# US 11,439,441 B2 · Modular surgical instruments and related methods > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 11,439,441 B2 - Document ID: US11439441B2 - Status: Granted - Kind: B2 - Application number: 16/815,945 - Filed: 2020-03-11 - Published: 2020-07-02 - Granted: 2022-09-13 - Earliest claimed: 2017-09-05 - Assignees: Medos International Sarl - Applicants: Medos International Sarl - Inventors: Christopher Mickiewicz; Mark Gracia; Thomas Runco; Sarah Batchelor; Richard Fournier - Web page: https://patentgrep.com/patent/US11439441B2 ## CPC - 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 17/0206: {with antagonistic arms as supports for retractor elements} - A61B 17/7001: {Screws or hooks combined with longitudinal elements which do not contact vertebrae (A61B17/7058 takes precedence)} - A61B 17/7076: {for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation} - A61B 17/708: {with tubular extensions coaxially mounted on the bone anchors} - A61B 17/7086: {Rod reducers, i.e. devices providing a mechanical advantage to allow a user to force a rod into or onto an anchor head other than by means of a rod-to-bone anchor locking element; rod removers} - A61B 17/861: {specially shaped for gripping driver} - A61B 17/7032: {Screws or hooks with U-shaped head or back through which longitudinal rods pass} - A61B 17/7085: {for insertion of a longitudinal element down one or more hollow screw or hook extensions, i.e. at least a part of the element within an extension has a component of movement parallel to the extension's axis} - A61B 17/7091: {for applying, tightening or removing longitudinal element-to-bone anchor locking elements, e.g. caps, set screws, nuts or wedges} - A61B 2017/0046: {with a releasable handle; with handle and operating part separable} - A61B 2090/037: {with a frangible part, e.g. by reduced diameter} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract Modular surgical instruments and related methods are disclosed herein, e.g., for performing rod reduction, derotation, and/or set screw insertion during spinal surgery. An exemplary system can include an instrument body configured to couple to a bone anchor assembly to provide a modular platform for carrying out various steps of a surgical procedure. For example, the instrument body can receive a reduction instrument therethrough for reducing a spinal rod into the bone anchor assembly. A derotation instrument can be attached to the reduction instrument for performing derotation maneuvers or applying other manipulation forces. A modular driver or handle adapter can be attached to the reduction instrument and/or to the derotation instrument to facilitate rod reduction. Any of the instrument body, the reduction instrument, and the derotation instrument can include a working channel therethrough. A set screw or closure mechanism, and a driver instrument for applying the set screw or closure mechanism to the bone anchor assembly, can be inserted through the working channel. ## Claims ### Claim 1 A surgical method, comprising: implanting a bone anchor in a bone of a patient, the bone anchor comprising a receiver member having a rod seat; positioning an instrument body in an unlocked configuration, the instrument body having a housing, opposed fixed arms extending distally from the housing and defining a rod slot therebetween, opposed pivoting arms movably coupled to the housing, a locking member, and a working channel extending through the instrument body, wherein the pivoting arms are free to pivot relative to the housing when the instrument body is in the unlocked configuration; moving distal ends of the pivoting arms apart from one another; positioning the bone anchor between the fixed arms of the instrument body such that the rod slot of the instrument body is aligned with the rod seat of the bone anchor; moving the distal ends of the pivoting arms towards one another to engage a mating feature of the bone anchor; and positioning the instrument body in a locked configuration by rotating the locking member relative to the instrument body to interfere with movement of the pivoting arms relative to the housing when the instrument body is in the locked configuration, thereby preventing the pivoting arms from disengaging from the mating feature of the bone anchor. ### Claim 2 (depends on 1) The method of claim 1, further comprising placing a rod within the rod slot and advancing a reducer shaft through the working channel of the instrument body to urge the rod distally into the rod seat of the bone anchor. ### Claim 3 (depends on 2) The method of claim 2, further comprising attaching a driver adapter to the reducer shaft and applying torque to the driver adapter to rotate the reducer shaft. ### Claim 4 (depends on 2) The method of claim 2, further comprising inserting a set screw through a working channel of the reducer shaft and through the working channel of the instrument body and securing the set screw to the bone anchor. ### Claim 5 (depends on 4) The method of claim 4, wherein urging the rod into the rod seat and a securing the set screw to the bone anchor are performed without disconnecting the instrument body from the bone anchor. ### Claim 6 (depends on 2) The method of claim 2, further comprising attaching a derotation shaft to the reducer shaft and applying a manipulation force to the derotation shaft to reposition the bone of the patient. ### Claim 7 (depends on 6) The method of claim 6, further comprising inserting a set screw through a working channel of the derotation shaft, through a working channel of the reducer shaft, and through the working channel of the instrument body, and securing the set screw to the bone anchor. ### Claim 8 (depends on 7) The method of claim 7, wherein applying the manipulation force, urging the rod into the rod seat, and securing the set screw to the bone anchor are performed without disconnecting the instrument body from the bone anchor. ### Claim 9 (depends on 6) The method of claim 6, wherein attaching the derotation shaft comprises inserting a male drive interface of the reducer shaft into a female drive interface of the derotation shaft. ### Claim 10 (depends on 6) The method of claim 6, wherein attaching the derotation shaft comprises moving hinged arms of the derotation shaft into engagement with a groove formed in the reducer shaft. ### Claim 11 (depends on 10) The method of claim 10, wherein the hinged arms are moved into engagement with the groove by rotating or axially translating a locking ring along an exterior surface of the derotation shaft. ### Claim 12 (depends on 6) The method of claim 6, further comprising attaching a driver adapter to the derotation shaft and applying torque to the driver adapter to rotate the derotation shaft and the reducer shaft. ### Claim 13 (depends on 1) The method of claim 1, wherein the bone anchor is implanted after attaching the instrument body to the bone anchor. ### Claim 14 (depends on 1) The method of claim 1, wherein the bone anchor is implanted using a driver shaft inserted through the working channel of the instrument body while the instrument body is attached to the bone anchor. ### Claim 15 (depends on 1) The method of claim 1, wherein the pivoting arms are free to pivot within a slot in the opposed fixed arms when the instrument body is in the unlocked configuration. ### Claim 16 (depends on 1) The method of claim 1, wherein moving the distal ends of the pivoting arms towards one another increases a distance between the fixed arms and the pivoting arms. ### Claim 17 (depends on 1) The method of claim 1, wherein moving the distal ends of the pivoting arms towards one another occurs after positioning the bone anchor between the fixed arms of the instrument body. ### Claim 18 A surgical method, comprising: docking an instrument body in an unlocked position to an implant such that the implant is received within a working channel that extends through the instrument body; moving the instrument body into a locked position to mate the instrument body to the implant; placing a rod within the working channel and reducing the rod into the implant using a reducer shaft received within the working channel of the instrument body, the reducer shaft having a working lumen formed therethrough; inserting a set screw through the working channel and securing the set screw to the implant; coupling a derotation assembly to the reducer shaft; and derotating the reducer shaft to urge the rod toward the implant. ### Claim 19 (depends on 18) The method of claim 18, wherein a central axis of the working channel of the instrument body is aligned with a central axis of the working lumen of the reducer shaft. ### Claim 20 (depends on 18) The method of claim 18, wherein the set screw is inserted through one or more of the working lumen of the reducer shaft or a working lumen of the derotation assembly prior to securing the set screw to the implant. ### Claim 21 (depends on 18) The method of claim 18, wherein the reducer shaft is disposed within the instrument body prior to the instrument body being docked to the implant. ### Claim 22 (depends on 18) The method of claim 18, wherein docking the instrument body to the implant further comprises advancing the instrument body relative to the implant to pivot a pair of arms coupled to the instrument body in a radially-outward direction, and engaging a mating feature of the implant by moving the pair of arms in a radially-inward direction to mate the instrument body to the implant. ### Claim 23 (depends on 22) The method of claim 22, wherein moving the instrument body into the locked position further comprises rotating a locking member relative to the instrument body in a first direction to prevent the pair of arms from pivoting relative to the implant. ### Claim 24 (depends on 23) The method of claim 23, further comprising detaching the instrument body from the implant by rotating the locking member relative to the instrument body in a second, opposite direction to allow the pair of arms to freely pivot radially-outward with respect to the instrument body to disengage the implant. ### Claim 25 (depends on 18) The method of claim 18, wherein the implant further comprises a receiver head of a bone anchor, with the bone anchor being implanted in a body of a patient. ### Claim 26 (depends on 18) The method of claim 18, wherein advancing the rod through the working channel into the implant further comprises rotating the reducer shaft relative to the instrument body to urge the rod distally into the implant. ### Claim 27 A surgical method, comprising: implanting a bone anchor in a bone of a patient, the bone anchor comprising a receiver member having a rod seat; positioning an instrument body in an unlocked configuration, the instrument body having a housing, opposed fixed arms extending distally from the housing and defining a rod slot therebetween, opposed pivoting arms movably coupled to the housing, a locking member, and a working channel extending through the instrument body, wherein the pivoting arms are free to pivot relative to the housing when the instrument body is in the unlocked configuration; moving distal ends of the pivoting arms apart from one another; positioning the bone anchor between the fixed arms of the instrument body such that the rod slot of the instrument body is aligned with the rod seat of the bone anchor; moving the distal ends of the pivoting arms towards one another to engage a mating feature of the bone anchor after positioning the bone anchor between the fixed arms of the instrument body; and positioning the instrument body in a locked configuration, wherein the locking member interferes with movement of the pivoting arms relative to the housing when the instrument body is in the locked configuration, thereby preventing the pivoting arms from disengaging from the mating feature of the bone anchor.