US20070208342A1

US20070208342A1 - Connector

Info

Publication number: US20070208342A1
Application number: US11/801,263
Authority: US
Inventors: Julian Ellis; Alan McLeod; Peter Butcher
Original assignee: Individual
Current assignee: Individual
Priority date: 2000-10-11
Filing date: 2007-05-08
Publication date: 2007-09-06
Also published as: WO2002030306A1; EP1326547B1; GB0024898D0; ATE352261T1; KR20030076570A; JP4083007B2; US20040024403A1; DE60126299D1; ZA200303606B; AU2001294001A1; EP1326547A1; JP2004510538A; DE60126299T2; US7214225B2; KR100653242B1

Abstract

A connector comprising at least one pair of apertures for receiving a fixation means, such as a screw, a load bearing filament extending continuously along a predefined circuitous path which extends between and around each of the apertures of said pair of apertures, said load bearing filament extending around each aperture to define multiple aperture forming strands of said load bearing filaments, said multiple aperture forming strands of said load bearing filament being bound together around each aperture by binding filaments in order to constrain relative lateral movement between said aperture forming multiple strands and to define the shape of each aperture.

Description

CROSS REFERENCES TO RELATED APPLICATIONS

The present application is a division of U.S. patent application Ser. No. 10/399,016, filed on Oct. 11, 2001 and issued on May 8, 2007 as U.S. Pat. No. 7,214,225, the entire contents of which are hereby expressly incorporated by reference into this disclosure as if set forth fully herein.

FIELD OF THE INVENTION

The present invention concerns a connector, in particular but not exclusively, a connector for use in surgery for connecting bones or bone parts to one another.

BACKGROUND OF THE INVENTION

When connecting bones or bone parts to one another using a connector, it is desirable for the connector to be capable of transmitting loads between the connected bone parts in a predetermined manner. This may be done to constrain separation between the bone parts by a predetermined amount and also constrain to a predetermined amount, the amount of torsional movement between the bone parts.

SUMMARY OF THE INVENTION

According to one aspect of the present invention there is provided a connector comprising at least one pair of apertures for receiving a fixation means, such as a screw or a toggle, a load bearing filament extending continuously along a predefined circuitous path which extends between and around each of the apertures of said pair of apertures, said load bearing filament extending around each aperture to define multiple aperture forming strands of said load bearing filaments, said aperture forming multiple strands of said load bearing filament being bound together around each aperture by binding filaments in order to constrain relative lateral movement between said aperture forming multiple strands and to define the shape of each aperture.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a schematic plan view of a connector according to a first embodiment of the present invention;
FIGS. 2 a to 2 c are diagrammatic plan views of modifications to the first embodiment of the present invention;
FIG. 3 is a diagrammatic plan view of a connector according to a second embodiment of the present invention;
FIG. 4 diagrammatically illustrates a first example of formation of the second embodiment;
FIG. 5 is a diagrammatic plan view of a third embodiment of the present invention;
FIG. 6 is a diagrammatic plan view of a fourth embodiment of the present invention;
FIG. 7 is a diagrammatic illustration of connectors according to the present invention.
FIG. 8 is a second example of formation of the second embodiment; and
FIGS. 9 a to 9 d schematically illustrate laying of load bearing filaments to form multiple aperture forming strands.

DESCRIPTION OF THE PREFERRED EMBODIMENT

Referring initially to FIG. 1, there is shown a connector 500 according to a first embodiment of the present invention.
The connector 500 includes a pair of apertures 18 a, 18 b and a load bearing filament 28 which follows a circuitous path which extends continuously around and between the apertures 18 a, 18 b. In use, the connector is attached to say a pair of bone parts by a fixation means, such as a screw or a toggle, located in the apertures 18 a, 18 b.
The filament 28 is preferably laid along said circuitous path for a plurality of complete circuits so as to define multiple strands 28 a, 28 b and 28 c.
In FIG. 1, the multiple strands 28 a define aperture connecting strands which extend in a direction parallel to the central axis CL joining the pair of apertures 18 a, 18 b; strands 28 b define aperture forming strands which extend continuously around each aperture 18 a, 18 b; and strands 28 c define aperture connecting strands which extend diagonally between the apertures 18 a, 18 b.
As indicated in FIGS. 2 a, 2 b and 2 c the circuitous path may be varied in order to change the configuration of the connector 500.
In FIG. 2 a, the diagonal strands 28 c are omitted such that the apertures 18 a, 18 b defined by the strands 28 b are connected by strands 28 a only.
Alternatively, as indicated in FIG. 2 b, strands 28 a are omitted such that strands 28 b are connected by diagonal strands 28 c only.
In the embodiment of FIG. 2 c, strands 28 b only partially extend around the outer periphery of each aperture 18 a, 18 b.
With this embodiment, strands 28 a may also be included such that apertures 18 a, 18 b are connected by strands 28 a and 28 c; or alternatively strands 28 a may be provided instead of strands 28 c.
Binding filaments 30 are provided which secure the strands 28 b together in order to constrain relative movement therebetween around each aperture 18 a, 18 b and also define the shape of each aperture 18 a, 18 b.
The binding filaments 30 thereby act to maintain integrity of each aperture 18 a, 18 b when a fixation means, such as a bone screw, is to be inserted through the aperture during attachment of the connector; the binding filaments 30 also act to maintain integrity of each aperture 18 a, 18 b when a tensile load is applied between the apertures 18 a, 18 b during use.
Accordingly, a bone screw may be inserted directly into apertures 18 a, 18 b without the need for an intermediary support such as a washer or collar.
In the embodiments of FIGS. 1, 2 a and 2 b the binding filaments 30 preferably extend around the entire periphery of each aperture 18 a, 18 b.
In the embodiment of FIG. 2 c, the binding filaments 30 extend about the outer periphery only of the apertures 18 a, 18 b.
In FIG. 3 a further embodiment 600 is illustrated which comprises a first pair of apertures 18 a, 18 b linked with a second pair of apertures 18 b, 18 c. The apertures 18 a, 18 b; 18 b, 18 c in each pair are connected to one another and defined by the load bearing filament 28. As with the first embodiment, the load bearing filament 28 extends along a circuitous path between and around the apertures 18 a, 18 b and 18 c so as to connect them by multiple strands 28 a and/or 28 c and define them by strands 28 b. In the embodiment illustrated in FIG. 3, strands 28 a only are provided.
Preferably the circuitous path along which the load bearing filament 28 extends enables the strands 28 a (and/or 28 c if provided) to be severed (as indicated by line S_V) between one pair of apertures 18 b, 18 c without adversely affecting the connection between the other pairs of apertures 18 a, 18 b.
The connection defined by the load bearing filament 28 between each pair of apertures may thus be considered as a chain defined by a series of chain links.
An illustration of a circuitous path for the load bearing filament 28 in order to form the embodiment 600 is illustrated in FIG. 4.
The starting point of the path is Sp and the finishing point is F_p. The load bearing yarn 28 is laid along the path in the direction indicated by the arrows.
Initially the filament is laid partially around the periphery of aperture 18 a, then extends to and completely around aperture 18 b then extends to and completely around aperture 18 c and then extends to and around aperture 18 b. It then extends to and completely round aperture 18 a.
This produces single strands 28 a and multiple strands 28 b.
If desired the load bearing yarn 28 may be laid along this circuitous path several times in order to provide multiple strands 28 a.
The multiple strands 28 b are secured together by binding filaments 30 after the load bearing filament 28 has been laid along the circuitous path.
An alternative circuitous path for forming the embodiment 600 of FIG. 4 is illustrated in FIG. 8.
Initially the filament 28 is laid partially around the periphery of 18 a, then extends to and partially around the aperture 18 a. Thus the filament 28 initially follows a first substantially elliptical path which extends about apertures 18 a, 18 b. The filament 28 is repeatedly laid along the first elliptical path for a predetermined number of times so as to define multiple strands 28 a and multiple strands 28 b. These collectively form a first chain link or loop L₁.
After the filament 28 has been laid along the first elliptical path for said predetermined number of times, it is then laid along a second substantially elliptical path for another predetermined number of times; the second elliptical path extending around the next pair of apertures 18 b, 18 c. This forms a second chain link or loop L₂.
After completing laying of the filament 28 around the second elliptical path for said predetermined number of times, the filament 28 is laid along side the strand of the first elliptical path which extend between apertures 18 a, 18 b. In this way, the same number of strands 28 a are laid in between each pair of apertures 18 a, 18 b; and 18 b; 18 c.
After laying of the load bearing filament 28, the multiple aperture forming strands 28 b are secured together by binding filaments 30 which extend around each aperture (as shown in broken lines).
When the surgical connector includes multiple strands 28 a or 28 c, it is important that the tensile loads in between a pair of anchorage apertures be shared as equally as possible between the individual strands making up each multiple strand 28 a, and/or 28 c.
This is particularly important when, in use, the aperture interconnecting strands 28 a, and/or 28 c, extend between a pair of apertures located on different planes which are also possibly of different orientation.
In order to achieve, as best as possible an equal sharing of tensile loads in each individual strand which makes up a multiple aperture interconnecting strand 28 a, and/or 28 c, the filament 28 when being laid along the circuitous path is anchored at selected anchorage locations A_Lto a support backing sheet MS so that each individual strand extends between a series of anchorage locations spaced along its length and so is constrained thereby to follow a predefined path.
Preferably the filament is laid along the circuitous path by an embroidery machine having a base cloth support table movable in two dimensions in response to a patterning control for accurately positioning the base cloth relative to the sewing needle of the machine. The sewing needle is positioned on one side of the base cloth (referred to as the needle side of the base cloth) and when actuated penetrates through the base cloth to project from the opposite side of the base cloth (referred to as the looper side) in order to co-operate with a looper which supplies a looper thread to form a sewn stitch with thread supplied by the needle.
Preferably, the filament 28 is supplied as the looper thread and so is laid on the looper side of the base cloth. The stitches formed between the filament 28 and needle thread define the anchorage locations along the length of the filament.
As illustrated in FIGS. 9 a to 9 c the thread S_Tsupplied to the sewing needle is preferably chosen so as to be much finer than the filament 28 such that the filament 28 remains substantially flat with the base cloth and is not pulled through toward the needle side of the base cloth. In this way the filament 28 remains substantially straight between each adjacent anchorage location defined by the stitches.
The length of the filament 28 in between each adjacent stitch is therefore accurately predetermined.
It will be appreciated that as an alternative, the heavier load bearing filament 28 could be supplied by the needle and the finer thread S_Tbe supplied by the looper.
Preferably a minimal number of stitches are formed along the filament 28 defining the aperture interconnecting strands 28 a and/or 28 c.
When laying the filament 28 around an aperture, the anchorage locations are arranged to define a polygonal path (see FIG. 9). The number of anchorage locations A_Land the spacing between adjacent locations are chosen, bearing in mind the diametric size of the aperture to be formed and the bending capability of the filament 28.
It is envisaged that the number of anchorage locations around an aperture is at least 3.
In addition to laying the filament 28 to define predetermined lengths in between adjacent anchorage locations, the anchorage locations for adjacent individual strands 28 b around the aperture to be formed are positioned such that adjacent strands are nested in contact together in a predefined manner to resist lateral movement of the strands 28 b relative to one another when a tensile load is applied between a pair of adjacent apertures.
In addition, all the individual strands 28 b extending about a given aperture are bound together by sewn stitches formed from binding filaments 30. Preferably the binding filaments 30 are sewn in a zig-zag manner around each aperture so as to enclose the strands 28 b.
In this way, in use, the strands 28 b remain in substantially the same position relative to one another as when they were laid and so each retains a predefined position around the aperture and so all individual strands making up the multiple aperture interconnecting strands 28 a and/or 28 c also retain their predefined length when placed under a tensile load in between adjacent apertures 18 and so the tensile load is substantially equally shared by the individual aperture interconnecting strands.
As shown in FIGS. 9 b, 9 c, the anchorage locations around A_Lthe aperture to be formed for one strand 28 b are off-set from the anchorage locations of the neighboring strand 28 b. This enables the strands 28 b to be closely arranged.
Preferably, as shown in FIG. 9 d, the individual strands 28 b may be arranged on top of one another such that a strand 128 b is seated within a groove 129 formed in between a pair of adjacent strands 228 b. In this way, it is possible to stack strands 28 b on top of one another in a disciplined and predefined manner to obtain a relatively large number of nested strands in a relatively small space which co-operate with one another to resist relative lateral movement.
When stacking strands of filament 28 on top of one another, it is preferred to lay the strands closer to the aperture first and then successively lay strands on the outer side of the laid strands. This enables strands to be laid upon one another without reducing the desired diameter of the aperture.
In the embodiment illustrated in FIG. 1, the load bearing filament 28 is supported on a backing sheet MS which is preferably a mesh-like fabric formed from interconnected sewn stitches formed from yarns 20.
The backing sheet MS primarily serves the purpose of retaining the load bearing filament 28 in a disciplined fashion for facilitating handling of the connector during implantation; it is not intended to accommodate tensile loadings between adjacent apertures. Accordingly, yarns 20 may be of a lighter weight than the filament 28.
As discussed above, the sewn stitches are preferably formed using embroidery techniques which produce stitches above and below the load bearing filament 28 and so enwrap the load bearing filament 28 within the mesh-like fabric. Normally the embroidery will be performed on a base cloth which may be soluble so as to enable the base cloth to be dissolved away prior to implantation. In such a case, the sewn stitches defining the mesh-like fabric then constitute the backing sheet.
Alternatively, the base cloth may be retained to define the backing sheet MS, this may be a knitted or woven fabric or a sheet of material such as plastics to which the load bearing filament 28 is attached, by for example suitable stitching. The backing sheet MS whether formed by a sheet or a mesh-like fabric, or a knitted or woven fabric may be dissolvable so that once the backing sheet MS dissolves away it leaves apertures 18 a, 18 b connected solely by the load bearing filaments.
The load bearing filaments may be laid along the circuitous path by passing around pegs 70 (illustrated in FIG. 2 c) with the strands 28 b then being subsequently secured by either stitching filaments 30 or wrapping filaments 30 around the strands 28 b (e.g. using whipping techniques).
The load bearing filament 28 may be a textile yarn such as a polyester braided thread as used for sutures. Preferably the suture thread has a diametric size between 0.2 to 0.5 mm, preferably about 0.35 mm. Other types of yarn could also be used, for example polypropylene, polyethylene, and polyamide.
Preferably, the number of strands making up the multiple strands 28 z, 28 b and/or 28 c vary between 2 to 15; more preferably vary between 5 to 10.
Instead of a textile yarn, other types of filamentary material may be used, e.g. wire of suitable metals such as a SMA (Shape Memory Alloy), aramid fibres, glass strands.
The load bearing yarn may be formed from a material which slowly dissolves after implantation. Suitable examples are polylactic acid or alginate fibers.
In general it is envisaged that any filament having the desired load bearing capabilities and flexibility for bending to lie along the desired circuitous path may be used.
Preferably, the yarn 20 and/or binding filament 30 is a textile yarn, preferably a polyester braided thread. The yarn 20 and/or binding filament 30 is preferably a suture braid thread having a diametric size between 0.1 to 0.2 mm, preferably about 0.15 mm.
It will be appreciated that the principle of connecting adjacent pairs of apertures 18 a, 18 b by laying a load bearing filament 28 along a circuitous path enables many different types of connector to be constructed which are of the desired shapes and sizes tailored for a particular application.
As indicated in broken lines in FIG. 3, it is envisaged that the connector of the invention may incorporate a pulling tail or cord P_Twhich is longitudinally aligned with the row of apertures 18 a, 18 b and 18 c.
In use, a surgeon is able to secure the connector using aperture 18 a and then pull on the pulling tail P_Tin order to tension the connector before securing the connector using apertures 18 b and/or 18 c. The connector is therefore pre-tensioned before final fixing.
Preferably the pulling tail P_Tis formed by a plurality of strands of load bearing yarn 28 which are laid so as to form a continuation of the chain formation. After installation the pulling tail P_Tmay be cut away. Alternatively, the pulling tail may be used as a tie for providing additional anchorage of the connector.
By way of example, in FIG. 5 a connector 300 suitable for attachment to a vertebra is illustrated.
In connector 300, the load bearing filament 28, in effect, creates a chain-link between apertures 18 a, 18 b and a pair of chain links between apertures 18 b, 18 c and 18 b, 18 d. This means that loads are spread evenly from aperture 18 b to both apertures 18 c, 18 d.
Aperture 18 c is connected to three apertures 18 b, 18 d and 18 e by chain-links defined by strands 28 a such that loads are evenly distributed from aperture 18 c to apertures 18 b, 18 d and 18 e.
A further example is illustrated in FIG. 6 which is a connector 400 suitable for use as an anterior spinal plate.
The connector 400 includes six arms 401 each formed by a series of apertures 18 interconnected by chain-links formed by the filaments 28. The arms 401 radiate from three main fixation apertures 18 a, 18 b and 18 c. These apertures 18 a, 18 b and 18 c are attached to the LS vertebra of a patient and the arms 401 are attached to the sacrum. Due to the multiplicity of arms 401 and the plurality of apertures 18 they contain, it is possible to obtain good anchorage on the complex, three dimensional shape of the sacrum.
Preferably, as shown in FIG. 6, the end aperture 18 d of each of the outer pair of arms 401 is preferably interconnected to at least two of the apertures 18 a-18 c in order to provide a desired spread of loadings.
A specific use of connectors according to the present invention is illustrated in FIG. 7 wherein the connector is used as a spinal stabilization device. In FIG. 7, the connector 800 is shown as being connected to two vertebrae V₁, V₂by four pedicle screws 801, 802, 803 and 804. It will be seen that the pairs of screws 801, 802 and 803, 804 located on opposite sides of the vertebrae are each linked by flexible connectors 807 and that they are also linked by transverse connectors 808.
It is to be appreciated that in the connector of the present invention, the load bearing filament 28 is laid along a predefined circuitous path to define adjacent individual strands 28 b extending about each aperture with aperture connecting strands 28 a and/or 28 c extending in between adjacent apertures.
The individual strands 28 b are laid in a nested arrangement with individual strands held in the nested arrangement at anchorage locations connected to a backing sheet and by binding filaments 30 which bind all the individual strands 28 b together. Collectively securance of individual strands 28 b at said anchorage locations and binding all the strands 28 b together by filaments 30 serve to restrain relative lateral movement between the individual strands 28 b when a tensile load is applied between a pair of adjacent apertures. Accordingly, the prime purpose of the anchorage locations and binding filament 30 is to maintain the strands 28 b in position and not, themselves, to accommodate the tensile loadings in between adjacent apertures.
Accordingly the binding filament 30 and needle sewing thread used for forming the anchorage locations can be of a lighter weight than the load bearing filament 28. Since the binding filament 30 and sewing thread do not form a tensile load bearing function, the bulk size of the connector is, in the main, determined by the amount of load bearing filament 28 required.
This enables the connector of the present invention to be of a relatively small size compared to other known connectors.
Also, since the backing sheet is provided primarily to retain the load bearing strands, in particular strands 28 a, 28 c in a disciplined manner for handling purposes during implantation, the flexibility of strands 28 a, 28 c is not impeded by the relatively lightweight backing sheet and thereby enables the load bearing strands 28 a, 28 c to bend/flex in a smooth manner in between adjacent bone anchorage locations.
While the invention is susceptible to various modifications and alternative forms, specific embodiments thereof have been shown by way of example in the drawings and are herein described in detail. It should be understood, however, that the description herein of specific embodiments is not intended to limit the invention to the particular forms disclosed, but on the contrary, the invention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the invention as defined herein.

Claims

1. A connector dimensioned to extend between a first vertebral bone portion and a second vertebral bone portion, comprising:

a first fixation region configured for juxtaposition with said first vertebral bone portion and having a first fortified aperture dimensioned to receive a first fixation element;

a second fixation region configured for juxtaposition with said second vertebral bone portion and having a second fortified aperture dimensioned to receive a second fixation element; and

at least one load bearing filament extending at least between said first and second fixation regions.

2. The connector of claim 1, wherein said first and second vertebral bone portions comprise adjacent vertebral bodies.

3. The connector of claim 1, wherein said first and second apertures are fortified by binding filaments.

4. The connector of claim 1, wherein at least one of said first and second fixation elements comprises a bone screw.

5. The connector of claim 1, wherein said at least one load bearing filament extends continuously along a predefined circuitous path which extends between and at least partially around each of said first and second fortified apertures.

6. The connector of claim 5, wherein said at least one load bearing filament is laid along said predefined circuitous path via embroidery.

7. The connector of claim 1, wherein said at least one load bearing filament includes multiple aperture-forming strands extending around each of said first and second apertures.

8. The connector of claim 1, further comprising a backing sheet.

9. The connector of claim 8, wherein said backing sheet comprises at least one of an embroidered article, a knitted fabric, a woven fabric, and a plastic sheet.

10. A connector configured to extend between a first vertebral bone portion and a second vertebral bone portion, comprising:

a first fixation region configured for juxtaposition with said first vertebral bone portion and having a first fortified fastener-receiving element dimensioned to receive a first fastener;

a second fixation region configured for juxtaposition with said second vertebral bone portion and having a second fortified fastener-receiving element dimensioned to receive a second fastener; and

11. The connector of claim 10, wherein said first and second vertebral bone portions comprise adjacent vertebral bodies.

12. The connector of claim 10, wherein at least one of said first and second fastener-receiving elements comprises an aperture.

13. The connector of claim 10, wherein said first and second fastener-receiving elements are fortified by binding filaments.

14. The connector of claim 10, wherein at least one of said first and second fasteners comprises a bone screw.

15. The connector of claim 10, wherein said at least one load bearing filament extends continuously along a predefined circuitous path which extends between and at least partially around each of said first and second fortified apertures.

16. The connector of claim 15, wherein said at least one load bearing filament is laid along said predefined circuitous path via embroidery.

17. The connector of claim 10, wherein said at least one load bearing filament includes multiple aperture-forming strands extending around each of said first and second apertures.

18. The connector of claim 10, further comprising a backing sheet.

19. The connector of claim 18, wherein said backing sheet comprises at least one of an embroidered article, a knitted fabric, a woven fabric, and a plastic sheet.