Methods for implanting a bone screw

Patent metadata

Field	Value
Publication number	US-2016331418-A1
Application number	US-201514709425-A
Country	US
Kind code	A1
Filing date	May 11, 2015
Priority date	May 11, 2015
Publication date	Nov 17, 2016
Grant date	—

Abstract

A method for implanting a bone screw in a vertebra may first involve inserting the bone screw and a bone screw delivery mechanism through a proximal end of a guide tube along a first trajectory. A proximal end of the bone screw is attached to a distal end of the bone screw delivery mechanism, and a distal end of the guide tube is positioned adjacent the vertebra. The method may next involve advancing the bone screw and the bone screw delivery mechanism through a bend in the guide tube to cause the bone screw to exit the distal end of the guide tube along a second trajectory and contact the vertebra. The method may further involve rotating the delivery mechanism to cause the bone screw to screw into the vertebra and detaching the bone screw delivery mechanism from the bone screw.

First claim

What is claimed is:

1 . A method for implanting a bone screw in a vertebra, the method comprising:
inserting the bone screw and a bone screw delivery mechanism through a proximal end of a guide tube along a first trajectory, wherein a proximal end of the bone screw is attached to a distal end of the bone screw delivery mechanism, and wherein a distal end of the guide tube is positioned adjacent the vertebra; advancing the bone screw and the bone screw delivery mechanism through a bend in the guide tube to cause the bone screw to exit the distal end of the guide tube along a second trajectory and contact the vertebra; rotating the delivery mechanism to cause the bone screw to screw into the vertebra; and detaching the bone screw delivery mechanism from the bone screw.

2 . The method of claim 1 , wherein advancing the bone screw delivery mechanism comprises advancing the bone screw delivery mechanism in a straight direction along the first trajectory, and wherein the bend in the guide tube automatically adjusts a path of travel of the bone screw delivery mechanism from the first trajectory to the second trajectory.

3 . The method of claim 1 , wherein detaching the bone screw delivery mechanism from the bone screw comprises breaking the bone screw delivery mechanism off of the bone screw at a breakable junction.

4 . The method of claim 3 , wherein breaking the bone screw delivery mechanism off of the bone screw comprises screwing the bone screw into the vertebra until a break in the junction occurs.

5 . The method of claim 3 , wherein breaking the bone screw delivery mechanism off of the bone screw comprises applying force to the bone screw delivery mechanism until a break in the junction occurs.

6 . The method of claim 1 , wherein the bone screw and the bone screw delivery mechanism comprise a one-piece device with a breakable section between the bone screw and the bone screw delivery mechanism, and wherein detaching the bone screw delivery mechanism from the bone screw comprises breaking the bone screw delivery mechanism off of the bone screw at the breakable section.

7 . The method of claim 1 , wherein the first trajectory extends along a longitudinal axis of the guide tube, and wherein the second trajectory is angled between 15 and 55 degrees relative to the longitudinal axis.

8 . The method of claim 1 , further comprising advancing the guide tube into the patient to position the distal end of the guide tube adjacent the vertebra.

9 . The method of claim 8 , wherein advancing the guide tube comprises advancing it through a larger guide tube previously placed in the patient proximate the vertebra.

10 . The method of claim 1 , wherein the advancing step comprises advancing the bone screw through an opening in a facet joint implant located in a facet joint formed by the vertebra and an adjacent vertebra.

11 . The method of claim 10 , further comprising, prior to the inserting step:
advancing a larger guide tube into the patient from a posterior approach, to position a distal end of the larger guide tube in the facet joint; implanting the facet joint implant in the facet joint through the larger guide tube; and positioning the guide tube in a desired position for advancing the bone screw through the facet joint implant.

12 . The method of claim 1 , wherein, when the bone screw is engaged with the vertebra and the flexible region is flexed, a load is concentrated at a breakable junction.

13 . The method of claim 12 , wherein the bone screw delivery mechanism detaches from the bone screw upon the breakable junction experiencing a predetermined load.

14 . A method for implanting a bone screw through a facet joint implant to attach to a vertebra, the method comprising:
advancing a guide tube into the patient to position a distal end of the guide tube adjacent the facet joint; inserting a distal end of a bone screw device through the guide tube along a first trajectory; advancing the bone screw device through a bend in the guide tube to cause a distal bone screw portion of the bone screw device to exit the distal end of the guide tube along a second trajectory and advance through an opening in the facet implant at an angle; rotating the bone screw device to cause the distal bone screw portion to screw into the vertebra to secure the facet joint implant to the vertebra; and breaking a proximal elongate shaft portion of the bone screw device off of the distal bone screw portion at a breakable junction between the two portions.

15 . The method of claim 14 , wherein advancing the bone screw device comprises advancing the bone screw device in a straight direction along the first trajectory, and wherein the bend in the guide tube automatically adjusts a path of travel of the bone screw device from the first trajectory to the second trajectory.

16 . The method of claim 14 , wherein breaking the proximal elongate shaft portion off of the distal bone screw portion comprises screwing the distal bone screw portion into the vertebra until a break in the breakable junction occurs.

17 . The method of claim 14 , wherein breaking the proximal elongate shaft portion off of the distal bone screw portion comprises applying force to the proximal elongate shaft portion until a break in the breakable junction occurs.

18 . The method of claim 14 , wherein the proximal elongate shaft portion and the distal bone screw portion comprise a one-piece device with the breakable junction between them.

19 . A method for implanting a bone screw in a vertebra at or immediately adjacent a spinal joint implant disposed in a spinal joint formed by the vertebra and an adjacent vertebra, the method comprising:
inserting a bone screw delivery mechanism through a proximal end of a guide tube along a first trajectory, wherein a distal end of the bone screw delivery mechanism is attached to a proximal end of the bone screw, and wherein a distal end of the guide tube is positioned proximate the spinal implant; advancing the bone screw delivery mechanism through one or more bends in the guide tube to cause the bone screw to exit the distal end of the guide tube along a second trajectory and contact the vertebra; rotating the delivery mechanism to cause the bone screw to screw into the vertebra to help secure the spinal joint implant within the spinal joint; and separating the bone screw delivery mechanism from the bone screw.

20 . The method of claim 19 , wherein advancing the bone screw delivery mechanism comprises advancing the bone screw through an opening in the spinal joint implant to contact the vertebra.

21 . The method of claim 20 , wherein the spinal joint comprises a facet joint, and wherein the spinal joint implant comprises a facet joint implant.

22 . The method of claim 19 , wherein the spinal joint comprises a facet joint, wherein the spinal joint implant comprises a facet joint implant, and wherein advancing the bone screw delivery mechanism comprises advancing the bone screw into the vertebra immediately posterior to a posterior end of the facet joint implant, to help prevent the facet joint implant from backing out of the facet joint.

23 . The method of claim 19 , wherein separating the bone screw delivery mechanism from the bone screw comprises separating the bone screw delivery mechanism off of the bone screw at a junction.

24 . The method of claim 23 , wherein separating the bone screw delivery mechanism off of th

Assignees

• Providence Medical Tech Inc

Inventors

• Tanaka Shigeru
• Smith Jeffrey D
• Phan Christopher U
• Liou Edward

Classifications

• A61F2/30749

  Fixation appliances for connecting prostheses to the body · CPC title

• A61B17/8875 Primary

  Screwdrivers, spanners or wrenches · CPC title

• A61B17/7082 Primary

  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

• A61F2/4603

  for insertion or extraction of endoprosthetic joints or of accessories thereof · CPC title

• A61F2002/30558

  Force-limiting means · CPC title