CA2349544A1 - Anterior cervical plate and fixation system - Google Patents
Anterior cervical plate and fixation system Download PDFInfo
- Publication number
- CA2349544A1 CA2349544A1 CA002349544A CA2349544A CA2349544A1 CA 2349544 A1 CA2349544 A1 CA 2349544A1 CA 002349544 A CA002349544 A CA 002349544A CA 2349544 A CA2349544 A CA 2349544A CA 2349544 A1 CA2349544 A1 CA 2349544A1
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- Prior art keywords
- head
- fastener
- aperture
- structural member
- surface region
- Prior art date
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- Abandoned
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- 239000000463 material Substances 0.000 claims abstract description 32
- 210000000988 bone and bone Anatomy 0.000 claims description 17
- 238000003780 insertion Methods 0.000 claims description 5
- 230000037431 insertion Effects 0.000 claims description 5
- 230000035515 penetration Effects 0.000 claims description 5
- RTAQQCXQSZGOHL-UHFFFAOYSA-N Titanium Chemical compound [Ti] RTAQQCXQSZGOHL-UHFFFAOYSA-N 0.000 description 4
- 229910052719 titanium Inorganic materials 0.000 description 4
- 239000010936 titanium Substances 0.000 description 4
- 238000013459 approach Methods 0.000 description 3
- 230000002452 interceptive effect Effects 0.000 description 3
- 238000000034 method Methods 0.000 description 3
- 230000035939 shock Effects 0.000 description 3
- 208000020307 Spinal disease Diseases 0.000 description 2
- 230000008901 benefit Effects 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 230000005489 elastic deformation Effects 0.000 description 2
- 230000006355 external stress Effects 0.000 description 2
- 238000003698 laser cutting Methods 0.000 description 2
- 238000003754 machining Methods 0.000 description 2
- 230000002093 peripheral effect Effects 0.000 description 2
- 238000010079 rubber tapping Methods 0.000 description 2
- 238000005452 bending Methods 0.000 description 1
- 230000009194 climbing Effects 0.000 description 1
- 238000010276 construction Methods 0.000 description 1
- 238000005553 drilling Methods 0.000 description 1
- 230000002349 favourable effect Effects 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 238000009434 installation Methods 0.000 description 1
- 230000000717 retained effect Effects 0.000 description 1
- 210000004872 soft tissue Anatomy 0.000 description 1
- 229910001220 stainless steel Inorganic materials 0.000 description 1
- 230000008733 trauma Effects 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7059—Cortical plates
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8875—Screwdrivers, spanners or wrenches
- A61B17/8886—Screwdrivers, spanners or wrenches holding the screw head
- A61B17/8891—Screwdrivers, spanners or wrenches holding the screw head at its periphery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/8033—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers
- A61B17/8042—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers the additional component being a cover over the screw head
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/8052—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
- A61B17/8605—Heads, i.e. proximal ends projecting from bone
- A61B17/861—Heads, i.e. proximal ends projecting from bone specially shaped for gripping driver
- A61B17/862—Heads, i.e. proximal ends projecting from bone specially shaped for gripping driver at the periphery of the screw head
Abstract
An anterior cervical plate (22) is disclosed, along with threaded fasteners (24a-24d) for securing the plate to vertebrae (18, 20) or other osseous material. The cervical plate (22) has several pockets or apertures (30a-30d), preferably at least four, to receive a corresponding number of the fasteners (24a-24d). The pockets have spherical surfaces (34), and the fasteners have heads with similarly sized spherical surfaces (48), which when engaged permit each of the fasteners to be oriented at a variety of projection angles with respect to the plate (22). In connection with each pocket (30a-30d), the cervical plate (22) incorporates a fastener retaining feature (40). The feature can take the form of a cantilevered tab or a beam supported at its opposite ends, in each case plastically deformable between an open position for admitting the fastener and a closed position for preventing retraction.
Description
ANTERIOR CERVICAL PLATE AND FIXATION SYSTEM
This application claims the benefit of provisional application serial number 60/085,962 entitled "Anterior Cervical Plate Fixation" filed May 19, 1998, and provisional application number 60/105, 976 entitled "Anterior Cervical PIate With Fastener Retaining Tabs" filed October 28, 1998, which disclosures are incorporated herein.
Background of the Invention.
The present invention relates to cervical plates used for fusing cervical vertebrae in the treatment of spinal disorders, and more particularly to components for fastening such plates.
An increasingly accepted procedure for treating spinal disorders involves using substantially rigid plates to hold vertebrae in desired spatial relationships and orientations relative to each other. The upper cervical spine can be approached anteriorly or posteriorly, although anterior approaches are of more interest in connection with this invention. In either case, holes are drilled and tapped in at least two of the vertebrae, to receive screws or other fasteners used to secure the plate. The holes are accurately positioned with reference to openings formed through the cervical plate. In some cases the screws may be self tapping.
Typically the plate is curved about its longitudinal axis to facilitate contiguous surface engagement of the plates with the vertebrae. With the plate maintained against the vertebrae, the fasteners are secure within the holes. As a result, the plate maintains the attached vertebrae in a desired spacing and orientation with respect to each other.
One of the problems associated with this technique is the tendency of screws or other fasteners to gradually work loose after fixation. Slight shock or vibration of the vertebrae, due to walking, climbing stairs or more vigorous activity by the patient following treatment increases this tendency, j eopardizing the integrity of fixation. Moreover, as the fasteners work loose, the outward protrusion of the heads over other components of the fasteners can be a source of discomfort and present the risk of trauma to adjacent and surrounding soft tissue.
The curvature of cervical plates typically results in a convergence of fasteners that extend through spaced apart openings in the plate, particularly when each screw is perpendicular to the region of the plate surrounding it. Screws sufficiently short to avoid interfering with one another may not be long enough to assure a secure plate fixation.
Further, the physician may encounter difficulties in positioning the plate if one of the vertebrae, due to a particular shape and orientation, cannot readily retain a perpendicularly inserted fastener.
There have been attempts to solve the above problems. For example, screws or other fasteners can be provided with somewhat rounded heads as shown in U.S. Patent No. 5,324,290 (Zdeblick). U.S. Patent No. 5,261,910 (Warden, et al.} shows a nut with a rounded upper surface and a hexagonal recess. The nut has a conical portion that fits into a similarly shaped recess in a plate, thus to reduce the height at which the nut extends above the plate. U.S. Patent No. 5,364,339 (Lowery, et al.) discloses an anterior cervical plate system in which the openings through the plate guide the screws in a non-perpendicular orientation that causes the screws to diverge, rather than converge, as they proceed into the particular cervical vertebra. The plate has a recess for limiting the degree of outward protrusion of the screw heads. After each pair of screws is fully inserted, a locking screw is threaded into the plate until its head encounters the heads of the bone screws.
While the above approaches yield favorable results in certain circumstances, there remains a need for greater flexibility in positioning and orienting the bone screws or fasteners, and for a simpler, more reliable means of counteracting the tendency of the bone screws to work loose after cervical plate f xation.
Therefore, it is an object of the present invention to provide a cervical plate and fixation system in which bone screws or other fasteners are more securely retained and less likely to work loose, without the need for auxiliary screws or other additional fixtures.
Another object is to provide a fastening system in which the heads of the fasteners are recessed within the cervical plate to minimize their protrusion beyond the plate.
A further object is to provide fastener receiving apertures in cervical plates that are shaped to allow a variety of angular orientations of the fasteners with respect to the plate.
Yet another object is to provide a system including cervical plates with locking features for retaining fastener heads, in combination with tools for conveniently manipulating the locking features to selectively retain or release the fasteners.
This application claims the benefit of provisional application serial number 60/085,962 entitled "Anterior Cervical Plate Fixation" filed May 19, 1998, and provisional application number 60/105, 976 entitled "Anterior Cervical PIate With Fastener Retaining Tabs" filed October 28, 1998, which disclosures are incorporated herein.
Background of the Invention.
The present invention relates to cervical plates used for fusing cervical vertebrae in the treatment of spinal disorders, and more particularly to components for fastening such plates.
An increasingly accepted procedure for treating spinal disorders involves using substantially rigid plates to hold vertebrae in desired spatial relationships and orientations relative to each other. The upper cervical spine can be approached anteriorly or posteriorly, although anterior approaches are of more interest in connection with this invention. In either case, holes are drilled and tapped in at least two of the vertebrae, to receive screws or other fasteners used to secure the plate. The holes are accurately positioned with reference to openings formed through the cervical plate. In some cases the screws may be self tapping.
Typically the plate is curved about its longitudinal axis to facilitate contiguous surface engagement of the plates with the vertebrae. With the plate maintained against the vertebrae, the fasteners are secure within the holes. As a result, the plate maintains the attached vertebrae in a desired spacing and orientation with respect to each other.
One of the problems associated with this technique is the tendency of screws or other fasteners to gradually work loose after fixation. Slight shock or vibration of the vertebrae, due to walking, climbing stairs or more vigorous activity by the patient following treatment increases this tendency, j eopardizing the integrity of fixation. Moreover, as the fasteners work loose, the outward protrusion of the heads over other components of the fasteners can be a source of discomfort and present the risk of trauma to adjacent and surrounding soft tissue.
The curvature of cervical plates typically results in a convergence of fasteners that extend through spaced apart openings in the plate, particularly when each screw is perpendicular to the region of the plate surrounding it. Screws sufficiently short to avoid interfering with one another may not be long enough to assure a secure plate fixation.
Further, the physician may encounter difficulties in positioning the plate if one of the vertebrae, due to a particular shape and orientation, cannot readily retain a perpendicularly inserted fastener.
There have been attempts to solve the above problems. For example, screws or other fasteners can be provided with somewhat rounded heads as shown in U.S. Patent No. 5,324,290 (Zdeblick). U.S. Patent No. 5,261,910 (Warden, et al.} shows a nut with a rounded upper surface and a hexagonal recess. The nut has a conical portion that fits into a similarly shaped recess in a plate, thus to reduce the height at which the nut extends above the plate. U.S. Patent No. 5,364,339 (Lowery, et al.) discloses an anterior cervical plate system in which the openings through the plate guide the screws in a non-perpendicular orientation that causes the screws to diverge, rather than converge, as they proceed into the particular cervical vertebra. The plate has a recess for limiting the degree of outward protrusion of the screw heads. After each pair of screws is fully inserted, a locking screw is threaded into the plate until its head encounters the heads of the bone screws.
While the above approaches yield favorable results in certain circumstances, there remains a need for greater flexibility in positioning and orienting the bone screws or fasteners, and for a simpler, more reliable means of counteracting the tendency of the bone screws to work loose after cervical plate f xation.
Therefore, it is an object of the present invention to provide a cervical plate and fixation system in which bone screws or other fasteners are more securely retained and less likely to work loose, without the need for auxiliary screws or other additional fixtures.
Another object is to provide a fastening system in which the heads of the fasteners are recessed within the cervical plate to minimize their protrusion beyond the plate.
A further object is to provide fastener receiving apertures in cervical plates that are shaped to allow a variety of angular orientations of the fasteners with respect to the plate.
Yet another object is to provide a system including cervical plates with locking features for retaining fastener heads, in combination with tools for conveniently manipulating the locking features to selectively retain or release the fasteners.
2 WO 00/24325 PCTlUS99/25278 Summary of the Invention.
To achieve these and other objects, there is provided an appliance attachable to osseous or bony material within a body. The appliance includes a biocompatible structural member having an exterior surface including opposite first and second exterior surface regions. An interior surface region between the exterior surface regions defines an aperture through the structural member. A biocompatible fastener is provided, including an elongate longitudinal shank and a head larger in diameter than the shank. The shank is adapted for an insertion through the aperture and a penetration into osseous material to a depth sufficient to bring the first exterior surface region into a surface engagement with the osseous material while the head engages the interior surface region. Thus, the head tends to maintain the surface engagement to fix the structural member substantially integrally to the osseous material. A retaining element is permanently fixed to the structural member.
The retaining element is moveable from an open position for allowing travel of the head into the aperture and against the interior surface region, to a closed position for maintaining the head against the interior surface region.
Preferably the retaining element is resilient and ductile, and moveable from the open position to the closed position by applying an external force above the elastic limit of the retaining element. The retaining element can be a tab supported in cantilevered fashion, or alternatively an elongate member attached at two opposite ends to the structural member. As another alternative, the retaining element can be elastic, normally (when not subject to external stresses) tending to assume to the closed position, and elastically deformable into the open position when subject to an external force.
The fastener head, when maintained in the aperture against the interior surface region, is advantageously contained between the first and second exterior surface regions, so that the head does not protrude outwardly beyond the plate or other structural member.
According to another aspect of the invention, the aperture is sized with respect to the shank to allow a pivoting of the fastener with respect to the structural member about at least one transverse axis. More preferably, the fastener is pivotable about all transverse axes passing through a given point in the first aperture, thereby defining a conical volume within which the fastener is selectively positionable.
WO 00/24325 PCT/US99/2527$
The appliance preferably includes a second fastener substantially identical to the first fastener, and a second aperture through the structural member for receiving a head of the second fastener when a shank thereof is inserted through the second aperture.
Then, for example, when the osseous material comprises two vertebrae, the structural member is positioned for extension of the first and second fasteners through their respective apertures into different ones of the vertebrae. Thus the fasteners cooperate with the structural member to support the vertebrae substantially integrally with respect to one another.
A system including the structural member and fasteners can further include tools for securing and removing the structural member, particularly in conjunction with resilient and ductile retaining elements. In particular, heads of the fasteners can include non-circular recesses, and a drive tool with a drive shaft can be provided, one end of the shaft having a non-circular profile corresponding to the profile of the recess. The fastener shanks, in this approach, are externally threaded, with a drive tool rotatable to turn the fasteners. The drive tool further can incorporate a sleeve coaxial with the drive shaft and incorporating flexure members to grip the fastener being turned by the drive tool.
Preferably, locking and releasing tools also are provided. The locking tool can include a shaft with a locking end positionable against the retaining element and movable to plastically deform the retaining element, moving the element into the closed position. The releasing tool has a releasing end positionable against the retaining element when the same is in the closed position. The releasing end is movable to force the retaining element into the open position to allow a withdrawal of the associated fastener.
Thus in accordance with the present invention, cervical plates and other structural members can be secured to vertebrae or other osseous material in a manner that more reliably prevents fasteners from working loose in response to shock or vibration.
Resilient tabs or retaining members are moveable, through either plastic or elastic deformation, to open positions that allow insertion and removal of fasteners, and alternatively are positioned to prevent fasteners from working free of their respective apertures in the cervical plate or other structural members. The ability to select non-perpendicular angles at which the fasteners extend from the cervical plate permits relatively close positioning of fastener apertures without the risk of the fasteners interfering with one another, and more generally allows each WO 00/24325 PCTlUS99/25278 fastener to be aligned for its most convenient or most secure angle of penetration into a vertebrae or other bony material.
In the Drawings.
For a further appreciation of the above and other features and advantages, reference is made to the following detailed description and to the drawings, in which:
Figure 1 is a schematic view of an anterior cervical plate and fixation system secured to two vertebrae in accordance with the present invention;
Figure 2 is a top view of the cervical plate;
Figure 3 is a bottom view of the cervical plate;
Figures 4 and 5 are enlarged partial top and bottom views, respectively;
Figure 6 is a sectional view taken along the line 6-6 in Figure l;
Figure 7 is a sectional view taken along the line 7-7 in Figure 1;
Figure 8 is an isometric view of one of the system fasteners;
Figure 9 is a side view of the fastener;
Figure 10 is a top view of the fastener;
Figure 11 is a sectional view taken along the line 11-11 in Figure 10;
Figure 12 is a side view of a drive tool used to install the fasteners;
Figure 13 is an isometric view of one end of the drive tool;
Figure 14 is a side sectional view of a drive tool sleeve;
Figure I S is a side view of a locking tool shaft used to close the retaining feature;
Figure 16 is an end view of the locking tool shaft;
Figure 17 is a side view of a releasing tool shaft used to open the retaining feature;
Figure 18 is an end view of the releasing tool shaft;
Figure 19 is a top view similar to Figure 2, further illustrating the fastener;
Figure 20 is a sectional view taken along the line 20-20 in Figure 19;
S
Figure 21 is a top view similar to Figure 19, illustrating a retaining feature in the closed position;
Figure 22 is a sectional view taken along the line 22-22 in Figure 21;
Figure 23 is a partial top view of an alternative embodiment cervical plate;
Figure 24 is a top view similar to Figure 23, showing a retaining tab of the plate in a closed position;
Figure 25 is a sectional view of a further alternative embodiment cervical plate;
Figure 26 is a side view of an alternative embodiment fastener used with the plate in Figure 25;
Figure 27 is a sectional view showing the fastener installed within the plate;
and Figures 28 and 29 schematically illustrate alternative orientations of the fasteners with respect to the plate.
Detailed Description of the Preferred Embodiments Turning now to the drawings, there is shown in Figure 1 a cervical plate and fixation system 16 constructed in accordance with the present invention. System 16 is shown in connection with the upper cervical spine, secured to two vertebrae indicated at 18 and 20.
The system is secured integrally to both of the vertebrae, and thus maintains the vertebrae integrally with respect to one another, in a desired orientation and at a desired spacing .from one another as shown. System 16 includes a cervical plate 22 and four threaded fasteners or bone screws 24a-24d. Each of the fasteners extends through one of four apertures in the cervical plate, and further penetrates the osseous material (one of the vertebrae) to anchor the cervical plate.
The preferred material for plate 22 and fasteners 24 is titanium, which provides the requisite strength and resiliency for plate 22 to support the vertebrae in the manner indicated.
Further, the titanium plate has sufficient ductility to permit curving the plate about a longitudinal axis (vertical in the figure) so that the cervical plate more readily conforms to the vertebrae. The ductility also plays a role in the use of retaining features that capture each fastener within its aperture, as will be explained.
Certain stainless steels are suitable as alternatives to titanium in the plate and fastener construction.
Figures 2 and 3 show cervical plate 22 apart from the fasteners, in top plan and bottom plan, respectively, and also show the plate in a flat configuration prior to its curvature to conform to the vertebrae. The plate has opposite anterior and posterior surfaces, indicated respectively at 26 and 28, that are parallel to one another and substantially planar before the plate is curved. Four pockets or apertures indicated at 30a-30d are formed through the cervical plate for receiving fasteners 24a-24d used to secure the plate to the osseous material of the vertebrae. The plate is symmetrical about longitudinal and transverse central axes, which are respectively vertical and horizontal as viewed in Figures 2 and 3.
Figure 4 illustrates aperture 30a and the surrounding portion of cervical plate 22 in greater detail. Because apertures 30b-30d are similar, only aperture 30a is described in detail.
The aperture is defined by an interior wall of the plate that has three sections, an outer section 32, a spherical section 34 and an inner or posterior section 36 (Figure 7). Outer section 32 is beveled at about a 45° angle relative to anterior surface 26. The spherical profile of section 34 conforms to a spherical profile of the associated fastener 24a.
The utility of this arrangement is discussed below.
While outer section 32 is continuous about the aperture, spherical section 34 and posterior section 36 are not. More particularly, material is removed from plate 22, preferably by a laser machining process, not only to interrupt these latter sections but also to form a depression 38 open to the anterior side ofthe plate and extending approximately halfway through the plate thickness, as seen from Figure 6. Further, a portion of the plate material between aperture 30a, beginning at a point inwardly of the anterior surface 26, is removed to leave a curved retaining feature 40. The retaining feature resembles a beam or bridge, attached at its opposite ends to the remainder of the cervical plate.
The preferred process for forming the retaining feature is laser cutting or laser machining, due to accuracy and the ability to control the depth of depression 38, e.g., to about 0.5 inches in a cervical plate having a thickness of about 0.9 inches.
Figures 8-11 show fastener 24a, which is substantially identical to the remaining fasteners. As seen in Figures 8 and 9, the fastener includes an elongate shank 42 with external threads 44 for securing the fastener within a vertebra or other bony material, thus to anchor plate 22. The fastener also has an enlarged head 46 with a spherical profile 48 sized to allow the head to nest within spherical section 34 of the aperture. At the outward end of the head is a projection 50 with an annular curved surface 52 to facilitate a gripping of the fastener with a tool described below.
As seen in Figure 10, a hexagonal recess 54 is fornled into the fastener head, to allow use of a tool with a hexagonal shaft to turn or drive the fastener. The head, projection and recess also are seen in Figure 11.
Figure 12 shows a drive tool 56 used to secure the fasteners by turning them into bony material, thus to secure the cervical plate. Tool 56 includes an elongate shaft S8 and a handle 60 fixed to the proximal end of the shaft. A distal end 62 of the shaft has a profile that is non-circular, in this case hexagonal, corresponding to recess 54 of the fastener. A
sleeve 64 is removably mounted to shaft 58 near the distal end, positioned such that a portion of the shaft distal end projects beyond the sleeve.
As seen in Figure I4, sleeve 64 is internally threaded at 66 and is removably mounted to shaft 58 by virtue of corresponding external threads (not shown) on the shaft. Three flexures or sleeve segments 68 project distally from the remainder of sleeve 58, separated from one another by gaps 70. At the end of each flexure is a nodule 72, as best seen in Figure 14. When tool 56 is used to drive one of the fasteners, distal shaft end 62 is inserted into recess 54, while at the same time flexures 68 elastically bend sufficiently to position nodules 72 against curved surface 52 of projection 50. Thus, sleeve 64 holds the fastener firmly but releasably, to facilitate insertion and removal of the fastener.
The complete plate fixation system includes two further tools: a locking tool 74 and a releasing tool 76, used respectively to retain a fastener within its associated aperture and release the fastener from the aperture. Figure 15 shows a locking tool shaft 78. The shaft is knurled at its proximal end as indicated at 80, for the later installation of a handle similar to handle 60. A distal end 82 of the shaft is shaped to provide two projections 84 and 86 that are substantially circular except for a flattened region 88.
Release tool 76 includes an elongate shaft 90 shown in Figure 17, knurled at its proximal end 92 to accept a handle. A distal end 94 of the shaft supports a cuff 96 with a circular inside wall 98 surrounding the shaft, and a slightly elongated outer wall 100 presenting an oblong profile.
Use of system 16 to secure vertebrae 18 and 20 begins with forming (curving) and aligning cervical plate 22 to determine the proper locations for four openings to be drilled in the vertebrae to accommodate fasteners 24a-24d. The openings are then drilled and tapped.
Due to the spherical profiles of the apertures and the fastener heads, the axial extension of each fastener need not be perpendicular to the cervical plate, but instead can be offset by pivoting the screw about an axis transverse to the longitudinal extension of the fastener.
Thus, longer fasteners can be used for a more secure mounting, with the screws extended in directions to avoid their convergence or interference with one another.
After the openings are drilled and tapped, cervical plate 22 is placed with posterior surface 28 in contact with the vertebrae. Fasteners 24a-24d are secured within their respective apertures 30a-30d, turned inwardly or in the posterior direction by using drive tool 56. Each of the bone screws or fasteners is turned inwardly, causing shank 42 to penetrate the osseous material of the vertebra to a depth sufficient to ( 1 ) bring spherical surface 48 of head 46 into engagement with spherical section 34 of the aperture, and (2) bring posterior surface 28 into contiguous engagement with the bony material. Thus, each fastener becomes nested within its associated aperture while urging the cervical plate against the bony material, as seen in Figure 19 for fastener 24a. At this point head 46 and projection 50 are recessed within aperture 30, as best seen in Figure 20.
At this stage, retaining feature 40 is plastically defornied to move a medial region 102 radially inwardly, to a closed position in which the retaining member overlies head 46 of the fastener. Retaining feature 40, when in the closed position, engages head 46 to prevent any substantial retraction or movement of fastener 24 in the anterior direction, substantially maintaining head 46 against section 34 of the aperture, which in turn maintains posterior surface 28 of the plate against the bony material. This overcomes any tendency in fastener 24 to work loose when the fastener and plate are subject to shock, vibration or other disturbance.
Tool 74 is used to close or lock the retaining feature. In particular, projections 84 and 86 of the shaft are inserted into depression 38 when retaining feature 40 is in the open position shown in Figure I 9, with a substantial portion of the shaft in a rounded sector 104 of the depression and flat region 88 facing feature 40. At this point shaft 78 is rotated, bringing wider portions of the projections into contact with the retaining feature, until the force applied to the feature exceeds its elastic limit and bends the feature to the closed position shown in Figure 21. Again, titanium is the preferred material, providing a requisite ductility that enables retaining feature 40 to be plastically deformed as described, yet retain the degree of strength required to prevent retraction of the fastener. A slight force in the posterior direction is sufficient to retain the fastener.
It may become either necessary or desirable to inspect a previously installed cervical plate, or to reposition the plate, in either case requiring its removal. To this end, release tool 76 is inserted by its distal end into aperture 30, with cuff 96 oriented angularly so that the narrow-diameter portion is adjacent the closed retaining feature. From this position, shaft 90 is rotated, rotating the cuff to progressively present larger cuff diameters to the retaining feature. This eventually applies a force that exceeds the elastic limit of the feature, once again plastically deforming the feature to move it to the open position. This provides sufficient clearance for head 46 to pass through the aperture in the anterior direction, and also enables the insertion of drive tool 56 into the head to retract the fastener.
Figure 23 is a partial view of an anterior cervical plate 106 formed according to an alternative embodiment of the present invention. Plate 106 includes four apertures or pockets, one of which is shown at 108. A fastener 110, which can be substantially identical to fasteners 24, is nested within pocket 108. In connection with each pocket, material is removed by laser cutting or otherwise to form a tab 112 extended from the cervical plate in cantilevered fashion. In this figure, tab 112 is shown in the open position.
Cervical plate 106 is secured in much the same manner as described above for cervical plate 22. With tab 112 open, a locking tool such as tool 74 is inserted into a depression or cut-out 114, then rotated to bend tab 112 so that the tab overlies a portion of a fastener head 1 I6 as seen in Figure 24. Again, the deformation is plastic, so that the tab tends to remain in the closed position to maintain the fastener head within pocket 108.
In alternative embodiments, features like feature 40 and tab 112 can be resilient and less ductile, and normally (when not subject to external stress) in the closed position. A tool is used to elastically deform the tab or other feature to the open position, if it is necessary to retract the fastener.
Figure 25 is a sectional view of an anterior cervical plate 118 formed according to a further alternative embodiment of the invention. Two transversely spaced apart pockets 120a and 120b are illustrated, defined by spherical interior walls 122a and 122b, respectively. The center of each sphere is inside its associated pocket or aperture, i.e., between an anterior surface 124 and the posterior surface 126 of plate 118. Thus, each pocket includes a constriction 128 near the posterior surface, and a retaining feature in the form of a locking rim 130 near the anterior surface.
Figure 26 is a side elevation of an alternative embodiment bone screw or fastener 132.
The screw includes an elongate shank I34 with exterior threads 136 for securing the screw within vertebra or other bony matter. The screw further has an enlarged head 138 with a spherical profile, as indicated at 140.
Figure 27 shows fastener 132 with head 138 secured within pocket 120a.
Fastener I32, like fasteners 24 and 1 I0, incorporates a hexagonal or other non-circular recess for use with a similarly profiled drive tool. Further, six slots 142 are formed in a peripheral wall 144 of head 138, to divide the peripheral wall into six arcuit wall segments 146. These slots, each open to the anterior end of the fastener, extend in the posterior direction beyond a transverse plane corresponding to the sphere diameter, i.e., the maximum diameter of head 138. This facilitates an elastic deformation, in particular a radially inward bending of wall segments 146, to reduce the diameter of head 138 sufficiently to allow posterior travel of the head past locking rim 130, to achieve a capture of the head within pocket 120. Once the maximum-diameter portion of the head has traveled past the locking rim, wall segments 146 return toward their relaxed state, effectively enlarging the head toward its original configuration so that the head remains captured within the pocket or aperture.
Further, the respective spherical surfaces of the head and the pocket are maintained against one another, as seen in Figure 27. In further alternative embodiments the Locking rim rather than the head is elastically deformable to effect head capture.
Bone screw or fastener 132 is shown with its longitudinal extension substantially perpendicular to cervical plate 118. However, it is readily apparent that the head can be pivoted about any number of transverse axes (transverse with respect to the longitudinal screw extension) so that the fastener can assume a variety of non-perpendicular orientations relative to the plate. As a result, adjacent fasteners I32 can be oriented in a diverging fashion, parallel as shown in Figure 28, a converging but off=set fashion as in Figure 29, or in a variety of other orientations, given the degrees of freedom for movement of each fastener head within its associated pocket. In this manner, the fastener orientations can be selected to improve or maximize holding strength, or to minimize the difficulty of drilling and tapping the bone screw holes and later installing the bone screws. All embodiments can incorporate this feature.
Thus, in accordance with the present invention, structural members such as cervical ' plates are secured to vertebrae and other bony material in a manner that substantially prevents the fasteners from working loose when subject to vibration. Retaining features, provided near each pocket or aperture that receives a fastener, are moveable between open and closed positions, either by elastic or plastic deformation. A further improvement resides in the ability to orient fasteners at a variety of non-perpendicular angles with respect to the cervical plate, which allows a relatively close spacing of fasteners without the risk of fasteners interfering with one another.
To achieve these and other objects, there is provided an appliance attachable to osseous or bony material within a body. The appliance includes a biocompatible structural member having an exterior surface including opposite first and second exterior surface regions. An interior surface region between the exterior surface regions defines an aperture through the structural member. A biocompatible fastener is provided, including an elongate longitudinal shank and a head larger in diameter than the shank. The shank is adapted for an insertion through the aperture and a penetration into osseous material to a depth sufficient to bring the first exterior surface region into a surface engagement with the osseous material while the head engages the interior surface region. Thus, the head tends to maintain the surface engagement to fix the structural member substantially integrally to the osseous material. A retaining element is permanently fixed to the structural member.
The retaining element is moveable from an open position for allowing travel of the head into the aperture and against the interior surface region, to a closed position for maintaining the head against the interior surface region.
Preferably the retaining element is resilient and ductile, and moveable from the open position to the closed position by applying an external force above the elastic limit of the retaining element. The retaining element can be a tab supported in cantilevered fashion, or alternatively an elongate member attached at two opposite ends to the structural member. As another alternative, the retaining element can be elastic, normally (when not subject to external stresses) tending to assume to the closed position, and elastically deformable into the open position when subject to an external force.
The fastener head, when maintained in the aperture against the interior surface region, is advantageously contained between the first and second exterior surface regions, so that the head does not protrude outwardly beyond the plate or other structural member.
According to another aspect of the invention, the aperture is sized with respect to the shank to allow a pivoting of the fastener with respect to the structural member about at least one transverse axis. More preferably, the fastener is pivotable about all transverse axes passing through a given point in the first aperture, thereby defining a conical volume within which the fastener is selectively positionable.
WO 00/24325 PCT/US99/2527$
The appliance preferably includes a second fastener substantially identical to the first fastener, and a second aperture through the structural member for receiving a head of the second fastener when a shank thereof is inserted through the second aperture.
Then, for example, when the osseous material comprises two vertebrae, the structural member is positioned for extension of the first and second fasteners through their respective apertures into different ones of the vertebrae. Thus the fasteners cooperate with the structural member to support the vertebrae substantially integrally with respect to one another.
A system including the structural member and fasteners can further include tools for securing and removing the structural member, particularly in conjunction with resilient and ductile retaining elements. In particular, heads of the fasteners can include non-circular recesses, and a drive tool with a drive shaft can be provided, one end of the shaft having a non-circular profile corresponding to the profile of the recess. The fastener shanks, in this approach, are externally threaded, with a drive tool rotatable to turn the fasteners. The drive tool further can incorporate a sleeve coaxial with the drive shaft and incorporating flexure members to grip the fastener being turned by the drive tool.
Preferably, locking and releasing tools also are provided. The locking tool can include a shaft with a locking end positionable against the retaining element and movable to plastically deform the retaining element, moving the element into the closed position. The releasing tool has a releasing end positionable against the retaining element when the same is in the closed position. The releasing end is movable to force the retaining element into the open position to allow a withdrawal of the associated fastener.
Thus in accordance with the present invention, cervical plates and other structural members can be secured to vertebrae or other osseous material in a manner that more reliably prevents fasteners from working loose in response to shock or vibration.
Resilient tabs or retaining members are moveable, through either plastic or elastic deformation, to open positions that allow insertion and removal of fasteners, and alternatively are positioned to prevent fasteners from working free of their respective apertures in the cervical plate or other structural members. The ability to select non-perpendicular angles at which the fasteners extend from the cervical plate permits relatively close positioning of fastener apertures without the risk of the fasteners interfering with one another, and more generally allows each WO 00/24325 PCTlUS99/25278 fastener to be aligned for its most convenient or most secure angle of penetration into a vertebrae or other bony material.
In the Drawings.
For a further appreciation of the above and other features and advantages, reference is made to the following detailed description and to the drawings, in which:
Figure 1 is a schematic view of an anterior cervical plate and fixation system secured to two vertebrae in accordance with the present invention;
Figure 2 is a top view of the cervical plate;
Figure 3 is a bottom view of the cervical plate;
Figures 4 and 5 are enlarged partial top and bottom views, respectively;
Figure 6 is a sectional view taken along the line 6-6 in Figure l;
Figure 7 is a sectional view taken along the line 7-7 in Figure 1;
Figure 8 is an isometric view of one of the system fasteners;
Figure 9 is a side view of the fastener;
Figure 10 is a top view of the fastener;
Figure 11 is a sectional view taken along the line 11-11 in Figure 10;
Figure 12 is a side view of a drive tool used to install the fasteners;
Figure 13 is an isometric view of one end of the drive tool;
Figure 14 is a side sectional view of a drive tool sleeve;
Figure I S is a side view of a locking tool shaft used to close the retaining feature;
Figure 16 is an end view of the locking tool shaft;
Figure 17 is a side view of a releasing tool shaft used to open the retaining feature;
Figure 18 is an end view of the releasing tool shaft;
Figure 19 is a top view similar to Figure 2, further illustrating the fastener;
Figure 20 is a sectional view taken along the line 20-20 in Figure 19;
S
Figure 21 is a top view similar to Figure 19, illustrating a retaining feature in the closed position;
Figure 22 is a sectional view taken along the line 22-22 in Figure 21;
Figure 23 is a partial top view of an alternative embodiment cervical plate;
Figure 24 is a top view similar to Figure 23, showing a retaining tab of the plate in a closed position;
Figure 25 is a sectional view of a further alternative embodiment cervical plate;
Figure 26 is a side view of an alternative embodiment fastener used with the plate in Figure 25;
Figure 27 is a sectional view showing the fastener installed within the plate;
and Figures 28 and 29 schematically illustrate alternative orientations of the fasteners with respect to the plate.
Detailed Description of the Preferred Embodiments Turning now to the drawings, there is shown in Figure 1 a cervical plate and fixation system 16 constructed in accordance with the present invention. System 16 is shown in connection with the upper cervical spine, secured to two vertebrae indicated at 18 and 20.
The system is secured integrally to both of the vertebrae, and thus maintains the vertebrae integrally with respect to one another, in a desired orientation and at a desired spacing .from one another as shown. System 16 includes a cervical plate 22 and four threaded fasteners or bone screws 24a-24d. Each of the fasteners extends through one of four apertures in the cervical plate, and further penetrates the osseous material (one of the vertebrae) to anchor the cervical plate.
The preferred material for plate 22 and fasteners 24 is titanium, which provides the requisite strength and resiliency for plate 22 to support the vertebrae in the manner indicated.
Further, the titanium plate has sufficient ductility to permit curving the plate about a longitudinal axis (vertical in the figure) so that the cervical plate more readily conforms to the vertebrae. The ductility also plays a role in the use of retaining features that capture each fastener within its aperture, as will be explained.
Certain stainless steels are suitable as alternatives to titanium in the plate and fastener construction.
Figures 2 and 3 show cervical plate 22 apart from the fasteners, in top plan and bottom plan, respectively, and also show the plate in a flat configuration prior to its curvature to conform to the vertebrae. The plate has opposite anterior and posterior surfaces, indicated respectively at 26 and 28, that are parallel to one another and substantially planar before the plate is curved. Four pockets or apertures indicated at 30a-30d are formed through the cervical plate for receiving fasteners 24a-24d used to secure the plate to the osseous material of the vertebrae. The plate is symmetrical about longitudinal and transverse central axes, which are respectively vertical and horizontal as viewed in Figures 2 and 3.
Figure 4 illustrates aperture 30a and the surrounding portion of cervical plate 22 in greater detail. Because apertures 30b-30d are similar, only aperture 30a is described in detail.
The aperture is defined by an interior wall of the plate that has three sections, an outer section 32, a spherical section 34 and an inner or posterior section 36 (Figure 7). Outer section 32 is beveled at about a 45° angle relative to anterior surface 26. The spherical profile of section 34 conforms to a spherical profile of the associated fastener 24a.
The utility of this arrangement is discussed below.
While outer section 32 is continuous about the aperture, spherical section 34 and posterior section 36 are not. More particularly, material is removed from plate 22, preferably by a laser machining process, not only to interrupt these latter sections but also to form a depression 38 open to the anterior side ofthe plate and extending approximately halfway through the plate thickness, as seen from Figure 6. Further, a portion of the plate material between aperture 30a, beginning at a point inwardly of the anterior surface 26, is removed to leave a curved retaining feature 40. The retaining feature resembles a beam or bridge, attached at its opposite ends to the remainder of the cervical plate.
The preferred process for forming the retaining feature is laser cutting or laser machining, due to accuracy and the ability to control the depth of depression 38, e.g., to about 0.5 inches in a cervical plate having a thickness of about 0.9 inches.
Figures 8-11 show fastener 24a, which is substantially identical to the remaining fasteners. As seen in Figures 8 and 9, the fastener includes an elongate shank 42 with external threads 44 for securing the fastener within a vertebra or other bony material, thus to anchor plate 22. The fastener also has an enlarged head 46 with a spherical profile 48 sized to allow the head to nest within spherical section 34 of the aperture. At the outward end of the head is a projection 50 with an annular curved surface 52 to facilitate a gripping of the fastener with a tool described below.
As seen in Figure 10, a hexagonal recess 54 is fornled into the fastener head, to allow use of a tool with a hexagonal shaft to turn or drive the fastener. The head, projection and recess also are seen in Figure 11.
Figure 12 shows a drive tool 56 used to secure the fasteners by turning them into bony material, thus to secure the cervical plate. Tool 56 includes an elongate shaft S8 and a handle 60 fixed to the proximal end of the shaft. A distal end 62 of the shaft has a profile that is non-circular, in this case hexagonal, corresponding to recess 54 of the fastener. A
sleeve 64 is removably mounted to shaft 58 near the distal end, positioned such that a portion of the shaft distal end projects beyond the sleeve.
As seen in Figure I4, sleeve 64 is internally threaded at 66 and is removably mounted to shaft 58 by virtue of corresponding external threads (not shown) on the shaft. Three flexures or sleeve segments 68 project distally from the remainder of sleeve 58, separated from one another by gaps 70. At the end of each flexure is a nodule 72, as best seen in Figure 14. When tool 56 is used to drive one of the fasteners, distal shaft end 62 is inserted into recess 54, while at the same time flexures 68 elastically bend sufficiently to position nodules 72 against curved surface 52 of projection 50. Thus, sleeve 64 holds the fastener firmly but releasably, to facilitate insertion and removal of the fastener.
The complete plate fixation system includes two further tools: a locking tool 74 and a releasing tool 76, used respectively to retain a fastener within its associated aperture and release the fastener from the aperture. Figure 15 shows a locking tool shaft 78. The shaft is knurled at its proximal end as indicated at 80, for the later installation of a handle similar to handle 60. A distal end 82 of the shaft is shaped to provide two projections 84 and 86 that are substantially circular except for a flattened region 88.
Release tool 76 includes an elongate shaft 90 shown in Figure 17, knurled at its proximal end 92 to accept a handle. A distal end 94 of the shaft supports a cuff 96 with a circular inside wall 98 surrounding the shaft, and a slightly elongated outer wall 100 presenting an oblong profile.
Use of system 16 to secure vertebrae 18 and 20 begins with forming (curving) and aligning cervical plate 22 to determine the proper locations for four openings to be drilled in the vertebrae to accommodate fasteners 24a-24d. The openings are then drilled and tapped.
Due to the spherical profiles of the apertures and the fastener heads, the axial extension of each fastener need not be perpendicular to the cervical plate, but instead can be offset by pivoting the screw about an axis transverse to the longitudinal extension of the fastener.
Thus, longer fasteners can be used for a more secure mounting, with the screws extended in directions to avoid their convergence or interference with one another.
After the openings are drilled and tapped, cervical plate 22 is placed with posterior surface 28 in contact with the vertebrae. Fasteners 24a-24d are secured within their respective apertures 30a-30d, turned inwardly or in the posterior direction by using drive tool 56. Each of the bone screws or fasteners is turned inwardly, causing shank 42 to penetrate the osseous material of the vertebra to a depth sufficient to ( 1 ) bring spherical surface 48 of head 46 into engagement with spherical section 34 of the aperture, and (2) bring posterior surface 28 into contiguous engagement with the bony material. Thus, each fastener becomes nested within its associated aperture while urging the cervical plate against the bony material, as seen in Figure 19 for fastener 24a. At this point head 46 and projection 50 are recessed within aperture 30, as best seen in Figure 20.
At this stage, retaining feature 40 is plastically defornied to move a medial region 102 radially inwardly, to a closed position in which the retaining member overlies head 46 of the fastener. Retaining feature 40, when in the closed position, engages head 46 to prevent any substantial retraction or movement of fastener 24 in the anterior direction, substantially maintaining head 46 against section 34 of the aperture, which in turn maintains posterior surface 28 of the plate against the bony material. This overcomes any tendency in fastener 24 to work loose when the fastener and plate are subject to shock, vibration or other disturbance.
Tool 74 is used to close or lock the retaining feature. In particular, projections 84 and 86 of the shaft are inserted into depression 38 when retaining feature 40 is in the open position shown in Figure I 9, with a substantial portion of the shaft in a rounded sector 104 of the depression and flat region 88 facing feature 40. At this point shaft 78 is rotated, bringing wider portions of the projections into contact with the retaining feature, until the force applied to the feature exceeds its elastic limit and bends the feature to the closed position shown in Figure 21. Again, titanium is the preferred material, providing a requisite ductility that enables retaining feature 40 to be plastically deformed as described, yet retain the degree of strength required to prevent retraction of the fastener. A slight force in the posterior direction is sufficient to retain the fastener.
It may become either necessary or desirable to inspect a previously installed cervical plate, or to reposition the plate, in either case requiring its removal. To this end, release tool 76 is inserted by its distal end into aperture 30, with cuff 96 oriented angularly so that the narrow-diameter portion is adjacent the closed retaining feature. From this position, shaft 90 is rotated, rotating the cuff to progressively present larger cuff diameters to the retaining feature. This eventually applies a force that exceeds the elastic limit of the feature, once again plastically deforming the feature to move it to the open position. This provides sufficient clearance for head 46 to pass through the aperture in the anterior direction, and also enables the insertion of drive tool 56 into the head to retract the fastener.
Figure 23 is a partial view of an anterior cervical plate 106 formed according to an alternative embodiment of the present invention. Plate 106 includes four apertures or pockets, one of which is shown at 108. A fastener 110, which can be substantially identical to fasteners 24, is nested within pocket 108. In connection with each pocket, material is removed by laser cutting or otherwise to form a tab 112 extended from the cervical plate in cantilevered fashion. In this figure, tab 112 is shown in the open position.
Cervical plate 106 is secured in much the same manner as described above for cervical plate 22. With tab 112 open, a locking tool such as tool 74 is inserted into a depression or cut-out 114, then rotated to bend tab 112 so that the tab overlies a portion of a fastener head 1 I6 as seen in Figure 24. Again, the deformation is plastic, so that the tab tends to remain in the closed position to maintain the fastener head within pocket 108.
In alternative embodiments, features like feature 40 and tab 112 can be resilient and less ductile, and normally (when not subject to external stress) in the closed position. A tool is used to elastically deform the tab or other feature to the open position, if it is necessary to retract the fastener.
Figure 25 is a sectional view of an anterior cervical plate 118 formed according to a further alternative embodiment of the invention. Two transversely spaced apart pockets 120a and 120b are illustrated, defined by spherical interior walls 122a and 122b, respectively. The center of each sphere is inside its associated pocket or aperture, i.e., between an anterior surface 124 and the posterior surface 126 of plate 118. Thus, each pocket includes a constriction 128 near the posterior surface, and a retaining feature in the form of a locking rim 130 near the anterior surface.
Figure 26 is a side elevation of an alternative embodiment bone screw or fastener 132.
The screw includes an elongate shank I34 with exterior threads 136 for securing the screw within vertebra or other bony matter. The screw further has an enlarged head 138 with a spherical profile, as indicated at 140.
Figure 27 shows fastener 132 with head 138 secured within pocket 120a.
Fastener I32, like fasteners 24 and 1 I0, incorporates a hexagonal or other non-circular recess for use with a similarly profiled drive tool. Further, six slots 142 are formed in a peripheral wall 144 of head 138, to divide the peripheral wall into six arcuit wall segments 146. These slots, each open to the anterior end of the fastener, extend in the posterior direction beyond a transverse plane corresponding to the sphere diameter, i.e., the maximum diameter of head 138. This facilitates an elastic deformation, in particular a radially inward bending of wall segments 146, to reduce the diameter of head 138 sufficiently to allow posterior travel of the head past locking rim 130, to achieve a capture of the head within pocket 120. Once the maximum-diameter portion of the head has traveled past the locking rim, wall segments 146 return toward their relaxed state, effectively enlarging the head toward its original configuration so that the head remains captured within the pocket or aperture.
Further, the respective spherical surfaces of the head and the pocket are maintained against one another, as seen in Figure 27. In further alternative embodiments the Locking rim rather than the head is elastically deformable to effect head capture.
Bone screw or fastener 132 is shown with its longitudinal extension substantially perpendicular to cervical plate 118. However, it is readily apparent that the head can be pivoted about any number of transverse axes (transverse with respect to the longitudinal screw extension) so that the fastener can assume a variety of non-perpendicular orientations relative to the plate. As a result, adjacent fasteners I32 can be oriented in a diverging fashion, parallel as shown in Figure 28, a converging but off=set fashion as in Figure 29, or in a variety of other orientations, given the degrees of freedom for movement of each fastener head within its associated pocket. In this manner, the fastener orientations can be selected to improve or maximize holding strength, or to minimize the difficulty of drilling and tapping the bone screw holes and later installing the bone screws. All embodiments can incorporate this feature.
Thus, in accordance with the present invention, structural members such as cervical ' plates are secured to vertebrae and other bony material in a manner that substantially prevents the fasteners from working loose when subject to vibration. Retaining features, provided near each pocket or aperture that receives a fastener, are moveable between open and closed positions, either by elastic or plastic deformation. A further improvement resides in the ability to orient fasteners at a variety of non-perpendicular angles with respect to the cervical plate, which allows a relatively close spacing of fasteners without the risk of fasteners interfering with one another.
Claims (42)
1. An appliance attachable to osseous material within a body, including:
a biocompatible structural member having an exterior surface including opposite first and second exterior surface regions, and an interior surface region between said exterior surface regions defining a first aperture through the structural member;
a biocompatible first fastener including an elongate longitudinal shank and a head larger in diameter than the shank, said shank adapted for an insertion through the first aperture and a penetration into osseous material to a depth sufficient to bring the first exterior surface region into a surface engagement with the osseous material while the head engages the interior surface region and thereby tends to maintain said surface engagement to fix the structural member substantially integrally to the osseous material; and a first retaining element permanently fixed to the structural member and movable from an open position for allowing travel of the head into the first aperture and against the interior surface region, to a closed position for maintaining the head against the interior surface region.
a biocompatible structural member having an exterior surface including opposite first and second exterior surface regions, and an interior surface region between said exterior surface regions defining a first aperture through the structural member;
a biocompatible first fastener including an elongate longitudinal shank and a head larger in diameter than the shank, said shank adapted for an insertion through the first aperture and a penetration into osseous material to a depth sufficient to bring the first exterior surface region into a surface engagement with the osseous material while the head engages the interior surface region and thereby tends to maintain said surface engagement to fix the structural member substantially integrally to the osseous material; and a first retaining element permanently fixed to the structural member and movable from an open position for allowing travel of the head into the first aperture and against the interior surface region, to a closed position for maintaining the head against the interior surface region.
2. The appliance of claim 1 wherein:
the first retaining element is resilient and ductile, and movable from the open position to the closed position by applying an external force above an elastic limit thereof.
the first retaining element is resilient and ductile, and movable from the open position to the closed position by applying an external force above an elastic limit thereof.
3. The appliance of claim 2 wherein:
said retaining element comprises a tab supported by the structural member and extending therefrom in cantilevered fashion.
said retaining element comprises a tab supported by the structural member and extending therefrom in cantilevered fashion.
4. The appliance of claim 2 wherein:
the retaining element comprises an elongate member attached at two opposite ends to the structural member.
the retaining element comprises an elongate member attached at two opposite ends to the structural member.
5. The appliance of claim 1 wherein:
said first retaining element is elastic, normally tending to assume the closed position, and elastically deformable into the open position when subject to an external force.
said first retaining element is elastic, normally tending to assume the closed position, and elastically deformable into the open position when subject to an external force.
6. The appliance of claim 1 wherein:
the first exterior surface region and the second exterior surface region are substantially parallel to one another;
the first exterior surface region and the second exterior surface region are substantially parallel to one another;
7. The appliance of claim 6 wherein:
the head, when maintained in the first aperture against the interior surface region, is substantially contained between the first and second exterior surface regions.
the head, when maintained in the first aperture against the interior surface region, is substantially contained between the first and second exterior surface regions.
The appliance of claim 1 wherein:
the shank is externally threaded, the head incorporates a non-circular recess for receiving a drive tool used to tum the fastener.
the shank is externally threaded, the head incorporates a non-circular recess for receiving a drive tool used to tum the fastener.
9. The appliance of claim 1 wherein:
the aperture is sized with respect to the shank to allow a pivoting of the first fastener with respect to the structural member about at least one transverse axis disposed between the first and second exterior surface regions when the head is in the aperture.
the aperture is sized with respect to the shank to allow a pivoting of the first fastener with respect to the structural member about at least one transverse axis disposed between the first and second exterior surface regions when the head is in the aperture.
10. The appliance of claim 9 wherein:
the first fastener is pivotable about all transverse axes passing through a given point between the first and second exterior surface regions, thereby defining a conical volume within which the first fastener is selectively positionable.
the first fastener is pivotable about all transverse axes passing through a given point between the first and second exterior surface regions, thereby defining a conical volume within which the first fastener is selectively positionable.
11. The appliance of claim 10 wherein:
said interior surface region includes a spherical segment, and said head has a spherical surface portion in contact with the spherical segment.
said interior surface region includes a spherical segment, and said head has a spherical surface portion in contact with the spherical segment.
12. The appliance of claim 1 further including:
a second fastener substantially identical to the first fastener, and a second aperture formed though the structural member for receiving a head of the second fastener when a shank thereof is inserted through the second aperture.
a second fastener substantially identical to the first fastener, and a second aperture formed though the structural member for receiving a head of the second fastener when a shank thereof is inserted through the second aperture.
13. The appliance of claim 12 wherein:
the first and second apertures are disposed near opposite ends of the structural member, the osseous material comprises two vertebrae, and wherein the structural member is positionable with respect to the vertebrae such that the first and second fasteners are extendible through the first and second apertures respectively and into different ones of the vertebrae, and cooperate with the structural member to support the vertebrae substantially integrally with respect to one another.
the first and second apertures are disposed near opposite ends of the structural member, the osseous material comprises two vertebrae, and wherein the structural member is positionable with respect to the vertebrae such that the first and second fasteners are extendible through the first and second apertures respectively and into different ones of the vertebrae, and cooperate with the structural member to support the vertebrae substantially integrally with respect to one another.
14. The appliance of claim 1 wherein:
said biocompatible structural member is unitary, and the first retaining element is formed as part of the unitary biocompatible structural member.
said biocompatible structural member is unitary, and the first retaining element is formed as part of the unitary biocompatible structural member.
15. The appliance of claim 1 wherein:
said first retaining element further is movable from the closed position to the open position to allow a removal of the head from the first aperture, thus to allow a withdrawal of the first fastener from the osseous material and the structural member.
said first retaining element further is movable from the closed position to the open position to allow a removal of the head from the first aperture, thus to allow a withdrawal of the first fastener from the osseous material and the structural member.
16. An apparatus for fixing a body insertable member to bony material, including:
a biocompatible structural member having an exterior surface that includes a first surface region adapted for surface engagement with a bony material when the structural member is secured to the bony material;
a first fastener comprising an elongate shank extending in a longitudinal direction and having a transverse shank diameter, and further including a head having a transverse head dimension larger than the shank diameter; and a first aperture formed through the structural member, including a first constriction proximate the first surface region selectively sized with respect to the first fastener to allow a passage of the shank through the aperture and first constriction while preventing such passage of the head to maintain the head within the aperture, said first constriction further being of sufficient size to allow a pivoting of the first fastener with respect to the structural member about at least one transverse axis, thereby to allow the selection of a penetration angle at which the shank is inserted into the bony material to secure the structural member.
a biocompatible structural member having an exterior surface that includes a first surface region adapted for surface engagement with a bony material when the structural member is secured to the bony material;
a first fastener comprising an elongate shank extending in a longitudinal direction and having a transverse shank diameter, and further including a head having a transverse head dimension larger than the shank diameter; and a first aperture formed through the structural member, including a first constriction proximate the first surface region selectively sized with respect to the first fastener to allow a passage of the shank through the aperture and first constriction while preventing such passage of the head to maintain the head within the aperture, said first constriction further being of sufficient size to allow a pivoting of the first fastener with respect to the structural member about at least one transverse axis, thereby to allow the selection of a penetration angle at which the shank is inserted into the bony material to secure the structural member.
17. The apparatus of claim 16 wherein:
the head and the constriction are shaped to allow said pivoting about all of the transverse axes passing through a given point within the aperture.
the head and the constriction are shaped to allow said pivoting about all of the transverse axes passing through a given point within the aperture.
18. The apparatus of claim 17 wherein:
the first fastener is pivotable throughout a conical volume centered on an axis substantially perpendicular to the first surface region near the aperture and intersecting said point.
the first fastener is pivotable throughout a conical volume centered on an axis substantially perpendicular to the first surface region near the aperture and intersecting said point.
19. The apparatus of claim 16 wherein:
the structural member has a continuous interior wall that defines the first aperture including the constriction.
the structural member has a continuous interior wall that defines the first aperture including the constriction.
20. The apparatus of claim 19 wherein:
the interior wall and the head have respective spherical sections engaged with one another when the head is in the aperture.
the interior wall and the head have respective spherical sections engaged with one another when the head is in the aperture.
21. The apparatus of claim 20 wherein:
said exterior surface of the structural member further includes a second surface region opposite the first surface region, with the interior wall extending between the first and second surface regions.
said exterior surface of the structural member further includes a second surface region opposite the first surface region, with the interior wall extending between the first and second surface regions.
22. The apparatus of claim 21 wherein:
the spherical sections of the head and the interior wall are substantially concentric, and a center of the spherical sections is disposed between the first and second surface regions, whereby the aperture further includes a head retaining feature cooperating with the constriction to maintain the head in the aperture.
the spherical sections of the head and the interior wall are substantially concentric, and a center of the spherical sections is disposed between the first and second surface regions, whereby the aperture further includes a head retaining feature cooperating with the constriction to maintain the head in the aperture.
23. The apparatus of claim 22 wherein:
the head is elastically deformable to allow the head to travel past the head retaining feature into the aperture.
the head is elastically deformable to allow the head to travel past the head retaining feature into the aperture.
24. The apparatus of claim 16 further including:
a means for maintaining the head at least proximate the constriction to prevent withdrawal of the first fastener from the aperture.
a means for maintaining the head at least proximate the constriction to prevent withdrawal of the first fastener from the aperture.
25. The apparatus of claim 24 wherein:
the maintaining means comprises a retaining element fixed to the structural member, movable from an open position for allowing travel of the head into the aperture and against the constriction, to a closed position for so maintaining the head.
the maintaining means comprises a retaining element fixed to the structural member, movable from an open position for allowing travel of the head into the aperture and against the constriction, to a closed position for so maintaining the head.
26. The apparatus of claim 25 wherein:
the retaining element is resilient and ductile, and movable from the open position to the closed position by applying an external force above an elastic limit thereof.
the retaining element is resilient and ductile, and movable from the open position to the closed position by applying an external force above an elastic limit thereof.
27. The apparatus of claim 25 wherein:
the retaining element is elastic, normally tending to assume the closed position and elastically deformable into the open position when subject to an external force.
the retaining element is elastic, normally tending to assume the closed position and elastically deformable into the open position when subject to an external force.
28. A bone plate and fixation system, including:
a biocompatible bone plate having an exterior surface including a bone contact surface region adapted for surface engagement with vertebrae;
first and second spaced apart apertures formed through the bone plate, each of the apertures including a constriction proximate the first surface region;
first and second fasteners, each fastener including an elongate shank extending in a longitudinal direction and having a transverse shank diameter, and further including a head having a transverse head dimension greater than the shank diameter;
wherein the constriction in each of the first and second apertures is selectively sized with respect to its associated fastener to allow a passage of the shank of the associated fastener through the aperture while engaging the head to prevent such passage of the head;
and first and second retaining elements permanently fixed to the structural member and associated with the first and second apertures, respectively, each retaining element being movable from an open position for allowing travel of the head of its associated fastener into its associated aperture and against the constriction thereof, to a closed position for maintaining the associated head substantially against the associated constriction.
a biocompatible bone plate having an exterior surface including a bone contact surface region adapted for surface engagement with vertebrae;
first and second spaced apart apertures formed through the bone plate, each of the apertures including a constriction proximate the first surface region;
first and second fasteners, each fastener including an elongate shank extending in a longitudinal direction and having a transverse shank diameter, and further including a head having a transverse head dimension greater than the shank diameter;
wherein the constriction in each of the first and second apertures is selectively sized with respect to its associated fastener to allow a passage of the shank of the associated fastener through the aperture while engaging the head to prevent such passage of the head;
and first and second retaining elements permanently fixed to the structural member and associated with the first and second apertures, respectively, each retaining element being movable from an open position for allowing travel of the head of its associated fastener into its associated aperture and against the constriction thereof, to a closed position for maintaining the associated head substantially against the associated constriction.
29. The system of claim 28 wherein:
each of the retaining elements is resilient and ductile, movable from the open position to the closed position by applying an external force that exceeds an elastic limit of the retaining element.
each of the retaining elements is resilient and ductile, movable from the open position to the closed position by applying an external force that exceeds an elastic limit of the retaining element.
30. The system of claim 29 wherein:
the retaining elements comprise tabs extending from the structural member in cantilevered fashion.
the retaining elements comprise tabs extending from the structural member in cantilevered fashion.
31. The system of claim 29 wherein:
each of the retaining elements comprises an elongate member attached at two opposite ends to the structural member.
each of the retaining elements comprises an elongate member attached at two opposite ends to the structural member.
32. The system of claim 28 wherein:
each of the retaining elements is elastic, normally tending to assume the closed position and elastically deformable into the open position when subject to an external force.
each of the retaining elements is elastic, normally tending to assume the closed position and elastically deformable into the open position when subject to an external force.
33. The system of claim 28 wherein:
the exterior surface of the bone plate further includes an outer surface region opposite the bone contact surface region, and the heads, when maintained in their respective apertures against their respective constrictions, are substantially contained between the bone contact surface region and the outer surface region.
the exterior surface of the bone plate further includes an outer surface region opposite the bone contact surface region, and the heads, when maintained in their respective apertures against their respective constrictions, are substantially contained between the bone contact surface region and the outer surface region.
34. The system of claim 28 wherein:
the shanks of the fasteners are externally threaded, and the respective heads incorporate non-circular recesses for receiving a drive tool used to turn the fasteners.
the shanks of the fasteners are externally threaded, and the respective heads incorporate non-circular recesses for receiving a drive tool used to turn the fasteners.
35. The system of claim 28 wherein:
the constrictions are of sufficient size to allow a pivoting of their respective fasteners with respect to the structural member, each about at least one transverse axis, thereby to allow the selection of respective penetration angles at which the shanks are inserted into the vertebrae to secure the structural member.
the constrictions are of sufficient size to allow a pivoting of their respective fasteners with respect to the structural member, each about at least one transverse axis, thereby to allow the selection of respective penetration angles at which the shanks are inserted into the vertebrae to secure the structural member.
36. The system of claim 35 wherein:
each of the heads and their associated constrictions is shaped to allow said pivoting about all of the transverse axes passing through a given point within the associated aperture.
each of the heads and their associated constrictions is shaped to allow said pivoting about all of the transverse axes passing through a given point within the associated aperture.
37. The system of claim 28 further including:
a fastener drive tool having a drive shaft, said shaft having an end region with a non-circular profile corresponding to said non-circular recess in the respective heads.
a fastener drive tool having a drive shaft, said shaft having an end region with a non-circular profile corresponding to said non-circular recess in the respective heads.
38. The system of claim 37 further including:
a sleeve substantially coaxial with and surrounding said end of the drive shaft.
a sleeve substantially coaxial with and surrounding said end of the drive shaft.
39. The system of claim 38 wherein:
the sleeve removably attached to the drive shaft.
the sleeve removably attached to the drive shaft.
40. The system of claim 39 further including:
a plurality of flexure members at a distal end of the sleeve, for gripping one of the fasteners when said end of the drive shaft is received within its associated recess.
a plurality of flexure members at a distal end of the sleeve, for gripping one of the fasteners when said end of the drive shaft is received within its associated recess.
41. The system of claim 28 further including:
a locking tool including a shaft with a locking end positionable against the retaining element and movable to plastically deform the retaining element and thereby move the retaining element into the closed position.
a locking tool including a shaft with a locking end positionable against the retaining element and movable to plastically deform the retaining element and thereby move the retaining element into the closed position.
42. The system of claim 28 further including:
a fastener releasing tool having a shaft with a releasing end positionable against the retaining element when the same is in the closed position, and movable to force the retaining element into the open position to allow a withdrawal of the associated fastener.
a fastener releasing tool having a shaft with a releasing end positionable against the retaining element when the same is in the closed position, and movable to force the retaining element into the open position to allow a withdrawal of the associated fastener.
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Application Number | Priority Date | Filing Date | Title |
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US10597698P | 1998-10-28 | 1998-10-28 | |
US60/105,976 | 1998-10-28 | ||
US09/314,617 US6258089B1 (en) | 1998-05-19 | 1999-05-19 | Anterior cervical plate and fixation system |
US09/314,617 | 1999-05-19 | ||
PCT/US1999/025278 WO2000024325A1 (en) | 1998-10-28 | 1999-10-28 | Anterior cervical plate and fixation system |
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CA2349544A1 true CA2349544A1 (en) | 2000-05-04 |
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Family Applications (1)
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CA002349544A Abandoned CA2349544A1 (en) | 1998-10-28 | 1999-10-28 | Anterior cervical plate and fixation system |
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US (2) | US6258089B1 (en) |
EP (1) | EP1124493A4 (en) |
JP (1) | JP2002528162A (en) |
CA (1) | CA2349544A1 (en) |
WO (1) | WO2000024325A1 (en) |
Families Citing this family (389)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6533786B1 (en) * | 1999-10-13 | 2003-03-18 | Sdgi Holdings, Inc. | Anterior cervical plating system |
FR2778088B1 (en) | 1998-04-30 | 2000-09-08 | Materiel Orthopedique En Abreg | ANTERIOR IMPLANT, PARTICULARLY FOR THE CERVICAL RACHIS |
US20040220571A1 (en) * | 1998-04-30 | 2004-11-04 | Richard Assaker | Bone plate assembly |
US6258089B1 (en) * | 1998-05-19 | 2001-07-10 | Alphatec Manufacturing, Inc. | Anterior cervical plate and fixation system |
US6261291B1 (en) | 1999-07-08 | 2001-07-17 | David J. Talaber | Orthopedic implant assembly |
FR2897259B1 (en) | 2006-02-15 | 2008-05-09 | Ldr Medical Soc Par Actions Si | INTERSOMATIC TRANSFORAMINAL CAGE WITH INTERBREBAL FUSION GRAFT AND CAGE IMPLANTATION INSTRUMENT |
US6692503B2 (en) * | 1999-10-13 | 2004-02-17 | Sdgi Holdings, Inc | System and method for securing a plate to the spinal column |
US6706046B2 (en) | 2000-02-01 | 2004-03-16 | Hand Innovations, Inc. | Intramedullary fixation device for metaphyseal long bone fractures and methods of using the same |
US20040153073A1 (en) | 2000-02-01 | 2004-08-05 | Hand Innovations, Inc. | Orthopedic fixation system including plate element with threaded holes having divergent axes |
US20060041260A1 (en) * | 2000-02-01 | 2006-02-23 | Orbay Jorge L | Fixation system with plate having holes with divergent axes and multidirectional fixators for use therethrough |
US7695502B2 (en) | 2000-02-01 | 2010-04-13 | Depuy Products, Inc. | Bone stabilization system including plate having fixed-angle holes together with unidirectional locking screws and surgeon-directed locking screws |
US6767351B2 (en) | 2000-02-01 | 2004-07-27 | Hand Innovations, Inc. | Fixation system with multidirectional stabilization pegs |
US7857838B2 (en) | 2003-03-27 | 2010-12-28 | Depuy Products, Inc. | Anatomical distal radius fracture fixation plate |
EP1138267B1 (en) * | 2000-03-28 | 2007-03-21 | Showa IKA Kohgyo Co., Ltd. | Spinal implant |
FR2810532B1 (en) * | 2000-06-26 | 2003-05-30 | Stryker Spine Sa | BONE IMPLANT WITH ANNULAR LOCKING MEANS |
AU757023B2 (en) | 2000-06-26 | 2003-01-30 | Stryker European Holdings I, Llc | Bone screw retaining system |
WO2002003885A2 (en) | 2000-07-10 | 2002-01-17 | Michelson Gary K | Flanged interbody spinal fusion implants |
US7833250B2 (en) | 2004-11-10 | 2010-11-16 | Jackson Roger P | Polyaxial bone screw with helically wound capture connection |
US6740088B1 (en) | 2000-10-25 | 2004-05-25 | Sdgi Holdings, Inc. | Anterior lumbar plate and method |
US6656181B2 (en) * | 2000-11-22 | 2003-12-02 | Robert A Dixon | Method and device utilizing tapered screw shanks for spinal stabilization |
US20050010227A1 (en) * | 2000-11-28 | 2005-01-13 | Paul Kamaljit S. | Bone support plate assembly |
US6503250B2 (en) * | 2000-11-28 | 2003-01-07 | Kamaljit S. Paul | Bone support assembly |
US6726689B2 (en) | 2002-09-06 | 2004-04-27 | Roger P. Jackson | Helical interlocking mating guide and advancement structure |
US8377100B2 (en) | 2000-12-08 | 2013-02-19 | Roger P. Jackson | Closure for open-headed medical implant |
US6413259B1 (en) | 2000-12-14 | 2002-07-02 | Blackstone Medical, Inc | Bone plate assembly including a screw retaining member |
CA2442967A1 (en) * | 2001-04-06 | 2002-10-17 | Sdgi Holdings, Inc. | Anterior plating system and method |
FR2823096B1 (en) | 2001-04-06 | 2004-03-19 | Materiel Orthopedique En Abreg | PLATE FOR LTE AND LTE VERTEBRATE OSTEOSYNTHESIS DEVICE, OSTEOSYNTHESIS DEVICE INCLUDING SUCH A PLATE, AND INSTRUMENT FOR LAYING SUCH A PLATE |
US10258382B2 (en) | 2007-01-18 | 2019-04-16 | Roger P. Jackson | Rod-cord dynamic connection assemblies with slidable bone anchor attachment members along the cord |
US8292926B2 (en) | 2005-09-30 | 2012-10-23 | Jackson Roger P | Dynamic stabilization connecting member with elastic core and outer sleeve |
US10729469B2 (en) | 2006-01-09 | 2020-08-04 | Roger P. Jackson | Flexible spinal stabilization assembly with spacer having off-axis core member |
US7862587B2 (en) | 2004-02-27 | 2011-01-04 | Jackson Roger P | Dynamic stabilization assemblies, tool set and method |
US8353932B2 (en) | 2005-09-30 | 2013-01-15 | Jackson Roger P | Polyaxial bone anchor assembly with one-piece closure, pressure insert and plastic elongate member |
SI1389963T1 (en) * | 2001-05-28 | 2006-10-31 | Synthes Ag | Bone plate for the fixation of fractures of the proximal humerus |
CA2443429C (en) * | 2001-06-04 | 2010-08-10 | Gary Karlin Michelson | Anterior cervical plate system having vertebral body engaging anchors, connecting plate, and method for installation thereof |
US7186256B2 (en) * | 2001-06-04 | 2007-03-06 | Warsaw Orthopedic, Inc. | Dynamic, modular, single-lock anterior cervical plate system having assembleable and movable segments |
US7097645B2 (en) * | 2001-06-04 | 2006-08-29 | Sdgi Holdings, Inc. | Dynamic single-lock anterior cervical plate system having non-detachably fastened and moveable segments |
WO2002098276A2 (en) * | 2001-06-04 | 2002-12-12 | Michelson Gary K | Dynamic anterior cervical plate system having moveable segments, instrumentation, and method for installation thereof |
US7044952B2 (en) * | 2001-06-06 | 2006-05-16 | Sdgi Holdings, Inc. | Dynamic multilock anterior cervical plate system having non-detachably fastened and moveable segments |
US7041105B2 (en) * | 2001-06-06 | 2006-05-09 | Sdgi Holdings, Inc. | Dynamic, modular, multilock anterior cervical plate system having detachably fastened assembleable and moveable segments |
US7766947B2 (en) | 2001-10-31 | 2010-08-03 | Ortho Development Corporation | Cervical plate for stabilizing the human spine |
US6679883B2 (en) | 2001-10-31 | 2004-01-20 | Ortho Development Corporation | Cervical plate for stabilizing the human spine |
US7008426B2 (en) | 2001-12-14 | 2006-03-07 | Paul Kamaljit S | Bone treatment plate assembly |
US7070599B2 (en) | 2002-07-24 | 2006-07-04 | Paul Kamaljit S | Bone support assembly |
US6755833B1 (en) * | 2001-12-14 | 2004-06-29 | Kamaljit S. Paul | Bone support assembly |
AR038680A1 (en) | 2002-02-19 | 2005-01-26 | Synthes Ag | INTERVERTEBRAL IMPLANT |
US20050096657A1 (en) * | 2002-02-26 | 2005-05-05 | Alex Autericque | Osteosynthesis or arthrodesis material comprising a bony plate |
FR2836369B1 (en) * | 2002-02-26 | 2004-04-30 | Medicrea | OSTEOSYNTHESIS OR ARTHRODESIS MATERIAL COMPRISING A BONE PLATE AND SCREWS FOR FIXING THIS PLATE |
US6695846B2 (en) * | 2002-03-12 | 2004-02-24 | Spinal Innovations, Llc | Bone plate and screw retaining mechanism |
US7077843B2 (en) * | 2002-06-24 | 2006-07-18 | Lanx, Llc | Cervical plate |
US7175623B2 (en) * | 2002-06-24 | 2007-02-13 | Lanx, Llc | Cervical plate with backout protection |
US7001389B1 (en) | 2002-07-05 | 2006-02-21 | Navarro Richard R | Fixed and variable locking fixation assembly |
US6989012B2 (en) * | 2002-07-16 | 2006-01-24 | Sdgi Holdings, Inc. | Plating system for stabilizing a bony segment |
US8257402B2 (en) | 2002-09-06 | 2012-09-04 | Jackson Roger P | Closure for rod receiving orthopedic implant having left handed thread removal |
US8282673B2 (en) | 2002-09-06 | 2012-10-09 | Jackson Roger P | Anti-splay medical implant closure with multi-surface removal aperture |
US8876868B2 (en) | 2002-09-06 | 2014-11-04 | Roger P. Jackson | Helical guide and advancement flange with radially loaded lip |
US7625378B2 (en) * | 2002-09-30 | 2009-12-01 | Warsaw Orthopedic, Inc. | Devices and methods for securing a bone plate to a bony segment |
WO2004039236A2 (en) | 2002-10-28 | 2004-05-13 | Blackstone Medical, Inc. | Bone plate assembly provided with screw locking mechanisms |
US7682392B2 (en) | 2002-10-30 | 2010-03-23 | Depuy Spine, Inc. | Regenerative implants for stabilizing the spine and devices for attachment of said implants |
US7425213B2 (en) * | 2002-12-10 | 2008-09-16 | Depuy Products, Inc. | Method of endosteal nailing |
US7048739B2 (en) * | 2002-12-31 | 2006-05-23 | Depuy Spine, Inc. | Bone plate and resilient screw system allowing bi-directional assembly |
US7914561B2 (en) | 2002-12-31 | 2011-03-29 | Depuy Spine, Inc. | Resilient bone plate and screw system allowing bi-directional assembly |
US7175624B2 (en) * | 2002-12-31 | 2007-02-13 | Depuy Spine, Inc. | Bone plate and screw system allowing bi-directional assembly |
US7341591B2 (en) * | 2003-01-30 | 2008-03-11 | Depuy Spine, Inc. | Anterior buttress staple |
WO2004071276A2 (en) | 2003-02-05 | 2004-08-26 | Pioneer Laboratories, Inc. | Bone plate system |
EP2457541A1 (en) | 2003-02-06 | 2012-05-30 | Synthes GmbH | Implant between vertebrae |
US7819903B2 (en) | 2003-03-31 | 2010-10-26 | Depuy Spine, Inc. | Spinal fixation plate |
US6716214B1 (en) | 2003-06-18 | 2004-04-06 | Roger P. Jackson | Polyaxial bone screw with spline capture connection |
US8540753B2 (en) | 2003-04-09 | 2013-09-24 | Roger P. Jackson | Polyaxial bone screw with uploaded threaded shank and method of assembly and use |
US7621918B2 (en) | 2004-11-23 | 2009-11-24 | Jackson Roger P | Spinal fixation tool set and method |
US6945973B2 (en) * | 2003-05-01 | 2005-09-20 | Nuvasive, Inc. | Slidable bone plate system |
US7377923B2 (en) | 2003-05-22 | 2008-05-27 | Alphatec Spine, Inc. | Variable angle spinal screw assembly |
DE10326643A1 (en) * | 2003-06-11 | 2004-12-30 | Mückter, Helmut, Dr. med. Dipl.-Ing. | Osteosynthesis plate or comparable implant with ball sleeve |
US8257398B2 (en) * | 2003-06-18 | 2012-09-04 | Jackson Roger P | Polyaxial bone screw with cam capture |
US8092500B2 (en) | 2007-05-01 | 2012-01-10 | Jackson Roger P | Dynamic stabilization connecting member with floating core, compression spacer and over-mold |
US8137386B2 (en) | 2003-08-28 | 2012-03-20 | Jackson Roger P | Polyaxial bone screw apparatus |
US7766915B2 (en) | 2004-02-27 | 2010-08-03 | Jackson Roger P | Dynamic fixation assemblies with inner core and outer coil-like member |
US8377102B2 (en) | 2003-06-18 | 2013-02-19 | Roger P. Jackson | Polyaxial bone anchor with spline capture connection and lower pressure insert |
US8398682B2 (en) | 2003-06-18 | 2013-03-19 | Roger P. Jackson | Polyaxial bone screw assembly |
US8926670B2 (en) | 2003-06-18 | 2015-01-06 | Roger P. Jackson | Polyaxial bone screw assembly |
US7776067B2 (en) | 2005-05-27 | 2010-08-17 | Jackson Roger P | Polyaxial bone screw with shank articulation pressure insert and method |
US7967850B2 (en) | 2003-06-18 | 2011-06-28 | Jackson Roger P | Polyaxial bone anchor with helical capture connection, insert and dual locking assembly |
US8366753B2 (en) | 2003-06-18 | 2013-02-05 | Jackson Roger P | Polyaxial bone screw assembly with fixed retaining structure |
US7309340B2 (en) | 2003-06-20 | 2007-12-18 | Medicinelodge, Inc. | Method and apparatus for bone plating |
KR100552117B1 (en) * | 2003-07-22 | 2006-02-13 | 유앤아이 주식회사 | cervical spine fixator and driver |
US7857839B2 (en) * | 2003-09-03 | 2010-12-28 | Synthes Usa, Llc | Bone plate with captive clips |
US7909860B2 (en) | 2003-09-03 | 2011-03-22 | Synthes Usa, Llc | Bone plate with captive clips |
US20050049595A1 (en) | 2003-09-03 | 2005-03-03 | Suh Sean S. | Track-plate carriage system |
US9078706B2 (en) | 2003-09-30 | 2015-07-14 | X-Spine Systems, Inc. | Intervertebral fusion device utilizing multiple mobile uniaxial and bidirectional screw interface plates |
US8372152B2 (en) * | 2003-09-30 | 2013-02-12 | X-Spine Systems, Inc. | Spinal fusion system utilizing an implant plate having at least one integral lock and ratchet lock |
US7182782B2 (en) | 2003-09-30 | 2007-02-27 | X-Spine Systems, Inc. | Spinal fusion system and method for fusing spinal bones |
US7641701B2 (en) | 2003-09-30 | 2010-01-05 | X-Spine Systems, Inc. | Spinal fusion system and method for fusing spinal bones |
US8062367B2 (en) | 2003-09-30 | 2011-11-22 | X-Spine Systems, Inc. | Screw locking mechanism and method |
US8821553B2 (en) * | 2003-09-30 | 2014-09-02 | X-Spine Systems, Inc. | Spinal fusion system utilizing an implant plate having at least one integral lock |
US7306605B2 (en) | 2003-10-02 | 2007-12-11 | Zimmer Spine, Inc. | Anterior cervical plate |
US11419642B2 (en) | 2003-12-16 | 2022-08-23 | Medos International Sarl | Percutaneous access devices and bone anchor assemblies |
US7527638B2 (en) | 2003-12-16 | 2009-05-05 | Depuy Spine, Inc. | Methods and devices for minimally invasive spinal fixation element placement |
US7179261B2 (en) | 2003-12-16 | 2007-02-20 | Depuy Spine, Inc. | Percutaneous access devices and bone anchor assemblies |
US8182518B2 (en) * | 2003-12-22 | 2012-05-22 | Life Spine, Inc. | Static and dynamic cervical plates and cervical plate constructs |
US20050149021A1 (en) * | 2003-12-23 | 2005-07-07 | Tozzi James E. | Spinal implant device |
US7635366B2 (en) * | 2003-12-29 | 2009-12-22 | Abdou M Samy | Plating system for bone fixation and method of implantation |
US7678137B2 (en) | 2004-01-13 | 2010-03-16 | Life Spine, Inc. | Pedicle screw constructs for spine fixation systems |
US7740649B2 (en) | 2004-02-26 | 2010-06-22 | Pioneer Surgical Technology, Inc. | Bone plate system and methods |
US8900277B2 (en) | 2004-02-26 | 2014-12-02 | Pioneer Surgical Technology, Inc. | Bone plate system |
WO2005092218A1 (en) | 2004-02-27 | 2005-10-06 | Jackson Roger P | Orthopedic implant rod reduction tool set and method |
US7160300B2 (en) | 2004-02-27 | 2007-01-09 | Jackson Roger P | Orthopedic implant rod reduction tool set and method |
US8152810B2 (en) | 2004-11-23 | 2012-04-10 | Jackson Roger P | Spinal fixation tool set and method |
AU2005230804A1 (en) * | 2004-04-07 | 2005-10-20 | C G Surgical Limited | Devices to stabilise the lamina |
US7942913B2 (en) | 2004-04-08 | 2011-05-17 | Ebi, Llc | Bone fixation device |
US7465318B2 (en) | 2004-04-15 | 2008-12-16 | Soteira, Inc. | Cement-directing orthopedic implants |
US7909873B2 (en) | 2006-12-15 | 2011-03-22 | Soteira, Inc. | Delivery apparatus and methods for vertebrostenting |
US8236034B2 (en) | 2004-04-19 | 2012-08-07 | Globus Medical, Inc. | Bone fixation plate |
US7938848B2 (en) * | 2004-06-09 | 2011-05-10 | Life Spine, Inc. | Spinal fixation system |
US7744635B2 (en) | 2004-06-09 | 2010-06-29 | Spinal Generations, Llc | Spinal fixation system |
WO2005122922A2 (en) * | 2004-06-14 | 2005-12-29 | Abdou M S | Occipital fixation system and method of use |
US7727266B2 (en) | 2004-06-17 | 2010-06-01 | Warsaw Orthopedic, Inc. | Method and apparatus for retaining screws in a plate |
US7651496B2 (en) * | 2004-07-23 | 2010-01-26 | Zimmer Spine, Inc. | Methods and apparatuses for percutaneous implant delivery |
US20060036250A1 (en) * | 2004-08-12 | 2006-02-16 | Lange Eric C | Antero-lateral plating systems for spinal stabilization |
US7651502B2 (en) | 2004-09-24 | 2010-01-26 | Jackson Roger P | Spinal fixation tool set and method for rod reduction and fastener insertion |
US9615866B1 (en) | 2004-10-18 | 2017-04-11 | Nuvasive, Inc. | Surgical fixation system and related methods |
JP2008519656A (en) | 2004-11-10 | 2008-06-12 | ロジャー・ピー・ジャクソン | Helical guide and forward flange with break extension |
US8926672B2 (en) | 2004-11-10 | 2015-01-06 | Roger P. Jackson | Splay control closure for open bone anchor |
US9393047B2 (en) | 2009-06-15 | 2016-07-19 | Roger P. Jackson | Polyaxial bone anchor with pop-on shank and friction fit retainer with low profile edge lock |
US9216041B2 (en) | 2009-06-15 | 2015-12-22 | Roger P. Jackson | Spinal connecting members with tensioned cords and rigid sleeves for engaging compression inserts |
US8308782B2 (en) | 2004-11-23 | 2012-11-13 | Jackson Roger P | Bone anchors with longitudinal connecting member engaging inserts and closures for fixation and optional angulation |
US7875065B2 (en) | 2004-11-23 | 2011-01-25 | Jackson Roger P | Polyaxial bone screw with multi-part shank retainer and pressure insert |
US8444681B2 (en) | 2009-06-15 | 2013-05-21 | Roger P. Jackson | Polyaxial bone anchor with pop-on shank, friction fit retainer and winged insert |
US9980753B2 (en) | 2009-06-15 | 2018-05-29 | Roger P Jackson | pivotal anchor with snap-in-place insert having rotation blocking extensions |
US9168069B2 (en) | 2009-06-15 | 2015-10-27 | Roger P. Jackson | Polyaxial bone anchor with pop-on shank and winged insert with lower skirt for engaging a friction fit retainer |
US8556938B2 (en) | 2009-06-15 | 2013-10-15 | Roger P. Jackson | Polyaxial bone anchor with non-pivotable retainer and pop-on shank, some with friction fit |
WO2006057837A1 (en) | 2004-11-23 | 2006-06-01 | Jackson Roger P | Spinal fixation tool attachment structure |
EP1814474B1 (en) | 2004-11-24 | 2011-09-14 | Samy Abdou | Devices for inter-vertebral orthopedic device placement |
US7691133B2 (en) * | 2004-11-30 | 2010-04-06 | Integra Lifesciences Corporation | Systems and methods for bone fixation |
US7736380B2 (en) | 2004-12-21 | 2010-06-15 | Rhausler, Inc. | Cervical plate system |
US8353939B2 (en) * | 2005-01-12 | 2013-01-15 | Warsaw Orthopedic, Inc. | Anchor retaining mechanisms for bone plates |
US20060195089A1 (en) * | 2005-02-03 | 2006-08-31 | Lehuec Jean-Charles | Spinal plating and intervertebral support systems and methods |
BRPI0607139A2 (en) | 2005-02-18 | 2009-08-11 | M S Abdou | bone fixation set |
US7901437B2 (en) | 2007-01-26 | 2011-03-08 | Jackson Roger P | Dynamic stabilization member with molded connection |
US10076361B2 (en) | 2005-02-22 | 2018-09-18 | Roger P. Jackson | Polyaxial bone screw with spherical capture, compression and alignment and retention structures |
US20060229620A1 (en) * | 2005-03-03 | 2006-10-12 | Accin Corporation | Method and apparatus for providing a retainer for a bone stabilization device |
US7481811B2 (en) * | 2005-03-11 | 2009-01-27 | Synthes (U.S.A.) | Translational plate with spring beam retainer |
US20060235409A1 (en) | 2005-03-17 | 2006-10-19 | Jason Blain | Flanged interbody fusion device |
US20060241611A1 (en) * | 2005-04-12 | 2006-10-26 | Frank Castro | Modular spinal implant system to assist with cervical stabilization |
US7678113B2 (en) | 2005-04-19 | 2010-03-16 | Warsaw Orthopedic, Inc. | Antero-lateral plating systems and methods for spinal stabilization |
US7452370B2 (en) * | 2005-04-29 | 2008-11-18 | Warsaw Orthopedic, Inc | Apparatus for retaining a bone anchor in a bone plate and method for use thereof |
US20060271052A1 (en) * | 2005-05-12 | 2006-11-30 | Stern Joseph D | Revisable anterior cervical plating system |
US8070749B2 (en) | 2005-05-12 | 2011-12-06 | Stern Joseph D | Revisable anterior cervical plating system |
US7288094B2 (en) * | 2005-06-10 | 2007-10-30 | Sdgi Holdings, Inc. | System and method for retaining screws relative to a vertebral plate |
US20060293668A1 (en) * | 2005-06-10 | 2006-12-28 | Sdgi Holdings, Inc. | Bone screw locking mechanism and method of use |
US7905909B2 (en) | 2005-09-19 | 2011-03-15 | Depuy Products, Inc. | Bone stabilization system including multi-directional threaded fixation element |
FR2891135B1 (en) | 2005-09-23 | 2008-09-12 | Ldr Medical Sarl | INTERVERTEBRAL DISC PROSTHESIS |
US8105368B2 (en) | 2005-09-30 | 2012-01-31 | Jackson Roger P | Dynamic stabilization connecting member with slitted core and outer sleeve |
US7699880B2 (en) * | 2005-10-24 | 2010-04-20 | Depuy Products, Inc. | Bone fixation system and bone screws having anti-back out feature |
WO2007056516A2 (en) * | 2005-11-09 | 2007-05-18 | Abdou M S | Bone fixation systems and methods of implantation |
JP5357546B2 (en) * | 2005-11-16 | 2013-12-04 | シンセス ゲゼルシャフト ミット ベシュレンクテル ハフツング | Bone fixing device through hole |
US7704271B2 (en) | 2005-12-19 | 2010-04-27 | Abdou M Samy | Devices and methods for inter-vertebral orthopedic device placement |
US8663287B2 (en) | 2006-01-10 | 2014-03-04 | Life Spine, Inc. | Pedicle screw constructs and spinal rod attachment assemblies |
US7833252B2 (en) * | 2006-01-27 | 2010-11-16 | Warsaw Orthopedic, Inc. | Pivoting joints for spinal implants including designed resistance to motion and methods of use |
US8057519B2 (en) * | 2006-01-27 | 2011-11-15 | Warsaw Orthopedic, Inc. | Multi-axial screw assembly |
US7722652B2 (en) | 2006-01-27 | 2010-05-25 | Warsaw Orthopedic, Inc. | Pivoting joints for spinal implants including designed resistance to motion and methods of use |
US7951151B2 (en) * | 2006-02-21 | 2011-05-31 | Life Spine, Inc. | Structure for joining and retaining multi-part orthopedic implants |
WO2007098288A2 (en) | 2006-02-27 | 2007-08-30 | Synthes (U.S.A.) | Intervertebral implant with fixation geometry |
US20070225718A1 (en) * | 2006-03-22 | 2007-09-27 | Ensign Michael D | Rotolock cervical plate locking mechanism |
US7806900B2 (en) | 2006-04-26 | 2010-10-05 | Illuminoss Medical, Inc. | Apparatus and methods for delivery of reinforcing materials to bone |
FR2900326B1 (en) * | 2006-04-27 | 2008-07-04 | Medicrea Technologies | OSTEOSYNTHESIS PLATE |
US20070270859A1 (en) * | 2006-04-28 | 2007-11-22 | Sdgi Holdings, Inc. | Orthopedic screw with break away drive |
US20070270880A1 (en) * | 2006-04-28 | 2007-11-22 | Lindemann Gary S | Bone screw revision tools and methods of use |
DE102006026590B3 (en) * | 2006-05-31 | 2008-01-03 | Aesculap Ag & Co. Kg | implant |
US20120232595A1 (en) | 2011-03-07 | 2012-09-13 | Tyler HOLSCHLAG | Fastener retention system for spinal plates |
US8388660B1 (en) | 2006-08-01 | 2013-03-05 | Samy Abdou | Devices and methods for superior fixation of orthopedic devices onto the vertebral column |
US8262710B2 (en) * | 2006-10-24 | 2012-09-11 | Aesculap Implant Systems, Llc | Dynamic stabilization device for anterior lower lumbar vertebral fusion |
US8206390B2 (en) * | 2006-11-02 | 2012-06-26 | Warsaw Orthopedic, Inc. | Uni-directional ratcheting bone plate assembly |
US7811284B2 (en) | 2006-11-10 | 2010-10-12 | Illuminoss Medical, Inc. | Systems and methods for internal bone fixation |
US7879041B2 (en) | 2006-11-10 | 2011-02-01 | Illuminoss Medical, Inc. | Systems and methods for internal bone fixation |
CA2670988C (en) | 2006-12-08 | 2014-03-25 | Roger P. Jackson | Tool system for dynamic spinal implants |
US9192397B2 (en) | 2006-12-15 | 2015-11-24 | Gmedelaware 2 Llc | Devices and methods for fracture reduction |
US9480485B2 (en) | 2006-12-15 | 2016-11-01 | Globus Medical, Inc. | Devices and methods for vertebrostenting |
EP2124785A1 (en) * | 2006-12-19 | 2009-12-02 | Small Bone Innovations, Inc. | Locking fixation system and lag tool |
DE202006019220U1 (en) * | 2006-12-19 | 2007-05-24 | Zrinski Ag | Orthopedic screw fastening system for fixing at bone of patient, has through-holes cut on one another so that intersection line and surfaces are produced in direction of plate thickness, where line and surfaces co-operate with head windings |
US8475498B2 (en) | 2007-01-18 | 2013-07-02 | Roger P. Jackson | Dynamic stabilization connecting member with cord connection |
US8366745B2 (en) | 2007-05-01 | 2013-02-05 | Jackson Roger P | Dynamic stabilization assembly having pre-compressed spacers with differential displacements |
US10792074B2 (en) | 2007-01-22 | 2020-10-06 | Roger P. Jackson | Pivotal bone anchor assemly with twist-in-place friction fit insert |
US8012177B2 (en) | 2007-02-12 | 2011-09-06 | Jackson Roger P | Dynamic stabilization assembly with frusto-conical connection |
US8425607B2 (en) * | 2007-04-03 | 2013-04-23 | Warsaw Orthopedic, Inc. | Anchor member locking features |
US10383660B2 (en) | 2007-05-01 | 2019-08-20 | Roger P. Jackson | Soft stabilization assemblies with pretensioned cords |
US7942911B2 (en) | 2007-05-16 | 2011-05-17 | Ortho Innovations, Llc | Polyaxial bone screw |
US7942909B2 (en) | 2009-08-13 | 2011-05-17 | Ortho Innovations, Llc | Thread-thru polyaxial pedicle screw system |
US7942910B2 (en) | 2007-05-16 | 2011-05-17 | Ortho Innovations, Llc | Polyaxial bone screw |
US8197518B2 (en) | 2007-05-16 | 2012-06-12 | Ortho Innovations, Llc | Thread-thru polyaxial pedicle screw system |
US7951173B2 (en) | 2007-05-16 | 2011-05-31 | Ortho Innovations, Llc | Pedicle screw implant system |
US7947065B2 (en) | 2008-11-14 | 2011-05-24 | Ortho Innovations, Llc | Locking polyaxial ball and socket fastener |
CA2690038C (en) | 2007-05-31 | 2012-11-27 | Roger P. Jackson | Dynamic stabilization connecting member with pre-tensioned solid core |
FR2916956B1 (en) | 2007-06-08 | 2012-12-14 | Ldr Medical | INTERSOMATIC CAGE, INTERVERTEBRAL PROSTHESIS, ANCHORING DEVICE AND IMPLANTATION INSTRUMENTATION |
US8361126B2 (en) | 2007-07-03 | 2013-01-29 | Pioneer Surgical Technology, Inc. | Bone plate system |
WO2009006604A1 (en) | 2007-07-03 | 2009-01-08 | Pioneer Surgical Technology, Inc. | Bone plate system |
US7963982B2 (en) * | 2007-07-16 | 2011-06-21 | X-Spine Systems, Inc. | Implant plate screw locking system and screw having a locking member |
US20090177239A1 (en) * | 2007-08-06 | 2009-07-09 | Michael Castro | Cervical plate instrument kit |
US8852280B2 (en) | 2007-09-27 | 2014-10-07 | Warsaw Orthopedic, Inc. | Intervertebral implant |
US8613761B2 (en) | 2007-09-28 | 2013-12-24 | Warsaw Orthopedic, Inc. | Surgical implant with an anti-backout feature |
US8496693B2 (en) * | 2007-10-16 | 2013-07-30 | Amendia Inc. | Bone screw retaining and removal system |
US8911477B2 (en) | 2007-10-23 | 2014-12-16 | Roger P. Jackson | Dynamic stabilization member with end plate support and cable core extension |
WO2009059090A1 (en) | 2007-10-31 | 2009-05-07 | Illuminoss Medical, Inc. | Light source |
US8906077B2 (en) * | 2007-11-09 | 2014-12-09 | Stryker Spine | Cervical plate with a feedback device for selective association with bone screw blocking mechanism |
KR20100105580A (en) | 2007-11-16 | 2010-09-29 | 신세스 게엠바하 | Low profile intervertebral implant |
FR2924015A1 (en) * | 2007-11-26 | 2009-05-29 | Spineway Soc Par Actions Simpl | Screw head holding system for e.g. osteosynthesis plate in cervical backbone, has hole and screw head presenting complementary holding shapes after placing and locking screw in support, where hole presents arrangements formed by slit |
US8206143B2 (en) * | 2007-12-13 | 2012-06-26 | Biomet Manufacturing Corp. | Modular articulating cement spacer |
US8403968B2 (en) | 2007-12-26 | 2013-03-26 | Illuminoss Medical, Inc. | Apparatus and methods for repairing craniomaxillofacial bones using customized bone plates |
FR2926975B1 (en) * | 2008-02-01 | 2010-03-26 | Alexandre Worcel | OSTEOSYNTHESIS DEVICE WITH RAPID FASTENING MEANS |
US20090210008A1 (en) * | 2008-02-20 | 2009-08-20 | Life Spine, Inc. | Modular spine plate with projection and socket interface |
US8551144B2 (en) * | 2008-04-22 | 2013-10-08 | Collab Comlo, LLC | Bone plate system configurable as static or dynamic implant |
US8480716B2 (en) | 2008-04-25 | 2013-07-09 | Pioneer Surgical Technology, Inc. | Bone plate system |
US8425514B2 (en) * | 2008-06-25 | 2013-04-23 | Westmark Medical, Llc. | Spinal fixation device |
US8414584B2 (en) | 2008-07-09 | 2013-04-09 | Icon Orthopaedic Concepts, Llc | Ankle arthrodesis nail and outrigger assembly |
US8328807B2 (en) | 2008-07-09 | 2012-12-11 | Icon Orthopaedic Concepts, Llc | Ankle arthrodesis nail and outrigger assembly |
JP2012529969A (en) | 2008-08-01 | 2012-11-29 | ロジャー・ピー・ジャクソン | Longitudinal connecting member with tensioning cord with sleeve |
WO2010025405A1 (en) * | 2008-08-29 | 2010-03-04 | Life Spine, Inc. | Single-sided dynamic spine plates |
US8328872B2 (en) | 2008-09-02 | 2012-12-11 | Globus Medical, Inc. | Intervertebral fusion implant |
US8709083B2 (en) | 2009-06-04 | 2014-04-29 | William E. Duffield | Intervertebral fusion implant |
FR2936700B1 (en) | 2008-10-02 | 2012-04-13 | Memometal Technologies | ORTHOPEDIC IMPLANT IN THE FORM OF A PLATE TO BE FIXED BETWEEN TWO BONE PARTS |
US8409208B2 (en) | 2008-10-04 | 2013-04-02 | M. Samy Abdou | Device and method to access the anterior column of the spine |
WO2010054208A1 (en) | 2008-11-07 | 2010-05-14 | Synthes Usa, Llc | Vertebral interbody spacer and coupled plate assembly |
US20100121383A1 (en) * | 2008-11-10 | 2010-05-13 | Todd Stanaford | Method, system, and apparatus for mammalian bony segment stabilization |
US8821554B2 (en) | 2008-11-10 | 2014-09-02 | Amendia, Inc. | Method, system, and apparatus for mammalian bony segment stabilization |
US8075603B2 (en) | 2008-11-14 | 2011-12-13 | Ortho Innovations, Llc | Locking polyaxial ball and socket fastener |
US8992558B2 (en) | 2008-12-18 | 2015-03-31 | Osteomed, Llc | Lateral access system for the lumbar spine |
DE202009001900U1 (en) * | 2009-02-23 | 2009-07-16 | Zrinski Ag | Implant for fusion of bones or bone parts |
US8574270B2 (en) | 2009-03-13 | 2013-11-05 | Spinal Simplicity Llc | Bone plate assembly with bone screw retention features |
WO2010105279A1 (en) | 2009-03-13 | 2010-09-16 | Harold Hess | Dynamic vertebral column plate system |
US8486115B2 (en) * | 2009-03-13 | 2013-07-16 | Lanx, Inc. | Spinal plate assemblies with backout protection cap and methods |
BRPI1008924A2 (en) | 2009-03-16 | 2017-06-06 | Synthes Gmbh | System and method for stabilizing vertebra in spine surgery through a lateral access channel |
US9220547B2 (en) | 2009-03-27 | 2015-12-29 | Spinal Elements, Inc. | Flanged interbody fusion device |
US8210729B2 (en) | 2009-04-06 | 2012-07-03 | Illuminoss Medical, Inc. | Attachment system for light-conducting fibers |
US8211154B2 (en) * | 2009-04-06 | 2012-07-03 | Lanx, Inc. | Bone plate assemblies with backout protection and visual indicator |
US8512338B2 (en) | 2009-04-07 | 2013-08-20 | Illuminoss Medical, Inc. | Photodynamic bone stabilization systems and methods for reinforcing bone |
US9408715B2 (en) | 2009-04-15 | 2016-08-09 | DePuy Synthes Products, Inc. | Arcuate fixation member |
US8641766B2 (en) | 2009-04-15 | 2014-02-04 | DePuy Synthes Products, LLC | Arcuate fixation member |
US9668771B2 (en) | 2009-06-15 | 2017-06-06 | Roger P Jackson | Soft stabilization assemblies with off-set connector |
US11229457B2 (en) | 2009-06-15 | 2022-01-25 | Roger P. Jackson | Pivotal bone anchor assembly with insert tool deployment |
EP2757988A4 (en) | 2009-06-15 | 2015-08-19 | Jackson Roger P | Polyaxial bone anchor with pop-on shank and winged insert with friction fit compressive collet |
US8998959B2 (en) | 2009-06-15 | 2015-04-07 | Roger P Jackson | Polyaxial bone anchors with pop-on shank, fully constrained friction fit retainer and lock and release insert |
US8834536B2 (en) * | 2009-07-16 | 2014-09-16 | Nexxt Spine, LLC | Cervical plate fixation system |
EP2456376A4 (en) | 2009-07-24 | 2014-01-01 | Spinal USA LLC | Bone plate screw-blocking systems and methods |
US9095444B2 (en) | 2009-07-24 | 2015-08-04 | Warsaw Orthopedic, Inc. | Implant with an interference fit fastener |
KR20120082397A (en) * | 2009-07-24 | 2012-07-23 | 스파이널 유에스에이 엘엘씨 | Bone plate system and methods of using the same |
US8870965B2 (en) * | 2009-08-19 | 2014-10-28 | Illuminoss Medical, Inc. | Devices and methods for bone alignment, stabilization and distraction |
US8591555B2 (en) * | 2009-08-31 | 2013-11-26 | Warsaw Orthopedic, Inc. | System with integral locking mechanism |
BR112012005663A2 (en) | 2009-09-17 | 2021-07-27 | Synthes Gmbh | intervertebral implant with expandable bone fixation limbs |
USD734853S1 (en) | 2009-10-14 | 2015-07-21 | Nuvasive, Inc. | Bone plate |
US20110106157A1 (en) * | 2009-10-30 | 2011-05-05 | Warsaw Orthropedic, Inc. | Self-Locking Interference Bone Screw for use with Spinal Implant |
US9486263B2 (en) | 2009-11-04 | 2016-11-08 | X-Spine Systems, Inc. | Screw implant and system and method for locking a screw in an implant plate |
US8535356B2 (en) | 2009-11-04 | 2013-09-17 | X-Spine Systems, Inc. | Screw implant and system and method for locking a screw in an implant plate |
US8840668B1 (en) | 2009-11-11 | 2014-09-23 | Nuvasive, Inc. | Spinal implants, instruments and related methods |
US8740983B1 (en) | 2009-11-11 | 2014-06-03 | Nuvasive, Inc. | Spinal fusion implants and related methods |
US8764806B2 (en) | 2009-12-07 | 2014-07-01 | Samy Abdou | Devices and methods for minimally invasive spinal stabilization and instrumentation |
US9833331B2 (en) | 2009-12-31 | 2017-12-05 | Ldr Medical | Anchoring device and system for an intervertebral implant, intervertebral implant and implantation instrument |
US9155631B2 (en) | 2010-04-08 | 2015-10-13 | Globus Medical Inc. | Intervertbral implant |
US8858603B1 (en) | 2010-06-09 | 2014-10-14 | Choice Spine, L.P. | Cervical plate with screw retention clip |
US8377139B2 (en) | 2010-06-17 | 2013-02-19 | Aesculap Implant Systems, Llc | Standalone interbody fusion device with locking and release mechanism |
US8684965B2 (en) | 2010-06-21 | 2014-04-01 | Illuminoss Medical, Inc. | Photodynamic bone stabilization and drug delivery systems |
WO2012030712A1 (en) | 2010-08-30 | 2012-03-08 | Zimmer Spine, Inc. | Polyaxial pedicle screw |
JP2013540468A (en) | 2010-09-08 | 2013-11-07 | ロジャー・ピー・ジャクソン | Dynamic fixing member having an elastic part and an inelastic part |
US8753396B1 (en) | 2010-09-13 | 2014-06-17 | Theken Spine, Llc | Intervertebral implant having back-out prevention feature |
US8784027B2 (en) | 2010-09-14 | 2014-07-22 | Enduralock, Llc | Ratchet locking mechanism for threaded fastener |
US9657766B2 (en) | 2010-09-14 | 2017-05-23 | Enduralock, Llc | Tools and ratchet locking mechanisms for threaded fasteners |
US8562656B2 (en) | 2010-10-15 | 2013-10-22 | Warsaw Orrthopedic, Inc. | Retaining mechanism |
JP2013545527A (en) | 2010-11-02 | 2013-12-26 | ロジャー・ピー・ジャクソン | Multi-axis bone anchor with pop-on shank and pivotable retainer |
WO2012088238A2 (en) | 2010-12-21 | 2012-06-28 | Synthes Usa, Llc | Intervertebral implants, systems, and methods of use |
US9241809B2 (en) | 2010-12-21 | 2016-01-26 | DePuy Synthes Products, Inc. | Intervertebral implants, systems, and methods of use |
US9179959B2 (en) | 2010-12-22 | 2015-11-10 | Illuminoss Medical, Inc. | Systems and methods for treating conditions and diseases of the spine |
US9271770B2 (en) | 2011-01-20 | 2016-03-01 | Alphatec Spine, Inc | Bone fixation systems and methods |
US11154338B2 (en) | 2011-01-20 | 2021-10-26 | Alphatec Spine, Inc. | Bone fixation systems and methods |
US8940030B1 (en) | 2011-01-28 | 2015-01-27 | Nuvasive, Inc. | Spinal fixation system and related methods |
WO2012128825A1 (en) | 2011-03-24 | 2012-09-27 | Jackson Roger P | Polyaxial bone anchor with compound articulation and pop-on shank |
US9017412B2 (en) | 2011-04-29 | 2015-04-28 | Life Spine, Inc. | Spinal interbody implant with bone screw retention |
US8771324B2 (en) | 2011-05-27 | 2014-07-08 | Globus Medical, Inc. | Securing fasteners |
US8668723B2 (en) | 2011-07-19 | 2014-03-11 | Neurostructures, Inc. | Anterior cervical plate |
US8591556B2 (en) | 2011-07-19 | 2013-11-26 | Globus Medical, Inc. | Locking confirmation mechanism for a bone screw and plate assembly |
WO2013013072A1 (en) * | 2011-07-19 | 2013-01-24 | Illuminoss Medical, Inc. | Photodynamic articular joint implants and methods of use |
US8936644B2 (en) | 2011-07-19 | 2015-01-20 | Illuminoss Medical, Inc. | Systems and methods for joint stabilization |
US9775661B2 (en) | 2011-07-19 | 2017-10-03 | Illuminoss Medical, Inc. | Devices and methods for bone restructure and stabilization |
US9681959B2 (en) | 2011-09-16 | 2017-06-20 | Globus Medical, Inc. | Low profile plate |
US9848994B2 (en) | 2011-09-16 | 2017-12-26 | Globus Medical, Inc. | Low profile plate |
US10245155B2 (en) | 2011-09-16 | 2019-04-02 | Globus Medical, Inc. | Low profile plate |
US10881526B2 (en) | 2011-09-16 | 2021-01-05 | Globus Medical, Inc. | Low profile plate |
US9237957B2 (en) | 2011-09-16 | 2016-01-19 | Globus Medical, Inc. | Low profile plate |
US9539109B2 (en) | 2011-09-16 | 2017-01-10 | Globus Medical, Inc. | Low profile plate |
US9149365B2 (en) | 2013-03-05 | 2015-10-06 | Globus Medical, Inc. | Low profile plate |
US8845728B1 (en) | 2011-09-23 | 2014-09-30 | Samy Abdou | Spinal fixation devices and methods of use |
US11123117B1 (en) | 2011-11-01 | 2021-09-21 | Nuvasive, Inc. | Surgical fixation system and related methods |
US9198769B2 (en) | 2011-12-23 | 2015-12-01 | Pioneer Surgical Technology, Inc. | Bone anchor assembly, bone plate system, and method |
WO2013106217A1 (en) | 2012-01-10 | 2013-07-18 | Jackson, Roger, P. | Multi-start closures for open implants |
US8784459B2 (en) | 2012-01-17 | 2014-07-22 | Genesys Spine | Spinal plate and locking screw devices, methods, and systems |
US20130226240A1 (en) | 2012-02-22 | 2013-08-29 | Samy Abdou | Spinous process fixation devices and methods of use |
US8974504B2 (en) | 2012-05-10 | 2015-03-10 | Spinal Simplicity Llc | Dynamic bone fracture plates |
FR2990845B1 (en) | 2012-05-25 | 2015-04-24 | Spirits | VERTEBRAL IMPLANT HAVING AUTONOMOUS LOCKING AND UNLOCKING MEANS |
US20130325071A1 (en) | 2012-05-30 | 2013-12-05 | Marcin Niemiec | Aligning Vertebral Bodies |
US8939977B2 (en) | 2012-07-10 | 2015-01-27 | Illuminoss Medical, Inc. | Systems and methods for separating bone fixation devices from introducer |
US8814912B2 (en) | 2012-07-27 | 2014-08-26 | Zimmer Spine, Inc. | Bone stabilization member with bone screw retention mechanism |
KR101331428B1 (en) * | 2012-08-03 | 2013-11-21 | 주식회사 솔고 바이오메디칼 | Apparatus for fixing a cervical spine following an inserting angle of screw |
US9326861B2 (en) | 2012-08-03 | 2016-05-03 | Globus Medical, Inc. | Stabilizing joints |
US9198767B2 (en) | 2012-08-28 | 2015-12-01 | Samy Abdou | Devices and methods for spinal stabilization and instrumentation |
US9320617B2 (en) | 2012-10-22 | 2016-04-26 | Cogent Spine, LLC | Devices and methods for spinal stabilization and instrumentation |
US8911478B2 (en) | 2012-11-21 | 2014-12-16 | Roger P. Jackson | Splay control closure for open bone anchor |
US9687281B2 (en) | 2012-12-20 | 2017-06-27 | Illuminoss Medical, Inc. | Distal tip for bone fixation devices |
US10058354B2 (en) | 2013-01-28 | 2018-08-28 | Roger P. Jackson | Pivotal bone anchor assembly with frictional shank head seating surfaces |
US9642652B2 (en) * | 2013-02-13 | 2017-05-09 | Choice Spine, Lp | Variable angle bone plate with semi-constrained articulating screw |
US9585765B2 (en) | 2013-02-14 | 2017-03-07 | Globus Medical, Inc | Devices and methods for correcting vertebral misalignment |
US10105239B2 (en) | 2013-02-14 | 2018-10-23 | Globus Medical, Inc. | Devices and methods for correcting vertebral misalignment |
US8852239B2 (en) | 2013-02-15 | 2014-10-07 | Roger P Jackson | Sagittal angle screw with integral shank and receiver |
US10117754B2 (en) | 2013-02-25 | 2018-11-06 | Globus Medical, Inc. | Expandable intervertebral implant |
US9404525B2 (en) | 2013-03-14 | 2016-08-02 | Imds Llc | Polyaxial locking interface |
US10327910B2 (en) | 2013-03-14 | 2019-06-25 | X-Spine Systems, Inc. | Spinal implant and assembly |
US9103367B2 (en) | 2013-03-14 | 2015-08-11 | Imds Llc | Polyaxial locking interface |
US9149367B2 (en) | 2013-03-15 | 2015-10-06 | Globus Medical Inc | Expandable intervertebral implant |
US9034045B2 (en) | 2013-03-15 | 2015-05-19 | Globus Medical, Inc | Expandable intervertebral implant |
US9233009B2 (en) | 2013-03-15 | 2016-01-12 | Globus Medical, Inc. | Expandable intervertebral implant |
US9186258B2 (en) | 2013-03-15 | 2015-11-17 | Globus Medical, Inc. | Expandable intervertebral implant |
US9456906B2 (en) | 2013-03-15 | 2016-10-04 | Globus Medical, Inc. | Expandable intervertebral implant |
US9572677B2 (en) | 2013-03-15 | 2017-02-21 | Globus Medical, Inc. | Expandable intervertebral implant |
US9474622B2 (en) | 2013-03-15 | 2016-10-25 | Globus Medical, Inc | Expandable intervertebral implant |
US9539103B2 (en) | 2013-03-15 | 2017-01-10 | Globus Medical, Inc. | Expandable intervertebral implant |
US9453526B2 (en) | 2013-04-30 | 2016-09-27 | Degen Medical, Inc. | Bottom-loading anchor assembly |
FR3005569B1 (en) | 2013-05-16 | 2021-09-03 | Ldr Medical | VERTEBRAL IMPLANT, VERTEBRAL IMPLANT FIXATION DEVICE AND IMPLANTATION INSTRUMENTATION |
US9943341B2 (en) | 2013-07-16 | 2018-04-17 | K2M, Llc | Retention plate member for a spinal plate system |
KR101599603B1 (en) | 2013-08-26 | 2016-03-03 | 경북대학교 산학협력단 | Medical inserting apparatus |
WO2015038301A1 (en) | 2013-09-13 | 2015-03-19 | X-Spine Systems, Inc. | Screw implant and system and method for locking a screw in an implant plate |
USD745159S1 (en) | 2013-10-10 | 2015-12-08 | Nuvasive, Inc. | Intervertebral implant |
US9566092B2 (en) | 2013-10-29 | 2017-02-14 | Roger P. Jackson | Cervical bone anchor with collet retainer and outer locking sleeve |
US9717533B2 (en) | 2013-12-12 | 2017-08-01 | Roger P. Jackson | Bone anchor closure pivot-splay control flange form guide and advancement structure |
US9451993B2 (en) | 2014-01-09 | 2016-09-27 | Roger P. Jackson | Bi-radial pop-on cervical bone anchor |
US9629664B2 (en) | 2014-01-20 | 2017-04-25 | Neurostructures, Inc. | Anterior cervical plate |
US9889014B2 (en) | 2014-02-06 | 2018-02-13 | Life Spine, Inc. | Implant for bone fixation |
US9877759B2 (en) | 2014-02-06 | 2018-01-30 | Life Spine, Inc. | Foot implant for bone fixation |
US9486250B2 (en) | 2014-02-20 | 2016-11-08 | Mastros Innovations, LLC. | Lateral plate |
US9055983B1 (en) | 2014-04-24 | 2015-06-16 | Amendia, Inc. | Self-locking bone screw receiver |
FR3020756B1 (en) | 2014-05-06 | 2022-03-11 | Ldr Medical | VERTEBRAL IMPLANT, VERTEBRAL IMPLANT FIXATION DEVICE AND IMPLANT INSTRUMENTATION |
US9545320B2 (en) | 2014-05-15 | 2017-01-17 | Globus Medical, Inc. | Standalone interbody implants |
US9486327B2 (en) | 2014-05-15 | 2016-11-08 | Globus Medical, Inc. | Standalone interbody implants |
US11160666B2 (en) | 2014-05-15 | 2021-11-02 | Globus Medical, Inc. | Laterally insertable intervertebral spinal implant |
US9968461B2 (en) | 2014-05-15 | 2018-05-15 | Globus Medical, Inc. | Standalone interbody implants |
US9675465B2 (en) | 2014-05-15 | 2017-06-13 | Globus Medical, Inc. | Standalone interbody implants |
US9913672B2 (en) | 2014-05-28 | 2018-03-13 | Genesys Spine | Resiliant spinal plate system |
US9597119B2 (en) | 2014-06-04 | 2017-03-21 | Roger P. Jackson | Polyaxial bone anchor with polymer sleeve |
US10064658B2 (en) | 2014-06-04 | 2018-09-04 | Roger P. Jackson | Polyaxial bone anchor with insert guides |
US9192483B1 (en) | 2014-06-27 | 2015-11-24 | Amendia, Inc. | Spinal fusion system |
US10213237B2 (en) | 2014-10-03 | 2019-02-26 | Stryker European Holdings I, Llc | Periprosthetic extension plate |
US9867718B2 (en) | 2014-10-22 | 2018-01-16 | DePuy Synthes Products, Inc. | Intervertebral implants, systems, and methods of use |
KR101639887B1 (en) * | 2014-11-11 | 2016-07-14 | 경북대학교 산학협력단 | A system for fixing cervical vertebrae and a driver used for an appratus for fixing cervical vertebrae |
KR101608949B1 (en) | 2014-11-19 | 2016-04-04 | 경북대학교 산학협력단 | A system for fixing cervical vertebrae, an appratus for fixing cervical vertebrae and a driver used for an appratus for fixing cervical vertebrae |
USD858769S1 (en) | 2014-11-20 | 2019-09-03 | Nuvasive, Inc. | Intervertebral implant |
JP2018502693A (en) | 2015-01-27 | 2018-02-01 | スパイナル・エレメンツ・インコーポレーテッド | Facet joint implant |
US9381093B1 (en) | 2015-02-09 | 2016-07-05 | Alliance Partners, Llc | Locking device for fixation mechanism of medical implant |
US9987052B2 (en) | 2015-02-24 | 2018-06-05 | X-Spine Systems, Inc. | Modular interspinous fixation system with threaded component |
WO2016168589A1 (en) | 2015-04-17 | 2016-10-20 | Enduralock, Llc | Locking fastener with deflectable lock |
US10215217B2 (en) | 2015-04-17 | 2019-02-26 | Enduralock, Llc | Locking fastener with deflectable lock |
US10801540B2 (en) | 2015-04-17 | 2020-10-13 | Enduralock, Llc | Locking mechanisms with deflectable lock member |
US10039648B2 (en) | 2015-05-06 | 2018-08-07 | Choice Spine, Lp | Intervertebral implant device |
KR101670768B1 (en) | 2015-07-16 | 2016-10-31 | 경북대학교 산학협력단 | Screw anchor assembly |
US10034768B2 (en) | 2015-09-02 | 2018-07-31 | Globus Medical, Inc. | Implantable systems, devices and related methods |
WO2017044477A1 (en) | 2015-09-08 | 2017-03-16 | Enduralock, Llc | Locking mechanisms with deflectable washer members |
US10874445B2 (en) | 2015-10-13 | 2020-12-29 | Kyungpook National University Industry-Academic Cooperation Foundation | Screw fixing apparatus |
US10857003B1 (en) | 2015-10-14 | 2020-12-08 | Samy Abdou | Devices and methods for vertebral stabilization |
KR101712610B1 (en) | 2015-12-29 | 2017-03-06 | 경북대학교 산학협력단 | A rod connecter |
US10251685B2 (en) | 2016-03-17 | 2019-04-09 | Stryker European Holdings I, Llc | Floating locking insert |
KR101791004B1 (en) | 2016-06-08 | 2017-10-27 | 경북대학교 산학협력단 | Screw anchor assembly and a method for using the same to pedicle screw instrumentation |
US11166709B2 (en) | 2016-08-23 | 2021-11-09 | Stryker European Operations Holdings Llc | Instrumentation and methods for the implantation of spinal implants |
US10744000B1 (en) | 2016-10-25 | 2020-08-18 | Samy Abdou | Devices and methods for vertebral bone realignment |
US10973648B1 (en) | 2016-10-25 | 2021-04-13 | Samy Abdou | Devices and methods for vertebral bone realignment |
US11452608B2 (en) | 2017-04-05 | 2022-09-27 | Globus Medical, Inc. | Decoupled spacer and plate and method of installing the same |
US10376385B2 (en) | 2017-04-05 | 2019-08-13 | Globus Medical, Inc. | Decoupled spacer and plate and method of installing the same |
US10512547B2 (en) | 2017-05-04 | 2019-12-24 | Neurostructures, Inc. | Interbody spacer |
US10980641B2 (en) | 2017-05-04 | 2021-04-20 | Neurostructures, Inc. | Interbody spacer |
US11000321B2 (en) | 2017-05-25 | 2021-05-11 | Altus Partners Llc | Secondary screw blocking mechanism |
US11596495B2 (en) | 2017-08-17 | 2023-03-07 | Stryker European Operations Holdings Llc | Lateral access alignment guide and rigid arm |
EP3545857B1 (en) | 2018-03-30 | 2024-01-03 | Stryker European Operations Holdings LLC | Lateral access retractor and core insertion |
US11071572B2 (en) | 2018-06-27 | 2021-07-27 | Illuminoss Medical, Inc. | Systems and methods for bone stabilization and fixation |
US11076892B2 (en) | 2018-08-03 | 2021-08-03 | Neurostructures, Inc. | Anterior cervical plate |
AU2019342137A1 (en) | 2018-09-20 | 2021-03-25 | Spinal Elements, Inc. | Spinal implant device |
US11179248B2 (en) | 2018-10-02 | 2021-11-23 | Samy Abdou | Devices and methods for spinal implantation |
US11071629B2 (en) | 2018-10-13 | 2021-07-27 | Neurostructures Inc. | Interbody spacer |
US11298244B2 (en) | 2019-01-31 | 2022-04-12 | K2M, Inc. | Interbody implants and instrumentation |
US11111950B2 (en) | 2019-04-01 | 2021-09-07 | Enduralock, Llc | Locking mechanisms with deflectable lock member |
US11534307B2 (en) | 2019-09-16 | 2022-12-27 | K2M, Inc. | 3D printed cervical standalone implant |
US11564674B2 (en) | 2019-11-27 | 2023-01-31 | K2M, Inc. | Lateral access system and method of use |
US11877779B2 (en) | 2020-03-26 | 2024-01-23 | Xtant Medical Holdings, Inc. | Bone plate system |
US11382761B2 (en) | 2020-04-11 | 2022-07-12 | Neurostructures, Inc. | Expandable interbody spacer |
US11304817B2 (en) | 2020-06-05 | 2022-04-19 | Neurostructures, Inc. | Expandable interbody spacer |
US11911284B2 (en) | 2020-11-19 | 2024-02-27 | Spinal Elements, Inc. | Curved expandable interbody devices and deployment tools |
US11717419B2 (en) | 2020-12-10 | 2023-08-08 | Neurostructures, Inc. | Expandable interbody spacer |
JP7229575B1 (en) * | 2021-08-27 | 2023-02-28 | ヤマト科学株式会社 | test equipment |
Family Cites Families (49)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3901298A (en) * | 1974-04-05 | 1975-08-26 | John B Eby | Fastener holding attachment |
US4197886A (en) * | 1977-09-06 | 1980-04-15 | Clyde Corporation | Fastener driving tool and fastener holding nosepiece |
CH648197A5 (en) * | 1980-05-28 | 1985-03-15 | Synthes Ag | IMPLANT AND SCREW FASTENING ON ITS BONE. |
FR2519857A1 (en) * | 1982-01-19 | 1983-07-22 | Butel Jean | DEVICE FOR OSTEOSYNTHESIS OF THE FRACTURES OF THE END OF THE FEMUR |
US5129292A (en) * | 1991-02-06 | 1992-07-14 | Ocean Shore Toys | Disposable holder for starting screws |
US5176678A (en) * | 1991-03-14 | 1993-01-05 | Tsou Paul M | Orthopaedic device with angularly adjustable anchor attachments to the vertebrae |
US5486176A (en) * | 1991-03-27 | 1996-01-23 | Smith & Nephew Richards, Inc. | Angled bone fixation apparatus |
GB9110778D0 (en) * | 1991-05-18 | 1991-07-10 | Middleton Jeffrey K | Apparatus for use in surgery |
US5234430A (en) * | 1991-12-18 | 1993-08-10 | Huebner Randall J | Orthopedic fixation screw and method |
US5261910A (en) * | 1992-02-19 | 1993-11-16 | Acromed Corporation | Apparatus for maintaining spinal elements in a desired spatial relationship |
ZA937672B (en) * | 1992-10-22 | 1994-05-16 | Danek Medical Inc | Spinal rod transverse connector for supporting vertebral fixation elements |
CA2109907C (en) * | 1992-11-25 | 2000-01-25 | Ronald A. Yapp | Osteosynthesis plate system |
US5423826A (en) * | 1993-02-05 | 1995-06-13 | Danek Medical, Inc. | Anterior cervical plate holder/drill guide and method of use |
US5330473A (en) * | 1993-03-04 | 1994-07-19 | Advanced Spine Fixation Systems, Inc. | Branch connector for spinal fixation systems |
US5344421A (en) * | 1993-07-16 | 1994-09-06 | Amei Technologies Inc. | Apparatus and method for adjusting a bone plate |
FR2709246B1 (en) * | 1993-08-27 | 1995-09-29 | Martin Jean Raymond | Dynamic implanted spinal orthosis. |
US5454811A (en) * | 1993-11-08 | 1995-10-03 | Smith & Nephew Dyonics, Inc. | Cam lock orthopedic fixation screw and method |
TW283246B (en) * | 1994-02-17 | 1996-08-11 | Mitsubishi Electric Machine | |
US5662652A (en) * | 1994-04-28 | 1997-09-02 | Schafer Micomed Gmbh | Bone surgery holding apparatus |
US5498263A (en) * | 1994-06-28 | 1996-03-12 | Acromed Corporation | Transverse connector for spinal column corrective devices |
AU3207895A (en) * | 1994-08-23 | 1996-03-14 | Spine-Tech, Inc. | Cervical spine stabilization system |
US5520690A (en) * | 1995-04-13 | 1996-05-28 | Errico; Joseph P. | Anterior spinal polyaxial locking screw plate assembly |
US5669911A (en) * | 1995-04-13 | 1997-09-23 | Fastenetix, L.L.C. | Polyaxial pedicle screw |
US5733285A (en) * | 1995-07-13 | 1998-03-31 | Fastenetix, Llc | Polyaxial locking mechanism |
US5554157A (en) * | 1995-07-13 | 1996-09-10 | Fastenetix, L.L.C. | Rod securing polyaxial locking screw and coupling element assembly |
US5584834A (en) * | 1995-07-13 | 1996-12-17 | Fastenetix, L.L.C. | Polyaxial locking screw and coupling element assembly for use with side loading rod fixation apparatus |
US5549608A (en) * | 1995-07-13 | 1996-08-27 | Fastenetix, L.L.C. | Advanced polyaxial locking screw and coupling element device for use with rod fixation apparatus |
EP0848600B1 (en) * | 1995-09-06 | 2001-05-09 | SYNTHES AG Chur | Bone plate |
FR2748387B1 (en) * | 1996-05-13 | 1998-10-30 | Stryker France Sa | BONE FIXATION DEVICE, IN PARTICULAR TO THE SACRUM, IN OSTEOSYNTHESIS OF THE SPINE |
US5713900A (en) * | 1996-05-31 | 1998-02-03 | Acromed Corporation | Apparatus for retaining bone portions in a desired spatial relationship |
US5797911A (en) * | 1996-09-24 | 1998-08-25 | Sdgi Holdings, Inc. | Multi-axial bone screw assembly |
US5885286A (en) * | 1996-09-24 | 1999-03-23 | Sdgi Holdings, Inc. | Multi-axial bone screw assembly |
US5879350A (en) * | 1996-09-24 | 1999-03-09 | Sdgi Holdings, Inc. | Multi-axial bone screw assembly |
US5725528A (en) * | 1997-02-12 | 1998-03-10 | Third Millennium Engineering, Llc | Modular polyaxial locking pedicle screw |
US5800435A (en) * | 1996-10-09 | 1998-09-01 | Techsys, Llc | Modular spinal plate for use with modular polyaxial locking pedicle screws |
US5735851A (en) * | 1996-10-09 | 1998-04-07 | Third Millennium Engineering, Llc | Modular polyaxial locking pedicle screw |
US5964760A (en) * | 1996-10-18 | 1999-10-12 | Spinal Innovations | Spinal implant fixation assembly |
US5728098A (en) * | 1996-11-07 | 1998-03-17 | Sdgi Holdings, Inc. | Multi-angle bone screw assembly using shape-memory technology |
US5776135A (en) * | 1996-12-23 | 1998-07-07 | Third Millennium Engineering, Llc | Side mounted polyaxial pedicle screw |
AU6145998A (en) * | 1997-02-11 | 1998-08-26 | Gary Karlin Michelson | Skeletal plating system |
US5733286A (en) * | 1997-02-12 | 1998-03-31 | Third Millennium Engineering, Llc | Rod securing polyaxial locking screw and coupling element assembly |
US5785711A (en) * | 1997-05-15 | 1998-07-28 | Third Millennium Engineering, Llc | Polyaxial pedicle screw having a through bar clamp locking mechanism |
US5810819A (en) * | 1997-05-15 | 1998-09-22 | Spinal Concepts, Inc. | Polyaxial pedicle screw having a compression locking rod gripping mechanism |
US5891145A (en) * | 1997-07-14 | 1999-04-06 | Sdgi Holdings, Inc. | Multi-axial screw |
US5951558A (en) * | 1998-04-22 | 1999-09-14 | Fiz; Daniel | Bone fixation device |
US5976136A (en) * | 1998-05-11 | 1999-11-02 | Electro Biology, Inc. | Method and apparatus for external bone fixator |
US6258089B1 (en) * | 1998-05-19 | 2001-07-10 | Alphatec Manufacturing, Inc. | Anterior cervical plate and fixation system |
US5904683A (en) * | 1998-07-10 | 1999-05-18 | Sulzer Spine-Tech Inc. | Anterior cervical vertebral stabilizing device |
US6302883B1 (en) * | 1998-10-22 | 2001-10-16 | Depuy Acromed, Inc. | Bone plate-ratcheting compression apparatus |
-
1999
- 1999-05-19 US US09/314,617 patent/US6258089B1/en not_active Expired - Lifetime
- 1999-10-28 CA CA002349544A patent/CA2349544A1/en not_active Abandoned
- 1999-10-28 JP JP2000577943A patent/JP2002528162A/en active Pending
- 1999-10-28 WO PCT/US1999/025278 patent/WO2000024325A1/en not_active Application Discontinuation
- 1999-10-28 EP EP99958690A patent/EP1124493A4/en not_active Withdrawn
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2001
- 2001-03-09 US US09/803,394 patent/US6626907B2/en not_active Expired - Lifetime
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EP1124493A1 (en) | 2001-08-22 |
JP2002528162A (en) | 2002-09-03 |
US20010041894A1 (en) | 2001-11-15 |
WO2000024325A8 (en) | 2000-08-24 |
WO2000024325A1 (en) | 2000-05-04 |
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