Bone anchors and surgical instruments with integrated guide tips

Patent metadata

Field	Value
Publication number	US-9289249-B2
Application number	US-201414156517-A
Country	US
Kind code	B2
Filing date	Jan 16, 2014
Priority date	Mar 14, 2013
Publication date	Mar 22, 2016
Grant date	Mar 22, 2016

Abstract

Bone anchors and surgical instruments (e.g., bone taps, drivers, etc.) are disclosed herein that include integrated guide tips. Use of these anchors or instruments can eliminate one or more of the steps in a conventional bone anchor installation procedure, improving surgical efficiency and safety. For example, a surgical instrument can include a guide projection configured for insertion through a cannulation formed in a bone anchor when the surgical instrument is coupled to the bone anchor. The surgical instrument can also include various mechanisms for adjusting the position of the guide projection relative to the bone anchor. The guide projection can replace the needle, stylet, and guidewire used in typical insertion procedures. The bone anchor can also include integrated tapping features to eliminate the need for a separate bone tap instrument. Thus, in some embodiments, targeting, tapping, and driving the bone anchor can be performed in a single step.

First claim

What is claimed is:

1. A method of driving a bone anchor assembly into bone, comprising:
forming an incision;
passing a distal tip of a stylus through the incision to position the distal tip of the stylus in proximity to a bone, the stylus being coupled, during said passing, to a driver that is coupled to a bone anchor assembly such that the stylus extends through the driver and through a cannulation of the bone anchor assembly and protrudes from a distal end of the bone anchor assembly;
sliding a collar disposed around an outermost surface of the driver from a first position in which the stylus can translate axially relative to the driver only when the stylus is rotated relative to the driver to a second position in which the stylus is free to translate axially relative to the driver without being rotated relative to the driver;
advancing the distal tip of the stylus into the bone and relative to the bone anchor assembly; and
rotating the driver relative to the bone while holding a handle portion of the stylus at a fixed rotational position relative to the bone such that the stylus is translated axially in a proximal direction relative to the bone anchor assembly as the bone anchor assembly is advanced distally into the bone and such that the stylus is maintained at a fixed rotational and longitudinal position relative to the bone as the bone anchor assembly is advanced distally into the bone.

2. The method of claim 1 , wherein advancing the stylus comprises axially translating the stylus relative to the driver.

3. The method of claim 1 , further comprising rotating the stylus relative to the driver to adjust an axial position of the stylus relative to the bone anchor assembly.

4. The method of claim 1 , wherein advancing the stylus comprises:
impacting a proximal end of the stylus to translate the stylus axially relative to the driver and advance the stylus distally into the bone.

5. The method of claim 4 , wherein sliding the collar comprises moving the collar to a position in which a lock ball retained by the collar in an opening formed in the driver is free to move radially outward from the opening to disengage the stylus.

6. The method of claim 5 , wherein sliding the collar comprises rotating the collar relative to the driver or axially translating the collar relative to the driver.

7. The method of claim 1 , wherein the driver is coupled to the bone anchor assembly by threading an engagement portion of the driver into a corresponding threaded engagement portion of the bone anchor assembly.

8. The method of claim 1 , further comprising adjusting a length of the stylus by pressing a button to disengage the handle portion of the stylus from a guide projection of the stylus, translating the guide projection axially relative to the handle portion, and releasing the button to engage the handle portion with the guide projection.

9. A method of driving a bone anchor assembly, comprising:
forming an incision to access a bone in a patient's spine;
passing a distal tip of a guide projection through the incision to position the distal tip of the guide projection in proximity to the bone, the guide projection being formed on a distal end of a stylus, and the stylus being coupled, during said passing, to a driver such that the distal tip of the guide projection protrudes from a distal end of a bone anchor assembly coupled to the driver and such that a handle portion of the stylus is disposed adjacent to a proximal end of the driver;
sliding a collar disposed around an outermost surface of the driver from a first position in which the stylus can translate axially relative to the driver only when the stylus is rotated relative to the driver to a second position in which the stylus is free to translate axially relative to the driver without being rotated relative to the driver;
advancing the distal tip of the guide projection into the bone and relative to the bone anchor assembly; and
rotating the driver relative to the bone while holding the handle portion of the stylus at a fixed rotational position relative to the bone such that the guide projection is translated axially in a proximal direction relative to the bone anchor assembly as the bone anchor assembly is advanced distally into the bone and such that the guide projection is maintained at a fixed rotational and longitudinal position relative to the bone as the bone anchor assembly is advanced distally into the bone.

10. The method of claim 9 , wherein advancing the guide projection comprises axially translating the stylus relative to the driver.

11. The method of claim 9 , further comprising rotating the stylus relative to the driver to adjust an axial position of the guide projection relative to the bone anchor assembly.

12. The method of claim 9 , further comprising adjusting a length of the stylus by pressing a button to disengage the handle portion of the stylus from the guide projection, translating the guide projection axially relative to the handle portion, and releasing the button to engage the handle portion with the guide projection.

13. A method of driving a bone anchor assembly, comprising:
making an incision to access a bone;
inserting a stylus having a guide projection formed on a distal end thereof through a driver such that a distal tip of the guide projection protrudes from a distal end of the driver;
coupling a bone anchor assembly to the distal end of the driver such that the distal tip of the guide projection protrudes from a distal end of the bone anchor assembly;
after said inserting and said coupling, passing the distal tip of the guide projection through the incision to position the distal tip of the guide projection in proximity to the bone;
sliding a collar disposed around an outermost surface of the driver from a first position in which the stylus can translate axially relative to the driver only when the stylus is rotated relative to the driver to a second position in which the stylus is free to translate axially relative to the driver without being rotated relative to the driver;
advancing the distal tip of the guide projection into the bone and relative to the bone anchor assembly; and
rotating the driver relative to the bone while holding a handle portion of the stylus at a fixed rotational position relative to the bone such that the guide projection is translated axially in a proximal direction relative to the bone anchor assembly as the bone anchor assembly is advanced distally into the bone and such that the guide projection is maintained at a fixed rotational and longitudinal position relative to the bone as the bone anchor assembly is advanced distally into the bone.

14. The method of claim 13 , wherein advancing the guide projection comprises axially translating the stylus relative to the driver.

15. The method of claim 13 , further comprising rotating the stylus relative to the driver to adjust an axial position of the guide projection relative to the bone anchor assembly.

Assignees

• Depuy Synthes Products Inc

Inventors

• Ramsay Christopher
• Divincenzo John
• Pavento Nicholas

Classifications

• A61B17/1655

  for tapping · CPC title

• A61B17/7092

  for checking pedicle hole has correct depth or has an intact wall (pedicle drill depth limiters A61B17/1626) · CPC title

• A61B17/7037

  wherein pivoting is blocked when the rod is clamped · CPC title

• A61B17/8897

  Guide wires or guide pins · CPC title

• A61B2090/061

  for measuring dimensions, e.g. length · CPC title