# US 11,298,164 B2 · Anterior tether tensioner > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 11,298,164 B2 - Document ID: US11298164B2 - Status: Granted - Kind: B2 - Application number: 17/091,773 - Filed: 2020-11-06 - Published: 2021-05-13 - Granted: 2022-04-12 - Earliest claimed: 2019-11-08 - Assignees: K2M, Inc. - Applicants: K2M, Inc. - Inventors: Brian Kunes; Stacy Hollins; Laurel Blakemore; Brian Hsu; John Ferguson - Web page: https://patentgrep.com/patent/US11298164B2 ## CPC - A61B 17/7022: {Tethers, i.e. longitudinal elements capable of transmitting tension only, e.g. straps, sutures or cables (A61B17/702 takes precedence)} - A61B 17/7091: {for applying, tightening or removing longitudinal element-to-bone anchor locking elements, e.g. caps, set screws, nuts or wedges} - A61B 17/7032: {Screws or hooks with U-shaped head or back through which longitudinal rods pass} - 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 17/8869: {Tensioning devices} - A61B 2017/00367: {Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like} - A61B 2017/00407: {Ratchet means} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract A tether tensioner includes a handle assembly, an elongate member extending distally from the handle assembly, and an engaging portion. The handle assembly includes a stationary member, a trigger pivotably coupled to the stationary member, and a spool rotatably supported on the stationary member. The spool is configured to wrap a tether thereabout. The spool is operatively coupled with the trigger such that pivoting of the trigger relative to the stationary member causes rotation of the spool. The elongate member includes a channel configured to slidably receive a tether therethrough. The engaging portion is configured to receive a head portion of a bone screw such that a tether extends from the head portion disposed in the engaging portion to the spool through the channel of the elongate member. ## Claims ### Claim 1 A tether tensioner comprising: a handle assembly including: a stationary member; a trigger pivotably coupled to the stationary member; and a spool rotatably supported on the stationary member, the spool configured to wrap a tether thereabout, the spool operatively coupled with the trigger such that pivoting of the trigger relative to the stationary member causes rotation of the spool: an elongate member extending distally from the handle assembly, the elongate member including a channel configured to slidably receive a tether therethrough; and an engaging portion configured to receive a head portion of a bone screw such that a tether extends from the head portion disposed in the engaging portion to the spool through the channel of the elongate member, the tether configured to be locked within the engaging portion by compression between surfaces. ### Claim 2 (depends on 1) The tether tensioner according to claim 1, wherein the handle assembly further includes a ratchet wheel operatively coupled with the spool for concomitant rotation therewith. ### Claim 3 (depends on 2) The tether tensioner according to claim 2, wherein the trigger includes a rack including teeth to engage teeth of the ratchet wheel. ### Claim 4 (depends on 3) The tether tensioner according to claim 3, wherein the handle assembly further includes a biasing member to urge the rack towards engagement with the ratchet wheel. ### Claim 5 (depends on 3) The tether tensioner according to claim 3, wherein the handle assembly further includes a biasing member to urge the trigger away from the stationary member. ### Claim 6 (depends on 1) The tether tensioner according to claim 1, wherein the spool of the handle assembly and the channel of the elongate member are axially aligned. ### Claim 7 (depends on 1) The tether tensioner according to claim 1, wherein the engaging portion is disposed at a distal portion of the elongate member. ### Claim 8 (depends on 1) The tether tensioner according to claim 1, wherein the elongate member is substantially parallel to the stationary member of the handle assembly. ### Claim 9 (depends on 1) The tether tensioner according to claim 1, wherein the engaging portion includes a chamber defining an aperture to receive a head portion of a bone screw therethrough. ### Claim 10 (depends on 9) The tether tensioner according to claim 9, wherein the elongate member defines a bore dimensioned to receive a tether therethrough, the bore in communication with the aperture of the chamber of the engaging portion. ### Claim 11 (depends on 9) The tether tensioner according to claim 9, wherein the engaging portion is positioned with a tether receiving channel of the tensioner aligned with a tether receiving slot of the head of the bone screw. ### Claim 12 (depends on 9) The tether tensioner according to claim 9, wherein the chamber includes an inner wall having threads to threadably secure a set screw of a bone screw thereto. ### Claim 13 (depends on 1) The tether tensioner according to claim 1, wherein the elongate member defines a groove along a length thereof, the groove configured to receive a driver to drive a set screw of a bone screw, wherein the groove of the elongate member is aligned with the engaging portion. ### Claim 14 A method of applying tension to a tether comprising: securing a first end portion of a tether relative to a bone screw; and passing a second end portion of the tether through a first slot in a bone screw and through a second slot defined in a distal end of an engaging portion of a tether tensioner; extending the second end portion of the tether through a bore defined in an elongate member of the tether tensioner towards a handle assembly of the tether tensioner; wrapping the second end portion of the tether around a spool of the handle assembly; placing the engaging portion of the tether tensioner over a head portion of the bone screw such that the tether extends through the first slot defined in the head portion of the bone screw and the second slot of the engaging portion; rotating the spool to provide tension in the tether; and securing the tether to the bone screw. ### Claim 15 (depends on 14) The method according to claim 14, further comprising manipulating the tether to provide proper tension prior to rotating the spool. ### Claim 16 (depends on 14) The method according to claim 14, further comprising partially securing the tether to the bone screw prior to rotating the spool. ### Claim 17 (depends on 16) The method according to claim 16, wherein the step of securing the first end portion relative to the bone screw further comprises securing the first end portion of the tether to the bone screw and looping the tether around an anatomical structure before passing the second end portion of the tether through the first and second slots of the bone screw and the engaging portion. ### Claim 18 (depends on 14) The method according to claim 14, further comprising feeding the second end portion of the tether through a channel of the elongate member and towards the handle assembly of the tether tensioner. ### Claim 19 (depends on 14) The method according to claim 14, wherein securing the tether to the bone screw includes threadably coupling a set screw disposed in the engaging portion to the head portion of the bone screw to secure the tether therebetween. ### Claim 20 (depends on 19) The method of claim 19, where the set screw includes a first non-planar surface and the first slot of the bone screw includes a second non-planar surface, the method further comprising tightening the set screw to apply a pressure between the first and second non-planar surfaces to lock the tether disposed therebetween and extending through the first slot.