CA2275250C - Device for connecting a longitudinal support to a pedicle screw - Google Patents

Device for connecting a longitudinal support to a pedicle screw Download PDF

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Publication number
CA2275250C
CA2275250C CA002275250A CA2275250A CA2275250C CA 2275250 C CA2275250 C CA 2275250C CA 002275250 A CA002275250 A CA 002275250A CA 2275250 A CA2275250 A CA 2275250A CA 2275250 C CA2275250 C CA 2275250C
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CA
Canada
Prior art keywords
fastener
spinal
fixation system
clamping element
head
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Expired - Lifetime
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CA002275250A
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French (fr)
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CA2275250A1 (en
Inventor
Fridolin Schlapfer
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Synthes USA LLC
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Synthes USA LLC
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7035—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • A61B17/7037—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other wherein pivoting is blocked when the rod is clamped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7041—Screws or hooks combined with longitudinal elements which do not contact vertebrae with single longitudinal rod offset laterally from single row of screws or hooks
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7032—Screws or hooks with U-shaped head or back through which longitudinal rods pass
    • A61B17/7034—Screws or hooks with U-shaped head or back through which longitudinal rods pass characterised by a lateral opening

Abstract

The invention relates to a device used to connect a longitudinal support (1) to a pedicle screw (2) by means of an accommodating head (3) having a channel (5) to accommodate the longitudinal support, wherein it is possible to freely choose from or mix laterally open, top open or closed accommodating heads. A top open accommodating head (3) facilitates, for example, insertion of the longitudinal support (1), whereas a lateral opening enables lateral corrections. The pedicle screw (2) and the accommodating head (3) are connected via a conical collet chuck (7) in the accommodating head (3) and by a spherical head on the pedicle screw. It is thus possible to subsequently engage the accommodating head (3) and screw in the pedicle screw (2) even without the accommodating head (3), thereby allowing better visibility when assembling the pedicle screw. According to the embodiment, a clamping member (10) for the longitudinal support (1) is built into the clamping screw (36) of the spherical head (9) or integrated into the intermediate element (12) and the longitudinal support (1) and the spherical head (9)) can be fastened separately.

Description

DEVICE FOR CONNECTING A LONGITUDINAL SUPPORT TO A PEDICLE
SCREW
There are already known several pedicle screws for the fixation of the vertebral column from the prior art, which show the advantage that the different pedicle screws can be implanted independent from the longitudinal support. The longitudinal support is subsequently entered into the pedicle screw either sidewardly or from the top and fastened. For example such a pedicle screw is disclosed in European Patent 330,881 (Canadian Patent 1,309,629).
The disadvantage of these known pedicle screws consists in the relatively complicated locking mechanism to fasten the longitudinal support after inserting it into the openly shaped head of the pedicle screw. Furthermore, in most cases the head of the screw is only adjustable to the position of the longitudinal support to a limited degree requiring a costly adjustment of the longitudinal support.
German DE-C 195 09 332 (Canadian Patent 2,171,068)discloses an anchoring element for connection of a longitudinal support using a pedicle screw, where the spherical head of a pedicle screw can springably be clicked in compressible pressure element enabling an angeled mounting of the pedicle screw to a certain degree. A tensioning of the pressure element in the retainer head is generated due to a mechanism already disclosed in WO 94/00066 (US 5,501,684) by moving the pressure element formed as truncated cone in a bore hole complementary conical towards the contracting end whereby it is jammed. By jamming the pressure element also the spherical head of the, bone screw is fastened at any angle.
The disadvantages of these known devices are the following:
a) the design of the hollow cylindrical pressure element which accepts the spherical head provides only two only downwardly open longitudinal slots extending in the same direction (in the direction of the bone screw). Therefore, while jamming no homogenous encompassment of the spherical head of the bone screw via the lamellas of the slotted pressure element takes place.
This inhomogenous encompassment of the spherical head causes a reduced jam force;
b) the bone screw must be mounted by inserting it together with the pressure element from the top via the recess for the tensioning element and fastened secured against rotation in the device, this means the bone screw cannot be screwed in independently from the retainer head. The retainer head enables no mounting after the implantation of the bone screw. As a , CA 02275250 1999-06-14 result a reduced view while screwing in the bone screw with mounted retainer head is yielded. If a system with differently formed retainer heads should be offered the system consists because of the premounting of the bone screw caused by the design of n * m implants [where n = number of head variants and m = number of lengths of the screws] instead of n + m implants.
A further disadvantage is that a change of the retainer heads in situ caused by the situation is impossible.
c) the low stability of the angle, which permits only a fixation by tension boom;
d) through the tension means the longitudinal support of the device and the spherical head of the bone screw are fastened at the same time. A loosening of the tension means causes a failure of the whole fixation system at once; and e) furthermore, depending on the situation one would like to fasten the connection between the device and the spherical head of the bone screw independently from the longitudinal support to distract or compress between longitudinal support and bone screw via the longitudinal support without loss of angle what is impossible with the known device.
Here, the present invention seeks to offer remedy. The aim of the invention is, to provide a device for the connection of a longitudinal support with a pedi~~le screw with the following properties:
- easy handling - inserting of screw part of the device without the retainer head;
- possibility of subsequent onclicking of the retainer head;
- depending on the situ~rtion or the preference of the surgeon free choice of ~or mixture of sidewardly open, upwardly open or closed retainer heads. For example an upwardly open retainer :head eases the insert. of the longitudinal support wh=~_Le a sideward opening enables correction sidewardly; and - depending on the emboci:iment separate fastening of the longitudinal support anc~ spherical head of the bone screw.
According to the invent=LOn, there is provided a spinal-fixation system compris_Lng a longitudinal member positionable along a sp=final column, a fastener having a threaded end for engaging a vertebra, and a connector member for connecting the fastener and the longitudinal member. The connector member has top, bottom, and side surfaces, and comprises a channel extending through the side surfaces for receiving the longitudinal member, a tapered opening extending through the bottom surface for_ receiving the fastener, a top opening extending through the top surface and operatively associated with the tapered opening. A fastener-cl<~mping element has a hollow truncated cone shape, top and bottom surfaces, and a plurality of slots, the element securing the fastener in the tapered opening at a surgeon-selected angle relative to the connector member and longitudinal member, and a tension element insertable in the top opening. Insertion of the tension element in the fop~ opening- causes downward movement of the fastener-clampin~~ element i.n the tapered opening, and thereby radial compression of the fastener-clamping 4a element to secure the f.=~stener at the surgeon-selected angle.
Preferably, the plurality of slots of the fastener-clamping element includes first ;:Lots intersecting the top surface, and second slots intersecting the bottom surface.
The fastener-clamping e=Lement maybe a half-cone angle which is between about 3° and 8°, and preferably between about.
5°
and 7°
In one embodiment, the i:apered opening has a half-cone angle which is between about 3° and 8°, and preferably about 5° to 7°.
Advantageously, the fastener-clamping element is radially compressible in diameter_ between about 0.8 mm and 1.2 mm, and preferably between <about= 0.9 mm and 1.1 mm.
Further, the fastener-c:Lamping element may radially expand in diameter between about 0.3 mm and 0.6 mm for receiving the fastener, and preferably about 0.35 mm and 0.45 mm i=or receiving the fastener.
In one embodiment, the Fastener-clamping element has a substantially concavely--shaped interior.
In another embodiment, the fastener has a substantially spherical head, wherein the spherical head includes at least one of fins or grooves for securing the fastener in the fastener-clamping e_Lement at the surgeon-selected angle.

4b Preferably, the head of t=he fastener is made of a material having a hardness which is greater than that of the interior of the fastener-clamping element, and preferably the head is made of a '-C:i.--Al-Nb alloy and the fastener-clamping element is madce of titanium.
In one embodiment, the diameter of the spherical head is between about 6 mm and l.0 mrn, and preferably about 7.5 rrun and 8 . 5 mm .
Advantageously, the head is spaced between about 4 mm and mm from the longitudinal member, and preferably the head is spaced between about 6 mm and 8 mm from the longitudinal member.
Preferably, the channel is oriented transversely to the tapered opening so that insertion of the tension element: in the top opening fixes the longitudinal member in the channel.
The spinal-fixation syst=em may also comprise a hollow-cylindrical insert posit=Toned between the longitudinal member and the fastener--clamping element, wherein insertion of the tension element __n the top opening, presses against the longitudinal member, thereby pressing the insert against the fastener crimping element..
The tension element may have an exterior surface that includes threads, and at. least a portion of walls of the top opening are threade~~t for threadably receiving the tension element, and the channel may include an opening to allow insertion of the _i_ongitudinal member in the channel.

4c Preferably, the tension element comprises a fastener tensioning screw for ser_uring the fastener at the surgeon-selected angle, and hav:i.ng a through opening with a threaded wall, and a longitudinal member-tensioning screw threadably received in the through opening for securing the longitudinal member in t=he channel.
Preferably, the tapered opening is laterally displaced from the channel.
The spinal-fixation syst=em may further comprise a longitudinal member clamping element for securing the longitudinal member in the channel.
The device according to the invention consists of a retainer head accepting the longitudinal support where a pedicle screw with a pre:Eerably spherical head can be subsequently clicked in and fastened. The retainer head may be clicked on in the desired amount and variant on t:he already implanted pedic=Le screws with spherical head so that a primary connection between the longitudinal support and the pedicle screw is produced. I3y screwing in the tension means in the fixation device the longitudinal support is fixed axially and rotatively in the device and at the same time the device fastened at a steady angle. At the same time the locking screw used as a tension means presses on the longitudinal support inserted into the device, this one presses on hollow truncated cone which is alternating slotted than= itself is compressed caused by the conical shape of the ini.ernal bore hole of t:he head of the fixation device and by this means jams the preferable spherical head of the pedicle screw. For an optimal load transmission from the longitudinal support to hollow truncated cone a rigid insert is advantageously inserted between longitudinal support an hollow truncated cone. Depending on the design of the insert and the tension means the present invention also enables to fasten the longitudinal support and the preferably spherical head of the bone screw separately.
Thus the device according to the invention offers the advantage compared to the known devices that the pedicle screws are not only fastenable perpendicular to the longitudinal support but allow an angle of until ~ 25' and because of the distance between the center of rotation at the retainer head and the axis of the longitudinal support sideward deviations between the longitudinal support and the pedicle screw may be equalized to a certain degree depending on the 'thickness of the longitudinal support between 4 and 10 mm. This is particularly important if the longitudinal support was inaccurately bent what causes serious difficulties in the mounting in case of ordinary systems. Another advantage of the device according to the invention consists in it, that depending on the embodiment of the rigid insert and the tension ;means respectively embodiment of the device the longitudinal support and the preferably spherical head of the bone screw may be separately fastened.
A preferred embodiment of the device according to the invention consists in it, that the preferably spherical head of the pedicle screw is provided preferably with a structure in the shape of transverse grooves respectively transverse fins to reach a better fastening (jamming against the spring chuck).
The stability of the angle may be improved by this means that the head of the screw consists of a relatively hard material (e. g. Titan-Aluminium-Niob-alloy) and the hollow truncated cone which is alternating slotted consists of a relatively unrigid material (e. g. Titan in its soft state).
Another possibility for the improvement of the stability of the angle consists therein to roughen the preferably spherical head of the pedicle screw and/or the complementary cavity in hollow truncated cone with a three dimensional structure e.g. in the form of grooves.
Therewith the structure of relatively hard material situated at the head of the screw is pressed into the relatively unrigid material of the hollow truncated cone.
To screw in the pedicle screws into the bone they are preferably provided in the spherical head with a hexagon socket. If the onclickable head is through cannul~ated only the pedicle screw or at once the whole device may be screwed in optionally. The latter especially has the advantage that at any time the device may be screwed in further or screwed back to gain a leveling.
The click mechanism used inventionally still has the further advantage compared to other known click mechanisms, e.g.
according to US-A 5 549 608, that after succeeded onclicking an erroneous loosening of the established connection is not possible through the manipulations to be performed. Should the established connection be loosened again intentionally then this needs a particular instrument.
The invention and further embodiments of the invention are further discussed in the following with the help of different embodiments.
It is shown in:
Fig. 1 a perspective exploded view of the device according to the invention with an upwardly open retainer head together with a longitudinal support, a pedicle screw with spherical head and a tension :means;
Fig. 2 a longitudinal cut through the device according to the invention according to fig. 1 along the central axis;
Fig. 3 a perspective view of .a modified device according to the invention with a closed channel for the acceptance of a longitudinal support as well .as a tension means;
Fig. 4 a perspective view of a modified device according to the invention with a sidewardly (instead of upwardly) open channel for the acceptance of a longitudinal support as well as a tension means:
Fig. 5 a perspective view of a modified device according to the invention with a sidewardly open channel for the acceptance of a longitudinal support as well as a supplementary sleeve and nut to the fastening of the longitudinal support;
Fig. 6 a perspective view of .a modified device according to the invention where the longitudinal support is distant to the central axis;
Fig. 7 a longitudinal cut through a modified device according to the invention where the longitudinal support and the preferably spherical lhead of the bone screw may be fastened separately;
Fig. 8 a longitudinal cut through a modified device according to the invention with features as disclosed in fig. 7 with the difference that the locking screws for the fastening of the longitudinal support and the preferably spherical head of the bone screw are mechanically decoupled; and Fig. 9 a longitudinal cut through a modified device according to the invention according to fig. 8 with the advantage that the longitudinal support is insertable from above.
The device according to the invention represented in fig. 1 and 2 essentially consists of a retainer head 3 with the central axis 4 and upwardly open channel 5 shaped as a yoke and running transversely to the central axis 4 as well as a downwardly open cavity 6 shaped as a truncated cone tapering downwardly with the central axis 4 wherein spring chuck 7 shaped as a hollow truncated cone with alternating slots is provided coaxially removable which is formed to the acceptance of the head 9 of a pedicle screw 2.
As shown in fig. 2 the cavity 6 shaped as a truncated cone practically provides a half cone angle a/2 of about 6°. The spring chuck 7 shaped as a hollow truncated cone having alternating slots 8 provides a corresponding half cone angle a/2 of about 6°. The spring chuck 7 ca:n, by means of its slots 8, be extended in its diameter by about 0,4 mm and be compressed by up to 1 mm so that the head 9 of the pedicle screw 2 is snappable into it. For this purpose the interior of the spring chuck 7 is shaped concave, practically in the form of a hollow sphere.
The cavity 6 reaches upwardly in the axial direction into the channel 5 so far that the spring chuck 7, respectively the above lying insert 12 which is preferalbly formed hollow cylindrical (e. g. in the shape of a washer) is pressable axially downwards via the longitudinal support 1 inserted in the channel 5 - when the longitudinal support 1 is axially and rotatively fixed in the channel 5 by means of the tension means 10. At the same time with the downward axial displacement of the spring chuck 7 inside the cavity 6 which tapers conically downwards and is preferably shaped as a truncated cone a decrease of the diameter of the spring chuck 7 takes place so that the head 9 of the pedicle screw 2 which was previously snapped into the spring chuck 7 from below is jammed a:nd fastened in its relative position to the retainer head 3 (and thus with the longitudinal support 1). Thanks to the decoupling between the spring chuck 7 and the insert 12 a homogenous encapsulation of the head 9 takes place what provides an optimal firmness of the connection between retainer head 3 and the pedicle screw 2.
The tension means 10 provides an external thread 19 and the channel 5 provides in the region of the two legs 20 forming a yoke a corresponding internal thread 21. To screw the locking screw 19 into the internal thread 21 it provides at its upper end a transverse slot 22 and an internal thread 30 to accept an correspondingly shaped manipulating instrument (not shown in the drawings). Instead of the transverse slot 22 and the internal thread 30 a hexagonal socket for instance can also be applied.

The function of the insert 12 consists in special case just therein to enable a transmission of the forces as homogenous as possible from the longitudinal support to the spring chuck 7 which might easily jam in the cavity 6.
The head 9 of the pedicle screw 2 is preferably provided at its upper end with a hexagonal socket 23 to screw in the pedicle screw 2 into the bone by means of a hexagon screw driver.
In fig. 3 a variant of the device according to the invention is represented by which the retainer :head provides an upwardly open threadened through hole 13 which communicates with the channel 5 wherein a tension means 10 with hexagon socket 24 is screwable such that a longitudinal support 1 inserted into the channel 5 is axially and rotatively fixable.
In fig. 4 another variant of 'the device according to the invention following fig. 3 is represented where the channel 5 is open towards one side to accept the longitudinal support 1 from the side what provides some intraoperative advantages. Instead of the hexagon socket 24 the tension means 10 can also be provided with a transverse slot 2:Z and an internal thread 30.
The transverse slot 22 and the initernal thread 30 in this case serve to the acceptance of a manipulating device (not shown in the drawings).

In fig. 5 a further variant of the device according to the invention is represented wherein the channel 5 is similarly open to one side as in the variant according to fig. 4. However, the retainer head 3 provides at its upper section 14 an external thread 15 with a transverse slot 25 and an internal thread 30 around which the hollow cylindric sleeve 16 with the recesses 18 can be reverse drawn auto the longitudinal support 1. Via the nut 17 which provides an internal thread corresponding to the external thread 15 the sleeve 16 can be tensioned against the longitudinal support 1 inserted i:n the channel 5 so that the longitudinal support 1 is axially and rotatively fixed on the one side and on the other side presses on the insert 12 respectively via the opening 11 on the spring chuck 7.
By the further variant of the device according to the invention shown in fig. 6 the retainer head 3 is slablike shaped; it contains apart from the cavity 6 tapering conically downwards with the central axis 4 the channel 5 - fully closed - and running transverse to the latter to the acceptance of the longitudinal support 1 with the longitudinal axis 32. The fixation of the spring chuck 7 happens via the tension means 10 which presses onto the washer 12. The washer 12 can in case of this embodiment be omitted without any problem so that the tension means presses directly on the spring chuck 7. Through the pressure on the spring chuck '7 it glides downwards within the conically tapering cavity 6 therewith contracting itself in diameter so that an inserted preferably spherical head of a pedicle screw is fastened.

In this embodiment the fixation of the longitudinal support separately happens via an additional locking screw 31 which can be screwed in from above in a bore hole communicating with the channel 5 till it reaches the longitudinal support.
The preferably spherical head 9 of the pedicle screw 2 can be provided instead of the hexagon socket with a device to attach an extension (not shown in the drawings) that enables a manipulation of the pedicle screw 2 through the tension means l0 (this needs a large, through opening). The connection between pedicle screw 2 and the extension is preferably reversible and stable in view to rotation, tension and pressure.
The variant of the device according to the invention shown in fig. 7 demonstrates the application of a tension means 10 and a tensioning screw 36. Therewith a separate fixation of the longitudinal support 1 and the pedicle screw 2 is possible. The tensioning screw 36 is screwed in into the retainer head and fastens only the spherical head 9 of the pedicle screw 2. Hence, the screw can be displaced along t:he longitudinal support with its spherical head fastened without varying the angle between longitudinal support 1 and pedicle screw 2. The tension means 10 to the fixation of the longitudinal support is integrated in the tensioning screw 36. The tension means 10 is then fastened to the fixation of the longitudinal support 1 after the spherical head 9 was fixed via the tensioning screw 36. The acceptance of the longitudinal support 1 in 'the retainer head 3 can be realized as shown in fig. 1 through a upwardly open channel 5.

The acceptance of the longitudinal support 1 is possible as well by a bore hole a shown in fig. 3 or by a sidewardly placed open channel 5 according to fig. 4. The acceptance of the longitudinal support 1 in the insert 12 is possible by a bore hole 43 according to fig. 8. For the simplification of the mounting in case of upwardly open retainer head 3 according to fig. 1 an insert 12 having an upwardly open channel 37 according to fig. 12 is insertable. In t:he contrary to fig. 8 and 9, however, the insert 12 is so far open on top that the tension means 10 presses umimpeded directly on the longitudinal support 1. The foregoing catenation of the insert 12 on the longitudinal support 1 is not necessary. It i;s possible, too to provide the insert 12 with a sideward channel 5 according to fig. 5. The mounting of the insert 12 is pre:Eerably done from the side of the spring chuck 7. A rim 39 at the insert 12 hinders the insert from sliding upwardly out of the retainer head 3. The sliding out towards below is hindered by tile spring chuck 7. In case of use of a retainer head 3 which is upwardly open because of the channel 5 and of a tensioning screw 36 a safety sleeve 41 prevents the retainer head 3 from widening when the tensioning screw 36 is tightened. Instead of the tensioning screw 36 a tensioning nut 38 similarly as shown in fig. 9 is possible.
In fig. 8 a further variant of the device according to the invention is shown. Similarly to l.he variant shown in fig. 7 a second tensioning screw 36 fixes the spherical head 9 via the insert 12 without jamming the 7Longitudinal support. In the contrary to the variant shown in fig. 7 the tension means 10 which serves to the fixation of the longitudinal support 1 is inserted in the insert 12 which is further drawn up and provided with an internal thread 42. The insert 12 provides a closed upwardly open thread hole 42. The closed bottom of the insert 12 enables to press homogeneously on the spring chuck 7. The acceptance of the longitudinal support 1 in the retainer head 3 may be realized by an upwardly open channel 5 as shown in fig.
1. As well an acceptance of the longitudinal support 1 by a bore hole as shown in fig. 3 or by a sidewards placed open channel 5 as shown in fig. 4 is possiible. The acceptance of the longitudinal support 1 in the insert 12 is possible by a bore hole 43. Even though the insert 12 must be catenated on the longitudinal support 1 before the longitudinal support 1 is inserted into the retainer head 3. An upwardly open channel 5 at the insert 12 as shown in fig. 7 is possible too if the diameter of the longitudinal support 1 amounts about 3/5 of the core diameter of the internal thread 42. In case of use of a retainer head 3 which is upwardly open because of the channel 5 and of a tension screw 36 a safety sleeve 41 prevents a widening of the retainer head 3 when the tensioning screw 36 is tightened.
Instead of the tensioning screw 36 also a tensioning nut 38 similar as shown in fig. 9 is possible.
The variant of the device according to the invention shown in fig. 9 is marked as shown in fig. 8 through a drawn up insert 12 and a tension means 10 fixation of the longitudinal support 1 integrated therein. Whereas the spring chuck 7 is fixed via a tensioning nut 38. This tensioning nut 38 presses on the insert 12 and the spring chuck 7 whereby the spherical head 9 is fixed without jamming the longitudinal support 1. A second tension means 10 runs in the insert 12 and jams the longitudinal support 1. The fixations of the spherical head 9 and the longitudinal support 1 are so mechanically decoupled. The acceptance of the longitudinal support 1 may be realized by an upwardly open channel 5 as shown in fig. 1. An acceptance of the longitudinal support 1 via a bore hole as shown in fig. 3 or via a sidewardly placed open channel 5 according to fig. 4 is possible as well.
The acceptance of the longitudinal support 1 in the insert 12 is possible through a bore hole 43 according to fig. 8. For the simplification of the mounting in case of an upwardly open retainer head 3 according to fig. 1 an insert 12 provided with an upwardly open channel 37 according to fig. 9 is insertable.
The longitudinal support 1 then can be introduced from above into the insert 12. A foregoing catenation of the insert 12 on the longitudinal support 1 is not necessary. It is possible as well to provide the insert 12 with a sidewardly channel 5 according to fig. 4. The mounting of the insert 12 preferably takes place from the side of the spring chuck 7. A rim 39 at the insert 12 hinders a sliding out of the insert 12 towards the top of the retainer head 3. The sliding out towards the bottom is hindered through the spring chuck '7.

Claims (26)

The embodiments of the invention in which an exclusive property or privilege is claimed are defined as follows:
1. A spinal-fixation system comprising:

a longitudinal member positionable along a spinal column;
a fastener having a threaded end for engaging a vertebra;
and a connector member for connecting the fastener and the longitudinal member, said connector member having top, bottom, and side surfaces, and comprising:
a channel extending through the side surfaces for receiving the longitudinal member;
a tapered opening extending through the bottom surface for receiving the fastener;
a top opening extending through the top surface and operatively associated with the tapered opening;
a fastener-clamping element having a hollow truncated cone shape, top and bottom surfaces, and a plurality of slots, the element securing the fastener in the tapered opening at a surgeon-selected angle relative to the connector member and longitudinal member; and a tension element insertable in the top opening, wherein insertion of the tension element in the top opening causes downward movement of the fastener-clamping element in the tapered opening, and thereby radial compression of the fastener-clamping element to secure the fastener at the surgeon-selected angle.
2. The spinal-fixation system of claim 1, wherein the plurality of slots of the fastener-clamping element includes first slots intersecting the top surface, and second slots intersecting the bottom surface.
3. The spinal-fixation system of claim 1 or 2, wherein the fastener-clamping element has a half-cone angle which is between about 3° and 8°.
4. The spinal-fixation system of claim 3, wherein the fastener-clamping element has a half-cone angle which is between about 5° and 7°.
5. The spinal-fixation system of any one of claims 1 to 4, wherein the tapered opening has a half-cone angle which is between about 3° and 8°.
6. The spinal-fixation system of claim 5, wherein the tapered opening has a half-cone angle which is between about 5° to 7°.
7. The spinal-fixation system of any one of claims 1 to 6, wherein the fastener-clamping element is radially compressible in diameter between about 0.8 mm and 1.2 mm.
8. The spinal-fixation system of claim 7, wherein the fastener-clamping element is radially compressible in diameter between about 0.9 mm and 1.1 mm.
9. The spinal-fixation system of any one of claims 1 to 8, wherein the fastener-clamping element radially expands in diameter between about 0.3 mm and 0.6 mm for receiving the fastener.
10. The spinal-fixation system of claim 9, wherein the fastener-clamping element radially expands in diameter between about 0.35 mm and 0.45 mm for receiving the fastener.
11. The spinal-fixation system of any one of claims 1 to 10, wherein the fastener-clamping element has a substantially concavely-shaped interior.
12. The spinal-fixation system of any one of claims 1 to 11, wherein the fastener has a substantially spherical head.
13. The spinal-fixation system of claim 12, wherein the spherical head includes at least one of fins or grooves for securing the fastener in the fastener-clamping element at the surgeon-selected angle.
14. The spinal-fixation system of claim 12 or 13, wherein the head of the fastener is made of a material having a hardness which is greater than that of the interior of the fastener-clamping element.
15. The spinal-fixation system of claim 12, 13 or 14, wherein the head is made of a Ti-Al-Nb alloy and the fastener-clamping element is made of titanium.
16. The spinal-fixation system of any one of claims 12 to 15, wherein the diameter of the spherical head is between about 6 mm and 10 mm.
17. The spinal-fixation system of claim 16, wherein the diameter of the spherical head is between about 7.5 mm and 8.5 mm.
18. The spinal-fixation system of any one of claims 12 to 17, wherein the head is spaced between about 4 mm and 10 mm from the longitudinal member.
19. The spinal-fixation system of claim 18, wherein the head is spaced between about 6 mm and 8 mm from the longitudinal member.
20. The spinal-fixation system of any one of claims 1 to 19, wherein the channel is oriented transversely to the tapered opening so that insertion of the tension element in the top opening fixes the longitudinal member in the channel.
21. The spinal-fixation system of any one of claims 1 to 20, further comprising:

a hollow-cylindrical insert positioned between the longitudinal member and the fastener-clamping element;
wherein insertion of the tension element in the top opening, presses against the longitudinal member, thereby pressing the insert against the fastener clamping element.
22. The spinal-fixation system of any one of claims 1 to 21, wherein the tension element has an exterior surface that includes threads, and at least a portion of walls of the top opening are threaded for threadably receiving the tension element.
23. The spinal-fixation system of any one of claim 1 to 22, wherein the channel includes an opening too allow insertion of the longitudinal member in the channel.
24. The spinal-fixation system of any one of claims 1 to 23, wherein the tension element comprises:

a fastener tensioning screw for securing the fastener at the surgeon-selected angle, and having a through opening with a threaded wall; and a longitudinal member-tensioning screw threadably received in the through opening for securing the longitudinal member in the channel.
25. The spinal-fixation system of any one of claims 1 to 24, wherein the tapered opening is laterally displaced from the channel.
26. The spinal-fixation system of any one of claims 1 to 25, further comprising a longitudinal member clamping element for securing the longitudinal member in the channel.
CA002275250A 1996-12-12 1996-12-12 Device for connecting a longitudinal support to a pedicle screw Expired - Lifetime CA2275250C (en)

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PCT/CH1996/000437 WO1998025534A1 (en) 1996-12-12 1996-12-12 Device for connecting a longitudinal support to a pedicle screw

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CA2275250A1 CA2275250A1 (en) 1998-06-18
CA2275250C true CA2275250C (en) 2004-06-29

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EP (1) EP0951245B1 (en)
JP (1) JP3766107B2 (en)
KR (1) KR100417222B1 (en)
AT (1) ATE234046T1 (en)
AU (1) AU732351B2 (en)
CA (1) CA2275250C (en)
DE (1) DE59610225D1 (en)
ES (1) ES2191775T3 (en)
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WO1998025534A1 (en) 1998-06-18
HK1022617A1 (en) 2000-08-18
DE59610225D1 (en) 2003-04-17
EP0951245B1 (en) 2003-03-12
KR100417222B1 (en) 2004-02-05
ES2191775T3 (en) 2003-09-16
US6063090A (en) 2000-05-16
CA2275250A1 (en) 1998-06-18
JP3766107B2 (en) 2006-04-12
AU7690196A (en) 1998-07-03
EP0951245A1 (en) 1999-10-27
JP2001505469A (en) 2001-04-24
AU732351B2 (en) 2001-04-26
ATE234046T1 (en) 2003-03-15
KR20000057562A (en) 2000-09-25

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