Source: https://patents.google.com/patent/US9445849B2/en
Timestamp: 2019-09-20 12:38:13
Document Index: 567822011

Matched Legal Cases: ['art 2110', 'art 2130', 'art 2130', 'art 2130', 'art 2130', 'art 2110', 'art 2130', 'art 2130', 'art 2110', 'art 2110', 'art 2130', 'art 2110', 'art 2610', 'art 2130', 'art 2160']

US9445849B2 - Surgical instrument with integrated compression and distraction mechanisms - Google Patents
US9445849B2
US9445849B2 US14/790,469 US201514790469A US9445849B2 US 9445849 B2 US9445849 B2 US 9445849B2 US 201514790469 A US201514790469 A US 201514790469A US 9445849 B2 US9445849 B2 US 9445849B2
US14/790,469
US20150297264A1 (en
2012-01-17 Priority to US13/351,673 priority patent/US9101414B2/en
2015-07-02 Application filed by Zimmer Spine Inc filed Critical Zimmer Spine Inc
2015-07-02 Priority to US14/790,469 priority patent/US9445849B2/en
2015-10-22 Publication of US20150297264A1 publication Critical patent/US20150297264A1/en
2016-09-20 Publication of US9445849B2 publication Critical patent/US9445849B2/en
Embodiments disclosed herein provide compression/distraction methods and tools useful for fitting a spinal stabilization system in a patient through minimally invasive surgery. The spinal stabilization system may comprise screws anchored in vertebrae. The vertebrae may need to be compressed or distracted. One embodiment of an instrument disclosed herein may comprise a shaft for engaging one of the screws through an extender sleeve. A driver may engage another screw through an opening of the instrument. Through this engagement, a surgeon may use the rack and pinion of the instrument to compress or distract one or more levels of the vertebrae in a parallel motion, which can be advantageous clinically in certain situations.
This application is a continuation of U.S. patent application Ser. No. 13/351,673, filed on Jan. 17, 2012, which is a divisional of Ser. No. 12/479,445, filed on Jun. 5, 2009, now U.S. Pat. No. 8,287,546, which is a continuation-in-part of Ser. No. 12/183,967, filed on Jul. 31, 2008, now U.S. Pat. No. 9,066,763, the contents of which are fully incorporated herein by reference.
FIG. 21 depicts a perspective view of one embodiment of surgical instrument 2100 comprising first part 2110 and second part 2130. In some embodiments, second part 2130 may comprise sliding bar 2134 and alignment tube 2132. Alignment tube 2132 may have opening 2136 constructed for receiving a driver. In some embodiments, sliding bar 2134 may be connected to alignment tube 2132 at a fixed angle. In some embodiments, sliding bar 2134 may be connected to alignment tube 2132′ via an alignment tube connection mechanism comprising pivot locking knob 2150′. The angle at which alignment tube 2132′ is connected to sliding bar 2134 may be adjusted using pivot locking knob 2150′. Other embodiments of second part 2130 with sliding bar 2134 are also possible. Embodiments of second part 2130 may be used with embodiments of first part 2110 interchangeably. For example, a surgeon may try a couple of embodiments of second part 2130 with different fixed angle alignment tubes and decide to use an embodiment of second part 2130′ with pivot locking knob 2150′. The modular design can thus provide the surgeon with the flexibility to choose the best angle that is the most suitable for a particular scenario.
In some embodiments, first part 2110 may comprise elongated body 2120, shaft 2140, pivot locking knob 2150, and shaft connection mechanism 2152 for joining shaft 2140, pivot locking knob 2150, and elongated body 2120. In some embodiments, first part 2110 may further comprise gear mechanism 2160 having circular gear 2162 at a first end and tool portion 2164 at a second end. Elongated body 2120 comprises an opening constructed for accommodating sliding bar 2134. As illustrated in FIG. 2, a portion of sliding bar 2134 may comprise teeth 2802. In some embodiments, circular gear 2162 of gear mechanism 2160 may engage teeth 2802 of sliding bar 2134 inside elongated body 2120.
As illustrate in FIG. 22A, the sliding bar of surgical instrument 2100 may be connected to the alignment tube at angle .beta. relative to axis x of the sliding bar and axis y2 of the alignment tube. As discussed above, angle .beta. may vary depending upon implementation and may be fixed or lockable via a pivot locking mechanism. The shaft of surgical instrument 2100 may be connected to the elongated body at angle .alpha.1 relative to axis x of the elongated body and axis y1 of the shaft. The shaft is movable about a pivot and is lockable at angle .alpha.1 utilizing the pivot locking knob. FIG. 22A illustrates example distraction distance w2 that may be achieved by sliding the second part away from the first part by distance w1. FIG. 22B illustrates example compression distance w2′ that may be achieved with the shaft locked at angle .alpha.2 and the sliding bar of the second part is completely received by the elongated body of the first part.
After attaching handle 2550 to surgical instrument 2100, a surgeon may turn handle 2550 clockwise to compress or counterclockwise to distract. As FIGS. 25A and 25B illustrate, turning handle 2550 clockwise turns circular gear 2162 in the same direction. By the engagement of circular gear 2162 of gear mechanism 2160 and teeth 2802 of sliding bar 2134, the rotational force applied by the surgeon to handle 2550 is translated to a linear motion and cause second part 2130 to move closer to first part 2110 which, in turn, causes driver 350 to move in a direction parallel to elongated body 2120, as indicated by arrow 2250. One or more windows 2122 on elongated body 2120 may provide an enhanced visibility. Additionally, elongated body 2120, sliding bar 2134, or both may have markers, labels, or indicia to provide the surgeon with a visual indication of the travel distance caused by the linear motion. This linear motion is translated from driver 350 to extender sleeve 170′ to bone fastener assembly 102′ and ultimately to the vertebra anchoring bone fastener assembly 102′. Because the closure top of bone fastener assembly 102 is locked relative to rod 104 and the closure top of bone fastener assembly 102′ is not locked and movable relative to rod 104, when the maneuver is complete, the surgeon may provisionally tighten the closure top of bone fastener assembly 102′ to maintain the final position of bone fastener assembly 102′ relative to rod 104. Rod 104 may be straight or bent. As illustrated in FIG. 25C, an embodiment of driver 2350 having handle 2560 may be used to provisionally tighten the closure top of bone fastener assembly 102′ by turning handle 2560 clockwise.
FIG. 26 depicts a perspective view of one embodiment of surgical instrument 2600 comprising first part 2610 and second part 2130. First part 2160 may comprise elongated body 2620, shaft 2140, gear mechanism 2660, ratchet mechanism 2670, and pivot locking knob 2150. Shaft 2140 may be pivotally connected to elongated body 2620 at angle .alpha. relative to axis x of elongated body 2620. Angle .alpha. may be adjusted and locked via pivot locking knob 2150. Gear mechanism 2660 may comprise circular gear 2662 and tool portion 2664 with connecting head 2666 constructed for receiving a handle such as handle 2550. Ratchet mechanism 2670 can be in any orientation. The location and orientation of ratchet mechanism 2670 are not limited by what is shown in FIG. 26. Other types and configurations of ratchet mechanism 2670 are also possible.
an interchangeable first member, comprising:
an alignment tube defining a lumen configured for receiving a driver;
a first connection mechanism; and
a bar coupled to the alignment tube via the first connection mechanism at a first angle, wherein a portion of the bar comprises an engaging element;
wherein the first member is selected from a plurality of first members, each of the plurality of first members having a different value for the first angle; and
a second member, comprising:
a pivot locking knob configured to connect with the shaft; and
an elongated body defining an elongated body longitudinal axis and having an opening disposed in a first end thereof constructed for accommodating the bar along the elongated body longitudinal axis, a gear mechanism for engaging the engaging element of the bar inside the elongated body, and a shaft connection mechanism for joining the shaft, the pivot locking knob, and the elongated body, wherein the shaft connection mechanism is located between the gear mechanism and the first member along the elongated body longitudinal axis, wherein the shaft is movable about a pivot, wherein the shaft is lockable at a second angle relative to the elongated body utilizing the pivot locking knob, wherein the second angle is adjustable, wherein turning the gear mechanism which is engaged with the engaging element of the bar changes a linear distance between the shaft and the first member along the elongated body longitudinal axis, wherein the bar is continuously movable under tension via the engagement with the gear mechanism.
2. The device of claim 1, wherein the gear mechanism is spaced apart along the elongated body from the shaft connection mechanism.
3. The device of claim 1, wherein the shaft extends from a first face of the elongated body and the gear mechanism extends from a second, opposing face of the elongated body.
4. The device of claim 1, wherein the gear mechanism includes a circular gear at a first end, a tool portion at a second end, and a longitudinal axis extending therebetween.
5. The device of claim 4, wherein the longitudinal axis of the gear mechanism extends substantially perpendicular to a longitudinal axis of the elongated body.
6. The device of claim 4, further comprising a detachable handle configured to attach to the tool portion.
7. The device of claim 4, wherein the elongated body further comprises a ratchet mechanism having a projection for engaging with the gear mechanism to prevent the circular gear from spinning.
8. The device of claim 1, wherein the elongated body comprises one or more windows through which the bar is visible inside the elongated body.
9. The device of claim 1, wherein the elongated body comprises a track pin, wherein the bar comprises a track, and wherein the track pin and the track define a travel distance for the bar relative to the elongated body.
a first member, comprising:
an alignment tube having a lumen extending therethrough, configured for receiving a driver;
a bar connectable to the first member via the first connection mechanism at a first angle between the alignment tube and the bar, wherein a portion of the bar comprises an engaging element;
an elongated body defining an elongated body longitudinal axis and having an opening disposed in a first end thereof configured to receive the bar along the elongated body longitudinal axis, a gear mechanism for engaging the engaging element of the bar inside the elongated body, and a shaft connection mechanism for joining the shaft, the pivot locking knob, and the elongated body;
wherein the shaft connection member is located between the gear mechanism and the first member along the elongated body longitudinal axis;
wherein the shaft extends from a first face of the elongated body and the gear mechanism extends from a second, opposing face of the elongated body, the gear mechanism including a circular gear at a first end for engaging the engaging element of the bar, and a tool portion at a second end;
wherein the shaft is movable about a pivot, wherein the shaft is lockable at a second angle relative to the elongated body utilizing the pivot locking knob, wherein the second angle is adjustable; and
wherein turning the gear mechanism which is engaged with the engaging element of the bar changes a linear distance between the shaft and the first member along the elongated body longitudinal axis, wherein the bar is continuously movable under tension via engagement with the gear mechanism.
11. The device of claim 10, further comprising a detachable handle configured to attach to the tool portion, wherein the handle extends from the second face of the elongated body, substantially perpendicular to a longitudinal axis of the elongated body.
12. The device of claim 10, wherein the gear mechanism is spaced apart along the elongated body from the shaft connection mechanism.
13. The device of claim 10, wherein the elongated body comprises one or more windows through which the bar is visible inside the elongated body.
14. The device of claim 10, wherein the elongated body comprises a track pin, wherein the bar comprises a track, and wherein the track pin and the track define a travel distance for the bar relative to the elongated body.
US14/790,469 2008-07-31 2015-07-02 Surgical instrument with integrated compression and distraction mechanisms Active US9445849B2 (en)
US13/351,673 Continuation US9101414B2 (en) 2008-07-31 2012-01-17 Surgical instrument with integrated compression and distraction mechanisms
US15/244,225 Continuation US9833267B2 (en) 2008-07-31 2016-08-23 Surgical instrument with integrated compression and distraction mechanisms
US20150297264A1 US20150297264A1 (en) 2015-10-22
US9445849B2 true US9445849B2 (en) 2016-09-20
JP4718137B2 (en) 2004-07-23 2011-07-06 株式会社ブリヂストン Anti-vibration device
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