# US 10,478,227 B2 · Orthopedic fixation devices and methods of installation thereof > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 10,478,227 B2 - Document ID: US10478227B2 - Status: Granted - Kind: B2 - Application number: 15/433,003 - Filed: 2017-02-15 - Published: 2017-08-10 - Granted: 2019-11-19 - Earliest claimed: 2011-07-15 - Assignees: Globus Medical, Inc. - Applicants: Globus Medical, Inc. - Inventors: David N. Leff; Khiem Pham; Patrick Nolan; Devjeet Mishra; Michael Harper; Milan George; Katherine Manninen; John Perkins - Web page: https://patentgrep.com/patent/US10478227B2 ## CPC - A61B 17/7034: {characterised by a lateral opening} - A61B 17/7001: {Screws or hooks combined with longitudinal elements which do not contact vertebrae (A61B17/7058 takes precedence)} - A61B 17/7004: {with a cross-section which varies along its length (A61B17/7019 takes precedence)} - A61B 17/7011: {Longitudinal element being non-straight, e.g. curved, angled or branched (adjustable length longitudinal elements A61B17/7014; A61B17/7019 takes precedence, e.g. coil springs)} - A61B 17/7037: {wherein pivoting is blocked when the rod is clamped} - A61B 17/7047: {Clamps comprising opposed elements which grasp one vertebra between them} - A61B 17/705: {for linking adjacent ends of longitudinal elements} - A61B 17/7056: {Hooks with specially-designed bone-contacting part} - A61B 17/7082: {for driving, i.e. rotating, screws or screw parts specially adapted for spinal fixation, e.g. for driving polyaxial or tulip-headed screws} - A61B 17/8816: {characterised by the conduit, e.g. tube, along which fluid flows into the body or by conduit connections} - A61B 2017/681: {Alignment, compression, or distraction mechanisms} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract The present invention is generally directed to orthopedic fixation devices that comprise a coupling element and a bone fastener, whereby the bone fastener can be loaded into the coupling element through the bottom of a bore in the coupling element. The orthopedic fixation devices described herein can include modular locking clamp assemblies that can be fixed onto fasteners that are already implanted in bone. The modular locking clamp assemblies can include polyaxial locking clamp assemblies, as well as monoaxial locking clamp assemblies. ## Claims ### Claim 1 A modular tulip system for spine stabilization, said system comprising: a first tulip assembly comprising a first tulip element and a second tulip element separated from the first tulip element, wherein the first tulip element is configured to be received modularly over a first bone fastener, wherein the first tulip element comprises a first pair of arms defining a first channel and the second tulip element comprises a second pair of arms defining a second channel, wherein a bridge extends between the first pair of arms and the second pair of arms, wherein the first pair of arms and the second pair of arms are formed monolithically with the bridge; a first locking cap assembly configured to be received in the first channel between the first pair of arms and a second locking cap assembly configured to be received in the second channel between the second pair of arms; and a first rod member configured to be received in the first tulip assembly via the first tulip element, wherein the first pair of arms and the second pair of arms are positioned in a vertical direction such that the first rod member can be downwardly deposited into the first pair of arms, and wherein the first tulip element has an exposed opening for receiving a first bone fastener while the second tulip element of the first tulip assembly does not have an exposed opening for receiving a bone fastener. ### Claim 2 (depends on 1) The modular tulip system of claim 1, wherein a second rod member can be downwardly deposited into the second pair of arms. ### Claim 3 (depends on 1) The modular tulip system of claim 1, wherein each of the arms of the first tulip assembly are independent from one another such that they do not share a wall. ### Claim 4 (depends on 1) The modular tulip system of claim 1, wherein the second tulip element is at an angle relative to the first tulip element. ### Claim 5 (depends on 4) The modular tulip system of claim 4, wherein the second tulip element has a longitudinal axis that is at an angle between 15 and 20 degrees relative to a longitudinal axis that extends through the first tulip element. ### Claim 6 (depends on 1) The modular tulip system of claim 1, wherein the first tulip element has tool engagement features. ### Claim 7 (depends on 6) The modular tulip system of claim 6, wherein the first tulip element has one or more side tool engagement features. ### Claim 8 (depends on 1) The modular tulip system of claim 1, further comprising: a second tulip assembly comprising a third tulip element and a fourth tulip element, wherein the third tulip element is configured to be received modularly over a second bone fastener, wherein the second tulip assembly is configured to receive the first rod member via the third tulip element; and a second rod member configured to be received by the first tulip assembly via the second tulip element and the second tulip assembly via the fourth tulip element. ### Claim 9 A modular tulip system for spine stabilization, said system comprising: a first tulip assembly comprising a first tulip element and a second tulip element, wherein the first tulip element is configured to be received modularly over a first bone fastener, wherein the first tulip element comprises a first pair of arms defining a first channel and the second tulip element comprises a second pair of arms defining a second channel, wherein the first tulip element is separated from the second tulip element via a bridge, wherein the first pair of arms and the second pair of arms are formed monolithically with the bridge; a second tulip assembly comprising at least one tulip element, wherein the at least one tulip element is configured to be received modularly over a second bone fastener; a first locking cap assembly configured to be received in the first channel between the first pair of arms and a second locking cap assembly configured to be received in the second channel between the second pair of arms; and a first rod member that extends from the first tulip assembly to the second tulip assembly, wherein the first pair of arms and the second pair of arms are positioned in a vertical direction such that the first rod member can be downwardly deposited into the first pair of arms, and wherein the first tulip element of the first tulip assembly comprises an opening through a lower surface for receiving the first bone fastener therethrough and the second tulip element of the first tulip assembly has no opening through a lower surface. ### Claim 10 (depends on 9) The modular tulip system of claim 9, further comprising a third tulip assembly comprising a modular single tulip element and a fourth tulip assembly comprising a modular single tulip element. ### Claim 11 (depends on 10) The modular tulip system of claim 10, wherein the third tulip assembly is modularly placed over a third bone fastener and the fourth tulip assembly is modularly placed over a fourth bone fastener. ### Claim 12 (depends on 9) The modular tulip system of claim 9, wherein the second tulip element of the first tulip assembly is at an angle relative to the first tulip element of the first tulip assembly. ### Claim 13 (depends on 9) The modular tulip system of claim 9, wherein the second tulip element of the first tulip assembly is parallel relative to the first tulip element of the first tulip assembly. ### Claim 14 (depends on 9) The modular tulip system of claim 9, wherein the first tulip element of the first tulip assembly includes one or more side tool engagement features and the second tulip element of the first tulip assembly does not include any side tool engagement features. ### Claim 15 (depends on 9) The modular tulip system of claim 9, wherein the first tulip element of the first tulip assembly includes one or more side tool engagement features and the second tulip element of the first tulip assembly also includes one or more side tool engagement features. ### Claim 16 (depends on 9) The modular tulip system of claim 9, further comprising a first and second locking cap assembly downwardly deposited over the first and second tulip elements of the first tulip assembly. ### Claim 17 (depends on 9) The spine stabilization system of claim 9, further comprising a third tulip assembly comprising a single tulip element and a fourth tulip assembly comprising a single tulip element, wherein the third tulip assembly is modularly received over a third bone fastener and the fourth tulip assembly is modularly received over a fourth bone fastener.