# Patent

## Title
Variable geometry occipital fixation plate

## Abstract

A fixation device for connecting a stabilization device to a bone comprises a first member comprising a first portion for attachment to a bone, and a second member comprising a second portion for attachment to a bone and connected to the first member by a pivotal connection such that the first and second portions are spaced apart by an adjustable distance, at least one of the first and second members further comprising a portion for mounting a connector adapted to secure a stabilization device.

## Background
CROSS-REFERENCE TO RELATED APPLICATIONS
This application is a divisional of, and claims a benefit of priority under 35 U.S.C. §120 from U.S. patent application Ser. No. 12/609,868, now allowed, entitled “VARIABLE GEOMETRY OCCIPITAL FIXATION PLATE,” filed Oct. 30, 2009, now U.S. Pat. No. 8,007,499, which is a continuation of U.S. patent application Ser. No. 11/085,672, entitled “VARIABLE GEOMETRY OCCIPITAL FIXATION PLATE,” filed Mar. 21, 2005, now U.S. Pat. No. 7,621,942, the entire contents of which are fully incorporated herein by reference for all purposes.


TECHNICAL FIELD
Embodiments disclosed herein relate generally to fixation devices used in orthopedic surgery and, more particularly, to devices used for cervical posterior fixation by means of a plate attached to a bone in the occipital region and secured to a rod which attaches to a cable, wire, plate, or screw fastened in the spinal region.
BACKGROUND
Fixation devices are used in orthopedic surgery to stabilize bones such as those in the spinal column. One type of fixation device includes a plate attachable to a portion of a bone. The plate may be connected to another bone or another portion of the same bone, directly or through other connecting devices. For example, posterior fixation devices can include a plate fastened to the skull, or occiput, one or more rods running longitudinally along the spine and connected to the plate, and plates, cables, wires, hooks, screws, or other connectors attached to a vertebra and connected to the rod.
A number of such mechanisms are known in the act. To accommodate the variation in patient size and anatomy, a plate often needs to be chosen from a set of plates of multiple sizes and/or varying geometry. This results in a higher cost of the device assembly and a need to maintain separate inventory of the various size and geometry devices. It also increases the surgical time because the surgeon must search for the device that best fits the patient. Accordingly, there is a need for an improved fixation plate.
SUMMARY
A fixation device for connecting a stabilization device to a bone comprises a first member comprising a first portion for attachment to a bone; a second member comprising a second portion for attachment to a bone and connected to the first member by a pivotal connection such that the first and second portions are spaced apart by an adjustable distance, at least one of the first and second members further comprising a portion for mounting a connector adapted to secure a stabilization device
A method of attaching a stabilization device to a bone comprises attaching a first plate to a bone at a first portion on the first plate; attaching a second plate, pivotally attached to the first plate, to a bone at a second portion on the second plate; pivotally adjusting the position of the second plate relative to the first plate to adjust the distance between the first portion and the second portion; and attaching a stabilization device to either the first plate or the second plate.
While multiple embodiments are disclosed, still other embodiments of the invention will become apparent to those skilled in the art from the following detailed description, which shows and describes illustrative embodiments of the invention. As will be realized, the invention is capable of modifications in various obvious aspects, all without departing from the spirit and scope of the invention. Accordingly, the drawings and detailed description are to be regarded as illustrative in nature and not restrictive.



BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 shows a variable geometry occipital device, according to one embodiment of the invention.
FIG. 2 shows a perspective view of the variable geometry occipital fixation device of FIG. 1
FIG. 3 shows an exploded view of the variable geometry occipital fixation device of FIG. 1.
FIG. 4 shows another exploded view of the variable geometry occipital fixation device of FIG. 1 after insertion of the attachment bosses.
FIG. 5A shows a top plan view of the variable geometry occipital fixation device of FIG. 1 in its narrowest configuration.
FIG. 5B shows a top plan view of the variable geometry occipital fixation device of FIG. 1 in its widest configuration.
FIG. 6 shows an exemplary method of using the variable geometry occipital fixation device of FIG. 1.



While the invention is amenable to various modifications and alternative forms, specific embodiments have been shown by way of example in the drawings and are described in detail below. The intention, however, is not to limit the invention to the particular embodiments described. On the contrary, the invention is intended to cover all modifications, equivalents, and alternatives falling within the scope of the invention as defined by the appended claims.
DETAILED DESCRIPTION
FIG. 1 shows a variable geometry occipital device 10 in one embodiment of the invention. The variable geometry occipital device 10 in this case is affixed to the occiput 2 of the patient 4. One or more rods 6 are attached to the device 10 and run substantially along the spine column 8 and are attached to various segments of the spinal column 8.
FIG. 2 shows a perspective view of the variable geometry occipital device 10 of FIG. 1. The variable geometry occipital fixation device 10 includes a first lateral member 12, a second lateral member 14, and a midline member 16. The first lateral member includes a proximal end 18, a distal end 20, and an attachment bore 22 located at the distal end 20.
The second lateral member includes a proximal end 24, a distal end 26, and an attachment bore 28 located at the distal end 26. The midline member includes a proximal end 30 and a distal end 32. In the embodiment shown in FIG. 2, the proximal ends 18, 24, and 30 are stacked on top of each other. Attachment bosses 34 are inserted into the attachment bores 22 and 28. Each attachment boss 34 has a slot 35 for receiving a stabilization device such as a rod, a cable or a cord. The attachment boss 34 further has a threaded portion 76 for receiving a threaded fastener, such as a set screw, which can be tightened directly or indirectly (e.g., through a spacer) against the stabilization device to retain it in the slot 35. Any other suitable connectors for securing stabilization devices can be used instead of the attachment bosses 34 to achieve the desired performance.
FIG. 3 shows an exploded view of the variable geometry occipital fixation device 10 of FIG. 1. The first lateral member 12 includes the attachment bore 22, a pivot bore 36 located at the proximal end 18, and a fixation bore 38 interposed between the attachment bore 22 and the pivot bore 36. A groove 40 is interposed between the proximal end 18 and the distal end 20. The groove 40 facilitates bending of the first lateral member 12 so that it conforms to the occiput. In the embodiment shown in FIG. 3, the groove 40 is located on a top surface 42. The groove 40 could alternatively be located in any other suitable area. Alternatively, the first lateral member 12 could have more than one groove 40, or no groove at all.
Similarly, the second lateral member 14 includes a pivot bore 44 located at the proximal end 24, the attachment bore 28 located at the distal end 26, and a fixation bore 46 interposed between the attachment bore 28 and the pivot bore 44. A groove 48 is interposed between the proximal end 24 and the distal end 26 and is located on a top surface 50. Alternatively, the groove 48 could be located in some other suitable area. The second lateral member 14 could include any appropriate number of grooves 48.
The midline member 16 includes a proximal end 30 and a distal end 32. A pivot bore 52 is located at the proximal end 30 and a fixation bore 54 is located at the distal end 32. A groove 56 is interposed between the proximal end 30 and the distal end 32 and is located on a top surface 58. The midline member 16 could include any appropriate number of grooves 56 located in any suitable area.
In the embodiment shown in FIGS. 1-3, the pivot bores 36, 44, and 52 are aligned so that the first lateral member 12 and the second lateral member 14 rotate around a common axis 60. The thickness 62 of the proximal end 18 of the first lateral member 12 is less than the thickness 64 of the distal end 20. Similarly, the thickness 66 of the proximal end 24 of the second lateral member 14 is less than the thickness 68 of the distal end 26. The thickness 70 of the proximal end 30 of the midline member 16 is also less than the thickness 72 of the distal end 32. In this manner, when the three members 12, 14, and 16 are assembled together and installed in the patient 4, the thickness of the occipital device 10 is substantially uniform across the members 12, 14, and 16 and the stacked portions of members 12, 14, and 16. However, the invention is not limited to a device of such uniform thickness. The thicknesses 64, 68, and 72 need not be less than the thicknesses 66, 70, and 74 or be less by the same amounts as in this illustrative embodiment of the invention.
In the embodiment shown in FIGS. 1-3, the fixation bore 38 in the first lateral member 12 is countersunk so that when a fastener (not shown) is inserted into fixation bore 38, the height of the fastener protruding above the top surface 42 is minimized. The fixation bores 46 and 54 in the second lateral member 14 and the midline member 16 are also countersunk in a similar manner. Alternatively, some or all of the fixation bores 38, 46, and 54 need not be countersunk.
The three members 12, 14, and 16 can be attached to each other in a number of ways. In one embodiment of the invention, the members are swaged together so that they remain attached to each other while being handled but can be manipulated into different angular relationships to each other. Alternatively, the three members 12, 14, and 16 can remain separate until implantation into the patient 4, when they become linked to one another by the insertion of a fastener (not shown) into the pivot bores 36, 44, and 52. The fastener could be a rivet, screw, or any other suitable fastener.
FIG. 4 is a perspective and partially exploded view of the variable geometry occipital fixation device 10 of FIG. 1 after insertion of the attachment bosses 34 into attachment bores 22 and 28. In the embodiment shown in FIG. 4, the attachment bosses 34 are inserted into the attachment bores 22 and 28. The attachment bosses 34 could be press-fit, riveted or swaged into the attachment bores 22 and 28 or inserted in any other suitable manner. The attachment bosses 34 preferably are free to rotate inside of the bores 22 and 28 so as to maintain the orientation of the stabilization device after the orientations of the lateral members 12 and 14 are adjusted.
FIG. 5A shows a top plan view of the variable geometry occipital fixation device 10 shown in a narrow configuration. As shown in FIG. 5A, the angle 78 between the lateral members 12 and 14 is relatively small, thereby reducing the distance 80 between the bosses 34. The angle 78 can vary as needed achieve the desired distance 80.
FIG. 5B shows a top plan view of the variable geometry occipital fixation device 10 shown in a wide configuration. As shown in FIG. 5B, the angle 78 between the lateral members 12 and 14 is larger than the angle 78 shown in FIG. 5A, thereby spanning a larger distance 80 between the bosses 34 than shown in FIG. 5A. In one embodiment of the invention, the angle 78 is approximately 100 degrees when the distance 80 is minimized and is approximately 170 degrees when the distance 80 is maximized. The available range for angle 80 need not be limited to these angles, but instead can include any desirable range.
The first and second lateral members 12 and 14 and the midline member 16 can include any configuration of fixation bores, attachment bores, and pivot bores suitable for achieving the desired variability in the distance 78 between the attachment bores 24 and 38. The number and the location of the fixation bores, attachment bores, and pivot bores can vary as needed.
FIG. 6 shows an exemplary method 200 of using the occipital fixation bracket 10 of the invention. A first lateral member 12 and a first attachment boss 34 are provided (block 205). Then, a second lateral member 14 and a second attachment boss 34 are provided (block 210). The attachment bosses 34 are preferably inserted into the first and second lateral members 12 and 14 prior to surgery. A midline section 16 is also provided (block 215).
The second lateral member 14 is positioned in the desired location against the occiput (block 220). The first lateral member 12 is positioned against the occiput and overlying the second lateral member 14 so that the pivot bores 36 and 44 rotate around a common axis 60 (block 225). The midline member 16 is then positioned against the occiput and overlying the first lateral member 12 (block 230). The pivot bore 52 is aligned with the pivot bores 36 and 44.
Next, fasteners are inserted through the pivot bore 52 and the fixation bore 54 of the midline member 16 and into the occiput, thereby attaching the midline member 16 to the occiput (block 235). The first lateral member 12 and the second lateral member 14 are rotated around the common axis 60 until the desired distance 80 between the attachment bosses 34 is achieved (block 240). The attachment bosses 34 are free to rotate in their bores 22 and 28. The fasteners are then inserted into the fixation bores 38 and 46 of the first and second lateral members 12 and 14, thereby fastening them to the occiput and fixing the position of the attachment bosses 34 (blocks 245 and 250). In this manner, the variable geometry occipital fixation device may be installed and adjusted to accommodate a variety of patient sizes and anatomy.
Various modifications and additions can be made to the exemplary embodiments discussed without departing from the scope of the invention. Accordingly, the scope of the invention is intended to embrace all such alternatives, modifications, and variations as fall within the scope of the claims, together with all equivalents thereof.

## Claims

1. An occipital fixation method, comprising:
coupling three distinct members of a variable geometry occipital fixation device to an occiput via a first fastener by inserting the first fastener into the occiput, the first fastener extending along a common axis, wherein each of the three distinct members has a pivot bore and wherein the first fastener couples the three distinct members to the occiput through the pivot bores;
rotating two of the three distinct members of the variable geometry occipital fixation device around the common axis; and
securing the variable geometry occipital fixation device to the occiput.

2. An occipital fixation method according to claim 1, wherein attachment bosses are coupled to the two of the three distinct members of the variable geometry occipital fixation device and wherein the two of the three distinct members are rotated until a desired distance between the attachment bosses is achieved.

3. An occipital fixation method according to claim 2, wherein the attachment bosses are free to rotate in attachment bores of the two of the three distinct members of the variable geometry occipital fixation device.

4. An occipital fixation method according to claim 2, wherein rods are attached to the attachment bosses and wherein securing the variable geometry occipital fixation device to the occiput fixes positions of the attachment bosses relative to the rods.

5. An occipital fixation method according to claim 1, prior to coupling the three distinct members of the variable geometry occipital fixation device to the occiput, further comprising:
aligning the pivot bores of the three distinct members; and
inserting the first fastener through the pivot bores of the three distinct members.

6. An occipital fixation method according to claim 1, wherein the step of coupling the three distinct members of the variable geometry occipital fixation device to the occiput, includes the sub-steps of:
positioning the variable geometry occipital fixation device against the occiput followed by
inserting the first fastener through each of the pivot bores of each of the three distinct members of the variable geometry occipital fixation device and into the occiput.

7. An occipital fixation method according to claim 1, wherein securing the variable geometry occipital fixation device to the occiput further comprises:
inserting a second fastener into a fixation bore of at least one of the three distinct members of the variable geometry occipital fixation device.

8. An occipital fixation method according to claim 1, wherein one of the three distinct members is a midline member.

9. An occipital fixation method according to claim 8, further comprising:
inserting a second fastener through a fixation bore of the midline member; and
fastening the second fastener to attach the midline member to the occiput.

10. An occipital fixation method according to claim 8, wherein the midline member is attached to the occiput through the first fastener and a second fastener.

11. An occipital fixation method according to claim 1, further comprising bending one or more of the three distinct members of the variable geometry occipital fixation device.

12. An occipital fixation method, comprising:
inserting a first fastener through a pivot bore of a midline member of a variable geometry occipital fixation device, a pivot bore of a first lateral member of the variable geometry occipital fixation device, and a pivot bore of a second lateral member of the variable geometry occipital fixation device, the first fastener extending along a common axis;
inserting a second fastener through a fixation bore of the midline member;
fastening the first fastener and the second fastener to attach the midline member to an occiput;
rotating the first lateral member and the second lateral member around the common axis; and
securing the variable geometry occipital fixation device to the occiput.

13. An occipital fixation method according to claim 12, wherein attachment bosses are coupled to the first lateral member and the second lateral member and wherein the first lateral member and the second lateral member are rotated until a desired distance between the attachment bosses is achieved.

14. An occipital fixation method according to claim 13, wherein the attachment bosses are free to rotate in attachment bores of the first lateral member and the second lateral member.

15. An occipital fixation method according to claim 13, wherein rods are attached to the attachment bosses and wherein securing the variable geometry occipital fixation device to the occiput fixes positions of the attachment bosses relative to the rods.