Patent Description:
<CIT> describes a clamp system known in the art.

According to the invention it is provided a sublaminar band clamp system having the features of claim <NUM> while preferred embodiments are set forth in the dependent claims.

According to the invention, the present disclosure provides a sublaminar band clamp system that includes a first locking mechanism, a second locking mechanism, and a body. The body includes a first portion comprising a first passage, wherein the first locking mechanism is disposed within the first passage. The body further includes a second portion comprising a second passage, wherein the second locking mechanism is disposed within the second passage. A third passage extends across the body and is be in fluid communication with the second passage. An opening is positioned between the first and second portions, and the opening is in fluid communication with the first passage.

It is further described but does not fall within the scope of the invention, a sublaminar band clamp system that may include a tulip comprising a passage and a chamber fluidly coupled to the passage. A protrusion may extend inward from an inner surface of the chamber. A locking mechanism may be movably disposed within the chamber. The locking mechanism may include a saddle comprising a groove and a clamp. The saddle may be coupled to the clamp.

In another embodiment, the present disclosure provides a sublaminar band clamp system that may include a spinal rod comprising an elongated portion, and a clamp positioned at a first end of the spinal rod. The clamp may include a passage that extends in a direction from the first end to a second end of the spinal rod. The sublaminar band system may also include a locking mechanism extending toward the passage.

These drawings illustrate certain aspects of some of the embodiments of the present disclosure and should not be used to limit or define the disclosure.

The invention is particularly shown in <FIG>, <FIG>, the remaining features being reported for increase the understanding of the invention.

For the purposes of promoting an understanding of the principles of the present disclosure, reference will now be made to the implementations illustrated in the drawings and specific language will be used to describe them. It will nevertheless be understood that no limitation of the scope of the disclosure may be intended. Any alterations and further modifications to the described devices, instruments, methods, and any further application of the principles of the present disclosure are fully contemplated as would normally occur to one skilled in the art to which the disclosure relates. In particular, it may be fully contemplated that the features, components, and/or steps described with reference to one or more implementations may be combined with the features, components, and/or steps described with reference to other implementations of the present disclosure. For simplicity, in some instances the same reference numbers are used throughout the drawings to refer to the same or like parts.

Embodiments generally relate to spinal surgery. More particularly, embodiments relate to systems, devices for fixating spinal anatomy with a sublaminar band.

Sublaminar bands should be understood by one having skill in the art. The sublaminar bands may be utilized to provide posterior fixation of the spine as an alternative to pedicle screw instrumentation. They may be used in patients with poor bone quality or difficult anatomy where an interface between a bone and an implant is compromised. Patients with pediatric deformity often times have dysmorphic vertebrae, which restrict the use of pedicle screws. Additionally, the risk of screw pullout is increased in patients with osteoporosis due to weak connection between the bone and the implant. Also, the sublaminar bands may be used in cases where patients have fractured pedicles. In these clinical scenarios, the sublaminar bands offer an advantage of contacting the cortical bone of the lamina instead of relying on the cancellous bone within the pedicle and vertebral body. Alternatively, sublaminar bands may be wrapped around the lamina and transverse process to create a figure eight pattern.

<FIG> illustrates a sublaminar band clamp ("clamp") <NUM> in accordance with particular embodiments of the present disclosure. The clamp <NUM> may be a rigid member including a body <NUM>. The body <NUM> may include a nose portion <NUM>. The nose portion <NUM> may include a planar wall or surface. The body <NUM> may also include portions 104a and 104b that may extend from the nose portion <NUM>, thereby forming an opening <NUM> between distal ends 108a and 108b of the portions 104a and 104b. The opening <NUM> may extend from between the distal ends 108a and 108b to (or at least partially through) a central portion <NUM> of the clamp <NUM>, as shown. The opening <NUM> may be bound by inner surfaces 112a, 112b, and 110a of the portions 104a, 104b, and the central portion <NUM>, respectively. In certain embodiments, the clamp <NUM> may generally be C-shaped or U-shaped and/or the opening <NUM> may generally be of or include a cylindrical shape or a portion thereof.

An outer portion 114a of the portion 104a may include a first clamping mechanism 116a (e.g., a set screw) which may extend through a passage <NUM> which extends through and from outer surface portion 114a to and through the inner surface 112a, as shown. That is, the passage <NUM> is in fluid communication with the opening <NUM>. Pins <NUM> extend through the passage <NUM> to prevent the first clamping mechanism 116a from being removed from the passage <NUM>. For example, the pins <NUM> may extend orthogonally, relative to a longitudinal axis of the passage <NUM>, to prevent the first clamping mechanism 116a (e.g., the set screw) from being backed out or completely rotated out of the passage <NUM>. The first clamping mechanism 116a may secure a spinal rod (e.g., spinal rod <NUM> shown on <FIG>) within the opening <NUM>.

<FIG> is a cross-section, of the clamp <NUM> of <FIG>, taken along the dashed line extending between A and A' (as shown on <FIG>). As shown on <FIG>, an outer portion 114b of the portion 104b may include a second clamping mechanism 116b (e.g., a set screw) which may extend through a passage <NUM>. The passage <NUM> extends from the outer surface portion 114b to an internal conduit ("conduit") <NUM>. The passage <NUM> may be in fluid communication with the conduit <NUM>. In certain embodiments, the passage <NUM> may extend orthogonally from the conduit <NUM>, as shown. The inner conduit <NUM> extends internally between the portion 104b and a portion of the nose portion <NUM> and may include an opening 125a at the nose portion <NUM> and may also include an opening 125b on outer portion 114b. The passage <NUM> extends between the openings 125a and 125b. The second clamping mechanism 116b may secure a portion of the sublaminar band (e.g., sublaminar band <NUM> as shown on <FIG>) within the inner conduit <NUM>. Both the clamping mechanisms 116a and 116b may be movable in a forward direction (e.g., toward a center of the clamp <NUM>) and a reverse direction.

The passages <NUM> and <NUM> may be threaded. Also, as previously noted, the pins <NUM> may extend through the passage <NUM>. As shown, a lip <NUM> at a distal end of the first clamping mechanism 116a is positioned adjacent to the pins <NUM>. The lip <NUM> is positioned between the pins <NUM> and the opening <NUM>, thereby preventing the first clamping mechanism 116a from being completely removed from the passage <NUM>.

<FIG> illustrates the clamp <NUM> with a spinal rod <NUM> and a sublaminar band <NUM> in accordance with particular embodiments of the present disclosure. As shown, the spinal rod <NUM> may extend through the opening <NUM> of the clamp <NUM>. The first clamping mechanism 116a may be tightened or moved forward to press the spinal rod <NUM> against the inner surface 112b thereby securing the spinal rod <NUM> within the opening <NUM>.

The sublaminar band <NUM> may extend through the passage <NUM>. The sublaminar band <NUM> may be folded or curved and may include portions 132a and 132b which are stacked upon each other, as shown.

<FIG> illustrates a cross-section, of the clamp <NUM> of <FIG>, taken along the dashed line extending between B and B' (as shown on <FIG>). As shown on <FIG>, the first clamping mechanism 116a may be tightened or moved forward away from the pins <NUM> and toward the spinal rod <NUM>. A distal end <NUM> of the first clamping mechanism 116a may include a protrusion 133a that contacts the spinal rod <NUM>. Upon tightening, the spinal rod <NUM> is secured within the opening <NUM>. That is, the spinal rod <NUM> is compressed between the tapered distal end <NUM> and the inner surface 112b, upon tightening. The inner surface 112b may include teeth or grooves <NUM> to assist with gripping and stabilizing the spinal rod <NUM> within the opening <NUM>, as shown. The second clamping mechanism 116b may be tightened or moved forward to compress the portions 132a and 132b of the sublaminar band <NUM> within the passage <NUM>, thereby securing the portions 132a and 132b between an inner surface <NUM> of the passage <NUM> and a distal end <NUM> of the second clamping mechanism 116b, as shown.

<FIG> illustrates a clamp <NUM> in accordance with particular embodiments of the present disclosure. The clamp <NUM> may be similar to the clamp <NUM> (e.g., shown on <FIG>). However, instead of the opening <NUM>, the clamp <NUM> includes an aperture <NUM> that is completely surrounded by a body <NUM> of the clamp <NUM>, as shown. The aperture <NUM> is in fluid communication with the passage <NUM>.

<FIG> illustrates a cross-section of the clamp <NUM> of <FIG> taken along the dashed line extending between C and C' (as shown on <FIG>). As shown on <FIG>, the first clamping mechanism 116a may be tightened or moved forward away from the pins <NUM> and toward the spinal rod <NUM>. A distal end <NUM> of the first clamping mechanism 116a may include a protrusion 133a that contacts the spinal rod <NUM> thereby securing the spinal rod <NUM> within the opening <NUM>, upon tightening. That is, upon tightening, the spinal rod <NUM> is compressed between the distal end <NUM> and an inner surface <NUM> of the aperture <NUM>. The second clamping mechanism 116b may be tightened or moved forward to compress the portions 132a and 132b of the sublaminar band <NUM> within the passage <NUM>, thereby securing the portions 132a and 132b between an inner surface <NUM> of the passage <NUM> and a distal end <NUM> of the second clamping mechanism 116b, as shown.

<FIG> illustrates a clamp system <NUM> in accordance with particular embodiments of the present disclosure (does not fall within the scope of the invention). The clamp system <NUM> may include a tulip <NUM>. The tulip <NUM> may resemble a bullet with a hollow interior. The tulip <NUM> may include a portion <NUM> that may be hollow and extends from a nose portion <NUM>, as shown. The portion <NUM> may include openings <NUM> on opposing sides of the tulip <NUM>, as shown. In certain embodiments, the openings <NUM> may resemble arches to correspond with a curvature of a spinal rod that may be positioned within the openings <NUM>. The openings <NUM> may extend from a distal end <NUM> to (or at least partially through) a central portion <NUM> of the tulip <NUM>, as shown. The portion <NUM> may include slots <NUM> positioned on an end of the tulip <NUM> that is opposite to the nose portion <NUM>.

A passage <NUM> may extend centrally and longitudinally from and through the nose portion <NUM> through the tulip <NUM>. The passage <NUM> may be in fluid communication with the openings <NUM> and the slots <NUM>, as shown.

The clamp system <NUM> may further include a saddle <NUM> and a clamp <NUM> that are disposed within the tulip <NUM>. The saddle <NUM> and the clamp <NUM> may be coupled together to form a locking mechanism <NUM>, as shown on <FIG>.

<FIG> is a perspective view of the locking mechanism <NUM> in accordance with particular embodiments of the present disclosure. As shown, the saddle <NUM> may be of a cylindrical shape and may include a groove <NUM> extending along a circumference of the saddle <NUM>, as shown. The groove <NUM> may be positioned between ridges 730a and 730b which also extend circumferentially about the saddle <NUM>, as shown. A passage <NUM> may be disposed at the center of the locking mechanism <NUM>, as shown.

<FIG> is a cross-section of <FIG> taken along the dashed line extending between D and D' (as shown on <FIG>). As shown on <FIG>, the clamp <NUM> may include a first portion 732a and a second portion 732b which may be placed adjacent to each other to form a ring <NUM>, as best shown on <FIG>. The passage <NUM> may extend through the saddle <NUM> and the ring <NUM>. The ring <NUM> may be positioned within a groove <NUM> that extends internally along an internal circumference of the saddle <NUM>. The saddle <NUM> may also include ramps <NUM> extending along an outer edge of the saddle <NUM> to facilitate installation or coupling of the clamp <NUM> to the saddle <NUM>. The clamp <NUM> may also include ridges <NUM> positioned along an internal surface of an opening <NUM> formed by the portions 732a and 732b.

<FIG> illustrates a cross-section of the clamp system <NUM> including the locking mechanism <NUM> positioned within the tulip <NUM> in a first configuration or unlocked position, in accordance with particular embodiments of the present disclosure. That is, the position of the locking mechanism <NUM> may be adjustable. In some embodiments, the locking mechanism <NUM> may be move axially in a direction of a longitudinal axis L. As shown, the passage <NUM> may be threaded and may include protrusion <NUM> that extends into the groove <NUM> of the saddle <NUM> to secure the locking mechanism within the tulip <NUM>. As shown, the protrusion <NUM> is between and adjacent to the ridges 730a and 730b. In this unlocked position, a space <NUM> is formed between the distal ends <NUM> and distal ends <NUM> of the portions 732a and 732b, as shown. The space <NUM> may be in fluid communication with the opening <NUM> and the slots <NUM> of the tulip <NUM>. The space <NUM> can allow placement or installation of a sublaminar band (e.g., sublaminar band <NUM> as shown on <FIG> and <FIG>) within the clamp system <NUM>. The opening <NUM> may include a profile that aligns with and corresponds to the shape the opening <NUM> shown on <FIG> to allow reception and securing of a spinal rod (e.g., spinal rod <NUM> as shown on <FIG> and <FIG>).

<FIG> is a bottom view of the portions 732a and 732b positioned within the tulip <NUM> in accordance with particular embodiments of the present disclosure. As shown, the inner surfaces of distal ends <NUM> of the tulip <NUM> may include recesses <NUM> to complement, mate, or correspond with ridges <NUM> that protrude outward from the portions 732a and 732b that may be positioned between the distal ends <NUM> and the portions 732a and 732b. The distal ends <NUM> may include tapered regions 745a to force the distal ends <NUM> inward thereby securing the sublaminar band, upon depression of the locking mechanism <NUM>. Also, the tapered regions 745a may retain the locking mechanism <NUM> within the tulip <NUM>.

<FIG> illustrates a cross-section of the locking mechanism <NUM> positioned within the tulip <NUM> in a second configuration or locked position, in accordance with particular embodiments of the present disclosure. As shown, the passage <NUM> includes a first portion <NUM> (e.g., a threaded portion) and a second portion <NUM> (e.g., a chamber). In certain embodiments, the second portion <NUM> does not include threads and may have an inner diameter that is larger than an inner diameter of the first portion <NUM>. The saddle <NUM> may have an outer diameter that is larger than an inner diameter of the first portion <NUM>. The protrusion <NUM> may be positioned within the second portion <NUM>. In the second position, the second portion <NUM> is not completely occupied resulting in a gap <NUM> positioned between the ridge 730a and the first portion <NUM>. In comparison, with reference back to <FIG>, in the first position, the second portion <NUM> is completely occupied with no gap <NUM>. As shown in the locked position, the space <NUM> is reduced thereby holding or locking a sublaminar band in place between the distal ends <NUM> and the distal ends <NUM>.

<FIG> illustrates a cross-section of the clamp system <NUM>, with the sublaminar band <NUM>, in the unlocked position, in accordance with particular embodiments of the present disclosure. As shown, the portions 132a and 132b of the sublaminar band <NUM> may be positioned through the space <NUM> and the slots <NUM>, as shown. The spinal rod <NUM> may be disposed between the portions 732a and 732b, as shown. The spinal rod <NUM> may extend in a lateral direction relative to a longitudinal axis L of the clamp system <NUM>, as shown. In the unlocked position, the protrusion <NUM> may be aligned and positioned within with the groove <NUM>.

<FIG> illustrates a cross-section of the clamp system <NUM>, with the sublaminar band <NUM>, in the locked position, in accordance with particular embodiments of the present disclosure. As shown, the space <NUM> is reduced thereby holding or locking a sublaminar band in place between the distal ends <NUM> and the distal ends <NUM>. As previously noted, the tapered regions 745a cause the distal ends <NUM> to move inward as the locking mechanism <NUM> is moved or translated toward the sublaminar band <NUM>. This inward movement secures or locks the sublaminar band <NUM> in place, as shown. In the locked position, the protrusion <NUM> is not aligned with the groove <NUM> and is positioned outside (e.g., above the groove <NUM>) of and adjacent to the groove <NUM>, as shown.

In certain embodiments, the clamp system <NUM> may further include a threaded locking cap <NUM>. The locking mechanism <NUM> may be moved, translated, or locked into place with the threaded locking cap <NUM> that may be removably disposed (e.g., a separate piece) within the passage <NUM>, as shown. The threaded locking cap <NUM> may be rotated thereby moving or shifting the locking mechanism <NUM> toward the spinal rod <NUM>, thereby securing the spinal rod <NUM> and the sublaminar band <NUM>, as shown. In other words, the threaded locking cap <NUM> may be rotated to translate the locking mechanism <NUM> from the unlocked position to the locked position, as described herein.

<FIG> illustrates a cross-section of a clamp system <NUM> in an unlocked position in accordance with particular embodiments of the present disclosure. The clamp system <NUM> is similar to the clamp system <NUM> (e.g., shown on <FIG>). However, placement of the sublaminar band <NUM> differs from previously described configurations. As shown, the sublaminar band <NUM> may be positioned to extend through a passage or central cannulation <NUM> of the threaded locking cap <NUM> and through the passage <NUM> of the locking mechanism <NUM>.

<FIG> illustrates a cross-section of the clamp system <NUM> in a locked position in accordance with particular embodiments of the present disclosure. As shown, as the locking mechanism <NUM> is translated (e.g., moved toward the spinal rod <NUM>) into a locked position with the threaded locking cap <NUM>, the sublaminar band <NUM> may be squeezed and secured between the spinal rod <NUM> and the locking mechanism <NUM>, as shown.

<FIG> illustrates a cross-section of a clamp system <NUM> in an unlocked position in accordance with particular embodiments of the present disclosure. The clamp system <NUM> is similar to the clamp system <NUM> (e.g., shown on <FIG>). However, placement of the sublaminar band <NUM> differs from previously described configurations. As shown, the portions 132a and 32b of the sublaminar band <NUM> are stacked and positioned to extend through a passage <NUM> that extends between the first portion <NUM> and the second portion <NUM> of the passage <NUM>.

<FIG> illustrates a cross-section of the clamp system <NUM> in a locked position in accordance with particular embodiments of the present disclosure. As shown, as the locking mechanism <NUM> is translated (e.g., moved toward the spinal rod <NUM>) into a locked position with the threaded locking cap <NUM>, the sublaminar band <NUM> may be squeezed and secured between the locking mechanism <NUM> and the threaded locking cap <NUM>, as shown. Also, the spinal rod <NUM> may be locked into place due to the tapered regions 745a as described herein.

<FIG> illustrates a clamp <NUM> that is similar to the clamp <NUM> (e.g., shown on <FIG>). However, placement of the sublaminar band differs from previously described configurations. As shown, the clamp <NUM> includes a passage <NUM> extending through the portion 104b. The clamp <NUM> also includes a sliding or moveable member ("member") <NUM> to secure the sublaminar band within the passage <NUM>. The member <NUM> may be elongated and rigid, and may be disposed between the opening <NUM> and the passage <NUM>, as shown.

<FIG> illustrates a cross-section of the clamp <NUM> taken along the dashed line extending between E and E' (as shown on <FIG>). As shown on <FIG>, the passage <NUM> is in fluid communication with the passage <NUM> that contains the member <NUM>. The passage <NUM> may intersect the passage <NUM> orthogonally. As shown, the passage <NUM> extends through the inner surface 112b.

<FIG> illustrates another cross-section of the clamp <NUM> including the sublaminar band <NUM> and the spinal rod <NUM>, in accordance with particular embodiments of the present disclosure. As shown, the sublaminar band <NUM> may extend through the passage <NUM>. The sublaminar band <NUM> may be folded or curved and may include portions 132a and 132b which are stacked upon each other, as shown. The locking mechanism 116a may be tightened to move the spinal rod <NUM> toward the member <NUM>. This causes the member <NUM> to move toward the passage <NUM> thereby compressing and securing the sublaminar band <NUM>, as shown. Additionally, the spinal rod <NUM> may be secured between a portion of the member <NUM> and the locking mechanism 116a, as shown.

<FIG> illustrates a clamp <NUM> that is similar to the clamp <NUM> (e.g., shown on <FIG>), in accordance with particular embodiments of the present disclosure. However, placement of the sublaminar band differs from previously described configurations. As shown, the clamp <NUM> includes a groove <NUM> positioned on the inner surface 112b. The clamp <NUM> also includes a passage <NUM> extending from the nose portion <NUM> to the opening <NUM>, as shown.

<FIG> illustrates a cross-section of the clamp <NUM> taken along the dashed line extending between F and F' (as shown on <FIG>). As shown on <FIG>, the groove <NUM> may extend along the passage <NUM>, as shown. The passage <NUM> may include a curve <NUM> that corresponds with the shape of the spinal rod <NUM>, as shown on <FIG>.

<FIG> illustrates another cross-section of the clamp <NUM> including the sublaminar band <NUM> and the spinal rod <NUM>, in accordance with particular embodiments of the present disclosure. The groove <NUM> can stabilize the sublaminar band <NUM> within the passage <NUM> and against the curve <NUM>. As shown, the locking mechanism 116a may be tightened to move the spinal rod <NUM> toward the sublaminar band <NUM>. The spinal rod <NUM> may be secured between the locking mechanism 116a and the sublaminar band <NUM>, as shown. The sublaminar band <NUM> may be secured between the spinal rod <NUM> and the curve <NUM> of the passage <NUM>, as shown.

<FIG> illustrates a spinal rod <NUM> in accordance with embodiments of the present disclosure. The spinal rod <NUM> may be similar to the spinal rod <NUM> (e.g., shown on <FIG>, <FIG>, <FIG>, <FIG>, <FIG>, <FIG>, <FIG>, <FIG>) as described herein. The spinal rod <NUM> may include an elongated portion <NUM> that is integrated with a clamp <NUM> that may be similar to previously described clamps.

The clamp <NUM> may include a body <NUM> and may include the locking mechanism 116a (and the passage <NUM> as shown on <FIG>, for example). The clamp <NUM> may be disposed on an end of the elongated portion <NUM>, as shown. The clamp <NUM> may include a passage <NUM> that extends through the body <NUM> in a direction toward an end <NUM> of the elongated portion <NUM> that is opposite to the clamp <NUM>. The passage <NUM> may be in fluid communication with the passage <NUM>.

<FIG> illustrates the spinal rod <NUM> with the sublaminar band <NUM>, in accordance with particular embodiments of the present disclosure. As shown, the sublaminar band <NUM> may extend through the passage <NUM>. The passage <NUM> may include an opening <NUM> at a distal end of the spinal rod <NUM>, as shown. Additionally, the passage <NUM> may include an opening <NUM> at a section of the clamp <NUM> that is adjacent to the elongated portion <NUM>, as shown. The portions 132a and 132b of the sublaminar band <NUM> may extend adjacent to the elongated portion <NUM>, as shown. The locking mechanism 116a may be tightened thereby securing the sublaminar band <NUM> within the passage <NUM>.

<FIG> illustrates a clamp <NUM> in accordance with particular embodiments of the present disclosure. As shown, the clamp <NUM> may include an opening <NUM> situated between portions 2204a and 2204b. A curved portion <NUM> may be disposed between the portions 2204a and 2204b, as shown. In certain embodiments, the opening <NUM> may extend from the curved portion <NUM> to distal ends 2204b and 2204c of the portions 2204a and 2204b, as shown. Inner surfaces 2206a and 2206b of the portions 2204a and 2204b may be threaded. The portions 2204a and 2204b may include apertures 2207a and 2207b. The apertures 2207a and 2207b may be in fluid communication with the opening <NUM>, as shown. The sublaminar band <NUM> may extend through the apertures 2207a, 2207b, and the opening <NUM>, as shown.

<FIG> illustrates the clamp <NUM> secured to the spinal rod <NUM> in accordance with particular embodiments of the present disclosure. As shown, the rod <NUM> may extend through the opening <NUM>. The spinal rod <NUM> may be disposed between the sublaminar band <NUM> and a set screw or locking cap <NUM> that may be inserted between the portions 2204a and 2204b, as shown. The locking cap <NUM> may be threaded and may be tightened to secure the spinal rod <NUM> and the sublaminar band within the opening <NUM>, as shown. The sublaminar band <NUM> may be secured between the curved portion <NUM> and the spinal rod <NUM>. And the spinal rod <NUM> may be secured between the locking cap <NUM> and the sublaminar band <NUM>, as shown. In certain embodiments, the spinal rod <NUM> may be positioned orthogonal to the sublaminar band <NUM>.

<FIG> illustrates the clamp <NUM> positioned between pedicle screw assemblies 2402a and 2402b, in accordance with particular embodiments of the present disclosure. The pedicle screw assemblies 2402a and 2402b may include similar components to that of the clamp <NUM>. For example, the pedicle screw assemblies 2402a and 2402b may include clamps 2402a and 2402b that are similar to the clamp <NUM>, as described herein. The clamps 2402a and 2402b may include portions 2404a, 2404b, and 2406a, 2406b, respectively, that are similar to the portions 2204a and 2204b. Also, locking caps 2408a and 2408b may be disposed between the portions 2404a, 2404b, and 2406a, 2406b, respectively. The locking caps 2408a and 2408b may be similar to the locking cap <NUM>.

Pedicle screws 2410a and 2410b may extend through curved portions 2412a and 2412b, as shown, for attachment into a bone of a patient during a surgical procedure, for example. The curved portions 2412a and 2412b may be similar to the curved portion <NUM>.

<FIG> illustrates a clamp system <NUM> in accordance with particular embodiments of the present disclosure. The clamp system <NUM> may include first portion 2500a including a clamp <NUM> that is similar to the clamp <NUM> as shown on <FIG>, for example. However, the clamp <NUM> may include a passage <NUM> that is in fluid communication with the opening <NUM>. The passage <NUM> may be positioned within a base <NUM>, as shown. Portions <NUM> and <NUM> may extend from the base <NUM>. The base <NUM> may be opposite to distal ends 2505a and 2505b of the portions <NUM> and <NUM>, as shown. The first portion 2500a may extend in a direction of a longitudinal axis L<NUM>.

The clamp system <NUM> may further include the saddle <NUM> and the clamp <NUM> to form the locking mechanism <NUM>, as previously described. In certain embodiments, the clamp <NUM> may be made of separate overlapping or interlocking portions 726a and 726b. The locking mechanism <NUM> may be secured within the passage <NUM>.

The clamp system <NUM> may further include a second portion 2500b that may be coupled to the first portion 2500a. The second portion 2500b may include a body <NUM> that may extend in a direction of a longitudinal axis L<NUM>. In some embodiments, L<NUM> may be parallel to L<NUM>. The second portion 2500b may include an aperture <NUM> in fluid communication with an opening <NUM>, as shown. A screw <NUM> may include a flange 2508a disposed adjacent to a threaded portion 2508b. The flange 2508a may be inserted through the opening <NUM> and press-fitted into an aperture <NUM> of a carriage <NUM> thereby coupling the carriage <NUM> to the screw <NUM>. In certain embodiments, a carriage assembly <NUM> may include the carriage <NUM> and the screw <NUM>. The carriage assembly <NUM> may be retained in the second portion 2500b.

<FIG> illustrates the carriage assembly <NUM> installed into the second portion 2500b, and also shows the locking mechanism <NUM> installed into the first portion 2500a, in accordance with particular embodiments of the present disclosure. In other words, the components of <FIG> are shown assembled in <FIG>, to form the clamp system <NUM>.

<FIG> is a partial cross-section of the clamp system <NUM> taken along the dashed line extending between G and G' (as shown on <FIG>). <FIG> illustrates the locking mechanism <NUM> in an unlocked position. The partial cross-section illustrates an inside of the first portion 2500a with the locking mechanism <NUM> disposed therein. As shown, the locking mechanism <NUM> is disposed within passage <NUM>. In certain embodiments, the clamp <NUM> may include an inner surface <NUM> that is threaded to correspond with a head of a screw such as the pedicle screws 2410a and 2410b, shown on <FIG> for example. The passage <NUM> may extend through the base <NUM>.

Protrusion <NUM> of an inner surface <NUM> of the passage <NUM> may extend into the groove <NUM>. The protrusion <NUM> may be similar to the protrusion <NUM>, shown on <FIG> for example. As shown, the locking mechanism <NUM> may be disposed within the passage <NUM> and may move axially therein, in a direction of a longitudinal axis L.

<FIG> is a partial cross-section of the clamp system <NUM> taken along the dashed line extending between G and G' (as shown on <FIG>). <FIG> illustrates the locking mechanism <NUM> in a locked position. As shown, the inner surface <NUM> includes tapered portions <NUM> that are similar to the tapered regions 745a (shown on <FIG> for example). As the locking mechanism <NUM> moves toward a distal end <NUM> of the passage <NUM>, the tapered portions <NUM> cause the portions 726a and 726b to move inward to squeeze and secure a pedicle screw, for example. A head of the pedicle screw may be inserted into a distal portion <NUM> of the passage <NUM> and may be retained by the clamp <NUM>. The locking mechanism <NUM> may be moved into a locked position by the threaded locking cap <NUM> shown on <FIG> for example.

<FIG> is a cross-section of the second portion 2500b taken along the dashed line extending between G and G' (as shown on <FIG>). <FIG> illustrates the carriage assembly <NUM> in an unlocked position. As shown on <FIG>, the sublaminar band <NUM> extends through the aperture <NUM>. The portions 132a and 132b may be in a stacked configuration. In the unlocked position, the carriage assembly <NUM> does not contact the sublaminar band <NUM>, as shown.

<FIG> is a cross-section of the second portion 2500b taken along the dashed line extending between G and G' (as shown on <FIG>). <FIG> illustrates the carriage assembly <NUM> in an unlocked position. As shown, the carriage assembly <NUM> may be tightened thereby closing the aperture <NUM>. Specifically, the screw <NUM> may be moved toward the sublaminar band <NUM> thereby causing the carriage <NUM> to squeeze and secure the sublaminar band <NUM> within the aperture <NUM>, as shown on <FIG>. That is, the sublaminar band <NUM> may be secured between an inner surface 2504a of the aperture <NUM> and a distal end 2512a of the carriage <NUM>, for example.

<FIG> illustrates a perspective view of the clamp system <NUM> with a pedicle screw <NUM> and the sublaminar band <NUM> in accordance with particular embodiments of the present disclosure. As shown, the first and second portions 2500a and 2500b are in locked positions, thereby securing the pedicle screw <NUM> to the locking mechanism <NUM> and securing the sublaminar band <NUM> to the carriage assembly <NUM>, as described herein. The spinal rod <NUM> (shown on <FIG> for example) may be positioned to extend through the opening <NUM> such that the spinal rod <NUM> is perpendicular to L<NUM>. Then, the threaded locking cap <NUM> (shown on <FIG>) may be disposed and tightened within the opening <NUM> to secure the spinal rod <NUM> therein.

<FIG> illustrates the clamp system <NUM> further including pedicle screw assemblies 2900a and 2900b and the spinal rod <NUM> in accordance with particular embodiments of the present disclosure. The pedicle screw assemblies 2900a and 2900b may include tulips 2902a and 2902b, as shown, that may be similar to the first portion 2500a. Threaded locking caps 2904a, 2904b, and 2904c may be disposed within pedicle the screw assemblies 2900a and 2900b and the first portion 2500a, as shown. The threaded locking caps 2904a, 2904b, and 2904c may be similar to the threaded locking cap <NUM>, shown <FIG> for example.

As shown, locking mechanisms <NUM>, 2906a and 2906b may be fastened (in a locked position) to the pedicle screws <NUM>, 2800a, and 2800b. The spinal rod <NUM> may be positioned to extend through the pedicle screw assemblies 2900a and 2900b, and through the first portion 2500a, as illustrated. The threaded locking caps 2904a, 2904b, and 2904c may be disposed and tightened to move toward the spinal rod <NUM> thereby securing the spinal rod <NUM> to the clamp system <NUM>. The sublaminar band <NUM> may extend through the second portion 2500b and may be secured therein, as previously described. The configuration of the clamp system <NUM> should reduce operating time for a spinal procedure by allowing simultaneous fixations or installations of the sublaminar band <NUM> and the pedicle screws <NUM>, 2800a, and 2800b, as described herein.

<FIG> illustrates the first portion 2500a coupled to the second portion 2500b by a bridge <NUM>, in accordance with particular embodiments of the present disclosure. The bridge <NUM> may be collapsible. That is, the bridge <NUM> can be adjusted to shorten a distance D between the first portion 2500a and the second portion 2500b by moving the first portion 2500a and/or the second portion 2500b toward each other. The bridge <NUM> may also be extendable. That is, the bridge <NUM> may be adjusted to lengthen the distance D by moving the first portion 2500a and/or the second portion 2500b away from each other. The adjustability of D should allow the clamp system <NUM> to adjust to specific patient anatomy.

The bridge <NUM> may include a first portion 3002a extending from an outer surface <NUM> of the first portion 2500a. The first portion 3002a may include a recess <NUM> comprising at least one slot 3008a. In certain embodiments, another slot may be positioned on an opposite side (opposite from the first slot 3008a) of the recess <NUM>. The position of the second slot is indicated by reference 3008b, as shown. The bridge <NUM> may also include a second portion 3002b that may be an elongated member including at least one rail 3010a that is aligned with and extends into the slot 3008a, as shown. The second portion 3002b may also include a second rail (not shown) opposite to the first rail that extends into the second slot that indicated by the reference 3008b. In certain embodiments, the first portion 2500a may be initially separate from the second portion 2500b and may be assembled to form the clamp system <NUM>. That is, the clamp system <NUM> may be assembled by at least inserting the rail 3010a into the slot <NUM>.

<FIG> illustrates the clamp system <NUM> further including a hook <NUM>, in accordance with particular embodiments of the present disclosure. The hook <NUM> may extend from a portion <NUM> of the clamp system <NUM> that may be positioned between and/or adjacent to the first portion 2500a and the second portion 2500b, as shown. The hook <NUM> may include a flat surface that may taper in a direction away from the portion <NUM>.

<FIG> illustrates the clamp system <NUM> with the sublaminar band <NUM> secured therein, in accordance with particular embodiments of the present disclosure. As shown, the sublaminar band <NUM> may extend through the second portion 2500b. The sublaminar band <NUM> may be positioned adjacent to the hook <NUM>. The hook <NUM> may be engaged with a lamina, pedicle or transverse process of a patient before the spinal rod <NUM> is inserted through the first portion 2500a and secured therein.

<FIG> illustrates the clamp system <NUM> and the hook <NUM> attached to the spinal rod <NUM> along with the pedicle screw assemblies 2900a and 2900b, in accordance with particular embodiments of the present disclosure. The configuration shown in <FIG> may be similar to the configuration shown in <FIG>.

As shown in a locked position, the first portion 2500a and the second portion 2500b may be disposed between the pedicle screw assemblies 2900a and 2900b. As shown, the spinal rod <NUM> may be retained in the clamp system <NUM> via the threaded locking caps 2904a, 2904b, and 2904c. The sublaminar band <NUM> may be secured to the second portion 2500b. The configuration shown in <FIG> may allow a surgeon to create a claw construct by placing the hook <NUM> on a lamina of one vertebral level and placing the sublaminar band <NUM> around a lamina of an adjacent vertebral level. When the sublaminar band <NUM> is tensioned, the two vertebral levels may be compressed together to offer an increased fixation to the claw construct.

<FIG> illustrates the first portion 2500a (as shown on <FIG>) further including the hook <NUM> (as shown on <FIG>, for example). This configuration allows a distance Dh between the hook <NUM> and the second portion 2500b to be adjusted due to the adjustability of the first portion 2500a relative to the second portion 2500b via the bridge <NUM>, as described herein. As noted previously, the first portion 2500a (including the hook <NUM>) may be initially separate from the second portion 2500b and may subsequently be connected to each other to form the clamp system <NUM> or a portion thereof.

<FIG> illustrates an embodiment in which the sublaminar band <NUM> is secured to the second portion 2500b that includes the hook <NUM>, in accordance with particular embodiments of the present disclosure. As shown, the hook <NUM> may extend from the second portion 2500b, and the sublaminar band <NUM> may extend through the second portion 2500b such that the sublaminar band <NUM> is adjacent to the hook <NUM>.

The described embodiments allow surgeons to fixate the spine by securing a sublaminar band to a spinal rod construct or by securing two vertebral levels to each other. Sublaminar bands are useful when traditional pedicle screw fixation is compromised or not possible, for example in the case of patients with dysmorphic vertebrae, osteoporosis, or fractured pedicles. The embodiments described above provide a means to fixate the spine using a sublaminar band in these clinical scenarios.

Claim 1:
A sublaminar band clamp system (<NUM>; <NUM>; <NUM>); comprising:
- a first locking mechanism (116a);
- a second locking mechanism (116b); and
- a body (<NUM>) comprising:
- a first portion (104a) comprising a first passage (<NUM>), wherein the first locking mechanism (116a) is disposed within the first passage (<NUM>);
- a second portion (104b) comprising a second passage (<NUM>), wherein the second locking mechanism (116b) is disposed within the second passage (<NUM>);
- a third passage (<NUM>) extending across the body (<NUM>), the third passage (<NUM>) in fluid communication with the second passage (<NUM>) and adapted to receive a sublaminar band (<NUM>); and
- an opening (<NUM>; <NUM>) positioned between the first and second portions (104a, 104b), the opening (<NUM>; <NUM>) and adapted to receive a spinal rod (<NUM>),
- a longitudinal axis of the first passage (<NUM>) is perpendicular to a longitudinal axis of the second passage (<NUM>) characterized in that
- the opening (<NUM>; <NUM>) is in fluid communication with the first passage (<NUM>) and the third passage (<NUM>) extends internally between the second portion (104b) and a portion of the nose portion (<NUM>) between an opening (125a) at the nose portion (<NUM>) and an opening (125b) on outer portion (114b).