WO2017021618A1

WO2017021618A1 - Gripping device for a pedicle screw

Info

Publication number: WO2017021618A1
Application number: PCT/FR2016/051893
Authority: WO
Inventors: Guy Viart; Jean Yves Leroy; Brice KRIER; Sebastien SHULLER; Jean Paul Steib; Nicolas Virgaux
Original assignee: Clariance
Priority date: 2015-07-31
Filing date: 2016-07-21
Publication date: 2017-02-09
Also published as: FR3039390B1; FR3039390A1

Abstract

The gripping device (1) according to the present invention that can be used for installing and attaching a clamping screw (101) inside a U-shaped link connector (102) of a polyaxial or monoaxial pedicle screw (103) for immobilising a link rod (104) of an osteosynthesis device (100) known per se, comprises: ⋅ locking means (2) that come to bear on the link connector (102), making it possible to ensure the coaxiality of the main axes of said gripping device (1) with those of the link connector (102) and making it possible to hold the link rod (104) inside said link connector (102); ⋅ and means (3) for unlocking the gripping device (1) after installing and tightening the clamping screw (101) inside the link connector (102).

Description

GRIPPING DEVICE FOR SCREW PEDFEED E

The present invention relates to a gripping device for setting up and fixing a clamping screw inside a U-shaped connection connector of a poiy-axial or mono-axial pedicle screw. for immobilization in rotation and in translation of a connecting rod of an osteosynthesis device known per se.

Known gripping devices of this kind which allow the establishment of clamping screws inside connection connector for the immobilization of a connecting rod. It should be noted that most gripping devices known per se and described, for example, in prior patents US2004 / 0049191 and WO2008039441 teach an attachment of the connection connector by a hinge system or by an elastically deformable device. These solutions do not allow the good behavior on the connector connector, deciipsing impromptu and frequent, or on the contrary do not allow easy unlocking, unable to get out of said connector connector because of the flesh for example.

The previous gripping devices do not allow to adjust and ensure the coaxiality between the main axes of said device and those of the connecting connector secured to the pedicle screw.

This condition requiring the adjustment of coaxiality is essential to make the gripping device practical to use and limit the risk to the patient of poor fixation of the rod connection in the connector connector of the known osteosynthesis device in soil.

The gripping device according to the present invention allows the implementation and setting within a locking screw ^of a U-shaped connecting connector of a poly-axial pedicle screw or monoaxially for immobilization of a connecting rod of an osteosynthesis device known per se

The gripping device according to the present invention comprises:

* Locking means coming to bear on the connector for connecting the one hand to ensure the coaxiality of the main axes of said gripping device with those of the link connector and another bet to maintain the connecting rod at ^the Interior of said connector connector;

"And unlocking means of the gripping device after the introduction and screwing of the clamping screw inside the connection connector. The gripping device according to the present invention comprises locking means which consist of:

* a guide body ensuring the establishment of said gripping device around the connecting connector of the pedicle screw;

* A sleeve with elastic blades having a truncated profile for assembly around the guide body; and translation means which consist of a guiding handle co-operating firstly ^through a double-threaded connection with the guide body and on the other hand via a pivot connection with a tube pushes guided rod inside and with respect to said guide body of said gripping device in order to push the connecting rod inside the connection connector and come to bear on the peripheral upper edge of said connector, said means translation device for generating a pressure force between said connecting connector and said rod pushing tube causing a displacement of the guide body so that it bears against the resilient blades of said sleeve with a cancellation adapted to block them to l interior spaces arranged in the connection connector.

The gripping device according to the present invention comprises unlocking means which consist of a lever guided in rotation relative to the guide body, allowing after the release means to translate, to exert a translational force on the sleeve to resilient blades for moving the latter relative to said guide body causing the spacing of the resilient blades and the unlocking of said gripping device of the connecting connector.

The gripping device according to the present invention comprises a guide body which is formed ^of a longitudinal tube having a first end provided with two lateral and opposite évldements delimiting two retaining legs in which are arranged the guide windows and a second end comprising an internal thread cooperating with the external one of a guide handle. The gripping device according to the present invention comprises a guide body comprising on its outer face and between its two ends retaining means for the introduction and the attachment of the elastic blade sleeve so that the ends of said elastic blades open at the end. inside the guiding windows of each retaining branch.

The gripping device according to the present invention comprises a guide body having at its second end connecting means cooperating with those of the lever unlocking means allowing the latter to tilt around said body and come to exercise a translational force on the sleeve with elastic blades to move the latter relative to said guide body, The gripping device according to the present invention comprises a tube push rod translation means having a first end which cooperates with the guide handle and a second end comprising two opposite extensions each having a concave profile seat intended to cooperate with the rod of connecting the osteosynthesis device to allow centering of the latter inside the connection connector.

The gripping device according to the present invention comprises a shaft tube pushes the extensions of which respectively comprise an external profile for the angular indexing uuuu ^'tube pushes rod within the guide body so that the seat is always concave profile positioned in the lateral evdemenis dudli guiding body to allow passage of the connecting rod of the osteosynthesis device. The gripping device according to the present invention comprises a push rod having at the extensions an abutment for clamping the gripping device to ensure the coaxlallté main axes of the connector connection with those uuiiii gripping device. The following description with reference to the accompanying drawings, given by way of non-limiting examples _{: will} provide a better understanding of the invention, the characteristics it has and the advantages it is likely to provide: FIGS. 1 and 2 are exploded perspective views illustrating the various elements constituting the gripping device according to the present invention.

Figures 3 and 4 are side views showing in the assembled position the gripping device according to the present invention.

Figures 5A to 5D are side and sectional views showing the guide body of the gripper according to the present invention.

Figures SA. 6C are side views and perspective illustrating the lever of the unlocking means of the gripping device according to the present invention.

Figures 7A and 7B are side views and perspective showing the sleeve with resilient blades of the gripper according to the present invention.

Figures 8A and 8B are side views showing the guide handle of the translation means of the gripper according to the present invention.

Figures 9A and 9B are side views illustrating the tube push rod means of translation of the gripping device according to the present invention. Figures 10A and 10B are perspective views illustrating the establishment of a counter torque device cooperating with the gripping device ensuring tightening of the clamping screw of the osteosynthesis device. Figure 11 is a sectional view showing the introduction of a device for inserting the clamping screw into the gripping device according to the present invention.

Figures 12A-12D are sectional views showing the different steps of the locking chain of the gripping device on a connection connector of a polyaxial pedicle screw of an osteosynthesis device known per se.

13A to 13D are cross-sectional views showing the different steps of the release chain of the gripping device of the connection connector of a polyaxial pedicle screw of a known osteosynthesis device in the floor.

Figure 14 is a detailed sectional view showing the chain of clamping forces of the gripping device on the connection connector of the polyaxial pedicle screw of the osteosynthesis device known per se.

FIGS. 1 to 4 and 1 1 show a gripping device 1 comprising locking means 2 and unlocking means 3 enabling the establishment and the screwing of a clamping screw 101 inside a U-shaped connection connector 102 of a polyaxial or monoaxial pedicle screw 103 for immobilization in transiation and rotation of a connecting rod 104 of a known osteosynthesis device 100 in the floor.

The locking means 2 of the gripping device 1 are intended to bear on the connection connector 102 for a bet ensure the coaxiallté main axes of said gripping device 1 with those of said connection connector 102 and secondly maintain before its immobilization the connecting rod 1 04 inside and near the bottom of the U of the connection connector.

The unlocking means 3 allow, after tightening the clamping screw 101 inside the connecting connector 102 and the locking in rotation and in translation of the connecting rod 104 in the bottom of the U, the unlocking means of locking 2 and the release of the gripping device 1 of the connecting connector 102 of the peddle screw 103 known per se.

The locking means 2 consist of a guide body 4 ensuring the introduction of the gripping device 1 around the connecting connector 102 of the pedal screw 103, a sleeve 5 with elastic blades Sa, 5b and means of transiation 6. FIGS. 5A to 5D show the guiding body 4 of the locking means 2 which has the profile of a longitudinal tube 4a comprising a first end provided with two lateral recesses and opposite 4b _: 4c opening on the outside for the passage of the connecting rod 104 and delimiting two retaining branches 4d, 4® in which are respectively arranged guiding windows 4f, 4g.

Each branch 4d, 4e has on its outer face and in the proiongement of the guide windows 41 4g a flat 4 opening into a groove 41 for guiding the corresponding elastic blade 5§ _: 5b of the sleeve 5 when mounted around every body guide 4.

Each branch 4d, 4e has on its internal face a pin 4 | having a double slope profile for locking and unlatching the corresponding elastic blade 5, 5j of the sleeve 5 when the latter come into contact with the connecting connector 102.

The longitudinal tube 4a comprises opposite the first end a second end comprising in its internal part a thread 4k cooperating with that 7a of a guide handle 7 of the translation means 6.

The longitudinal tube 4g has on its outer face and at its second end a recessed shape 41 for coupling with a handling tool 200 providing a counter torque device during the final tightening of the clamping screw 101 by the Intermediate an introducer 300 (FIGS. 10A, 1 GB and 11).

The longitudinal tube 4a has between its two ends an outer diameter less than that of said ends for receiving the sleeve 5 with elastic blades whose outer diameter is truncated above Tax ensuring the securing of the assembly and the translational guide of said sleeve around the tube.

For this, the longitudinal tube 4a comprises near its first end a circular abutment 4m beveled profile which cooperates with a stop 5e of complementary profile formed between the elastic blades 5a _; 5b of the sleeve 5 (FIGS. 5C, 7A and 7B). ^"

Also, the longitudinal tube 4a has in its reduced portion and opposite to the circular abutment 4m 4i axial openings which are diametrically opposed to allow the reception of internal ribs 5d positioned at the opposite of the elastic blades 5a, 5b and exits truncated profile of the sleeve 5 (Figures 5B, 7A). The longitudinal tube 4a comprises near its imprinted shape 4! a half-circular rib 4g bearing at each end of the pins 4c¾ cooperating respectively with holes 9a arranged at one end of a lever 9 of the unlocking means 3 in order to achieve a pivot connection between said lever and the guide body 4 (Figures 58, 6B and 6C).

FIGS. 7A, 7B show the sleeve 5 with resilient blades comprising, on the external face, ribs 5d of the guide pins 5c which respectively cooperate with an inclined and emergent groove 9b formed in the internal part of the unlocking lever 9 and opposite the holes 9a to transform the rotational movement of the lever lever 9 around the guide body 4 into a translation movement of said sleeve 5 along said guide body.

The unlatching lever 9 comprises a strip cut in the mass and deformed piastically inwardly of said lever to form a raopel spring between the guide body 4 and the unlocking lever 9 (FIGS. 8A and 68).

The sleeve 5 comprises, in the extension of its truncated profile and opposite the guiding axes 5e, the resilient blades 5a, 5b which are each constituted by a flexible part 5f acting in flexion and an internal profile comprising an inclined part. 5a and a lug 5 separated because a reception esoace 51 iflaures 7A. 7B and 1 1).

Each inclined portion 5g allows the spacing of the elastic strips 5a, 5b during the unlocking of the gripping device 1 of the connecting connector 102 of the pedal screw 103 via the lever 9 of the unlocking means 3.

Each lug 5h comprises an oriented bevel 5j and a flattened 5k respectively ensuring the introduction and the translation of the elastic blades 5a and 5b within the blind holes 05 made bet and the other of the connecting connector 102 of the pedicle screw 103 known per se.

FIGS. 8A, 8B and 108 show the guide handle 7 of the translation means 6 which consists of a cylindrical tube 7b pierced right through with an internal bore 7c for the passage and the guiding of a device 300 introducing the clamping screw 101 of the osteosynthesis device 100 known per se.

The cylindrical tube 7b is integral at one of its ends with a gripping head 7d ensuring the surgeon a perfect grip of the translation means 6.

The cylindrical tube 7b is machined on its outer face with a thread 7g double threaded with right-hand pitch to convert the rotational movement into a translation movement when the surgeon acts on the guide handle 7. The cylindrical tube 7b comprises, in the extension of the double threading 7a, a rapid coupling device consisting of elastic strips 7e regularly distributed over the periphery of said tube and of a rotating sleeve housed inside the cylindrical tube 7b and making it possible to carry out the pivot connection with the tube pushes rod 8.

Shown in FIGS. SA and SB, the tube pushes rod 8 with translation means 6 which comprises a first end 8a of cylindrical shape and complementary to that of the coupling device with an elastic blade 7§ and a rotating sleeve to cooperate with the tube cylindrical? h of the guide handle 7.

The tube 8 push rod has a second end 8g consists of two opposite extensions% 8c each having a seat 8d concave profile intended to cooperate with the connecting rod 104 of the osteosynthesis device 100 known in soil to allow the centering of this last inside the link connector 102.

The extensions 81b, 8c of the tube push rod 8 respectively comprise an external profile 8s cooperating with a complementary shape formed inside the guide body for allowing the angular indexing of said tube pushes rod inside the guide body 4.

This angular indexing of said rod push rod 8 with respect to the guide body 4 allows the concave profile seat 8cf to be always positioned in the lateral bulges 4b, 4a or 4 of the guide body 4 to allow the passage of the connecting rod 104 of the osteosynthesis device 100 known in soil.

The tube push rod 8 comprises at the extensions 8b, 8c an abutment 8f coming during the clamping of the gripping device 1 on the pedicle screw 103 to rest on the top of the connecting connector 1 02 to ensure the coaxiality of the main axes said link connector 102 with those àuùi ⁱ gripping device (9A to 1 1). This coaxiality between the main axes of the connection connector 102 and the gripping device 1 makes it possible to correctly position the clamping screw 101 before its introduction and its cooperation with the internal threading 108 of the connection connector 102 (FIG. 11). FUNCTIONING OF LM VETOQM

There is shown in Figures 12A to 12D of the locking channel of the gripping device 1 on ie link connector 102 ^of a pedicle screw 103 known floor. The screw 103 pédieulaire polyaxiaie or monoaxlafe provided with the link connector 102 must first be anchored in the pedicle of a Pv darkness of a spinal segment of a spinal column to be paired by the means ^of: ostéosynfhèse 100 known per se, Also the connecting rod 104 must be presented above the connecting connector 102.

The surgeon presents and approaches the gripping device 1 so that the retaining branches 4d, 4s of the guide body 4 bear against the upper edge of the U-shaped branches of the connection connector 102.

It is noted in this position that the recesses 4b, 4s of the guide body 4 are in the extension of the openings of the U-shaped connector 102 for the passage of the connecting rod 104. The surgeon then apprehends on the gripping device 1 guided along the U-shape of the connecting connector 102. In this manner, the resilient blades 5s, 5b of the sleeve 5 deform around the connecting connector 102 to clip into the blind holes 105 to this connecting connector. The gripping device 1 is then fixed on the connecting connector 102 of the pedal screw 103.

Then, the surgeon actuates the knob 7d of the guide handle 7 in order to move the tube pushes rod 8 relative to the guide body 4 and therefore opposite the connection connector 02 of the pedal screw 1 03. The tube pushes rod S comes into contact with the connecting rod 104 by means of its seats B 1 and pushes it centrally into the lower part of the U-shaped profile of the connecting connector 102 (FIGS. 12C and 12D).

When the tube pushes rod 8 into contact on the top of the connecting connector 102, it is in abutment. The pressure forces between the tube push rod 8 and the top of the connecting connector 102 causes a clearance clearance between the guide body 4 and said connecting connector 102 (Figure 14).

This retraction causes the impossibility for the elastic blades 5a, 5b of the sleeve 5 to move apart because they are blocked by the ends of the retaining arms 4dj, 4e of the guide body 4 (Figure 14).

As soon as the tube pushes rod 8 is in abutment against the top of the connecting connector 102 _: the gripping device 1 is completely fixed and secured dudlt connection connector 102 allowing the main axes dudlt gripping device 1 are eoaxlaux with those dudlt connector link 102. the coaxiaiité principal axes allows correct positioning of the clamping screw 101 through the insertion ^device 300 so that the latter cooperates with the internal thread 106 of link connector 102 (figures 12A to 12D ei 14 ). FIGS. 13A to 130 show its unlocking chain of the gripping device 1 of the connection connector 102 of a cuff screw 103 known per se.

The unlocking of the gripping device 1 of the connection connector 102 requires a release of the pressure generated by said gripping device on said connector in actlonnemeni in the reverse direction as previously the knob 7d of the guide handle 7.

By moving the tube push rod 8 towards the opposite of the connection connector 102, a free play is set up between the guide body 4 and the elastic strips 5a, 5b of the sleeve 5,

By actuating the unlocking lever 9, the elastic sleeve 5 is translated in a direction opposite to the connecting connector 102 causing the elastic blades 5a, 5b of the sleeve 5 to open _; left free by the game that there is between them and the guide body 4.

The opening of the elastic blades 5, 5b of the sleeve 5 is achieved thanks to the two inclined faces 5g arranged on the inner face of said resilient blades which up along the guide body 4, respectively support the flats 4h retaining branches 4d, 4th causing them to deviate from the connection connector 10.2.

When the spacing of the elastic blades 5a, 5b is sufficient the gripping device 1 is detached from the connecting connector 102 allowing its removal.

It must also be understood that the foregoing description has been given by way of example only, and that in no way limits the scope of the invention of which we would not go out by replacing the details of execution described by any other equivalent.

Claims

Gripping device (1) for placing and securing a clamping screw (101) within a U-shaped connection connector (102) of a pedicle screw (103) axial or mono-axial for the immobilization of a connecting rod (104) of an osteosynthesis device (100) known in the soil, characterized in that it comprises:

"Locking means (2) relying on the connecting connector (102) for the one hand to ensure the coaxiallte of the main axes of said gripper (1) with those of said connector connector (102) and d on the other hand to maintain the link rod (104) within said link connector; "And unlocking means (3) of the gripping device (1) after the introduction and screwing of the clamping screw (101) inside the connecting connector (102).

Gripping device (1) according to Claim 1, characterized in that the locking means (2) consist of:

s of a guide body (4) ensuring the establishment of said gripping device (1) around the connecting connector (102) of the pedal screw (103);

s of a sleeve with elastic blades (5) having a truncated profile allowing its assembly around the guide body (4);

"And translation means (6) which consist of a guide handle (7) cooperating on the one hand via a threaded connection with the guide body (4) and on the other hand by the intermediate of a pivot connection with a tube push rod (8) guided inside and with respect to said guide body (4) of said gripping device (1) in order to push the connecting rod (104) to the lower part of the connecting connector (102) and coming to rest on the peripheral upper edge of said connector (102), said translation means (6) making it possible to generate a pressure force between said connection connector (102) and said tube pushes rod (8) causing a displacement of the guide body (4) so that it bears against the resilient blades (Sa, 5b) of said sleeve (5) with a cancellation adapted to block them inside of spaces M 05) arranged in the connection connector (102).

Gripping device (1) according to Claim 1, characterized in that the unlocking means (3) consist of a lever (9) guided in rotation with respect to the guide body (4), which, after loosening, allows the means to be unscrewed. translation (8) _; to exert a translation force on the sleeve with elastic blades (5) in order to move the latter with respect to said guide body (4) driving the spacing of the elastic blades (5a, 5b) and the unlocking of said gripping device ( 1) of the connection connector (102).

4. A gripping device (1) according to claim 2, characterized in that the guiding body (4) is formed of a longitudinal tube (4g) comprising a first end provided with two lateral recesses and opposite (4b, 4c delimiting two holding branches (4d _: 4e) in which are arranged guide windows (41 4g) and a second end comprising an internal thread (4k) cooperating with the external one (7¾) of the guide handle (?) means of translation (6).

5, gripping device (1) according to claims 2 and 4, characterized in that ue the guide body (4) comprises on its outer face and between its two ends retaining means for the establishment and fixing of the sleeve with resilient blades (5) so that the ends of said elastic blades (5a, 5b) open inside the guiding windows (41, 4g) of each retaining branch (4dL 4§).

8. A gripping device (1) according to claims 1 and 3, characterized in that the guiding body (4) comprises at its second end connecting means cooperating with those of the lever (9) unlocking means ( 3) allowing the latter to swing around the body and to exert a translational force on the elastic blade sleeve (5) in order to move the latter with respect to said guide body (4).

7. A gripping device (1) according to claim 1, characterized in that the tube pushes rod (8) translation means (6) comprises a first end (8a) which cooperates with the guide handle (7) and a second end (8g) comprising two opposed extensions (81b, 8c) each having a seat è concave profile (8d) for è cooperate with the connecting rod (104) of the ^{osteosynthesis} device (100) to allow the centering of this last inside the connection connector (102).

8. A gripping device (1) according to claim 7 _: characterized in that the extensions (8b, Se) of the tube push rod (8) respectively comprise an outer profile (8e) for the angular indexing dudlt tube push rod (8) ) inside the guide body (4) so that the concave profile seat (8d) is always positioned in the lateral recesses (4b, 46) of the guide body (4) to allow the passage of the rod link (104) of the osteosynthesis device (100).

S. gripping device according to claim 7, characterized in that the rod push rod (8) comprises at the extensions (8b, 8e) an abutment (8f) for clamping the gripping device (1) to ensure the ooaxiality of the main axes of the connection connector (102) with those of the gripper device (1).