a securing mechanism112, such as a set screw, that is rotatably connected thereto. Open clamp portion110includes a blind passage114with a clamp opening116that extends along a first axis “A1”. Securing mechanism112is mounted in a through passage118(shown inFIG. 5) extending generally orthogonally relative to first axis A1.

Closed clamp portion130is rotatably connected to open clamp portion110. Closed clamp portion130has a passage132extending therethrough that is sized to allow passage of a second rod70(shown inFIG. 3) therethrough. The passage132is preferably sized and shaped to receive the rod70. In the embodiment shown, the passage132is elongated to have a length greater than its width to allow for some translation of the rod70in the passage132before the securing member134is tightened. It is envisioned, however, that the passage132may be substantially circular or cylindrical in shape. Rod70may be a Z-rod (shown inFIG. 71) in order to extend rod50co-linearly, as shown inFIG. 3. Although not shown, any other suitable rod may be selected, for example, to allow for a parallel configuration or to select a rod that may be bent in situ.

Closed clamp portion130includes a securing member134that is adapted to bias second rod70. Securing member134is rotatably mounted in a through-passage135that extends generally obliquely relative to longitudinal axis A1. The rotation of closed clamp portion130relative to open clamp portion110is illustrated inFIGS. 4A-4E, which show closed clamp portion130rotated across five different positions relative to open clamp portion110. Those skilled in the art will recognize that closed clamp130has 360° of rotation relative to open clamp portion110. It is envisioned, however, that the clamp130may be permitted to rotate any suitable amount relative to open clamp portion110.

Referring toFIG. 5, a locking mechanism150is configured to releasably prevent rotation of closed clamp portion130relative to open clamp portion110when rod70(not shown inFIG. 5) is inserted into passage132. Locking mechanism150includes a blind passage152formed in closed clamp portion130and extending along longitudinal axis A1. Passage152has a first set of teeth154. An insert156is longitudinally disposed in passage152. Insert156has a second set of teeth158that are releasably engageable with the first set of teeth154, such that, when insert156is longitudinally translated toward open clamp portion110, second set of teeth158engages first set of teeth154, restricting rotation of open clamp portion110relative to closed clamp portion130.

Passage152has an outwardly flared opening160, and insert156has a corresponding outwardly flared end162that is adapted to engage outwardly flared opening160when insert156is longitudinally translated toward open clamp portion110. Flared opening160of passage152also includes a lip164that extends radially away from first axis A1.

A cap170is threadably connected to closed clamp portion130to rotatably retain closed clamp portion130on open clamp portion110. Cap170includes a threaded connection172that threadably engaged with mating threads174on closed clamp portion130. An exterior of cap170also includes radially spaced recesses176allow for the application of a tool (not shown), such as, for example, a spanner wrench, to attach/remove cap170to/from closed clamp portion130.

A plurality of bushings and washers180-184are located on the exterior of open clamp portion110between cap170and lip164and serve to form a frictional connection between cap170and lip164when closed clamp portion130is locked to open clamp portion110.

To assemble connector assembly100and add rod70to an existing construct, clamp opening116of connector assembly100is secured to rod50, and rod70is then inserted into passage132as shown in the exemplary configuration shown inFIG. 3. When rod70is located at a desired angle with respect to rod50, securing mechanism112is advanced through passage118, such that securing mechanism112biases rod70against insert156, advancing insert156along longitudinal axis A1toward passage114. Teeth158on insert156engage with teeth154in passage152and seat flared end162of insert156on flared opening160of passage152, forcing lip164to bias toward cap170, thereby restricting rotation of open clamp portion110relative to closed clamp portion130.

In an alternative embodiment, shown inFIG. 6, a clamp assembly200incorporates closed clamp portion130, but, instead of open clamp portion110, includes an open clamp portion210rotatably attached thereto. Open clamp portion210comprises a clamp opening216extending obliquely relative to the first axis A1, with opening216in an offset plane relative to opening132in closed clamp portion130.

In another alternative embodiment of a connector assembly300, shown inFIG. 7, wherein an open clamp portion310comprises a clamp opening316extending generally orthogonally relative to first axis A1such that a blind end of opening316extends along first axis A1, allowing the insertion of rod50in opening316to be coplanar with rod70after rod70is inserted into passage132.FIG. 8shows the connection of connector assembly300with rod70extending in the same lateral plane as existing rod50. This configuration allows the open clamp portion310to be positioned beneath the existing rod50. A threaded cap (not shown) may then be engaged with the threaded portion on the top of the open clamp portion310to secure the rod50therein, thereby coupling rod50to rod70.

In still another embodiment of a connector assembly400, shown inFIGS. 9 and 10, an open clamp portion410comprises a clamp opening416extending generally orthogonally relative to first axis A1such that a blind end of opening416extends above first axis A1, allowing the insertion of rod50in opening416to be skewed with respect to rod70after rod70is inserted into passage132. The open clamp portion410may have a generally U-shaped configuration allowing for the open clamp portion410to be positioned beneath the existing rod50. A threaded cap (not shown) may then be engaged with the threaded portion on the top of the open clamp portion410to secure the rod50therein, thereby coupling existing rod50to new rod70.

In yet another embodiment of a connector assembly500, shown inFIG. 11, and articulating modular lateral head connector is provided. In this embodiment, the open clamp portion is replaced with a connection point, such as a post, configured to receive a rod having a modular connection point1220, for example, as depicted inFIG. 28and described in more detail below. The post or connection point may have a partially spherical outer surface with a generally flat top surface to enable engagement with a corresponding opening in the rod.

Referring now toFIGS. 12-27, a plurality of integrated revision connectors according to exemplary embodiments are shown. In an exemplary embodiment, shown inFIG. 12, a spinal revision connector assembly600includes a body610having a first end612and a second end614. Body610is generally a closed loop that provides a space sufficiently large for the insertion of a pre-existing construct, such as, for example, a spinal implant screw head (not shown) therethrough, thereby minimizing the amount of new construct that is to be connected to an existing construct.

A first connecting member620is located at first end612. In an exemplary embodiment, first connecting member620can be a threaded opening that allows for the insertion of a fastener, such as a set screw (not shown), that provides for connection to existing construct.

An upper surface622of first end612includes an arcuate recess624sized to accept a rod (not shown) from an existing construct. Similarly, a lower surface626includes an arcuate recess628sized to accept a rod (not shown) from an existing construct. Recesses624,626can be the same or different sizes (as shown) in order to be able to accommodate rods of different diameters.

A rod630extends from second end614of body610. Rod630can have a tapered tip632at a distal end of rod630from body610. Rod630can extend an existing construct two adjacent level in order to provide required fixation.

In an alternative exemplary embodiment, shown inFIGS. 13-16, a spinal revision connector assembly700includes a body710having a first end712and a second end714. Body710is generally an open loop that provides a space sufficiently large for the insertion of body710over the top of a screw head60in an existing construct where rod50is of insufficient length protruding from the side of screw head60, as shown inFIGS. 14 and 15. Alternatively, body710can go around screw head60in the existing construct, as shown inFIG. 16.

A first connecting member720is located at first end712. In an exemplary embodiment, first connecting member720can be one or more threaded openings722,724, that allow for the insertion of a fastener, such as a set screw (not shown), that provides for connection to existing construct. Additionally, a lower lip726is used to support an underside of rod50to provide secure clamping of first connecting member720to rod50, such that a passage727is formed between lower lip726and first end712.

A rod730extends from second end714of body710. Rod730can have a tapered tip732at a distal end of rod730from body710. Rod730extends along a common axis with passage727such that rod730extends the existing construct of rod50at an adjacent level.

In another alternative exemplary embodiment, shown inFIGS. 17 and 18, a spinal revision connector assembly800includes a body800and having a first end812and a second end814. Body810is generally an open loop with a space between first end812and second end814that allows for the insertion of body810over the top of screw head60in an existing construct where rod50is of insufficient length protruding from the side of screw head60, as shown inFIG. 18. It is noted that, inFIG. 18, the length of rod50extending beyond screw head60is longer than that shown inFIG. 14, allowing for the use of assembly800, as shown inFIG. 18.

A first connecting member820is located at first end812and a second connecting member822is located at second end814. First connecting member820and second connecting member822can be threaded openings that allow for the insertion of a fastener, such as a set screw (not shown), to secure assembly800to rod50where rod50is sufficiently long to allow rod50to extend beyond screw head60, such that rod50can be engaged and secured by second connecting member822, as shown inFIG. 18. Additionally, a first lower lip824at first connecting member820and a second lower lip826at second connecting member822are used to support an underside of rod50to provide secure clamping of connecting members820,822to rod50, such that a passage827is formed between first lower lip824and first end812and between second lower lip826and second end814.

A rod830extends from second end814of body810. Rod830can have a tapered tip832at a distal end of rod830from body810. Rod830extends along a common axis with passage827such that rod730extends the existing construct of rod50at an adjacent level.

In still another alternative exemplary embodiment, shown inFIG. 19, a spinal revision connector assembly900includes a body910having a first end912and a second end914. Body910is generally a closed loop that provides a space between first end912and second end914sufficiently large for the insertion of a pre-existing construct, such as, for example, screw head60, therethrough, thereby minimizing the amount of new construct that is to be connected to an existing construct.

A first connecting member920is located at first end912and a second connecting member922is located at second end914. First connecting member920and second connecting member922can be threaded openings that allow for the insertion of a fastener, such as a set screw (not shown), to secure assembly900to rod50where rod50is sufficiently long to allow rod50to extend beyond screw head60, such that rod50can be engaged and secured by second connecting member922.

A rod930extends from second end914of body910. Rod930can have a tapered tip932at a distal end of rod930from body910.

In still another alternative exemplary embodiment, shown inFIGS. 20-22, a spinal revision connector assembly1000includes a body1010having a first end1012and a second end1014. Body1010is generally an open loop that provides a space between first end1012and second end1014that is sufficiently large for the insertion of a pre-existing construct, such as, for example, screw head60, therethrough, thereby minimizing the amount of new construct that is to be connected to an existing construct.FIG. 21shows body1010extending over top of screw head60, whileFIG. 22shows body1010extending around screw head60.

A first connecting member1020is located at first end1012. First connecting member1020can be a threaded opening that allows for the insertion of a fastener, such as a set screw (not shown), to secure assembly1000to rod50. Connecting member1020also includes clamping surfaces1022,1024that extend outwardly from first end1012. Clamping surfaces1022,1024are spaced sufficiently from each other to allow rod50to slide therethrough such that, when the fastener or set screw is secured, first connecting member1020securely grips rod50.

A rod1030extends from second end1014of body1010. Rod1030can have a tapered tip1032at a distal end of rod1030from body1010. Rod1030extends at the adjacent level as for50(shown inFIG. 21).

In another alternative exemplary embodiment, shown inFIGS. 23-27, a spinal revision connector assembly1100includes a body1110having a first end1112and a second end1114. First end112includes a clamp housing that contains an inner revolving mechanism1116that can be rotated to surround the underside of an existing rod50.

Mechanism1116includes a rotating clamp1118that is mounted on a pivot1120. A distal end of clamp1118includes a plurality of ratchet teeth1122. When clamp1118is rotated from the position shown inFIG. 24Ato the position shown inFIG. 24D, ratchet teeth1122engage a securing mechanism in the form of internal ratchet teeth1124within body1110to secure clamp1118around rod50, as shown inFIG. 25, preventing clamp1118from rotating backwards after final tightening. Clamp1118is rotated by rotating mechanism1120. As shown inFIGS. 24A-24D, rotating mechanism1120can be a hex head screw that can be rotated by engaging a hex head tool, such as, for example, an Allen wrench (not shown), with rotating mechanism1120and rotating.

Body1110includes arcuate cutouts1126on opposing sides thereof (only one cutout1126shown inFIG. 25), that are sized to receive rod50so that body1110snugly fits on rod50. Body1110also includes a threaded top opening1128sized to receive a set screw1129inserted therein so that set screw1129can be screwed on top of rod50, as shown inFIG. 26.

A rod1130extends from second end1114of body1110. Second end1114comprises an offset portion1132and distal end1134extending away from offset portion1132, such that distal end1134is at an adjacent level with rod50, as shown inFIG. 27. A space is provided between first end1112and second end1114that is sufficiently large for the insertion of a pre-existing construct, such as, for example, a spinal implant screw head (not shown) therethrough, thereby minimizing the amount of new construct that is to be connected to an existing construct.

Referring now toFIGS. 28-38, a plurality of link connectors according to exemplary embodiments are shown. A first exemplary link connector1200is used with a mating modular connection point on a spinal screw, or a secondary connector implant.

Referring specifically toFIGS. 28 and 29, a connector1200includes a rod1210within modular connection point1220at a first end. Connection point1220is a generally hollow body. Also, connection point1220includes a threaded connector, such as, for example, a fastener or set screw1222rotatably connected thereto and extending into the hollow body of connection point1220. Additionally, connection point1220includes a diametrically opposed indents1224(only one indent1224shown inFIG. 28) to accommodate a gripping tool, such as, for example, a spanner wrench (not shown) that can be used to secure rod1210at a desired position while set screw1220is being tightened.

FIG. 29shows connector1200spanning screw heads60,62. Connection point1220is secured directly to screw62, while rod1210is secured to screw head60, placed at an adjacent level.

Referring toFIG. 30, an exemplary embodiment of a lateral connector1300is shown. Lateral connector1300includes a base1310having a first end1312with a connection point1314extending upwardly therefrom. Connection point1314is sized to fit into connection point1220and receives set screw1222from link connector1200.

Base1310also has a second end1320that includes a rod clamp1322. Rod clamp1322includes an arcuate surface1324for engaging a rod and a top surface1326, extending above connection point1314, that supports a securing member, such as, for example, a set screw1328that can be rotated to secure rod50within rod clamp1322, as shown inFIG. 32. As shown inFIG. 32, rod1210can extend at an oblique angle relative to rod50, in order to accommodate for the lateral offset in lateral connector1300.

Referring toFIG. 31, a top loading connector1400is shown. Connector1400includes a body1410that includes a rod clamp1412. Rod clamp1412includes an arcuate surface1414for engaging a rod and a flat top surface1416disposed above arcuate surface1414. Top surface1416includes a first threaded connection1418that receives a set screw1420. Top surface1416also includes a second threaded connection1422, for receiving an additional connector (not shown).

Referring now toFIGS. 33 and 34, a lateral offset link connector1500is shown. Link connector1500is similar to link connector1200, with the exception that, instead of a straight elongate body1210, link connector1500includes a body1510having a first end1512connected to a modular connection point1520, similar to modular connection point1220, a second, free end,1514, and a lateral offset1516, connecting first end1512with second end1514. Lateral offset1516is sized to accommodate the same lateral offset as with lateral connector1300.

As shown inFIG. 34, modular connection point1520can be connected to lateral connector1300, which in turn is connected to a rod50in an existing construct such that second end1514extends generally co-linearly with rod50, thereby allowing second end1514, to effectively act as an extension of rod50.

Referring now toFIGS. 35 and 36, a sagittal offset link connector1600is shown. Link connector1600is similar to link connector1500, with the exception that, instead of lateral offset1516, link connector1600includes a body1610having a first end1612connected to modular connection point1620, similar to modular connection point1520, a second, free end,1614, and a sagittal offset1616, connecting first end1612with second end1614. Sagittal offset1616is sized to allow connector1600to extend upward and over a screw head60when connected to a lateral connector1300and rod50, as shown inFIG. 36.

As shown inFIG. 36, modular connection point1620can be connected to lateral connector1300, which in turn is connected to a rod50in an existing construct such that second end1614extends generally co-linearly with rod50, thereby allowing second end1514, to effectively act as an extension of rod50.

Referring now toFIGS. 37-57, a plurality of link connectors according to exemplary embodiments are shown.FIGS. 37-41show a connector1700according to an exemplary embodiment. Connector1700is connected to an existing rod by a twisting connection and subsequent to attachment, a second, new rod may be positioned above and in-line with the existing rod. For example, connector1700may be inserted between two existing screw head60, proximal to an adjacent level that needs additional fixation.

Connector1700includes a body1710having a connecting portion1712at a first end and a screw head portion1720at an opposing end. Connecting portion1712includes a pair of outwardly extending curved legs1714,1716that extend downwardly from diametrically opposed sides of body1710in opposing directions, forming a passage1718sized to allow a rod50to extend therethrough.

Screw head portion1720includes a first arcuate portion1722and a second arcuate portion1724diametrically opposed from first arcuate portion1722, forming a rod through-passage1725extending therebetween. The interior faces of each of arcuate portion1722,1724are threaded at threads1726to accommodate insertion of a set screw1730, shown inFIG. 41.

To install connector1700on a rod50, connector1700is inserted with rod through-hole1725facing in a medial/lateral direction and legs1714,1716straddling rod50, as shown inFIG. 40. Connector1700is then rotated 90° in situ, so that rod50extends through passage1718, with legs1714,1716extending underneath rod50, as shown inFIG. 41. Set screw1730is then screwed downward to engage rod50, securing connector1700to rod50.

In an alternative embodiment of a connector1800, shown inFIG. 42, instead of threads1726and set screw1730, lower interior surfaces of a first arcuate portion1822and a second arcuate portion1824are unthreaded and a wedge1826is advanced through a rod through-passage1825to engage rod50and secure rod50to connector1800.

As shown inFIG. 43, either connector1700or connector1800can be attached to an existing rod50through passage1718and a new construct with a rod80can be inserted through rod through-passage1725,1825. A threaded cap (not shown) may then be engaged with the threaded portion on the top of the screw head portion1720to secure the rod80therein, thereby achieving fixation. If required, rod80can be bent to maintain new construct and an adjacent level with the existing rod50.

FIGS. 44-46show a connector1900according to an exemplary embodiment. Connector1900includes a body1910having a connecting portion1912at a first end and a head portion1930at an opposing end. Connecting portion1912includes a first generally longitudinally extending leg1914having a connection mechanism1916extending therethrough. In an exemplary embodiment, connection mechanism1916can be a set screw.

Connecting portion1912also includes a second leg1917, having a first portion1918that extends generally longitudinally away from body1910, generally parallel to first leg1914. Second leg1917also includes a curved portion1919that curves an arcuate fashion toward first leg1914, forming a passage1920therebetween. Passage1920is sized to allow connector1900to be connected to an existing rod50, as shown inFIG. 46. Connection mechanism1916extends sufficiently through first leg1914to be able to extend into passage1920.

Head portion1930includes a first arcuate portion1932and a second arcuate portion1934diametrically opposed from first arcuate portion1932, forming a rod through-passage1935extending therebetween. Rod through-passage1935is sized to receive a rod80as part of a newly assembled construct, as shown inFIG. 46. If rod80is a “Z-Rod”, rod80can be configured to achieve fixation at an adjacent level with rod50.

FIGS. 47-50show a connector2000according to an alternative exemplary embodiment. Connector2000is similar to connector1900as described above, with the exception that connector2000includes only a single leg2017extending downward from a body2010. Leg2017includes a first portion2018that extends longitudinally outwardly, away from body2010and a curved portion2019that curves in an open hook fashion toward an opposing side of body2010, forming an open passage2020. Curved portion2019includes an arcuate support face2021faces open passage2020and serves as a support for an existing rod50, as shown inFIG. 50.

FIG. 48shows connector2000with an optional set screw2030can be threaded into a threaded passage2032to secure connector2002existing construct, such as, for example, rod50.

Alternatively,FIG. 49shows connector2000and optional wedge2040that can be used in place of set screw2030, to secure rod50in connector2000.

Similarly to connector1900, connector2000has a rod through-passage2035is sized to receive a rod80as part of a newly assembled construct, as shown inFIG. 50. If rod80is a “Z-Rod”, rod80can be configured to achieve fixation at an adjacent level with rod50.

Lateral connector1300, shown previously inFIG. 30, can be used as shown inFIG. 51to connect to a rod50in an existing construct. As shown inFIGS. 52-54, new construct90can be attached at connection point1314to achieve fixation. Instead of installing connector1200at an angle, as shown inFIG. 32,FIGS. 53 and 54show that, when rod80is a Z-Rod, lateral connector1300can be used to support rod80such the rod80extends collinear with existing rod50.

Top loading connector1400, shown previously inFIG. 31, can be used. As shown inFIGS. 55-57to connect to an existing rod50. In an existing construct. As shown inFIGS. 56 and 57, new construct90can be attached at connection1422to achieve fixation. As will be appreciated by those skilled in the art, after the rod80is secured and attached to the existing rod50and the adjacent vertebra or vertebrae using a minimally invasive surgical (MIS) approach, the extensions may be detached from the tulips, thereby leaving the connector1400and rod80subcutaneously implanted in the patient.

Referring now toFIGS. 58 and 59, an offset revision rod2100according to an exemplary embodiment is shown. Revision rod2100has an elongate body2110having a first end2112, with an integrated single open clamp2120extending laterally therefrom. Claim2120includes a body2122with a clamp portion2124sized to accept and retain a rod (not shown) between proximal existing screw heads (also not shown). Body2122also includes a threaded opening2126sized to accept a fastener, such as a set screw (not shown), that can be screwed downwardly to secure the rod into clamp portion2124.

Body2110further has a second end2130an offset2132, between first end2112and second and2130, such that first and2112and second end2130extend parallel to each other. Rod2100allows a fixation to be extended to adjacent level with a single implant. Offset2132allows rod2100to navigate around a most proximal screw head (not shown) in an existing construct.

A distraction/compression clamp2200is shown inFIGS. 60-61. Clamp2200has a single open clamp2210with a through passage2212sized to accept a rod50inserted therethrough. Claim2200also includes a threaded opening2220that is sized to accept a set screw2222to secure clamp2200to rod50. Clamp2200can provide a fixed point for distraction and/or compression.

A double-headed lateral connector2300is shown inFIGS. 62-64. Connector2300includes a body2310having a first screw head2320(e.g., a first tulip) having a passage2322and a second screw head2330(e.g., a second tulip) having a passage2332. Screw heads2320and2330are separated from each other by a connecting member2340. Passage2322is sized to accept a first rod (not shown) from an existing construct and passage2332is sized to accept a second rod (not shown) from the new construct in order to extend the existing construct to an adjacent level. A threaded cap (not shown) may then be engaged with each of the threaded portions on the tops of the screw heads2320and2330to secure the respective rods therein, thereby coupling the rods substantially parallel to one another. WhileFIG. 62shows screw heads2320,2330extending parallel to each other, those skilled in the art will recognize that screw heads2320,2330can also be offset or angled relative to each other.

WhileFIG. 62shows connecting member2340connecting first screw head2320and second screw head2330only at the bottom portion of connector2300,FIGS. 63 and 64show a connecting member2350that connects first screw head2320and second screw head2330along the length of the screw heads.

FIG. 65shows a double-headed in-line connector2400according to an exemplary embodiment. While lateral connector2300discussed above laterally connects adjacent rods, in-line connector2400connects adjacent rods longitudinally. Connector2400includes a body2410having a first screw head2420having a passage2422and a second screw head2430having a passage2432. Screw heads2420and2430are separated from each other by a connecting member2440. Passage2422is sized to accept a rod (not shown) from an existing construct and passage2432is sized to accept a rod (not shown) from the new construct in order to extend existing construct to an adjacent level. A threaded cap (not shown) may then be engaged with each of the threaded portions on the tops of the screw heads2420and2430to secure the respective rods therein, thereby coupling the rods substantially in-line with one another. WhileFIG. 65shows screw heads2420,2430extending parallel to each other, those skilled in the art will recognize that screw heads2420,2430can also be offset or angled relative to each other.

A J-hook connector2500according to an exemplary embodiment is shown inFIG. 66. Connector2500includes an elongate body2510having a first end2512and a second end2514. First end2512includes an open clamp2520attached thereto. Clamp2520includes a passage2522sized to allow a rod (not shown) to be inserted therethrough. Clamp2520also includes a threaded opening2524sized to allow a set screw (not shown) to be inserted therethrough to secure the rod within opening2524.

Connector2500is used to connect a rod (not shown) on a first side of a patient's spine with first end2512, and to insert second end2514into a screw head (not shown) on an opposing side of the patient's spine.

A parallel connector2600according to an exemplary embodiment is shown inFIGS. 67 and 68. Connector2600includes a body2610having a generally oblong opening2612that is sized to allow the insertion of 2 rods50,50′ therethrough to extend the length of rod50, with rod50′. As shown inFIG. 68, a single set screw2620extends through body2610between rods50,50′ to secure rods50,50′ to connector2600. While a single set screw2600is shown, those skilled in the art will recognize that to set screws, one located above each of rod50,50′, can be used to secure rods50,50′, respectively, to connector2600.

FIG. 69shows a single open head lateral connector2700according to an exemplary embodiment. Connector2700includes an open clamp2710and an adjacent screw head2720, coupled to each other by a connector2730.

Open clamp2710includes an arcuate portion2712, forming a through-passage2713that is sized to accept a rod (not shown) from an existing construct inserted therein. Open clamp2710also includes a threaded opening2714sized to accept a set screw (not shown) that can be threaded into through-passage2713to secure the rod in through-passage2713.

Screw head2720includes a passage2722that is sized to allow the insertion of a rod (not shown) in new construct therein. Through-passage2713and passage2722extend in a common plane such that the rod in the new construct is at the same level as the rod in the existing construct.

FIG. 70shows a double modular lateral connector2800according to an exemplary embodiment. Connector2800includes an elongate body2810having a first end2812and a second end2814, distal from first end2812. Each end2812,2814includes a point of attachment2820,2822, respectively for the attachment of modular screw heads side-by-side, as shown, allowing for options variety of screw heads. Each point of attachment2820,2822may be in the form of a post having a partially-spherical outer surface with a substantially flatten top surface having one or more recesses therein. In one embodiment, a tulip can be placed on attachment point2820before or after connecting to an existing rod (not shown). The new rod (not shown) can then be introduced, for example, in a second tulip attached to attachment point2822in order to extend the fixation at an adjacent level. In the alternative, a rod1200, for example, shown inFIG. 28, with an integrated attachment point1220can connect to one or more of the posts on connector2800. While connection points2820and2822are shown as being parallel to each other, those skilled in the art will recognize that connection points2820,2822can also be offset or angled relative to each other.

FIG. 71shows a Z-rod80according to an exemplary embodiment. As shown previously throughout, rod80is used to link to an existing construct at an adjacent level. Rod80includes a generally elongate body82having a first end, a second end86, distal from first end84, and a bent portion88, located along body82, between first and84and second end86. The position and offset distance of bend portion88can be varied depending upon the location of existing construct and the particular patient anatomy.

FIG. 72shows an in-line connector with an integrated rod3000according to an exemplary embodiment. Rod3000includes an elongate body3010having a first end3012and a second end3014, distal from first end3012. A closed connector3020is attached to first end3012. Connector3020includes an opening3022, in line with, and, distal from body3010into which an existing rod (not shown) is inserted to extend the length of an existing construct at an adjacent level. Then one or more fasteners or set screws (not shown) may be positioned in the one or more openings in the connector portion3020to secure the existing rod therein, thereby coupling the new rod extension to the existing rod construct.

The connectors described herein offer versatility in connecting spinal rod implants together. In the case of an existing construct being accessed in a revision surgery, the new fixation constructs may be attached without the need to remove the original surgical hardware. By attaching directly to existing spinal rod constructs saves operating time, causes less disruption to the patient, and improves patient healing times. The connectors maximize utility in cases of varying patient anatomy and different configurations for existing constructs. The different connection modes offer a wide range of options for improved patient outcomes.