Screw guide and tissue retractor instrument

An apparatus is provided for performing spinal surgery having a handle assembly, a screw guide, and a retractor. A shaft is provided with a handle, a neck portion and a connecting portion. The screw guide is provided with a connecting element coupled to the connecting portion of the handle assembly. A retractor for retracting tissue is coupled to the screw guide, wherein the neck portion of the handle assembly is provided with a spring loaded sleeve adapted to engage one of a plurality of holes positioned on a portion of the connecting element. The connecting portion is pivotably coupled to the connecting element.

FIELD OF THE INVENTION

The present invention relates to an instrument for guiding a screw and retracting soft tissue.

BACKGROUND OF THE INVENTION

During spinal surgery, there is a need to guide a screw into the spine and retract soft tissue around the surgery area. Previously, specific instruments are used to guide a screw into the spine and other specialized instruments are used to retract the soft tissue around the surgery area.

There is a need for a single instrument that allows the screw to be guided as well as retract soft tissue.

SUMMARY OF THE INVENTION

An apparatus for performing spinal surgery having a handle assembly, a screw guide, and a retractor. A shaft is provided with a handle, a neck portion and a connecting portion. The screw guide is provided with a connecting element coupled to the connecting portion of the handle assembly. A retractor for retracting tissue is coupled to the screw guide, wherein the neck portion of the handle assembly is provided with a spring loaded sleeve adapted to engage one of a plurality of holes positioned on a portion of the connecting element. The connecting portion is pivotably coupled to the connecting element.

DETAILED DESCRIPTION OF THE INVENTION

Embodiments of the invention will now be described. The following detailed description of the invention is not intended to be illustrative of all embodiments. In describing embodiments of the present invention, specific terminology is employed for the sake of clarity. However, the invention is not intended to be limited to the specific terminology so selected. It is to be understood that each specific element includes all technical equivalents that operate in a similar manner to accomplish a similar purpose.

FIGS. 1 and 2illustrate various views of the screw guide and soft tissue retractor system10according to one embodiment of the present invention. As illustrated inFIGS. 1 and 2, the system10is configured with a handle assembly12, a screw guide14, and a retractor16. In one embodiment, the screw guide and soft tissue retractor system is utilized to stabilize the facets of the spine as an aid to fusion of adjacent vertebrae.

FIGS. 3 and 4illustrate exploded views of the handle assembly12of the present invention. The handle assembly12is composed of a handle portion18, a sleeve20, and connecting element22. The upper portion of the handle assembly is angled away from the blade and is designed not to interfere with the handle assembly of the drill guide. The handle angles away to avoid contact with soft tissue. The handle is also removable from the blade to eliminate interference when using other instrumentation.

The sleeve20is adapted to enclose the shaft portion24of the handle assembly12.FIGS. 3-5illustrate the spring loaded sleeve20which works with the incremental cuts in a manner so that the spring loaded sleeve20is designed to be pulled back towards the handle to disengage the handle12from a standard orientation. The sleeve20will then snap into the next slot available automatically. This mechanism is a push button release and spring loaded lock which is used to secure the many proximal attachments that can be inserted into the handle assembly. The spring-loaded lock has a dowel28that enters one of the plurality of holes30which is designed to snap into a mating hole in the attachments. When adding an attachment, the part is automatically locked into the handle assembly. To remove the attachment, the user will push the button, which removes the dowel from the circular through way, thereby allowing the user to easily remove that attachment.

More specifically, the shaft portion24is provided with a spring26which the sleeve20encompasses when the system is assembled. The sleeve20is also provided with a dowel28and is designed to translate along the shaft portion24, via the spring mechanism provided on the shaft portion24of the handle assembly12. The dowel28is designed and configured to engage one of a plurality of holes30positioned on the connecting element22. The handle assembly12is adapted to translate angularly within the connecting element22. Once a position is selected for the handle assembly18, the sleeve20is translated and the dowel28is fit into one of the plurality of holes30. The connecting element22and handle assembly12may be coupled together through the use of pin32which extends through the hole30of the shaft portion24which secures the connecting element22to the handle assembly12.

FIG. 5illustrates an exploded view of the connecting element22according to the present invention. The connecting element22is configured to receive the shaft portion24of the handle assembly12in slot34. As mentioned above, pin32is utilized to couple the shaft portion24to the connecting element22. The shaft portion24once connected to the connecting element is pivotable so that the handle assembly12may be rotated into different predetermined locations. Also, on the connecting element22, there is provided a mechanism for the screw guide14to be coupled to the connecting element22, which is discussed in greater detail with regard toFIG. 6.

A spring loaded pin assembly38is utilized in another portion of the connecting element22to enable access to instruments other than the screw guide. For instance through hole42may be used to provide access to the surgical site for instruments such as a k-wire. Cannulas that enable this can be adapted to fit into the through hole42. The spring loaded pin assembly38is configured to actuate pin40. Pin40extends through the inner wall of the through hole42and extends out through hole44. When the spring loaded pin assembly38is engaged, pin40is retreated from the through hole36, thereby enabling a cannula or any other instrument to be positioned within the through hole42. Once the instrument is positioned in the through hole, the spring loaded pin assembly38is disengaged, allowing pin40to engage the instrument and thereby locking the instrument within the connecting element22.

FIG. 6illustrates the screw guide14attached to the connecting element22of the present invention. The screw guide14is designed as a cannula that attaches to the connecting element22. More specifically, the screw guide14is configured and dimensioned to be cylindrical in shape which enables a surgeon an easier access for insertion into soft tissue. The geometry of the screw guide14is also configured so that a continuous smooth surface is provided to eliminate the change of damaging the surrounding soft tissue. The screw guide14is further provided with protrusions on the bottom surface of the guide14to allow the guide to be docked or articulate on the fracture site. The distal end of the screw guide14has a bottom surface that matches the curve of the cervical spine in this particular embodiment of the invention. Although, the distal end may be configured to match the curve of any portion of the spine. The matching curvature of the distal end aides in establishing the trajectory of the instruments and implants.

Now turning toFIGS. 7 and 8, the screw guide14will be discussed in greater detail. As illustrated inFIGS. 7 and 8, a connecting element46is provided on the top surface of the guide14, and this connecting element46is the locking mechanism by which the screw guide14is attached to the handle assembly12. The connecting element46is configured to fit into the slot48provided on the upper surface of the connecting element22, as seen inFIG. 6. The screw guide14is also provided with rails50on the top surface that are spaced apart and angled to allow the screw guide to couple with the retractor. At the distal end of the guide, there is provided a protrusion52which is coupled to the distal end of the guide by pins54, that is used to dock or articulate the screw guide14near or about the surgical site. The distal portion of the guide14also is configured to have a curvature which enables accessing the surgical site easier. The guide14is also configured with three radioopaque rods56with two rods being placed 180 degrees apart and one being positioned vertically, as illustrated inFIGS. 7 and 8. The rods56are used in conjunction with x-ray imaging to provide alignment verification through lateral and anterior-posterior x-ray images.

FIGS. 9 and 10illustrate the top and bottom views of the soft tissue retractor16in greater detail. The retractor16is utilized to access the surgical site and providing a safe cavity for inserting of the screw guide. The soft tissue retractor16is typically the first instrument assembled to the screw guide and the first instrument used. It is used for reaching the fracture side initially, and creates a safe cavity to the insert the screw guide. The tip of the soft tissue retractor16has a concave shape to match the anterior geometry of the normal cervical vertebral body. This allows the soft tissue retractor to be seated on the anterior body instead of having a flat tip that unstablizes the retractor.

The soft tissue retractor16also includes at least three radio opaque balls58that is pressed into the surface of the soft tissue retractor16that allows the user to verify the retractor's position through lateral and anterior-posterior imaging. At least two of the balls58will be visible when the retractor is level in the lateral plane while the ball at the tip will be visible when the retractor has reached the vertebral body. The retractor blade16is also composed of a radiolucent material so that the blade itself is visible in the x-ray images.

As further illustrated inFIG. 9, axial slots60are provided on the bottom portion of the retractor16. These slots60are configured and designed to couple the retractor16with the rails of the screw guide. It should be noted that any mechanism for attaching the rails to the screw guide can be used. For example, a dove tail type connection can be used couple the screw guide to the retractor16.FIG. 10also illustrates the top portion of the retractor. In this particular embodiment, a connection assembly62is provided for attaching the retractor to another instrument such as a hex driver so that the surgeon may remove the retractor without removing the screw guide from the screw guide assembly.

While the invention herein disclosed has been described by means of specific embodiments and applications thereof, numerous modifications and variations can be made thereto by those skilled in the art without departing from the scope of the invention as set forth in the claims.