Methods for percutaneously extending an existing spinal construct

Patent metadata

Field	Value
Publication number	US-10016227-B2
Application number	US-201715581865-A
Country	US
Kind code	B2
Filing date	Apr 28, 2017
Priority date	Dec 8, 2011
Publication date	Jul 10, 2018
Grant date	Jul 10, 2018

Abstract

Apparatus and devices for percutaneously extending an existing spinal construct ipsilaterally with an additional spinal construct in a patient are disclosed. The additional spinal construct comprises a rod connector that includes an elongate additional rod integrally attached thereto. The additional rod is placed through an access port in a first orientation generally parallel to the longitudinal axis of the access port and rotated to a different second orientation generally transverse to the longitudinal axis of the access port. During such rotation the additional rod is moved subcutaneously beneath the skin of the patient from the existing spinal rod to an additional bone engaging implant. In another arrangement, the extension of an existing spinal construct in a minimally invasive procedure comprises a rod connector having an offset support for receiving an additional spinal rod that may be placed laterally interiorly or exteriorly of the existing spinal construct.

First claim

What is claimed is:

1. A method of percutaneously attaching an additional rod to an existing spinal construct implanted in a patient having at least two bone engaging implants engaged to corresponding spinal segments and interconnected by an existing spinal rod, comprising the steps of:
making a first incision through the skin of a patient to access a third bony segment;
percutaneously introducing a third bone engaging implant through said first incision and attaching said third bone engaging implant to said third bony segment;
making a second separate incision through the skin of said patient;
accessing through said second separate incision only a section of said existing spinal rod between two bone engaging implants;
percutaneously introducing a rod connector through said second incision, said rod connector including a first portion defining an axis and having a rod receiving opening for receipt of said section of said existing spinal rod, and a second portion having an opening therethrough and attached to said first portion, said second portion including an elongate additional rod having a free distal end projecting therefrom;
subcutaneously moving said elongate additional rod between said first incision and said second incision while moving said first portion of said rod connector adjacent to said section of said existing spinal rod.

2. The method of claim 1 , wherein said step of accessing only said section of said existing rod includes the step of targeting the existing spinal rod to establish the position of said existing rod in said patient using a targeting rod with imaging techniques to determine the position of said existing spinal.

3. The method of claim 2 , wherein said section of said existing spinal rod comprises an interconnecting portion between two bone engaging implants, and wherein said targeting step includes targeting said interconnecting portion.

4. The method of claim 3 , wherein said accessing step includes the step of placing said targeting rod through said second incision and extending said targeting rod down to said interconnecting portion.

5. The method of claim 4 , further including the step of expanding said second incision by placing over said targeting rod a series of sequentially increasing dilating instruments.

6. The method of claim 5 , including the step of placing an elongate access port over the last placed dilating instrument, the access port having a distal end and a proximal end and a length extending therebetween, said access port defining a lumen extending therethrough, the distal end being placed adjacent said interconnecting portion of said existing spinal rod with said proximal end projecting outwardly from the skin of said patient.

7. The method of claim 6 , wherein said step of percutaneously introducing said rod connector includes inserting said rod connector through said access port and engaging said first portion of said rod connector with said interconnecting portion.

8. The method of claim 1 , wherein said first portion has in communication with said rod receiving opening a rod engagement member rotatable relative to said second portion for engagement with said section of said existing spinal rod.

9. The method of claim 1 , wherein said free distal end of said additional rod of said rod connector is inserted into said second incision prior to said first portion in a first angular orientation relative to said existing spinal rod until below the skin of said patient and moved subcutaneously to a different second orientation below the skin.

10. The method of claim 9 , wherein said additional rod is moved to said second orientation by rotating said rod connector relative to and toward said existing rod.

11. The method of claim 10 , wherein said rod connector is percutaneously introduced in a top-loading procedure without disturbing said existing spinal construct.

12. A method of percutaneously attaching an additional rod to an existing spinal construct implanted in a patient having at least two bone engaging implants engaged to corresponding spinal segments and interconnected by an existing spinal rod, comprising the steps of:
providing a rod connector comprising a first portion and a second portion, said first portion defining a rod receiving opening for receiving said existing spinal rod, said second portion including a connecting portion defining an elongate additional rod projecting therefrom and terminating in a free distal end;
making an incision through the skin of said patient to access only a section of said existing spinal rod between two bone engaging implants;
introducing said rod connector into said incision in a first orientation until the free distal end of said additional rod extends below the skin of said patient;
moving said rod connector to a second orientation during which movement said free distal end of said additional rod is moved subcutaneously below the skin of said patient and said rod receiving opening of said first portion is placed onto said section of said existing spinal rod; and
securing said rod connector to said section of said existing spinal rod.

13. The method of claim 12 , wherein said second portion is attached to said first portion in a first unlocked position in which said second portion is rotatable relative to said first portion, and in a second locked position in which said second portion is fixed relative to said first portion.

14. The method of claim 13 , wherein said second portion is locked to said first portion in said second locked position in a single operation with the securement of said rod connector to said section of said existing spinal rod.

15. The method of claim 14 , further including the steps of:
making another incision through the skin of said patient separate from said incision; and
percutaneously engaging an additional bone engaging implant to an additional bony segment.

16. The method of claim 15 , wherein said additional implant has a slot, and wherein the distal free end of said additional rod is moved subcutaneously through said tissue of said patient and into the slot of said additional implant.

17. A method of percutaneously extending an existing spinal construct implanted in a patient having at least two bone engaging implants engaged to corresponding spinal segments and interconnected ipsilaterally by an existing spinal rod, comprising the steps of:
providing a rod connector comprising a first portion, a second portion, and an additional rod projecting from and integral with said second portion, said additional rod terminating in distal free end;
percutaneously creating an access path to only a section of said existing spinal rod;
attaching said first portion of said rod connector to said section of said existing spinal rod through said access path;
percutaneously engaging an additional bone engaging implant to an additional bony segment through a path separate from said access path;
subcutaneously placing said additional rod between said section of said existing spinal rod and said additional implant;
securing said free distal end of said additional rod to said additional implant through said separate access path; and
securing said first portion of said rod connector to said section of said existing spinal rod through said access path.

18. The method of claim 17 , wherein said second portion of said rod connector has an opening therethrough.

19. The method of claim 18 , wherein said second portion is attached to said first portion in a first unlocked position in which said second portion rotates relati

Assignees

• Spine Wave Inc

Inventors

• Mclean Scott
• Adamson Tim E

Classifications

• A61B17/705

  for linking adjacent ends of longitudinal elements · CPC title

• A61B17/708

  with tubular extensions coaxially mounted on the bone anchors · CPC title

• A61B17/7032

  Screws or hooks with U-shaped head or back through which longitudinal rods pass · CPC title

• A61B17/7011

  Longitudinal element being non-straight, e.g. curved, angled or branched (adjustable length longitudinal elements A61B17/7014; A61B17/7019 takes precedence, e.g. coil springs) · CPC title

• A61B17/0218

  for minimally invasive surgery (A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence) · CPC title