Minimally invasive spinal fixation system including vertebral alignment features

Patent metadata

Field	Value
Publication number	US-2016199100-A1
Application number	US-201615077358-A
Country	US
Kind code	A1
Filing date	Mar 22, 2016
Priority date	May 27, 2011
Publication date	Jul 14, 2016
Grant date	—

Abstract

A bone anchor coupler assembly is configured to couple a bone anchor to a spine stabilization member, and includes a coupler body and an angular adjustment member movably coupled to the coupler body.

First claim

1 .- 10 . (canceled)

11 . A minimally invasive method of adjusting a spatial relation between a first vertebra and a second vertebra of a patient, the method comprising:
making a first percutaneous incision in a body of the patient over the first vertebra to provide a first percutaneous access to the first vertebra; advancing a first bone screw through the first percutaneous incision and toward the first vertebra until a first anchor portion of the first bone screw is attached to the first vertebra and a first shaft portion of the first bone screw extends beyond an outer skin of the patient so as to allow external manipulation of the first bone screw; making a second percutaneous incision in the body of the patient over the second vertebra to provide a second percutaneous access to the second vertebra, the second percutaneous incision is spaced from the first percutaneous incision; advancing a second bone screw through the second percutaneous incision and toward the second vertebra until a second anchor portion of the second bone screw is attached to the second vertebra and a second shaft portion of the second bone screw extends beyond the outer skin of the patient so as to allow external manipulation of the second bone screw; and moving a part of the first shaft portion that is located outside the body of the patient with respect to the second bone screw to move the first vertebra relative to the second vertebra.

12 . The method of claim 11 , further comprising advancing a bone anchor coupler assembly through the first percutaneous incision and coupling the bone anchor coupler assembly to the first bone screw.

13 . The method of claim 12 , wherein the bone anchor coupler assembly is coupled to a coupler holder during the steps of advancing the bone anchor coupler assembly through the first percutaneous incision and coupling the bone anchor coupler assembly to the first bone screw.

14 . The method of claim 12 , wherein the bone anchor coupler assembly includes a coupler defining a first coupler opening and a second coupler opening spaced from the first coupler opening.

15 . The method of claim 14 , wherein the step of coupling the bone anchor coupler assembly to the first bone screw comprises disposing the first shaft portion in the first coupler opening.

16 . The method of claim 14 , further comprising:
advancing a spine stabilization rod through the first percutaneous incision and toward the first vertebra; and inserting the spine stabilization rod within the second coupler opening so as to couple the spine stabilization rod to the coupler, the coupler coupling the spine stabilization rod to the first bone screw; and coupling the spine stabilization rod to the second bone screw.

17 . The method of claim 16 , wherein the step of advancing the spine stabilization rod includes holding the spine stabilization rod with a rod holder and advancing at least a portion of the rod holder through the first percutaneous incision and toward the first vertebra.

18 . The method of claim 16 , further comprising, after inserting the spine stabilization rod in the second coupler opening, inserting a locking cap in the second coupler opening so at to lock the spine stabilization rod to the coupler.

19 . The method of claim 18 , further comprising, prior to inserting the locking cap in the second coupler opening, advancing a fastener guide to the second coupler opening, the fastener guide carrying the locking cap.

20 . The method of claim 19 , further comprising:
advancing a driver through the fastener guide; engaging the locking cap with the driver; and turning the driver so as to tighten the locking cap within the second coupler opening.

21 . The method of claim 11 , wherein the first percutaneous incision defines a first incision end, a second incision end that is spaced from the first incision end in a cranial direction, and an incision length that extends from the first incision end to the second incision end, and the incision length ranges between about 20 millimeters and about 25 millimeters.

22 . The method of claim 11 , further comprising advancing a guidewire through the first percutaneous incision and toward the first vertebra until a portion of the guidewire is coupled to the first vertebra.

23 . The method of claim 22 , further comprising advancing a dilator over the guidewire and toward the first vertebra to dilate subcutaneous tissue that is between the outer skin and the first vertebra.

24 . The method of claim 22 , wherein the step of advancing the first bone screw includes advancing the first bone screw over the guidewire.

25 . The method of claim 22 , further comprising:
perforating a cortex of a first vertebra at a first location of the first vertebra; forming a first screw channel at the first location, wherein the step of advancing the guidewire further comprises advancing the guidewire into the first screw channel until the portion of the guidewire is coupled to the first vertebra within the first channel; perforating a cortex of the second vertebra at a second location of the second vertebra; forming a second screw channel at the second location; advancing a second guidewire through the second percutaneous incision and into the second screw channel until a portion of the second guidewire is coupled to the second vertebra within the second channel.

26 . The method of claim 25 , wherein the perforating and forming steps are each performed with one or more awls.

27 . The method of claim 25 , wherein the first location is at a pedicle of the first vertebra, and the second location is at a pedicle of the second vertebra.

28 . The method of claim 25 , wherein the step of advancing the second bone screw includes advancing the second bone screw over the second guidewire.

29 . The method of claim 11 , further comprising measuring a distance from the first bone screw to the second bone screw, wherein the measuring step includes placing a rod length indicator between portions of the first and second bone screws that are located outside the body of the patient.

30 . The method of claim 11 , further comprising trimming the first bone screw so that the first bone screw does not extend pass the outer skin of the patient, wherein the trimming step includes advancing at least a portion of a bolt cutter through the first percutaneous incision, coupling the bolt cutter to the first bone screw, and actuating the bolt cutter to trim the first bone screw.

Assignees

• Depuy Synthes Products Inc

Inventors

• Amstutz Yann
• Gonzalez Didier
• Guetlin Michael

Classifications

• A61B17/7002 Primary

  Longitudinal elements, e.g. rods · CPC title

• A61B2560/0443

  Modular apparatus · CPC title

• A61B17/7082

  for driving, i.e. rotating, screws or screw parts specially adapted for spinal fixation, e.g. for driving polyaxial or tulip-headed screws · CPC title

• A61B17/863

  with thread interrupted or changing its form along shank, other than constant taper · CPC title

• A61B17/7041 Primary

  with single longitudinal rod offset laterally from single row of screws or hooks (A61B17/7044 takes precedence) · CPC title