Source: http://www.google.fr/patents/US7655025
Timestamp: 2017-09-26 12:51:21
Document Index: 326542185

Matched Legal Cases: ['Application No. 60', 'Application No. 60', 'Application No. 60', 'Application No. 2006200772', 'Application No. 2003', 'Application No. 2006200772', 'Application No. 2', 'Application No. 2003', 'Application No. 2004216131', 'Application No. 2004216131']

Brevet US7655025 - Adjustable rod and connector device and method of use - Google Brevets
A low-profile surgical rod implant device is provided that allows the length of a rod spanning two bone screws to be adjusted at the time of implantation. In a separate aspect of the invention, the rod implant device can be secured by tightening and securing an end of the rod implant device at one of...http://www.google.fr/patents/US7655025?utm_source=gb-gplus-shareBrevet US7655025 - Adjustable rod and connector device and method of use
Numéro de publication US7655025 B2
Numéro de demande US 11/069,390
Date de publication 2 févr. 2010
Date de dépôt 1 mars 2005
Date de priorité 28 sept. 2001
Autre référence de publication CA2516791A1, CA2516791C, EP1596738A2, EP1596738A4, US6991632, US20040181223, US20050149023, US20100137914, WO2004075778A2, WO2004075778A3
Numéro de publication 069390, 11069390, US 7655025 B2, US 7655025B2, US-B2-7655025, US7655025 B2, US7655025B2
Inventeurs Stephen Ritland
Cessionnaire d'origine Stephen Ritland
Citations de brevets (381), Citations hors brevets (73), Référencé par (6), Classifications (13), Événements juridiques (3)
Adjustable rod and connector device and method of use
US 7655025 B2
A low-profile surgical rod implant device is provided that allows the length of a rod spanning two bone screws to be adjusted at the time of implantation. In a separate aspect of the invention, the rod implant device can be secured by tightening and securing an end of the rod implant device at one of the bone screws. Embodiments are provided for use with polyaxial pedicle screws and substantially straight shank pedicle screws in spinal applications. In a separate aspect of the invention, a bone screw connector having an interference type fit is also provided. A method for implanting the device is also provided.
1. A surgical implant for use with at least one pedicle screw comprising:
a first rod member including a beam;
a second monolithic rod member including an opening sized to circumferentially receive said beam, said second monolithic rod member including an interior hollow chamber for longitudinally receiving at least a portion of said beam, said second monolithic rod member including an upper arm and an opposing lower arm, said upper arm and said opposing lower arm spaced apart by a slot wherein said slot is contiguous with said interior hollow chamber, and wherein said upper arm is moveable to contact said beam and compress said beam between said upper arm and said opposing lower arm; and
means for tightening said second monolithic rod member to secure said beam within said second monolithic rod member, wherein said means for tightening also operates to secure said second monolithic rod member to the at least one pedicle screw; and
wherein the at least one pedicle screw intercepts a longitudinal axis of said beam.
2. The surgical implant as claimed in claim 1, wherein the longitudinal axis of said beam is substantially coincident with a longitudinal axis of said second monolithic rod member.
3. The surgical implant as claimed in claim 1, wherein said second monolithic rod member is of one-piece construction.
4. The surgical implant as claimed in claim 1, wherein said second monolithic rod member further includes a notch spaced apart from said opening.
5. The surgical implant as claimed in claim 1, wherein said opening has a circular shape.
6. The surgical implant as claimed in claim 1, wherein said opening has non-circular shape.
7. The surgical implant as claimed in claim 1, wherein said beam has a circular cross section.
8. The surgical implant as claimed in claim 1, wherein said beam has a non-circular cross section.
9. The surgical implant as claimed in claim 1, wherein said means for tightening does not include a set screw.
10. The surgical implant as claimed in claim 1, further comprising a first end connector attached to said beam and a second end connector attached to said second monolithic rod member.
11. The surgical implant as claimed in claim 1, wherein said second monolithic rod member further includes an end connector at an end of said lower arm, said end connector including a socket for receiving a head of a pedicle screw.
12. The surgical implant as claimed in claim 11, wherein said socket includes a hole for a tension link shaft, and said upper arm includes a hole substantially aligned with said hole in said socket.
13. The surgical implant as claimed in claim 1, wherein a deformable connector is situated within a cavity of the second monolithic rod member, said deformable connector securing a shank of a pedicle screw to said second monolithic rod member upon tightening of said means for tightening.
14. The surgical implant as claimed in claim 13, wherein said deformable connector is compressed by an upper shoulder of said upper arm, a lower shoulder of said opposing lower arm, and a shank of said means for tightening.
15. The surgical implant as claimed in claim 13, wherein said deformable connector comprises a groove.
16. The surgical implant as claimed in claim 13, wherein said deformable connector is substantially disc-shaped.
17. The surgical implant as claimed in claim 13, wherein at least a portion of said deformable connector comprises a skeletonized structure.
18. The surgical implant as claimed in claim 13, wherein at least a portion of said deformable connector has a truncated exterior surface.
19. The surgical implant as claimed in claim 13, wherein said deformable connector comprises an indentation along a portion of an exterior surface.
CROSS REFERENCE AND PRIORITY CLAIMS TO RELATED APPLICATION
This application is a continuation application of U.S. patent application Ser. No. 10/788,172 filed on Feb. 25, 2004, which is a continuation-in-part application of U.S. patent application Ser. No. 10/262,574 filed Sep. 30, 2002, entitled “Connection Rod For Screw or Hook Polyaxial System And Method of Use”, which claimed priority to U.S. Provisional Patent Application No. 60/325,809 filed Sep. 28, 2001, entitled “Connection Rod For Screw or Hook Polyaxial System And Method of Use”; U.S. patent application Ser. No. 10/788,172 filed on Feb. 25, 2004 also claimed priority to U.S. Provisional Patent Application No. 60/450,179 filed Feb. 25, 2003 entitled “Connection Rod For Screw or Hook Polyaxial System And Method of Use”, and to U.S. Provisional Patent Application No. 60/460,195 filed Apr. 4, 2003 entitled “Sliding Connector”. The entire disclosures of these applications are considered to be part of the disclosure of the present application and are hereby incorporated by reference in their entirety. Cross reference is also made to U.S. Pat. No. 6,736,816 entitled “Polyaxial Connection Device and Method” that issued on May 18, 2004, which is also incorporated herein by reference.
This invention relates generally to an adjustable rod and connectors for stabilizing a portion of the spine or stabilizing two or more bone segments, and a method of using the same.
The use of fixation devices for the treatment of vertebrae deformities and injuries is well known in the art. Various fixation devices are used in medical treatment to correct curvatures and deformities, treat trauma and remedy various abnormal spinal conditions.
The prior art fails to provide a low-profile device that allows the rod length to be easily adjusted during implantation with a minimal amount of effort by the installing surgeon. More particularly, where at least two bones or bone segments are involved, such as a first vertebra and a second vertebra, the rod typically extends beyond the connector, and needs to be specifically chosen or otherwise cut to accommodate the dimensions of the subject patient. Therefore, a need exists to provide an adjustable length rod implantation assembly and component parts that can be installed relatively easily by a surgeon, and that has the ability to be adjusted at the moment of implantation to thereby accommodate the geometry requirements of the patient.
The prior art also fails to provide pedicle screw to rod connectors that can be easily adjusted at the time of implantation. Such devices are needed to further accommodate the individual patient's requirements that exist and that are encountered upon performing and incision and encountering in situ conditions.
In view of the above, there is a long felt but unsolved need for devices and methods that avoid the above-mentioned deficiencies of the prior art and that are relatively simple to employ and require relatively minimal displacement or removal of bodily tissue.
The present invention addresses the shortcomings of the prior art. More specifically, implant assemblies and/or components of an implant are provided that allow a surgeon to adjust the implant for the patient's requirements as they are encountered during surgery, and/or which allow the surgeon to use low-profile implant components that result in minimal displacement of bodily tissue.
The above and other aspects of the invention are realized in specific illustrated embodiments of the invention, and components thereof. Thus, in one aspect of the present invention, a spinal rod implant for spanning at least one intervertebral disc is provided. The implant is interconnectable to a first vertebra using a first pedicle screw, and to a second vertebra using a second pedicle screw. The first pedicle screw is separated from the second pedicle screw by a bridge distance. The implant comprises a first rod member for interconnecting to the first vertebra, where the first rod member includes a beam having an effective length shorter than the bridge distance. The implant also includes a second rod member for interconnecting to the second vertebra, where the second rod member includes a clamp sized to receive at least a portion of the beam. The clamp also has an effective length shorter than the bridge distance. In addition, the implant includes a means for tightening the clamp to create a force to secure the beam within the clamp.
In a separate aspect of the invention, a surgical implant is provided, where the implant comprises a first rod member including a beam and a second rod member including an opening sized to circumferentially receive the beam. The second rod member also includes an interior hollow chamber for longitudinally receiving at least a portion of the beam. In addition, the second rod member includes an upper arm and an opposing lower arm spaced apart by a slot, wherein the slot is contiguous with the interior hollow chamber. The upper arm is moveable to contact the beam and compress the beam between the upper arm and the lower arm. In addition, the implant includes a means for tightening the second rod member to secure the beam within the second rod member.
A component of the assembly also has application to devices other than a rod implant that is parallel to the spine and that spans an intervertebral disc. For example, the clamp component could be used in bone stabilization unrelated to the spine. Alternatively, it could be used in rod extensions, or it could be adapted for use in cross-link assemblies that are used to structurally interconnect right and left stabilization assemblies that are implanted on either side of a spinous process. Thus, it is one aspect of the present invention to provide a rod member for use with a bone stabilizing rod, the rod member comprising and an upper arm and a lower arm interconnected to the upper arm. At least a portion of the lower arm is separated from the upper arm by a slot and a hollow chamber, where the hollow chamber is sized to receive at least a portion of the bone stabilizing rod. The upper arm is moveable to compress and secure the portion of the bone stabilizing rod between an interior surface of the upper arm and an interior surface of the lower arm.
One embodiment of the present invention features a rod clamping component that can be used in conjunction with a TSRH 3D pedicle screw known to those skilled in the art. The clamping component includes a deformable connector that preferably resides within a cavity in the rod clamping component. The deformable connector has potential application to being used with structures other than pedicle screws. For example, the deformable connector can be used with a properly adapted stabilizing rod that is used for bones other than the spine. Thus, it is one aspect of the present invention to provide a deformable connector for use with a stabilizing rod clamp, the deformable connector capable of securing a portion of a substantially cylindrical member, such as a shank of a TSRH 3D pedicle screw or a stabilizing rod, within a cavity in the stabilizing rod clamp. The deformable connector preferably comprises a disc having a passageway adapted to receive the substantially cylindrical member. In addition, the deformable connector preferably includes a groove along an exterior surface of the disc and extending to the passageway. When compressed within the stabilizing rod clamp, the disc secures the cylindrical member within the passageway.
It is further desirable to provide a low-profile connector that can be easily used in combination with a shank of a bone screw. In a separate embodiment, low profile connector is provided that utilizes an interference-type fit to secure the connector to the shank of the bone screw. Thus, it is one aspect of the present invention to provide a connector device for a bone screw, the connector device comprising a clamp that includes an upper section and a lower section separated by a slot. The upper section includes a first aperture and the lower section includes a second aperture substantially aligned with the first aperture, where the first and second apertures are sized to accommodate a shank of the bone screw. The connector further includes a tightening member operatively connected to the upper section and the lower section. The tightening member tightens the clamp and reduces the size of the slot between the upper section and the lower section. This secures the shank of the bone screw within the device.
It is a further aspect of the present invention to provide a bone stabilization assembly for securing a first bone segment to a second bone segment. This has particular application to being used to bridge an intervertebral disc between two vertebra. The assembly comprises a first bone screw attachable to the first bone segment and a second bone screw attachable to the second bone segment. In addition, the assembly includes a first rod member including a beam and an end connector, where the end connector is attachable to the first bone screw. Also, the assembly includes a second rod member. The second rod member includes an interior hollow chamber for longitudinally receiving at least a portion of the beam of the first rod member. The second rod member includes an upper arm and an opposing lower arm, where the upper arm and the lower arm are spaced apart by a slot, and wherein the slot is contiguous with the interior hollow chamber. The upper arm is moveable and/or deformable to contact the beam and compress the beam between the upper arm and the lower arm. In addition, the second rod member includes a connector attachable to the second bone screw. The assembly also includes a means for tightening the second rod member to secure the beam within the second rod member.
The present invention also includes various methods for using the devices presented herein. One such method concerns stabilizing one or more vertebra using an assembly. Thus, it is one aspect of the present invention to provide a method of stabilizing a first vertebra to a second vertebra. The method comprises the steps of attaching a first pedicle screw to the first vertebra and a second pedicle screw to the second vertebra. In addition, the method includes a step of inserting a beam of a first rod member into a second rod member, where the second rod member includes an interior hollow chamber for longitudinally receiving at least a portion of the beam of the first rod member. The second rod member also includes an upper arm and an opposing lower arm, where the upper arm and the lower arm spaced apart by a slot, and wherein the slot is contiguous with the interior hollow chamber. The upper arm is moveable to contact the beam and compress the beam between the upper arm and the lower arm. In addition, the second rod member includes an integral connector for attaching the second rod member to the second pedicle screw. The method also includes the step of connecting the first rod member to the first pedicle screw using a connector interconnected to the beam. In addition, the method includes the step of advancing a single tightening mechanism to secure (a) the second rod member to the beam of the first rod member, and (b) the second rod member to the second pedicle screw.
FIG. 1 is a side elevation view of one assembly that incorporates aspects of the present invention, wherein the assembly includes a first embodiment of a first rod member, a first embodiment of a second rod member, polyaxial pedicle screws, tension links, and tension link nuts;
FIG. 2 is a side elevation view of one assembly of the present invention shown after implantation into two vertebra;
FIG. 3 is a side elevation view of a first embodiment of a first rod member including a beam and an end connector that includes a socket;
FIG. 4 is a perspective view of the device shown in FIG. 3;
FIG. 5 is a perspective view of the device shown in FIG. 3 in combination with a polyaxial pedicle screw and a tension link;
FIG. 6 is a side perspective view of a first embodiment of a second rod member;
FIG. 7 is a reverse side elevation view of a one assembly of the present invention;
FIG. 8 a is a cross sectional view along line 8 a-8 a shown in FIG. 1, wherein the beam has a circular cross section;
FIG. 8 b is a cross sectional view along line 8 a-8 a shown in FIG. 1, wherein the beam has an oblong-shaped cross section;
FIG. 9 is a side elevation view of a second rod member;
FIG. 10 is a bottom perspective view of a second rod member;
FIG. 11 is a bottom perspective view of a first rod member within a second rod member;
FIG. 12 is a top perspective view of a first rod member within a second rod member;
FIG. 13 is a side elevation view of a second rod member having a recess on its upper arm and projection on its lower arm;
FIG. 14 is a side elevation view of a second embodiment of a second rod member that includes a deformable connector;
FIG. 15 is a side elevation view of a second embodiment of a first rod member that includes a deformable connector;
FIG. 16 a is a side perspective view of one version of a deformable connector or disc;
FIG. 16 b is a side perspective view of a second version of a deformable connector or disc, wherein the disc includes a side grove;
FIG. 17 is a plan view of the device shown in FIG. 16 b;
FIG. 18 is a side elevation view of the device shown in FIG. 16 b in combination with a pedicle screw having a substantially straight upper shank portion;
FIG. 19 is a side elevation view of a modified version of the device shown in FIG. 16 b;
FIG. 20 is a plan view of a yet a different version of the device shown in FIG. 16 b, wherein the device of FIG. 20 is spherical in shape rather than disc shaped;
FIG. 21 is a side elevation view of the device shown in FIG. 20;
FIG. 22 is a side elevation view of one assembly that incorporates aspects of the present invention, wherein the assembly includes a third embodiment of a first rod member, a second embodiment of a second rod member;
FIG. 23 is a plan view of the assembly shown in FIG. 22;
FIG. 24 is a side elevation view of the third embodiment of a first rod member shown in FIG. 22;
FIG. 25 is a plan view of the device shown in FIG. 24;
FIG. 26 is a side elevation view of separate embodiment of the device shown in FIG. 24;
FIG. 27 is a plan view of an assembly having a second embodiment of the second rod member, wherein the deformable connector of the second rod member has an indentation that cooperates with the tightening member;
FIG. 28 is a side elevation view of one assembly that incorporates aspects of the present invention, wherein the assembly includes a first embodiment of a first rod member, a second embodiment of a second rod member;
FIG. 29 is a plan view of a second embodiment of a deformable connector, wherein the deformable connector has a skeletonized structure;
FIG. 30 is a side elevation view of the deformable connector shown in FIG. 29, in combination with a pedicle screw having a substantially straight upper shank portion.
While the following disclosure describes the invention in connection with those embodiments presented, one should understand that the invention is not strictly limited to these embodiments. Furthermore, one should understand that the drawings are not necessarily to scale, and that in certain instances, the disclosure may not include details which are not necessary for an understanding of the present invention, such as conventional details of fabrication.
Referring to FIG. 1, a first embodiment of an adjustable rod implant 10 is shown. The adjustable rod implant 10 is preferably a multi-piece implant, and more preferably, a two-piece rod implant. By way of example and without limitation, the adjustable rod implant 10 can be used as a structural bridge to span a section of bone, or to span a distance between two portions of bone, or to span a distance between two different bones. As shown in FIG. 2, in one anticipated use, the adjustable rod implant 10 can be used as a vertebral bridge to span at least one intervertebral disc D between two vertebra V1 and V2. Accordingly, by way of illustration and without intending to limit the possible uses of the present invention, the examples of usage presented herein are generally directed toward spanning at least one intervertebral disc.
The adjustable rod implant 10 is preferably attached to the subject vertebrae using pedicle screws, with a connector interconnecting the pedicle screws to the adjustable rod implant 10. The pedicle screws used with the adjustable rod implant 10 may be of a type that allow for some rotational or polyaxial adjustment prior to securing the adjustable rod implant 10, as discussed further below, or the pedicle screws may be of the type that do not allow rotational or polyaxial adjustment. The adjustable rod implant could be used with other types of bone pedicle screws. For example, although not shown, instead of pedicle screws, the rod implant may be used with hook devices that attach to the vertebrae, such hook devices being known to those skilled in the art.
Referring again to FIG. 1, the adjustable rod implant 10 includes a first rod member 12. The first rod member 12 includes a rod or beam 14. As best shown in FIG. 3, the beam 14 has a longitudinal axis LAb-LAb. Beam 14 has a first beam end or distal beam end 16 and a second beam end or proximate beam end 18. The beam 14 also includes a posterior or top side 20 and an anterior or bottom side 22. The beam 14 may have a solid interior or it may have a hollow interior, depending upon the strength requirements of the particular application in which it is being used. For most spinal surgeries, it is anticipated that beam 14 will be solid.
First rod member 12 may be interconnected to a pedicle screw using a separate connector that is not an integral part of first rod member 12. Alternatively, an integral connector may be used. For the embodiment shown in FIG. 1, first rod member 12 includes an end connector 24 attached to the proximate beam end 18 of beam 14. End connector 24 is used to interconnect beam 14 to a pedicle screw. The end connector 24 is preferably incorporated directly into the first rod member 12 in the form of a receptacle 26.
Referring to FIGS. 1 and 3-5, end connector 24 is shown located at the proximate beam end 18 of a beam 14. In a preferred embodiment, the end connector 24 is adjustable and includes a receptacle 26 that is in the form of a socket that preferably includes a socket exterior 28 and a socket interior 30. The socket interior 30 essentially acts as a low-profile connector. The receptacle 26 is sized to fit over and receivingly accept a substantially spherical-headed pedicle screw, such as the enlarged area 32 of a polyaxial pedicle screw 34. Accordingly, socket interior 30 is preferably a recessed area at the proximate beam end 18 of a beam 14 that fits over the enlarged area 32 of the polyaxial pedicle screw 34. As shown in FIGS. 1 and 3-5, the socket interior 30 is preferably nearly spherical, to match a spherical-type shape of enlarged area 32 of the polyaxial pedicle screw 34. However, the socket interior 30 may be a variety of shapes that match the head of the pedicle screw. Within the top center area of the receptacle 26 is a tension link cavity 36 that is sized to accommodate the shaft 38 of a tension link 40. Referring to FIGS. 1 and 4, the tension link cavity 36 can be seen as an opening through the top of receptacle 26.
Referring now to FIG. 3, a side perspective view of the first rod member 12 is shown. The first rod member 12 includes the beam 14 and preferably includes an end connector 24 that is integrally formed with the beam 14, where the end connector 24 is positioned at the second end 18 of the rod member 14. As discussed, the end connector 24 includes structural features the allow the beam 14 to be interconnected to an appropriately configured pedicle screw S.
Referring now to FIG. 4, a top perspective view of the first rod member 12 is shown. For embodiments having an end connector 24, this view illustrates the tension link cavity 36 positioned at substantially the top of the end connector 24 at the proximate beam end 18 of the first rod member 12. The tension link cavity 36 is sized to accommodate the diameter of the shaft 38 of a tension link 40.
Referring now to FIG. 5, a bottom perspective view of the first rod member 12 is shown with an end connector 24, a polyaxial pedicle screw 34, a tension link 40, and a tension link nut 58. The substantially spherical enlarged area 32 of the polyaxial pedicle screw 34 and the substantially spherical socket interior 30 of the end connector 24 allows the end connector 24 to be rotated and adjusted over the enlarged area 32 of a polyaxial pedicle screw 34 before tightening using the tension link nut 58, thus providing adjustability to the rod, connector, and pedicle screw configuration.
When located at the proximate beam end 18 of beam 14, the principal advantage of the integral end connector 24 is to shrink the profile of the configuration as a system, and thereby reduce the length of the rod implant 10 that is longitudinally exposed beyond the pedicle screw location. In so doing, in spinal implant applications, the adjacent vertebra beyond the end of the first rod member 12 is not exposed to potentially impacting a rod section that would have previously extended longitudinally beyond the connector location. This can reduce patient pain and increase patient mobility. A further advantage is that the smaller profile results in less tissue displacement in the vicinity of end connector 24. However, it is again noted that a separate rod to pedicle screw connector known to those skilled in the art may be used to attach a section of rod to a pedicle screw, and therefore, although preferred, and end connector 24 is not required.
Referring again to FIG. 1 and also FIG. 6 and 9, the second rod member 42 of the adjustable rod implant 10 is shown. The second rod member 42 functions as a clamp, and is preferably a one-piece structure that is deformable to create a compressive force and secure the first rod member 12 within the second rod member 42 when a means for clamping or tightening the second rod member 42 is applied. The second rod member 42 includes an interior hollow chamber 44. The interior hollow chamber 44 is an elongated hollow region having a longitudinal axis LAc-LAc. The interior hollow chamber 44 is sized to accommodate at least a portion of the beam 14 of the first rod member 12.
Referring now to FIG. 10, the second rod member 42 preferably includes a slot 46 that separates an upper arm 48 from a lower arm 50. The lower arm 50 acts as a base for the second rod member 42. The slot 46 forms a gap that can be selectively reduced, whereby the slot 46 allows the upper arm 48 to be selectively deflected toward the lower arm 50.
As best seen in FIG. 10, the second rod member 42 also includes a distal opening 52 that leads to the interior hollow chamber 44. The distal opening 52 is sized to receive the beam 14. More particularly, the distal beam end 16 of beam 14 can be inserted into the distal opening 52, and the beam 14 selectively slid into the interior hollow chamber 44.
Referring to FIGS. 1 and 7, adjustment arrow A1 shows that the beam 14 may be moved from right to left and from left to right within the interior hollow chamber 44 of the second rod member 42 prior to applying a clamping or tightening force to the second rod member 42. The length of the beam 14 that is slid into the interior hollow chamber 44 can be adjusted by the surgeon. FIGS. 11 and 12 show two different perspective views of the beam 14 of the first rod member 12 positioned within the hollow chamber 44 of the second rod member 42. Since the overall length of the implant 10 can be adjusted at the time of the implantation by the surgeon, this allows the surgeon to readily accommodate a patient's particular needs.
By application of a clamping or tightening force to the second rod member 42, the upper arm 48 and lower arm 50 are compressed toward each other, thereby securing the beam 14 within the second rod member 42. In the preferred embodiment shown in FIG. 1, the base or lower arm 50 remains substantially immobile, and the upper arm 48 is deflected toward the lower arm 50. Arrows A2 of FIGS. 1 and 7 show that the upper arm 48 is forced toward the lower arm 50. That is, the upper arm 48 acts as a moveable and/or deformable structure that is suspended over the interior hollow chamber 44, and which can be forced toward the lower arm 50. In so doing, at least a portion of the interior surface 54 of the upper arm 48 applies a compressive force to the top side 20 of the beam 14. The beam 14 then presses downward such that the bottom side 22 of the beam 14 presses against the interior surface 56 of the base or lower arm 50 of the second rod member 42. This interaction of forces causes the beam 14 to be compressively secured within the second rod member 42.
Referring again to FIG. 1, similar to first rod member 12, the second rod member 42 preferably includes an end connector 24 attached to lower arm 50 of the second rod member 42. The end connector 24 is used to interconnect the second rod member 42 to a polyaxial pedicle screw 34. The end connector 24 is preferably incorporated directly into the second rod member 42 in the form of a receptacle 26. When located at the end of the second rod member 42, the principal advantage of the integral end connector 24 is to shrink the profile of the configuration as a system, and thereby reduce the length of the rod implant 10 that is longitudinally exposed beyond the pedicle screw location. In so doing, in spinal implant applications, the adjacent vertebra beyond the end of the second rod member 42 is not exposed to potentially impacting a rod section that would have previously extended longitudinally beyond the connector location. This can reduce patient pain and increase patient mobility. A further advantage is that the smaller profile results in less tissue displacement in the vicinity of the end connector 24.
The structure of the end connector 24 for the second rod member 42 is similar to that for the first rod member 12. However, both the upper arm 48 and lower arm 50 of the second rod member 42 include a tension link cavity 36 that is sized to accommodate the shaft 38 of the tension link 40. Referring to FIG. 1, the tension link cavity 36 can be seen as an opening through the top of the end of the upper arm 48, where the tension link cavity 36 in the upper arm 48 is aligned with the tension link cavity 36 in the lower arm 50. The pedicle screw to be connected to the second rod member 42 is preferably fitted with a tension link 40, and the tension link shaft 38 is extended through the tension link cavity 36 in the receptacle 26 and through the tension link cavity 36 in the upper arm 48. A tension link nut 58 is then threaded onto the end of the tension link shaft 38 and is tightened. The tension link nut 58 provides the tightening or clamping force for the second rod member 42, thereby deflecting the upper arm 48 toward the lower arm 50 and securing the beam 14 within the second rod member 42.
Referring again to FIG. 1, preferably, a notch 60 is positioned in the second rod member 42 near the distal opening 52. For those embodiments incorporating a notch 60, the distal opening 52 next to the notch 60 is essentially a hoop structure 62 through which the beam 14 passes to enter the interior hollow chamber 44. The notch 60 longitudinally separates the distal opening 52 from a second opening or interior opening 64. The interior opening 64 is formed by an arch 66 extending from and interconnecting the upper arm 48 to the lower arm 50.
As shown in FIGS. 1, 2 and 7, in a side elevation view, the notch 60 may be a variety of shapes, such as an inverted U-shape, or an inverted V-shape. Although not required, the hoop structure 62 of the distal opening 52 aligns and supports the beam 14 when it is positioned within the interior hollow chamber 44 prior to tightening of the second beam member 42. The hoop structure 62 of the distal opening 52 also functions to prevent the beam 14 from rocking up and down prior to applying a clamping or tightening force to the second rod member 42. More particularly, the hoop structure 62 substantially maintains the alignment of the longitudinal axis LAb-LAb of the beam 14 with the longitudinal axis LAc-LAc of the hollow chamber 44 of the second rod member 42 while sliding the beam 14 into the second rod member 42 and implanting the rod implant 10, and through such time as a clamping or tightening force is applied to the second rod member 42. The notch 60 also serves to lighten the second rod member 42 by reducing its mass.
The beam 14 and the second rod member 42 work in combination to provide an adjustable rod segment that can be shortened or lengthened during the implant procedure by the surgeon to accommodate the specific spacial requirements of the patient. One particular use of the implant is to span one level (one intervertebral disc). Referring to FIG. 2, in use, the surgeon first inserts a first pedicle screw 34 into a first vertebra V1 of the patient, and then inserts a second pedicle screw 34 into a second vertebra V2 of the patient. Tension links 40 are then inserted into the enlarged areas 32 of the pedicle screws 34. Alternately, the tension links are preloaded into the pedicle screws before they are implanted into the vertebrae. The beam 14 is then interconnected to the first pedicle screw 34 using a first connector, and the second rod member 42 is interconnected to the second pedicle screw 34 using a second connector. To perform this step, the beam 14 is preferably loosely inserted into the second rod member 42 in advance of interconnecting the second rod member 42 to the second pedicle screw. That is, the surgeon pre-assembles the beam 14 of the first rod member 12 inside the second rod member 42, but does not tighten the two members together. The surgeon then lowers both the first rod member 12 and the second rod member 42 as a unit over the pedicle screws. Referring again to FIGS. 1 and 2, the surgeon then preferably tightens a link nut 58 over the tension link shaft 38 that is associated with the first rod member 12. Again, the surgeon may then adjust the length of the beam 14 inside the second rod member 42 by sliding the beam 14 into or out of the clamp to obtain the proper bridge distance needed between the first pedicle screw and the second pedicle screw. Subsequently, the surgeon can apply a tightening force to the second rod member 42 to secure the beam 14 within the second rod member 42. The implant 10 provides the surgeon the ability to tighten the second rod member 42 to its associated pedicle screw and also clamp the second rod member 42 to the first rod member 12 using one effort and one structure. This is accomplished in the preferred assembly shown in FIGS. 1 and 2 by applying and tightening a link nut 58 to the tension link shaft 38 of the tension link 40, which is operatively connected to the enlarged area 32 of the pedicle screw 34 associated with the second rod member 42. This action progressively and selectively deflects the upper arm 48 toward the lower arm 50, thereby compressively securing the beam 14 of the first rod member 12 within the second rod member 42.
Referring now to the preferred embodiment shown in FIG. 2, and for purposes of this description, an effective beam length Lb of beam 14 is defined as the distance from the pedicle screw to which it is attached to the distal beam end 16. The effective clamp length Lc of second rod member 42 is defined as the distance from the pedicle screw to which it is attached to the distal opening 52. For the assembly shown in FIG. 2, both the effective beam length Lb and the effective clamp length Lc are shorter than the bridge distance DB, which is the distance between the first pedicle screw and the second pedicle screw.
Referring now to FIG. 3, rotational adjustability of the implant 10 can be provided by using a beam 14 that is rotatable within the interior hollow chamber 44. For example, a beam 14 having a circular cross section like that shown in FIG. 8 a can be coupled with a second rod member 42 preferably having a circular distal opening 52 and interior hollow chamber 44. In this example, the circular cross section of beam 14 may be rotated within the second rod member 42, thereby allowing the surgeon the ability to rotate and angularly adjust the position of the first rod member 12 relative to the second rod member 42. Rotational adjustability is permitted before applying a tightening force to the second rod member 42 and securing the beam 14 within the interior hollow chamber 44 of the second rod member 42. FIG. 8 b illustrates that beam 14 may have a cross section resembling an oblong shape. For this variation, the distal opening 52 and interior hollow chamber 44 are also preferably substantially oblong in shape. This modification provides an assembly that does not allow rotation of the first rod member 12 relative to the second rod member 42, which may be desirable in certain situations. Of course, other configurations are possible, such as corresponding triangular, rectangular, and polygonal shapes (not shown). In addition, the beam cross-section may differ from the shape of the cross-section of the interior hollow chamber. Thus, a variety of shapes and combination of shapes are possible for the cross section of the beam 14 and the interior hollow chamber 44, and such possible different shapes for the structures are within the scope of the present invention.
Referring now to FIG. 13, the upper arm 48 of the second rod member 42 may optionally include a recess 68 for receiving a cooperating projection 70 positioned on the edge of the slot of the lower arm 50. The recess 68 and projection 70 may be a variety of shapes, and may include means for interlocking. For example, the projection 70 may include a barb (not shown) that interlocks with one or more ridges (not shown) within the recess 68. The position of the recess 68 and projection 70 may be reversed such that the recess is located on the lower arm 50 and the projection is located on the upper arm 48.
Referring to FIGS. 1-13, the socket exterior 28 of the end connector 24 at one or both of the first rod member 12 and second rod member 42 may be rounded to substantially mirror the socket interior 30 as shown in FIG. 1. Alternatively, it may be have a different shape, such as the block shape shown in FIG. 7. Additionally, as shown in FIG. 1, the center of the enlarged areas 32 of the polyaxial pedicle screws 34 may be substantially aligned with the longitudinal axis of the beam 14 of the first rod member 12, and aligned with the longitudinal axis of the hollow chamber 44 of the second rod member 42, or the centers may be offset, as shown in FIG. 7.
In general, amongst its possible uses, the rod implant 10 permits a length of rod to be adjusted at the surgical site without having to cut the rod, or use a standardized rod length that may not fit the patient. Furthermore, utilizing the components of the present invention, the entire assembly can be tightened by securing a link nut 58 at the second rod member 42. This greatly simplifies the surgeon's efforts and serves to reduce operation time and associated patient risk. In addition, as will be appreciated by those skilled in the art, among its many potential uses the second rod member 42 can be used to attach a new section of rod to an existing section of rod, to extend a section of rod, to provide length adjustability to a rod, to provide a means of attaching a separate structure to the end of a new or existing rod, to provide a means of attaching a separate structure to the end of a new or existing rod while adjusting the length of the rod, or to reinforce an existing section of rod.
Referring now to FIG. 14, a further embodiment of the second rod member 42′ is shown. Second rod member 42′ includes a number of structural features that are similar to the previously described second rod member 42. That is, an interior hollow chamber 44 is sized to receive a beam 14 of a first rod member 12, and the second rod member 42′ functions as a clamp to provide a compressive force to secure the beam 14 of the first rod member 12 within the interior hollow chamber 44. Second rod member 42′ differs from second rod member 42 in that it includes a deformable connector 72 that can be used to secure the second rod member 42′ to a pedicle screw, wherein the pedicle screw has a substantially straight upper shank portion, such as a TSRH 3D pedicle screw 74 known to those skilled in the art. More particularly, the deformable connector 72 acts as a clamp within a clamp, by providing a compressive force around a portion of the shank 76 of a pedicle screw 74.
Referring still to FIG. 14, the deformable connector 72 is situated within an open portion or cavity 78 of the second rod member 42′. The upper arm 48 of the second rod member 42′ preferably includes a upper arm shoulder 80 against which a portion of the deformable connector 72 is positioned. Similarly, the lower arm 50 of the second rod member 42′ preferably includes a lower arm shoulder 82, also against which a portion of the deformable connector 72 is positioned. In addition, the second rod member 42′ includes a tightening member 84 that serves as a means for tightening the second rod member 42′ such that the second rod member 42′ compresses and acts as a clamp to hold the beam 14 of the first rod member 12 secure.
In one preferred embodiment, tightening member 84 is a screw or bolt positioned on a substantially opposing side of the deformable connector 72 relative to the positions of the upper arm shoulder 80 and the lower arm shoulder 82. That is, the tightening member 84 is preferably on one side of the shank 76 of the pedicle screw 74, and the upper arm shoulder 80 and the lower arm shoulder 82 are on situated on an opposing side of the shank 76 of the pedicle screw 74. When tightened, the tightening member 84 not only draws the upper arm 48 and the lower arm 50 together, thereby compressing the second rod member 42′, but also necessarily shrinks the size of the cavity 78 and consequently confines the deformable connector 72 between the upper arm shoulder 80, the lower arm shoulder 82 and a shank 86 of the tightening member 84. When fully tightened, the tightening member 84 puts at least a first point 90 of the perimeter 92 of the deformable connector 72 in contact with the upper arm shoulder 80. In addition, when fully tightened, the tightening member 84 puts at least a second point 94 of the perimeter 92 of the deformable connector 72 in contact with the lower arm shoulder 82. In addition, the shank 86 of the tightening member 84 contacts at least a third point 96 on the perimeter 92 of the deformable connector 72. These at least three points 90, 94, and 96 compress the deformable connector 72 such that it securely holds the shank 76 of the pedicle screw 74. Preferably, at least one of the upper arm shoulder 80 and the lower arm shoulder 82 are not parallel to a side surface 88 of the shank 76 of the pedicle screw 74.
Referring now to FIG. 15, the deformable connector 72 may also be adapted for use in a first rod member 12′, wherein the first rod member 12′ includes a beam 14 that is connected to a pedicle screw 74 by way of the deformable connector 72 that is situated within a cavity 78 of the first rod member 12′. Here, the deformable connector 72 is again confined within the first rod member 12′ by a upper arm shoulder 80 and lower arm shoulder 82, and further by the shank 86 of the tightening member 84.
Referring to FIGS. 14 and 15, one advantage to a substantially cylindrical-shaped deformable connector 72 is that it can be rotated within the cavity 78 prior to tightening to accommodate the position of the pedicle screw 74. Therefore, second rod member 42′ with deformable connector 72 overcomes the problem of where the pedicle screw 74 is not aligned sufficiently perpendicular to the intend rod axis. A substantially cylindrical-shaped deformable connector 72 can be rotated within the cavity 78 and then slipped over the shank 76 of the pedicle screw 74, and subsequently secured within the second rod member 42′ by tightening the tightening member 84. Thus, deformable connector 72 in combination with a clamping style first rod member 12′ or second rod member 42′ is rotatably adjustable prior to tightening. Rotation arrows A3 illustrate that the deformable connector 72 is rotatable within the cavity 78. This allows a surgeon to accommodate a patient's particular needs during the surgical procedure.
For the devices shown in FIGS. 14 and 15, and assuming that at least one of either first rod member 12′ or second rod member 42′ is being used, in use, a surgeon first installs a bone screw for general applications, or a pedicle screw if the device is to be interconnected to the pedicle of a vertebra. Assuming the device is used in an assembly for bridging an intervertebral disc, a second pedicle screw is attached to the other vertebra, or an existing second pedicle screw is used. Alternatively, the device could be used where two existing pedicle screws were already in place. The surgeon then preferably inserts the beam of the first rod member into the second rod member. Subsequently, the surgeon preferably lowers the first rod member and second rod member as a unit over the pedicle screws. The shank 76 of the pedicle screw 74 associated with first rod member 12′ or second rod member 42′ is slipped into the passageway 98 of the deformable connector 72 that is positioned in the cavity 78 of the respective first rod member 12′ or second rod member 42′. The deformable connector 72 is rotated as desired by the surgeon to obtain the proper alignment in order to slip the first rod member 12′ or second rod member 42′ over the pedicle screw 74. If first rod member 12′ is being used, then the surgeon tightens first rod member 12′ to its pedicle screw by advancing the tightening member 84 associated with the first rod member 12′. If first rod member 12′ is not being used, then the rod member opposite the second rod member 42′ is preferably otherwise secured to its pedicle screw. Subsequently, after adjusting the length of the beam 14 within the second rod member, the second rod member is then secured to the first rod member. If second rod member 42′ is being used, then the securing step is accomplished by advancing the tightening member 84 associated with the second rod member 42′.
Referring now to FIGS. 16-19, in one preferred embodiment, the deformable connector 72 is substantially cylindrical in shape, and this shape allows the cylindrical deformable connector 72 to rotate within the cavity 78 of the second rod member 42′. The deformable connector 72 includes a passageway 98 for receiving the shank 76 of the pedicle screw 74. More particularly, the passageway 98 is an opening through the deformable connector 72 that is sized to accommodate the shank 76 of a pedicle screw 74. In addition, the deformable connector 72 has a composition or structure allowing the deformable connector 72 to compress around the shank 76 of the pedicle screw 74 upon tightening of the second rod member 42′. More particularly, as shown in FIG. 16 a, the deformable connector 72 may be made of a type of material that can be compressed, such as a suitable resilient material. In use, upon tightening the tightening member 84, the deformable connector 72 is squeezed and compressed between the upper arm shoulder 80, lower arm shoulder 82 and the shank 86 of the tightening member 84 such that the shank 76 of the pedicle screw 74 is secured within the deformable connector 72, which in turn, is secured within the second rod member 42′.
Alternatively, as shown in FIGS. 16 b, 17, and 18, in a preferred embodiment, the deformable connector 72 may include a slit or groove 100 along a side that preferably intercepts the passageway 98. The groove includes a first edge 102 and an opposing and separated second edge 104. In use, upon tightening the tightening member 84, the deformable connector 72 is squeezed and compressed between the upper arm shoulder 80, lower arm shoulder 82 and the shank 86 of the tightening member 84. The first edge 102 of the groove 100 is moved in a direction of arrow A4 toward the second edge 104, which is being moved in a direction of arrow A5 toward first edge 102. As a result of the tightening force, the groove 100 allows the passageway 98 of deformable connector 72 to collapse around the shank 76 of the pedicle screw 74, such that the pedicle screw 74 is secured within the deformable connector 72, which in turn, is secured within the second rod member 42′.
The deformable connector 72 is anticipated to have a diameter of approximately 10 to 13 mm, and the passageway 98 within the deformable connector 72 is anticipated to have a diameter just slightly larger than the diameter of the shank 76 of a pedicle screw 74, which is typically on the order of about 5.2 mm in size.
Referring now to FIG. 19, for the case of a substantially cylindrical-shaped deformable connector 72, portions of the deformable connector 72 may be truncated to reduce the weight and displacement volume of the deformable connector 72. For example, a truncated first end 106 and/or a truncated second end 108 of the deformable connector 72 can be flattened or otherwise modified in shape. Preferably, the truncated first end 106 and truncated second end 108 are located at the passageway openings 110 and 112, respectively.
Referring now to FIG. 20 and 21, the deformable connector 72 may also take the form of a bead or sphere. A sphere-shaped deformable connector 72 allows the deformable connector 72 to be rotated in a multitude of directions to accommodate alignment with the shank 76 of a pedicle screw 74.
Referring now to FIG. 22, in a separate aspect of the invention, an interference fit connector 114 is presented. For purposes of illustration, a second rod member 42′ is shown in combination with a first rod member 12″, wherein first rod member 12″ incorporates an interference fit connector 114. For the embodiment shown in FIG. 22, the interference fit connector 114 is integrally attached to the beam 14. More particularly, the proximate beam end 18 of first rod member 12″ is attached to an interference fit connector 114.
Referring now to FIGS. 22-25, interference fit connector 114 has a C-shaped section 116 having a slot 118 separating an upper section 120 from a lower section 122. The first rod member 12″ includes a first aperture 124 through the upper section 120, and a second aperture 126 through the lower section 122. In addition, the C-shaped section 116 includes an interference tightening member 128, which serves as a means for tightening the C-shaped section 116 and drawing the upper section 120 and the lower section 122 in closer proximity relative to each other, such that the shank 76 of pedicle screw 74 is pinched or clamped within the C-shaped section 116 and secured to the first rod member 12″. As shown in FIGS. 22 and 24, the interference tightening member 128, or means for tightening the C-shaped section 116, can preferably take the form of a screw or a bolt. However, a band clamp, such as a worm-gear band could also be used to compress the upper section 120 and lower section 122 toward each other. Accordingly, a number of means for tightening the C-shaped section 116 are possible and are within the scope of the present invention.
One advantage of the C-shaped section 116 is that, when used in a first rod member 12″, it provides a rod and connector combination that is relatively easy for the surgeon to use. A second advantage is that it limits the length of the connector and implant structure that is longitudinally exposed beyond the pedicle screw 74 location. In so doing, in spinal implant applications, the adjacent vertebra beyond the end of the first rod member 12″ is not exposed to potentially impacting a rod section that would have previously extended longitudinally beyond the connector location. This can reduce patient pain and increase patient mobility. A further advantage is that the smaller profile results in less tissue displacement in the vicinity of C-shaped section 116.
Referring now to FIG. 26, a modified version of the device shown in FIG. 24 is presented. The first rod member 12′″ shown in FIG. 26 incorporates an integral connector that uses an interference fit, but has a reverse orientation as compared to the device shown in FIG. 24. More specifically, the proximate end 18 of first rod member 12′″ includes a reverse C-shaped section 130 having a slot 118 separating an upper section 120 from a lower section 122. The first rod member 12′″ includes a first aperture 124 through the upper section 120 and a second aperture 126 through the lower section 122. In addition, the reverse C-shaped section 130 includes an interference tightening member 128, which serves as a means for tightening the reverse C-shaped section 130 and drawing the upper section 120 and the lower section 122 in closer position relative to each other, such that the shank 76 of pedicle screw 74 is clamped or pinched within the reverse C-shaped section 130 and secured to the first rod member 12′″. As shown in FIG. 26, the interference tightening member 128, or means for tightening the reverse C-shaped section 130, can preferably take the form of a screw or a bolt. However, a band clamp, such as a worm-gear band could also be used to compress the upper section 120 and lower section 122 toward each other. Accordingly, a number of means for tightening the C-shaped section 130 are possible and are within the scope of the present invention.
One advantage of the reverse C-shaped section 130 is that, when used in a first rod member 12′″, it provides a rod and connector combination that is relatively easy for the surgeon to use. A second advantage is that it provides an interference type of connector fitting where the tightening member 128 is positioned on the opposite side of the pedicle screw 74 as that of the rod portion. Therefore, one potential use is for short bridge distances; that is, where the distance between pedicle screws is relatively small, and does not lend itself to placing the tightening member 128 in a position between the pedicle screws being spanned.
In use, a surgeon first installs a pedicle screw, or otherwise identifies an existing bone screw that the interference fit connector is to be attached to. Depending upon the choice of the device by the surgeon, the surgeon then slips the C-shaped section 116 or the reverse C-shaped section 130 over the shank 76 of the pedicle screw 74. To tighten the type C-shaped section 116 or the reverse C-shaped section 130 to the pedicle screw 74, the surgeon advances the tightening member 128. If a screw or bolt is used as a tightening member 128, this last step comprises advancing the screw or bolt until the C-shaped section 116 or the reverse C-shaped section 130 is secured to the shank 76 of the pedicle screw 74.
An interference fit connector can also be oriented at any angle relative to the beam that is between the pedicle screws. More particularly, FIG. 26 illustrates a reverse C-shaped section 130 that is situated at an angle of about 180 degrees relative to the C-shaped section 116 shown in FIG. 24. That is, it is not on the same side as the beam 14, but instead, it is on the opposite side of the pedicle screw relative to the beam 14. However, the C-shaped connector could be oriented at any angle, such as 30, 45, 60, 90, 135, etc. degrees (not shown) relative to the beam 14 to which it is attached. These different orientations for the C-shaped connector may be preferred depending upon a patient's needs, for example, because of an injury that makes such an orientation preferable.
Referring now to FIG. 27, an implant assembly is shown in plan view that includes two pedicle screws with an interference fit type of integral connector such as first rod member 12″ shown on the left side, and a second rod member 42″ with a deformable connector 72 shown on the right side. However, the deformable connector 72 of FIG. 27 includes a modified shape in the form of an indentation 132 that cooperates with the tightening member 84. The indentation 132 in the deformable connector 72 extends down the side of the deformable connector 72. The indentation 132 allows the distance d2 between the right-most pedicle screw 74 and the right-most tightening member 84 to be reduced relative to the distance d1 between the right-most pedicle screw 74 and the right-most tightening member 84 as shown in FIG. 23. Said differently, distance d1 of FIG. 23 is less than distance d2 of FIG. 27. This can be further reduced by using a screw as a tightening member 84 that has no upper flange. As a result of the indentation 132 feature, the distance d3 of the length of the second rod member 42″ between the right-most pedicle screw 74 and the right-most end of the second rod member 42″ is also reduced relative to the distance d4 of the length of the second rod member 42′ between the right-most pedicle screw 74 and the right-most end of the second rod member 42′, as shown in FIG. 23. For spinal implants, the adjacent vertebra beyond the end of the second rod member 42″ is not exposed to potentially impacting a rod section that would have previously extended longitudinally beyond pedicle screw location. This can reduce patient pain and increase patient mobility. A further advantage is that the smaller profile results in less tissue displacement in the vicinity of second rod member 42″.
Yet a separate aspect of the present invention is that different possible assemblies are available to meet a particular patient's needs. Referring now to FIG. 28, an implant assembly is shown that includes first rod member 12 in combination with a second rod member 42′. This combination allows for a polyaxial pedicle screw 34 to be used with a pedicle screw having a straight upper shank portion, such as pedicle screw 74 that is shown on the right side of the figure.
Referring now to FIG. 29, a modified deformable connector 72′ is shown wherein the deformable connector 72′ has a skeletonized structure to reduce its weight. As shown in FIG. 29, in a preferred embodiment, the skeletonized structure of the deformable connector 72′ can take the form of one or more tie beams 134 that structurally tie together portions of the deformable connector 72′. The tie beam 134 may include a textured surface 136 with, for example, a ridged, grooved or roughened surface for allowing the tie beam 134 to be selectively adjusted during the tightening process. The deformable connector 72′ can be formed of a structural frame that is partially compressible to lock the pedicle screw 74 in place and prevent its rotation after a tightening force is applied using a tightening member 84.
The exterior surface of the beam 14, such as the top side 20 and the bottom side 22 may possess surface features that interlock and aid in securing the beam 14 to the inside of the second rod member 42. Similarly, the inside surfaces of the second rod member 42, 42′ and/or 42″, such as the interior surfaces 54 and/or 56 of the upper arm 48 and lower arm 50, respectively, may also include features that interlock and aid in securing the beam 14 within the second rod member 42. For example, the various previously identified surfaces may include detents or depressions that receivingly accept other structural features. Surficial features may include texturing, ridges, bumps, projections, protrusions, indentations, adhesives, and coverings or coatings of alternate materials. In addition, although not required, at least one set screw could be used to interlock the beam 14 to the second rod member 42, 42′ and/or 42″.
In a separate aspect of the invention, although the second rod members 42, 42′, and 42″ are preferably a one-piece, monolithic structure, they may be manufactured, assembled, or implanted in plurality of pieces. By way of example and not limitation, a multi-piece second rod member 42, 42′, and 42″ can include an upper arm 48 separately and/or hingedly connected to the lower arm 50. Such a structure may be desirable to allow easy insertion of a deformable connector 72 or 72′ within a cavity 78 of a second rod member 42′ and 42″ during the manufacturing process.
The devices and structural features described herein are made from a material that possesses the appropriate strength characteristics necessary to withstand loading from the human body when used in medical applications. Tensile strength qualities of the materials used is a key consideration. Preferably, materials may include ceramics, plastics, metals, or carbon fiber composites. More preferably, the materials are made from titanium, a titanium alloy, or stainless steel.
Devices disclosed herein can also be made of thermal memory materials or materials that possess different elastic properties at varying temperatures. In this aspect of the invention, the subject component(s) may be heated or cooled to a desired temperature, implanted, then subsequently allowed to cool or warm to the temperature of the ambient conditions that will exist during the usage period for the subject device, namely, normal body temperature.
The dimensions of the devices disclosed herein are expected to vary depending upon the patient's needs. For example, a rod the entire length of the spine, such as 2 feet in length, may be used. Alternately, a rod only 10 to 40 mm long may be all that is necessary to span and bridge a disc of the spine. Therefore, for spinal applications, the preferable length of rod is simply an adequate length to bridge the necessary vertebral disc or discs. As a separate example, the beams of the first rod members described herein are anticipated to have a diameter of about 3-7 mm if solid and circular in cross section, and on the order of about 4-7 mm in length in the long dimension if solid and oblong in cross section. Again, the size of the dimensions of the devices is subject to the material used to construct the subject device, the intend use, and the specific characteristics of the patient. For example, a large person may have larger sized components than a device implanted in a child.
The curvature of the rod may also be variable depending upon the desired final curvature sought for the patient. The curvature may be established during manufacture of a given rod, and/or a given rod segment may have its curvature adjusted at the of time surgery prior to implantation.
The devices disclosed herein also have application to uses other than those specifically discussed. For example, one or more of the devices described herein have application to uses outside of surgical stabilization. For example, the devices could be used to connect framing of objects such as furniture. Even within the field of medicine and spinal surgery, one anticipated use involves using certain components described herein to cross-link or structurally interconnect right and left stabilization assemblies that are implanted on either side of a spinous process.
US569839 11 déc. 1895 20 oct. 1896 John t
US605652 1 juin 1897 14 juin 1898 Endoscopic instrument
US1090746 26 avr. 1913 17 mars 1914 Frank P Nourse Speculum.
US1097978 14 juin 1913 26 mai 1914 Hardwick Jackson J Combined dilator and catheter.
US3467079 14 avr. 1967 16 sept. 1969 James David Charles Gall bladder and common duct retractor
US3470872 25 nov. 1966 7 oct. 1969 Grieshaber Herman R Pivoted retractor with shielded spacer teeth
US3875595 15 avr. 1974 8 avr. 1975 Froning Edward C Intervertebral disc prosthesis and instruments for locating same
US3893454 6 févr. 1974 8 juil. 1975 Stille Werner Ab Instrument for use in coniotomy
US4041939 26 avr. 1976 16 août 1977 Downs Surgical Limited Surgical implant spinal screw
US4232660 26 mars 1979 11 nov. 1980 Coles Robert L Winged irrigating surgical retractor
US4440168 31 août 1981 3 avr. 1984 Warren Mark G Surgical device
US4481947 14 févr. 1980 13 nov. 1984 Chester Martin H Endotracheal tube retractor
US4545374 3 sept. 1982 8 oct. 1985 Jacobson Robert E Method and instruments for performing a percutaneous lumbar diskectomy
US4573448 5 oct. 1983 4 mars 1986 Pilling Co. Method for decompressing herniated intervertebral discs
US4617922 28 nov. 1984 21 oct. 1986 Richards Medical Company Compression screw assembly
US4620460 1 juil. 1985 4 nov. 1986 Gonzales Jr Frank Socket set
US4686972 30 avr. 1986 18 août 1987 Kurland Kenneth Z Surgical deflector and drilling guide
US4736738 2 mai 1985 12 avr. 1988 Matej Lipovsek Instrument kit and procedure for performing posterior lumbar interbody fusion
US4743260 10 juin 1985 10 mai 1988 Burton Charles V Method for a flexible stabilization system for a vertebral column
US4747394 8 oct. 1986 31 mai 1988 Watanabe Orthopedic Systems, Inc. Spinal retractor
US4798111 3 août 1987 17 janv. 1989 Cheeseman Charles D Socket-wrench hand tool
US4817587 31 août 1987 4 avr. 1989 Janese Woodrow W Ring para-spinal retractor
US4862891 14 mars 1988 5 sept. 1989 Canyon Medical Products Device for sequential percutaneous dilation
US4863423 23 mars 1988 5 sept. 1989 H. G. Wallace Ltd. Catheter and cannula assembly
US4882958 5 déc. 1988 28 nov. 1989 Mcneeley Richard L Stacking socket wrench set
US4995875 27 mai 1988 26 févr. 1991 Cecil Coes Femoral elevating tool
US5002542 * 30 oct. 1989 26 mars 1991 Synthes U.S.A. Pedicle screw clamp
US5002576 6 juin 1989 26 mars 1991 Mecron Medizinische Produkte Gmbh Intervertebral disk endoprosthesis
US5018507 13 juil. 1990 28 mai 1991 Montaldi David H One-piece disposable speculum
US5024213 8 févr. 1989 18 juin 1991 Acromed Corporation Connector for a corrective device
US5026373 6 nov. 1989 25 juin 1991 Surgical Dynamics, Inc. Surgical method and apparatus for fusing adjacent bone structures
US5030223 30 juin 1989 9 juil. 1991 Iowa State University Research Foundation, Inc. Head mounted stereotaxic apparatus
US5035232 21 oct. 1988 30 juil. 1991 Aesculap Ag Retractor
US5048379 29 mars 1990 17 sept. 1991 Gramera Robert E Multi-functional double-ended socket wrenches
US5052373 10 avr. 1990 1 oct. 1991 Michelson Gary K Spinal retractor
US5055104 6 nov. 1989 8 oct. 1991 Surgical Dynamics, Inc. Surgically implanting threaded fusion cages between adjacent low-back vertebrae by an anterior approach
US5084043 12 janv. 1990 28 janv. 1992 Laserscope Method for performing a percutaneous diskectomy using a laser
US5098435 21 nov. 1990 24 mars 1992 Alphatec Manufacturing Inc. Cannula
US5106376 3 juil. 1990 21 avr. 1992 B. Braun Melsungen Ag Anaesthesia set
US5129900 24 juil. 1990 14 juil. 1992 Acromed Corporation Spinal column retaining method and apparatus
US5133720 21 juin 1991 28 juil. 1992 Greenberg Alex M Surgical drill guide and retractor
US5135525 1 juin 1990 4 août 1992 B. Braun Melsungen Ag Catheter set for continuous spinal anaesthesia
US5148724 13 juin 1991 22 sept. 1992 Rexford Gary R Ratchet wrench and socket apparatus
US5158543 30 oct. 1990 27 oct. 1992 Lazarus Harrison M Laparoscopic surgical system and method
US5165306 4 oct. 1990 24 nov. 1992 Maclean-Fogg Company Vehicle stabilizer bar end link
US5195541 18 oct. 1991 23 mars 1993 Obenchain Theodore G Method of performing laparoscopic lumbar discectomy
US5217007 26 avr. 1991 8 juin 1993 Cook Incorporated Speculum for forming an ostomy in a trachea
US5275600 * 5 oct. 1992 4 janv. 1994 Zimmer, Inc. Telescoping rod to rod coupler for a spinal system
US5275611 13 juil. 1992 4 janv. 1994 Innerdyne Medical, Inc. Tension guide and dilator
US5279567 2 juil. 1992 18 janv. 1994 Conmed Corporation Trocar and tube with pressure signal
US5292309 22 janv. 1993 8 mars 1994 Schneider (Usa) Inc. Surgical depth measuring instrument and method
US5303694 9 févr. 1993 19 avr. 1994 Mikhail Michael W E Method for performing hip surgery and retractor for use therein
US5306309 4 mai 1992 26 avr. 1994 Calcitek, Inc. Spinal disk implant and implantation kit
US5312360 18 mars 1993 17 mai 1994 Innerdyne Medical, Inc. Tension guide and dilator
US5312405 6 juil. 1992 17 mai 1994 Zimmer, Inc. Spinal rod coupler
US5330473 4 mars 1993 19 juil. 1994 Advanced Spine Fixation Systems, Inc. Branch connector for spinal fixation systems
US5330476 18 nov. 1992 19 juil. 1994 Christophe Obry Protective cap for an osteosynthesis pin and assembly including this cap as well as an instrument for fixing it on the pin
US5356413 12 mars 1993 18 oct. 1994 Mitek Surgical Products, Inc. Surgical anchor and method for deploying the same
US5363841 2 juil. 1993 15 nov. 1994 Coker Wesley L Retractor for spinal surgery
US5415661 24 mars 1993 16 mai 1995 University Of Miami Implantable spinal assist device
US5431639 12 août 1993 11 juil. 1995 Boston Scientific Corporation Treating wounds caused by medical procedures
US5431651 8 févr. 1993 11 juil. 1995 Goble; E. Marlowe Cross pin and set screw femoral and tibial fixation method
US5439464 9 mars 1993 8 août 1995 Shapiro Partners Limited Method and instruments for performing arthroscopic spinal surgery
US5466238 22 déc. 1994 14 nov. 1995 Lin; Chih-I Vertebral locking and retrieving system having a fixation crossbar
US5472426 17 août 1993 5 déc. 1995 B.E.I. Medical Cervical discectomy instruments
US5474555 3 août 1994 12 déc. 1995 Cross Medical Products Spinal implant system
US5480401 10 févr. 1994 2 janv. 1996 Psi Extra-discal inter-vertebral prosthesis for controlling the variations of the inter-vertebral distance by means of a double damper
US5484440 18 août 1994 16 janv. 1996 Zimmer, Inc. Bone screw and screwdriver
US5489274 9 oct. 1992 6 févr. 1996 Boston Scientific Corporation Rotatable medical valve closure
US5489308 1 sept. 1994 6 févr. 1996 Spine-Tech, Inc. Spinal implant
US5499983 23 févr. 1994 19 mars 1996 Smith & Nephew Richards, Inc. Variable angle spinal screw
US5501684 25 juin 1992 26 mars 1996 Synthes (U.S.A.) Osteosynthetic fixation device
US5512038 15 nov. 1993 30 avr. 1996 O'neal; Darrell D. Spinal retractor apparatus having a curved blade
US5545166 14 juil. 1994 13 août 1996 Advanced Spine Fixation Systems, Incorporated Spinal segmental reduction derotational fixation system
US5549612 22 juin 1994 27 août 1996 Codman & Shurtleff, Inc. Osteosynthesis plate system
US5558622 2 sept. 1994 24 sept. 1996 Greenberg Surgical Technologies, Llc Mandibular border retractor and method for fixating a fractured mandible
US5562663 7 juin 1995 8 oct. 1996 Danek Medical, Inc. Implant interconnection mechanism
US5565502 24 mars 1995 15 oct. 1996 Children's Medical Center Corporation Isolation of the calcium-phosphate crystals of bone
US5569300 12 avr. 1995 29 oct. 1996 Redmon; Henry A. Dilating surgical forceps having illumination means on blade inner surface
US5584831 9 juil. 1993 17 déc. 1996 September 28, Inc. Spinal fixation device and method
US5584833 25 avr. 1995 17 déc. 1996 Soprane S.A. Device for retaining a connecting rod of a spine fixator on a pedicular screw
US5591166 27 mars 1995 7 janv. 1997 Smith & Nephew Richards, Inc. Multi angle bone bolt
US5591235 15 mars 1995 7 janv. 1997 Kuslich; Stephen D. Spinal fixation device
US5593409 17 févr. 1995 14 janv. 1997 Sofamor Danek Group, Inc. Interbody spinal fusion implants
US5601550 25 oct. 1994 11 févr. 1997 Esser; Rene D. Pelvic pin guide system for insertion of pins into iliac bone
US5603714 12 déc. 1994 18 févr. 1997 Mizuho Ika Kogyo Kabushiki Kaisha Instrument for anterior correction of scoliosis or the like
US5611778 12 mai 1993 18 mars 1997 Vygon Surgical instrument for performing epidural anesthesia
US5613968 * 1 mai 1995 25 mars 1997 Lin; Chih-I Universal pad fixation device for orthopedic surgery
US5628740 30 juin 1995 13 mai 1997 Mullane; Thomas S. Articulating toggle bolt bone screw
US5643263 14 août 1995 1 juil. 1997 Simonson; Peter Melott Spinal implant connection assembly
US5643264 13 sept. 1995 1 juil. 1997 Danek Medical, Inc. Iliac screw
US5645544 13 sept. 1995 8 juil. 1997 Danek Medical, Inc. Variable angle extension rod
US5667506 14 mars 1995 16 sept. 1997 Danek Medical, Inc. Spinal rod transverse connector for supporting vertebral fixation elements
US5683392 17 oct. 1995 4 nov. 1997 Wright Medical Technology, Inc. Multi-planar locking mechanism for bone fixation
US5683463 27 juil. 1994 4 nov. 1997 Advanced Technical Fabrication Intersomatic vertebral column implant
US5687739 30 avr. 1996 18 nov. 1997 Interventional Concepts, Inc. Biopsy specimen cutter
US5690632 30 nov. 1995 25 nov. 1997 Schwartz; Paul Steven Osteosynthesis screw fastener having angularly adjustable threads and methods of use therefor
US5691397 10 oct. 1996 25 nov. 1997 Children's Medical Center Corporation Isolation of the calcium-phosphate crystals of bone
US5695993 12 août 1994 9 déc. 1997 Oklahoma Medical Research Foundation Cloning and regulation of an endothelial cell protein C/activated protein C receptor
US5702455 3 juil. 1996 30 déc. 1997 Saggar; Rahul Expandable prosthesis for spinal fusion
US5716355 10 avr. 1995 10 févr. 1998 Sofamor Danek Group, Inc. Transverse connection for spinal rods
US5716415 8 mars 1996 10 févr. 1998 Acromed Corporation Spinal implant
US5725528 12 févr. 1997 10 mars 1998 Third Millennium Engineering, Llc Modular polyaxial locking pedicle screw
US5735850 30 janv. 1996 7 avr. 1998 Sulzer Medizinaltechnik Ag Fastening system for pedicel screws
US5735851 9 oct. 1996 7 avr. 1998 Third Millennium Engineering, Llc Modular polyaxial locking pedicle screw
US5735899 25 juil. 1996 7 avr. 1998 Vanderbilt University Low profile intraosseous anterior spinal fusion system and method
US5743853 9 sept. 1996 28 avr. 1998 Lauderdale; Robert A. Serrated S-retractor
US5746720 18 déc. 1995 5 mai 1998 Stouder, Jr.; Albert E. Method and apparatus for insertion of a cannula and trocar
US5746741 6 mai 1996 5 mai 1998 Tufts University External fixator system
US5752957 12 févr. 1997 19 mai 1998 Third Millennium Engineering, Llc Polyaxial mechanism for use with orthopaedic implant devices
US5766221 9 févr. 1995 16 juin 1998 Boston Scientific Technology, Inc. Bone anchor implantation device
US5766253 16 janv. 1996 16 juin 1998 Surgical Dynamics, Inc. Spinal fusion device
US5772582 8 avr. 1997 30 juin 1998 Bionix Development Corp. Nasal speculum
US5782832 1 oct. 1996 21 juil. 1998 Surgical Dynamics, Inc. Spinal fusion implant and method of insertion thereof
US5785648 9 oct. 1996 28 juil. 1998 David Min, M.D., Inc. Speculum
US5785710 7 juin 1995 28 juil. 1998 Sofamor Danek Group, Inc. Interbody spinal fusion implants
US5785712 16 avr. 1996 28 juil. 1998 Terray Corporation Reconstruction bone plate
US5792044 22 mars 1996 11 août 1998 Danek Medical, Inc. Devices and methods for percutaneous surgery
US5797912 19 août 1997 25 août 1998 Terray Corporation Washer for use with a bone screw
US5800435 1 mai 1997 1 sept. 1998 Techsys, Llc Modular spinal plate for use with modular polyaxial locking pedicle screws
US5810816 19 avr. 1995 22 sept. 1998 Roussouly; Pierre Device for stabilizing orthopedic anchors
US5810817 23 mai 1997 22 sept. 1998 Roussouly; Pierre Spinal therapy apparatus
US5816257 20 déc. 1995 6 oct. 1998 Origin Medsystems, Inc. Gasless retroperitoneal surgical procedure
US5827328 22 nov. 1996 27 oct. 1998 Buttermann; Glenn R. Intervertebral prosthetic device
US5836948 2 janv. 1997 17 nov. 1998 Saint Francis Medical Technologies, Llc Spine distraction implant and method
US5851207 1 juil. 1997 22 déc. 1998 Synthes (U.S.A.) Freely separable surgical drill guide and plate
US5860977 27 oct. 1997 19 janv. 1999 Saint Francis Medical Technologies, Llc Spine distraction implant and method
US5865847 29 juil. 1997 2 févr. 1999 Sulzer Spine-Tech Inc. Lordotic spinal implant
US5865848 12 sept. 1997 2 févr. 1999 Artifex, Ltd. Dynamic intervertebral spacer and method of use
US5876404 25 août 1998 2 mars 1999 St. Francis Medical Technologies, Llc Spine distraction implant and method
US5882344 18 oct. 1995 16 mars 1999 Stouder, Jr.; Albert E. Adjustable length cannula and trocar
US5885285 16 déc. 1996 23 mars 1999 Simonson; Peter Melott Spinal implant connection assembly
US5885299 14 mars 1996 23 mars 1999 Surgical Dynamics, Inc. Apparatus and method for implant insertion
US5885300 31 mars 1997 23 mars 1999 Asahi Kogaku Kogyo Kabushiki Kaisha Guide apparatus of intervertebral implant
US5891147 29 sept. 1997 6 avr. 1999 Sdgi Holdings, Inc. Minimally invasive spinal surgical methods & instruments
US5895352 17 mars 1998 20 avr. 1999 Kleiner; Jeffrey B. Surgical retractor
US5895390 23 juil. 1997 20 avr. 1999 Biomet, Inc. Pin placement guide used in making a bone entry hole for implantation of an intramedullary nail
US5897593 29 juil. 1997 27 avr. 1999 Sulzer Spine-Tech Inc. Lordotic spinal implant
US5899901 1 nov. 1995 4 mai 1999 Middleton; Jeffrey Keith Spinal fixation system
US5902231 24 oct. 1996 11 mai 1999 Sdgi Holdings, Inc. Devices and methods for percutaneous surgery
US5902304 27 nov. 1996 11 mai 1999 Walker; David A. Telescopic bone plate for use in bone lengthening by distraction osteogenesis
US5904650 9 oct. 1998 18 mai 1999 Genzyme Corporation Ball joint retractor
US5906616 15 janv. 1997 25 mai 1999 Surgical Dynamics, Inc. Conically shaped anterior fusion cage and method of implantation
US5913818 9 sept. 1997 22 juin 1999 General Surgical Innovations, Inc. Vascular retractor
US5928139 8 juil. 1998 27 juil. 1999 Koros; Tibor B. Retractor with adjustable length blades and light pipe guides
US5928233 21 mars 1997 27 juil. 1999 Ohio Medical Instrument Co., Inc. Spinal fixation device with laterally attachable connectors
US5931838 * 28 janv. 1998 3 août 1999 Vito; Raymond P. Fixation assembly for orthopedic applications
US5944658 23 sept. 1997 31 août 1999 Koros; Tibor B. Lumbar spinal fusion retractor and distractor system
US5947965 11 mars 1996 7 sept. 1999 Bryan; Donald W. Spinal fixation apparatus and method
US5954635 29 août 1997 21 sept. 1999 Sdgi Holdings Inc. Devices and methods for percutaneous surgery
US5954671 28 déc. 1998 21 sept. 1999 O'neill; Michael J. Bone harvesting method and apparatus
US5961516 25 juil. 1997 5 oct. 1999 Graf; Henry Device for mechanically connecting and assisting vertebrae with respect to one another
US5967970 17 sept. 1998 19 oct. 1999 Cowan; Michael A. System and method for balloon-assisted retraction tube
US5968098 22 oct. 1996 19 oct. 1999 Surgical Dynamics, Inc. Apparatus for fusing adjacent bone structures
US5971920 18 juin 1997 26 oct. 1999 Nagel; Gunther Peter Surgical retractor
US5976135 18 déc. 1997 2 nov. 1999 Sdgi Holdings, Inc. Lateral connector assembly
US5976146 11 juin 1998 2 nov. 1999 Olympus Optical Co., Ltd. Surgical operation system and method of securing working space for surgical operation in body
US5984924 7 oct. 1998 16 nov. 1999 Isola Implants, Inc. Bone alignment system having variable orientation bone anchors
US5996447 8 déc. 1997 7 déc. 1999 Bayouth; David Sink wrench
US5997539 30 avr. 1998 7 déc. 1999 Spinal Concepts, Inc. Polyaxial pedicle screw having a compression locking rod gripping mechanism
US6004322 10 sept. 1996 21 déc. 1999 Sdgi Holdings, Inc. Modular pedicle screw system
US6007487 29 août 1997 28 déc. 1999 Sdgi Holdings, Inc. Tissue retractor for use through a cannula
US6010520 1 mai 1998 4 janv. 2000 Pattison; C. Phillip Double tapered esophageal dilator
US6017342 5 août 1998 25 janv. 2000 Beere Precision Medical Instrumnets, Inc. Compression and distraction instrument
US6027533 18 mars 1996 22 févr. 2000 Olerud; Sven Device for fixating and adjusting the positions of vertebrae in vertebral surgical operations
US6045579 1 mai 1997 4 avr. 2000 Spinal Concepts, Inc. Adjustable height fusion device
US6048342 27 oct. 1998 11 avr. 2000 St. Francis Medical Technologies, Inc. Spine distraction implant
US6050997 25 janv. 1999 18 avr. 2000 Mullane; Thomas S. Spinal fixation system
US6063088 24 mars 1997 16 mai 2000 United States Surgical Corporation Method and instrumentation for implant insertion
US6068630 20 oct. 1998 30 mai 2000 St. Francis Medical Technologies, Inc. Spine distraction implant
US6074390 5 févr. 1998 13 juin 2000 St. Francis Medical Technologies, Inc. Spine distraction implant and method
US6074393 4 juin 1997 13 juin 2000 Robert Reid, Inc. Bone fixing screws
US6080155 27 févr. 1995 27 juin 2000 Michelson; Gary Karlin Method of inserting and preloading spinal implants
US6080193 15 sept. 1998 27 juin 2000 Spinal Concepts, Inc. Adjustable height fusion device
US6083225 8 juil. 1997 4 juil. 2000 Surgical Dynamics, Inc. Method and instrumentation for implant insertion
US6083226 17 sept. 1998 4 juil. 2000 Fiz; Daniel Bone fixation device and transverse linking bridge
US6090112 28 juil. 1998 18 juil. 2000 St. Francis Medical Technologies, Inc. Spine distraction implant and method
US6102948 20 août 1997 15 août 2000 Surgical Dynamics Inc. Spinal fusion device
US6113602 26 mars 1999 5 sept. 2000 Sulzer Spine-Tech Inc. Posterior spinal instrument guide and method
US6117137 27 avr. 1999 12 sept. 2000 Schafer Micomed Gmbh Osteosynthesis device
US6117174 16 sept. 1998 12 sept. 2000 Nolan; Wesley A. Spinal implant device
US6120434 22 août 1997 19 sept. 2000 Olympus Optical Co., Ltd. Method of securing a cavity using a rigid sheath with transparent cap
US6120506 29 juil. 1997 19 sept. 2000 Sulzer Spine-Tech Inc. Lordotic spinal implant
US6123705 1 oct. 1996 26 sept. 2000 Sdgi Holdings, Inc. Interbody spinal fusion implants
US6123706 17 déc. 1998 26 sept. 2000 Lange; Robert Apparatus for stabilizing certain vertebrae of the spine
US6132430 9 juin 1998 17 oct. 2000 Spinal Concepts, Inc. Spinal fixation system
US6146383 1 févr. 1999 14 nov. 2000 Sulzer Orthopadie Ag Pivotal securing system at a bone screw
US6149652 27 juil. 1999 21 nov. 2000 St. Francis Medical Technologies, Inc. Spine distraction implant and method
US6149686 16 oct. 1996 21 nov. 2000 Sulzer Spine-Tech Inc. Threaded spinal implant with bone ingrowth openings
US6152871 25 sept. 1998 28 nov. 2000 Sdgi Holdings, Inc. Apparatus for percutaneous surgery
US6152926 27 juil. 1999 28 nov. 2000 St. Francis Medical Technologies, Inc. Spine distraction implant and method
US6156006 7 oct. 1999 5 déc. 2000 Circon Corporation Medical instrument system for piercing through tissue
US6156038 6 mai 1999 5 déc. 2000 St. Francis Medical Technologies, Inc. Spine distraction implant and method
US6159179 12 mars 1999 12 déc. 2000 Simonson; Robert E. Cannula and sizing and insertion method
US6162170 20 janv. 1999 19 déc. 2000 Sdgi Holdings, Inc. Devices and methods for percutaneous surgery
US6162236 9 juil. 1997 19 déc. 2000 Terumo Kabushiki Kaisha Trocar needle and expandable trocar tube
US6176823 25 nov. 1998 23 janv. 2001 Sdgi Holdings, Inc. Fixture for supporting a viewing element within a cannula
US6179838 24 févr. 1998 30 janv. 2001 Daniel Fiz Bone fixation arrangements and method
US6183471 25 nov. 1998 6 févr. 2001 St. Francis Medical Technologies, Inc. Spine distraction implant and method
US6187005 9 sept. 1999 13 févr. 2001 Synthes (Usa) Variable angle spinal fixation system
US6190387 28 déc. 1999 20 févr. 2001 St. Francis Medical Technologies, Inc. Spine distraction implant
US6190414 31 oct. 1996 20 févr. 2001 Surgical Dynamics Inc. Apparatus for fusion of adjacent bone structures
US6196696 11 juin 1999 6 mars 2001 Hsuan-Sen Shiao Driving tool with illuminating capability
US6196969 21 mai 1999 6 mars 2001 Lab Engineering & Manufacturing, Inc. Tissue retractor adapted for the attachment of an auxiliary element
US6197002 8 févr. 1999 6 mars 2001 Phillips Plastics Corporation Laparoscopic tool and method
US6206822 2 juil. 1999 27 mars 2001 Sdgi Holdings, Inc. Devices and methods for percutaneous surgery
US6206826 18 juin 1999 27 mars 2001 Sdgi Holdings, Inc. Devices and methods for percutaneous surgery
US6206885 12 avr. 1999 27 mars 2001 Fathali Ghahremani Catheter guide and drill guide apparatus and method for perpendicular insertion into a cranium orifice
US6206922 28 janv. 1998 27 mars 2001 Sdgi Holdings, Inc. Methods and instruments for interbody fusion
US6206923 8 janv. 1999 27 mars 2001 Sdgi Holdings, Inc. Flexible implant using partially demineralized bone
US6210413 29 sept. 1999 3 avr. 2001 Sdgi Holdings, Inc. Connecting apparatus using shape-memory technology
US6214004 9 juin 1998 10 avr. 2001 Wesley L. Coker Vertebral triplaner alignment facilitator
US6217509 20 janv. 1999 17 avr. 2001 Sdgi Holdings, Inc. Devices and methods for percutaneous surgery
US6224597 13 août 1999 1 mai 2001 Wesley L. Coker Vertebral triplaner alignment method
US6224608 3 juin 1993 1 mai 2001 United States Surgical Corporation Tissue holding device and method
US6224631 20 mars 1998 1 mai 2001 Sulzer Spine-Tech Inc. Intervertebral implant with reduced contact area and method
US6231575 16 août 1999 15 mai 2001 Martin H. Krag Spinal column retainer
US6235030 28 déc. 1999 22 mai 2001 St. Francis Medical Technologies, Inc. Spine distraction implant
US6238397 28 déc. 1999 29 mai 2001 St. Francis Technologies, Inc. Spine distraction implant and method
US6245072 9 mars 1999 12 juin 2001 Sdgi Holdings, Inc. Methods and instruments for interbody fusion
US6248104 1 avr. 1998 19 juin 2001 Daniel Chopin Apparatus for osteosynthesis comprising a connector of the spinal pin and the anchoring elements
US6248106 25 févr. 2000 19 juin 2001 Bret Ferree Cross-coupled vertebral stabilizers
US6258097 2 juin 2000 10 juil. 2001 Bristol-Myers Squibb Co Head center instrument and method of using the same
US6261287 31 janv. 2000 17 juil. 2001 Stryker Trauma Gmbh Apparatus for bracing vertebrae
US6264658 2 juil. 1999 24 juil. 2001 Solco Surgical Instruments Co., Ltd. Spine fixing apparatus
US6267763 31 mars 1999 31 juil. 2001 Surgical Dynamics, Inc. Method and apparatus for spinal implant insertion
US6267764 13 nov. 1997 31 juil. 2001 Stryker France S.A. Osteosynthesis system with elastic deformation for spinal column
US6267765 3 juin 1998 31 juil. 2001 Jean Taylor Multidirectional adaptable vertebral osteosyntsis device with reduced space requirement
US6270498 7 juin 1995 7 août 2001 Gary Karlin Michelson Apparatus for inserting spinal implants
US6273914 2 déc. 1997 14 août 2001 Sparta, Inc. Spinal implant
US6283966 7 juil. 1999 4 sept. 2001 Sulzer Spine-Tech Inc. Spinal surgery tools and positioning method
US6287309 21 sept. 1998 11 sept. 2001 Dimso (Distribution Medicale Du Sudouest) Screw and plate system for backbone osteosynthesis
US6287313 23 nov. 1999 11 sept. 2001 Sdgi Holdings, Inc. Screw delivery system and method
US6287343 27 juil. 1999 11 sept. 2001 Sulzer Spine-Tech, Inc. Threaded spinal implant with bone ingrowth openings
US6290700 31 juil. 1998 18 sept. 2001 Plus Endoprothetik Ag Device for stiffening and/or correcting a vertebral column or such like
US6296609 14 avr. 2000 2 oct. 2001 Salvador A. Brau Surgical retractor and related surgical approach to access the anterior lumbar region
US6299614 29 mars 2000 9 oct. 2001 Signus Medizintechnik Gmbh Device for stabilizing vertebra bodies of the spinal column
US6302842 11 janv. 2001 16 oct. 2001 Innovative Surgical Design Llc Episiotomy retractor
US6309390 3 avr. 1998 30 oct. 2001 Stryker France S.A. Device for backbone osteosynthesis with offset intervertebral fixing rod
US6309391 15 mars 2000 30 oct. 2001 Sdgi Holding, Inc. Multidirectional pivoting bone screw and fixation system
US6312432 11 oct. 2000 6 nov. 2001 Nemco Medical, Inc. Bone drill
US6332883 6 nov. 2000 25 déc. 2001 St. Francis Medical Technologies, Inc. Spine distraction implant
US6342057 28 avr. 2000 29 janv. 2002 Synthes (Usa) Remotely aligned surgical drill guide
US6348058 10 déc. 1998 19 févr. 2002 Surgical Navigation Technologies, Inc. Image guided spinal surgery guide, system, and method for use thereof
US6354176 10 nov. 2000 12 mars 2002 Greenlee Textron, Inc. Universal deep socket and adapter
US6355038 25 sept. 1998 12 mars 2002 Perumala Corporation Multi-axis internal spinal fixation
US6361541 17 juil. 1998 26 mars 2002 The University Of Iowa Research Foundation Surgical instrument for extracting tissue ingrowth from a permeable member of an implanted catheter
US6368320 8 déc. 1998 9 avr. 2002 (Dimso) Distribution Medicale Du Sud-Ouest Connector for backbone osteosynthesis device
US6368350 11 mars 1999 9 avr. 2002 Sulzer Spine-Tech Inc. Intervertebral disc prosthesis and method
US6368351 27 mars 2001 9 avr. 2002 Bradley J. Glenn Intervertebral space implant for use in spinal fusion procedures
US6371959 5 avr. 2000 16 avr. 2002 Michael E. Trice Radiolucent position locating device and drill guide
US6371968 8 mai 1997 16 avr. 2002 Olympus Optical Co., Ltd. Cavity retaining tool for bone surgery, a cavity retaining tool for general surgery, an endoscopic surgery system involving the use of a cavity retaining tool, and a procedure for surgery
US6391058 21 oct. 1999 21 mai 2002 Sulzer Spine-Tech Inc. Threaded spinal implant with convex trailing surface
US6395033 10 avr. 2000 28 mai 2002 Tyco Healthcare Group Lp Dynamic fusion mechanostat devices
US6418821 25 mai 2000 16 juil. 2002 Sangadensetsukogyo Co., Ltd. Working tool
US6428472 8 août 2000 6 août 2002 Kent Haas Surgical retractor having a malleable support
US6440169 27 janv. 1999 27 août 2002 Dimso Interspinous stabilizer to be fixed to spinous processes of two vertebrae
US6440170 4 déc. 2000 27 août 2002 Roger P. Jackson Threaded interbody device
US6443953 6 mars 2000 3 sept. 2002 Cross Medical Products, Inc. Self-aligning cap nut for use with a spinal rod anchor
US6443989 4 déc. 2000 3 sept. 2002 Roger P. Jackson Posterior expandable fusion cage
US6461330 1 juin 2000 8 oct. 2002 Machida Endoscope Co., Ltd. Surgical operation guiding apparatus
US6461359 10 nov. 1999 8 oct. 2002 Clifford Tribus Spine stabilization device
US6471724 5 févr. 2001 29 oct. 2002 Sdgi Holdings, Inc. Methods and instruments for interbody fusion
US6478798 17 mai 2001 12 nov. 2002 Robert S. Howland Spinal fixation apparatus and methods for use
US6506151 10 avr. 2001 14 janv. 2003 Sdgi Holdings, Inc. Method and instrumentation for posterior interbody fusion
US6520907 30 nov. 1999 18 févr. 2003 Sdgi Holdings, Inc. Methods for accessing the spinal column
US6524238 20 déc. 2000 25 févr. 2003 Synthes Usa Universal handle and method for use
US6530880 29 mars 2001 11 mars 2003 Endius Incorporated Apparatus for supporting an endoscope
US6530926 1 août 2000 11 mars 2003 Endius Incorporated Method of securing vertebrae
US6540756 9 août 1999 1 avr. 2003 Thomas F. Vaughan Portal acquisition tool
US6562046 7 juin 2001 13 mai 2003 Sdgi Holdings, Inc. Screw delivery system and method
US6562073 6 févr. 2001 13 mai 2003 Sdgi Holding, Inc. Spinal bone implant
US6565569 29 avr. 1999 20 mai 2003 Stryker Spine Backbone osteosynthesis system with clamping means, in particlular for anterior fixing
US6569164 * 29 avr. 1999 27 mai 2003 Stryker Spine Spinal osteosynthesis system for anterior fixation
US6576017 6 févr. 2001 10 juin 2003 Sdgi Holdings, Inc. Spinal implant with attached ligament and methods
US6579292 18 juin 2001 17 juin 2003 Sdgi Holdings, Inc. Connection assembly for spinal implant systems
US6585738 27 avr. 1999 1 juil. 2003 Stryker Spine Spinal osteosynthesis device for anterior fixation with plate
US6585769 5 avr. 2000 1 juil. 2003 Howmedica Osteonics Corp. Artificial spinal ligament
US6595993 11 mai 2001 22 juil. 2003 Suler Orthopedics Ltd. Connection of a bone screw to a bone plate
US6610062 13 févr. 2001 26 août 2003 Ebi, L.P. Method and system for spinal fixation
US6626904 * 27 juil. 2000 30 sept. 2003 Societe Etudes Et Developpements - Sed Implantable intervertebral connection device
US6626906 23 oct. 2000 30 sept. 2003 Sdgi Holdings, Inc. Multi-planar adjustable connector
US6648887 23 janv. 2002 18 nov. 2003 Richard B. Ashman Variable angle spinal implant connection assembly
US6671725 18 avr. 2000 30 déc. 2003 International Business Machines Corporation Server cluster interconnection using network processor
US6676661 26 juin 2000 13 janv. 2004 Antonio Martin Benlloch Multiaxial connector for spinal implant
US6679833 23 mars 2001 20 janv. 2004 Sdgi Holdings, Inc. Devices and methods for percutaneous surgery
US6682532 22 mars 2002 27 janv. 2004 Depuy Acromed, Inc. Coupling system and method for extending spinal instrumentation
US6685705 23 oct. 2000 3 févr. 2004 Sdgi Holdings, Inc. Six-axis and seven-axis adjustable connector
US6692434 1 oct. 2001 17 févr. 2004 Stephen Ritland Method and device for retractor for microsurgical intermuscular lumbar arthrodesis
US6736816 2 juil. 2001 18 mai 2004 Stephen Ritland Polyaxial connection device and method
US6743257 21 nov. 2001 1 juin 2004 Cortek, Inc. Dynamic implanted intervertebral spacer
US6749613 18 févr. 2000 15 juin 2004 Stryker Spine Distraction/contraction device for spinal osteosynthesis system
US6749614 10 oct. 2001 15 juin 2004 Vertelink Corporation Formable orthopedic fixation system with cross linking
US6752832 26 déc. 2001 22 juin 2004 Ulrich Gmbh & Co., Kg Vertebral implant and setting tool therefor
US6761719 21 sept. 2001 13 juil. 2004 Sdgi Holdings, Inc. Superelastic spinal stabilization system and method
US6783528 23 janv. 2002 31 août 2004 Stryker Spine Position-adjustment system for an instrument for surgery of the spine
US6851430 30 nov. 2001 8 févr. 2005 Paul M. Tsou Method and apparatus for endoscopic spinal surgery
US6875211 * 7 déc. 2001 5 avr. 2005 Howmedica Osteonics Corp. Apparatus for spinal stabilization
US6955678 28 juin 2002 18 oct. 2005 Smith & Nephew, Inc. Soft tissue repair tool
US6974480 13 nov. 2002 13 déc. 2005 Synthes (Usa) Intervertebral implant for transforaminal posterior lumbar interbody fusion procedure
US6991632 * 25 févr. 2004 31 janv. 2006 Stephen Ritland Adjustable rod and connector device and method of use
US20010005796 5 févr. 2001 28 juin 2001 Thomas Zdeblick Methods and instruments for interbody fusion
US20010010021 2 févr. 2001 26 juil. 2001 Boyd Lawrence M. Flexible implant using partially demineralized bone
US20010012942 10 avr. 2001 9 août 2001 Estes Bradley T. Method and instrumentation for posterior interbody fusion
US20010027320 7 juin 2001 4 oct. 2001 Rick Sasso Screw delivery system and method
US20010047207 15 juin 2001 29 nov. 2001 Michelson Gary K. Self-broaching, rotatable, push-in interbody spinal fusion implant and method for deployment thereof
US20020011135 19 juin 2001 31 janv. 2002 Wayne Hall Reversible socket wrench set
US20020016592 30 mai 2001 7 févr. 2002 Branch Charles L. Interbody fusion grafts and instrumentation
US20020022764 23 mars 2001 21 févr. 2002 Smith Maurice M. Devices and methods for percutaneous surgery
US20020029082 28 août 2001 7 mars 2002 Muhanna Nabil L. Vertebral spacer and method of use
US20020049368 1 oct. 2001 25 avr. 2002 Stephen Ritland Method and device for retractor for microsurgical intermuscular lumbar arthrodesis
US20020052603 7 déc. 2001 2 mai 2002 Surgical Dynamics, Inc. Apparatus for spinal stabilization
US20020058948 11 oct. 2001 16 mai 2002 Yvan Arlettaz Targeting system and method for distal locking of intramedullary nails
US20020068973 4 déc. 2000 6 juin 2002 Jackson Roger P. Threaded interbody device
US20020068975 10 oct. 2001 6 juin 2002 Teitelbaum George P. Formable orthopedic fixation system with cross linking
US20020077632 30 nov. 2001 20 juin 2002 Tsou Paul M. Method and apparatus for endoscopic spinal surgery
US20020082695 26 déc. 2001 27 juin 2002 Ulrich Gmbh & Co. Kg Vertebral implant and setting tool therefor
US20020107571 6 févr. 2001 8 août 2002 Foley Kevin T. Spinal bone implant
US20020107572 6 févr. 2001 8 août 2002 Foley Kevin T. Spinal implant with attached ligament
US20020111625 12 févr. 2001 15 août 2002 Marc Richelsoph Rod to rod connector
US20020120270 26 févr. 2002 29 août 2002 Hai Trieu Flexible systems for spinal stabilization and fixation
US20020123668 29 janv. 2002 5 sept. 2002 Stephen Ritland Retractor and method for spinal pedicle screw placement
US20020143235 29 mars 2001 3 oct. 2002 Endius Incorporated Apparatus for supporting an endoscope
US20030045874 31 août 2001 6 mars 2003 Thomas James C. Transverse connector assembly for spine fixation system
US20030083688 30 oct. 2001 1 mai 2003 Simonson Robert E. Configured and sized cannula
US20030083689 30 oct. 2001 1 mai 2003 Simonson Robert E. Non cannulated dilators
US20030093078 30 sept. 2002 15 mai 2003 Stephen Ritland Connection rod for screw or hook polyaxial system and method of use
US20030109880 29 juil. 2002 12 juin 2003 Showa Ika Kohgyo Co., Ltd. Bone connector
US20030139812 8 nov. 2002 24 juil. 2003 Javier Garcia Spinal implant
US20030144665 26 janv. 2001 31 juil. 2003 Everard Munting Intervertebral linking device with connecting bar for fixing a linking rod
US20030171749 25 juil. 2001 11 sept. 2003 Regis Le Couedic Semirigid linking piece for stabilizing the spine
US20030171751 20 févr. 2003 11 sept. 2003 Stephen Ritland Pedicle screw connector apparatus and method
US20030187431 29 mars 2002 2 oct. 2003 Simonson Robert E. Apparatus and method for targeting for surgical procedures
US20030191470 4 avr. 2003 9 oct. 2003 Stephen Ritland Dynamic fixation device and method of use
US20030220689 21 mars 2003 27 nov. 2003 Stephen Ritland Device and method for assisting in positioning implants
US20030236447 13 mai 2003 25 déc. 2003 Stephen Ritland Retractor and method for spinal pedicle screw placement
US20040002708 8 mai 2003 1 janv. 2004 Stephen Ritland Dynamic fixation device and method of use
US20040106997 1 nov. 2002 3 juin 2004 Lieberson Robert E. Apparatus and method for creating a surgical channel
US20040138534 22 déc. 2003 15 juil. 2004 Stephen Ritland Method and device for retractor for microsurgical intermuscular lumbar arthrodesis
US20040172023 10 févr. 2004 2 sept. 2004 Stephen Ritland Polyaxial connection device and method
US20040181223 25 févr. 2004 16 sept. 2004 Stephen Ritland Adjustable rod and connector device and method of use
US20040254428 24 mai 2004 16 déc. 2004 Stephen Ritland Intermuscular guide for retractor insertion and method of use
US20050004593 26 juil. 2004 6 janv. 2005 Depuy Spine, Inc. Non cannulated dilators
US20050020920 21 juil. 2003 27 janv. 2005 Stephen Ritland Surgical image tracker mounting base apparatus and method of use
US20050027360 1 août 2003 3 févr. 2005 Webb Scott A. Spinal implant
US20050143737 31 déc. 2003 30 juin 2005 John Pafford Dynamic spinal stabilization system
US20050149191 22 oct. 2004 7 juil. 2005 Cragg Andrew H. Spinal mobility preservation apparatus having an expandable membrane
US20050203517 3 mars 2005 15 sept. 2005 N Spine, Inc. Spinal stabilization device
US20050203519 8 mars 2005 15 sept. 2005 Jurgen Harms Rod-like element for application in spinal or trauma surgery, and stabilization device with such a rod-like element
US20050209694 9 mars 2005 22 sept. 2005 Loeb Marvin P Artificial spinal joints and method of use
US20060009768 9 sept. 2005 12 janv. 2006 Stephen Ritland Dynamic fixation device and method of use
US20060041259 6 oct. 2005 23 févr. 2006 Paul David C Spine stabilization system
US20060064090 28 janv. 2005 23 mars 2006 Kyung-Woo Park Bio-flexible spinal fixation apparatus with shape memory alloy
US20060069390 14 oct. 2005 30 mars 2006 Robert Frigg Bone fixation device
US20060195087 2 févr. 2005 31 août 2006 Ronald Sacher Adjustable length implant
USD361381 17 mars 1994 15 août 1995 Combined spine and sternum retractor frame
USD399955 14 nov. 1997 20 oct. 1998 Combined spine/sternum retractor frame and blades
USD433296 12 juil. 1999 7 nov. 2000 Sangadensetsukogyo Co., Ltd. Socket for manual tool
USD436513 12 juil. 1999 23 janv. 2001 Sangadensetsukogyo Co., Ltd. Socket for screwdriver
USD438074 24 sept. 1999 27 févr. 2001 Donald E Marr Tap socket
USD466766 8 août 2001 10 déc. 2002 Masco Corporation Of Indiana Wrench
USRE36020 5 oct. 1995 29 déc. 1998 Orthopedic Systems, Inc. Method and apparatus for tying suture to bone
CA2320821A1 27 janv. 1999 19 août 1999 Dimso (Distribution Medicale Du Sud-Ouest) Interspinous stabiliser to be fixed to spinous processes of two vertebrae
EP0820731A3 22 juil. 1997 15 juil. 1998 Fred Zacouto Skeletal implant
FR2796828B1 Titre non disponible
FR2812185B1 Titre non disponible
1 "New Minimally Invasive Techniques, Improve Outcome of Spine Surgeries", Medtronic Sofamor Danek.
2 Amendment After Final Office Action dated Nov. 12, 2003 in U.S. Appl. No. 09/898,478.
3 Amendment and Response dated Aug. 25, 2008 in U.S. Appl. No. 10/776,094.
4 Amendment and Response dated Aug. 26, 2008 in U.S. Appl. No. 10/624,234.
5 Amendment and Response dated Feb. 12, 2008 in U.S. Appl. No. 10/776,094.
6 Amendment and Response dated Feb. 13, 2009 in U.S. Appl. No. 10/776,094.
7 Amendment and Response dated Feb. 5, 2007 in U.S. Appl. No. 10/776,094.
8 Amendment and Response dated Jan. 21, 2003 in U.S. Appl. No. 09/898,478.
9 Amendment and Response dated Jul. 26, 2007 in U.S. Appl. No. 10/776,094.
10 Amendment and Response to Election of Restriction Requirement dated Jul. 17, 2003 in U.S. Appl. No. 09/898,478.
11 Caspar; "Technique of Microsurgery: Microsurgery of the Lumbar Spine: Principles and Techniques in Spine Surgery"; Aspen Publications; 1990; 105-122.
12 China Chemical Reporter, "Rapid Development of Polyether Ether Ketone", CNCIC Chemdata Inc., 2004, 2 pages.
13 Fax Correspondence dated Mar. 13, 2003 from Examiner in U.S. Appl. No. 09/898,478.
14 Final Office Action dated Oct. 7, 2003 in U.S. Appl. No. 09/898,478.
15 Final Office Action mailed Apr. 23, 2008 in U.S. Appl. No. 10/776,094.
16 Green, "Body Building-Medical Materials for Systems and Scaffolding," Materials World, Journal of the Institute of Materials, vol. 10, No. 2, 2001, 4 pages.
17 Green, "Body Building—Medical Materials for Systems and Scaffolding," Materials World, Journal of the Institute of Materials, vol. 10, No. 2, 2001, 4 pages.
18 Green, "Effects of Gamma Sterilisation on Implant Grade Polyetheretherketone," Invibio Inc., Lancashire, United Kingdom, undated, 1 page.
19 Green, "In Vivo Biostability Study on Polyaryletheretherketone Biomaterial," Invibio Inc., Lancashire, United Kingdom, undated, 2 pages.
20 Green, et al., "A Polyaryletherketone Biomaterial for Use in Medical Implant Applications", Lancashire, United Kingdom, 2001, 1 page.
21 Green, et al., "Polyetheretherketone Polymer and Compounds for Surgical Applications," Lancashire, United Kingdom, undated, 9 pages.
22 Green, Stuart, "PEEK-Optima Polymer in the Implantable Medical Device Industry," Invibio Inc., Lancashire, United Kingdom, undated, 2 pages.
23 Hilton et al.; "Meditronic Sofamor Danek METRX Microdiscectomy Surgical Technique Brochure"; 2000.
24 International Preliminary Examination Report dated Apr. 23, 2003 in Application No. PCT/US2001/021205.
25 International Preliminary Examination Report for PCT Application Serial No. PCT/US02/31201 mailed Jan. 20, 2004 (4510-6-PCT).
26 International Preliminary Report on Patentability for PCT Application Serial No. PCT/US2004/005751 mailed Sep. 9, 2005 (4510-6-CIP-PCT).
27 International Search Report dated Sep. 13, 2001 in Application No. PCT/US2001/021205.
28 International Search Report for PCT Application Serial No. PCT/US02/31201 mailed Feb. 19, 2003 (4510-6-PCT).
29 International Search Report for PCT Application Serial No. PCT/US2004/005751 mailed Mar. 3, 2005 (4510-6-CIP-PCT).
30 Interview Summary dated Nov. 7, 2003 in U.S. Appl. No. 09/898,478.
31 Invibio, Biomaterials Solutions, "High Performance PEEK-Optima Biocompatible Polymer Chosen for Dental Abutment Healing Caps," Invibio Inc., Lancashire, United Kingdom, undated, 1 page.
32 Invibio, Biomaterials Solutions, "High Performance PEEK-Optima Biocompatible Polymer Chosen for New Generation Heart Valve," Invibio Inc., Lancashire, United Kingdom, undated, 1 page.
33 Invibio, Biomaterials Solutions, "PEEK-Classix," Invibio Inc., Lancashire, United Kingdom, 2003, 2 pages.
34 Invibio, Biomaterials Solutions, "PEEK-Optima Polymer: Performance Purity Flexibility Endurance," Invibio Inc., Lancashire, United Kingdom, 2004, 3 pages.
35 Invibio, Biomaterials Solutions, "PEEK-Optima, Composite Hip," Invibio Inc., Lancashire, United Kingdom, undated, 2 pages.
36 Invibio, Biomaterials Solutions, "PEEK-Optima, Spiked Washers," Invibio Inc., Lancashire, United Kingdom, undated, 1 page.
37 Kambin; "Arthroscopic Microdiscectomy: Minimal Intervention in Spinal Surgery"; National Library of Medicine; 1991; 67-100.
38 Kambin; "Percutaneous Posterolateral Discectomy"; Clincial Orthopaedics and Related Research, Section II; 145-154119.
39 Notice of Allowance and Approved Claim Set mailed Mar. 20, 2009 in Australian Application No. 2006200772.
40 Notice of Allowance dated Dec. 24, 2008 in Japanese Application No. 2003-530164.
41 Notice of Allowance dated Nov. 26, 2006 in U.S. Appl. No. 09/898,478.
42 Office Action dated Apr. 26, 2007 in U.S. Appl. No. 10/776,094.
43 Office Action dated Aug. 21, 2008, received in related Australian Application No. 2006200772.
44 Office Action dated Dec. 1, 2008, issued in related and co-pending Canadian Application No. 2,415,072.
45 Office Action dated Feb. 23, 2009 in U.S. Appl. No. 11/669,015.
46 Office Action dated Jan. 22, 2009 in U.S. Appl. No. 11/283,006.
47 Office Action dated Jul. 25, 2008 in U.S. Appl. No. 10/624,234.
48 Office Action dated Jun. 18, 2003 in U.S. Appl. No. 09/898,478.
49 Office Action dated Mar. 28, 2006 in U.S. Appl. No. 10/262,574.
50 Office Action dated May 27, 2008 in Japanese Application No. 2003-530164.
51 Office Action dated Nov. 14, 2008 in U.S. Appl. No. 10/776,094.
52 Office Action dated Nov. 21, 2008 in Australian Application No. 2004216131.
53 Office Action dated Oct. 12, 2007 in U.S. Appl. No. 10/776,094.
54 Office Action dated Oct. 5, 2006 in U.S. Appl. No. 10/776,094.
55 Office Action dated Sep. 20, 2002 in U.S. Appl. No. 09/898,478.
56 Office Action mailed Nov. 21, 2008, in related, co-pending Australian Application No. 2004216131.
57 Response to Written Opinion dated Oct. 13, 2001 in Application No. PCT/US2002/031201.
58 Savitz; "Same-Day Microsurgical Arthroscopic Latera-Approach Laser-Assisted (SMALL) Fluoroscopic Discectomy"; Journal of Neurosurgery; Jun. 1994; 1039-1045.
59 Schaffer et al.; "Percutaneous Posterolateral Lumbar Discectomy and Decompression with a 6.9 Millimeter Cannula"; Journal of Bone and Joint Surgery; 1991; 822-831.
60 Second Supplemental Amendment and Response dated Mar. 31, 2003 in U.S. Appl. No. 09/898,478.
61 Sofamor Danek Video Systems Brochure.
62 Supplemental Amendment and Response dated Mar. 4, 2003 in U.S. Appl. No. 09/898,478.
63 Supplemental Search Report dated Jul. 29, 2009, issued in European Application 02763815.4.
64 Tangram Technology Ltd., "Polymer Data File: Polyether Ether Keotone-PEEK," Available at http://www.tangram.co.uk/TI-Polymer-PEEK.html, 2001, 5 pages.
65 U.S. Appl. No. 10/165,991, Simonson.
66 U.S. Appl. No. 10/745,068 (-2-CON), filed Dec. 22, 2003, Ritland.
67 U.S. Appl. No. 11/091,970 (-2-CIP), filed Mar. 28, 2005, Ritland.
68 U.S. Appl. No. 11/425,987, Ritland.
69 Web pages, http://www.brainlab.com, Apr. 2, 2002; 5 pp.
70 Wiltse; "New Uses and Refinements of the Paraspinal Approach to the Lumbar Spine"; Spine; 1988; 13(6):696-706.
71 Written Opinion dated Jun. 10, 2002 in Application No. PCT/US2001/021205.
72 Written Opinion for PCT Application Serial No. PCT/US02/31201 mailed Aug. 14, 2003 (4510-6-PCT).
73 Written Opinion for PCT Application Serial No. PCT/US2004/005751 mailed Mar. 3, 2005 (4510-6-CIP-PCT).
US8231657 * 9 août 2010 31 juil. 2012 Warsaw Orthopedic Load bearing flexible spinal connecting element
US8425613 6 juin 2011 23 avr. 2013 K2M, Inc. Expandable intervertebral implant
US9358122 9 janv. 2012 7 juin 2016 K2M, Inc. Interbody spacer
US20100298883 * 9 août 2010 25 nov. 2010 Warsaw Orthopedic, Inc. Load Bearing Flexible Spinal Connecting Element
US20150170548 * 12 nov. 2014 18 juin 2015 K2M, Inc. Growing spine model
WO2011153536A1 * 6 juin 2011 8 déc. 2011 Spartan Cage, Llc. Expandable intervertebral implant
Classification aux États-Unis 606/258, 606/259
Classification internationale A61B17/56, A61F2/30, A61B17/70, A61F
Classification coopérative Y10T403/7077, A61B17/7014, A61B17/7004, A61B17/7007, A61B17/7037
Classification européenne A61B17/70B1L, A61B17/70B1C4
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