# US 11,998,248 B2 · Multipoint angled fixation implants for multiple screws and related methods

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- Number: US 11,998,248 B2
- Document ID: US11998248B2
- Status: Granted
- Kind: B2
- Application number: 17/878,872
- Filed: 2022-08-01
- Published: 2022-11-24
- Granted: 2024-06-04
- Earliest claimed: 2019-09-25
- Assignees: Medos International Sarl
- Applicants: Medos International Sarl
- Inventors: Kevin Lee; Christopher Ramsay; J. Riley Hawkins; Albert Montello
- Web page: https://patentgrep.com/patent/US11998248B2

## CPC

- A61B 17/7058: {Plates mounted on top of bone anchor heads or shoulders}
- A61B 5/4851: {Prosthesis assessment or monitoring}
- A61B 17/7032: {Screws or hooks with U-shaped head or back through which longitudinal rods pass}
- A61B 17/7035: {Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other}
- A61B 17/7037: {wherein pivoting is blocked when the rod is clamped}
- A61B 17/7044: {also having plates, staples or washers bearing on the vertebrae}
- A61B 17/7059: {Cortical plates (A61B17/7007, A61B17/7058 take precedence)}
- A61B 17/8057: {the interlocking form comprising a thread}
- A61F 2/60: Artificial legs or feet or parts thereof
- A61F 5/0123: {for the knees (A61F5/0106 takes precedence)}
- A61F 5/0127: {for the feet (A61F5/0111 takes precedence)}
- A61F 5/02: Orthopaedic corsets
- A61F 5/3738: {Slings}
- G01B 7/24: using change in magnetic properties
- G16H 40/63: for local operation
- A61B 17/7002: {Longitudinal elements, e.g. rods}
- A61B 2017/564: {Methods for bone or joint treatment}
- A61F 2220/0008: Fixation appliances for connecting prostheses to the body
- A61F 2250/0096: Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C)
- G01B: MEASURING LENGTH, THICKNESS OR SIMILAR LINEAR DIMENSIONS; MEASURING ANGLES; MEASURING AREAS; MEASURING IRREGULARITIES OF SURFACES OR CONTOURS
- G16H: HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA

## Abstract

Bone anchor assemblies and related methods are disclosed herein that can provide for improved fixation of a primary bone anchor. A bone anchor assembly can include a wing with a distal portion that can define a plurality of auxiliary bone anchor openings. Each auxiliary bone anchor opening can receive an auxiliary bone anchor that can augment fixation of a primary bone anchor of the bone anchor assembly. The plurality of auxiliary bone anchor openings can be oriented such that, when the wing is coupled to a primary bone anchor assembly of a vertebral level in a first configuration, at least one auxiliary bone anchor can be driven to extend across a facet plane of the vertebral level and, when coupled in a second configuration, each auxiliary bone anchor received within the wing can be driven to conform to the vertebral level.

## Claims

### Claim 1

A bone anchor assembly, comprising:
a bone anchor;
a receiver member coupled to a proximal end of the bone anchor and defining a recess configured to receive a rod;
a closure mechanism mated to the receiver member;
a wing having a proximal portion disposed proximal to the receiver member, a distal portion that defines a plurality of auxiliary screw openings, each of the plurality of auxiliary screw openings configured to receive an auxiliary bone anchor screw therein, and a spanning portion that connects the proximal and distal portions; and
a nut configured to engage the closure mechanism to secure the proximal portion of the wing to the proximal end of the receiver member,
wherein the plurality of auxiliary screw openings extend at an angled trajectory relative to a proximal-distal axis of the spanning portion to define a specified trajectory of insertion of the auxiliary screw such that in a first configuration each auxiliary screw received in each of the plurality of screw openings can conform to a vertebral level in which the bone anchor is inserted, and in a second configuration at least one of the plurality of auxiliary bone anchor screws received in at least one of the screw openings can extend across a facet plane of the vertebral level in which the bone anchor is inserted.

### Claim 2 (depends on 1)

The assembly of claim 1, wherein the distal portion extends generally perpendicular to the proximal-distal axis of the spanning portion.

### Claim 3 (depends on 1)

The assembly of claim 1, wherein a central axis of each of the plurality of screw openings extends in one of a caudal direction or a cephalad direction.

### Claim 4 (depends on 3)

The assembly of claim 3, wherein the central axis of each of the plurality of screw openings extends in a medial direction.

### Claim 5 (depends on 1)

The assembly of claim 1, wherein each of the plurality of screw openings defines an interlocking interface.

### Claim 6 (depends on 1)

The assembly of claim 1, wherein each of the plurality of screw openings includes at least one threaded portion such that a screw can be received at variable angles.

### Claim 7 (depends on 6)

The assembly of claim 6, wherein the at least one threaded portion is a conically threaded portion.

### Claim 8 (depends on 1)

The assembly of claim 1, wherein a central axis of each of the plurality of screw openings extends at an angle between about 0 and about 60 degrees relative to the proximal-distal axis of the spanning portion.

### Claim 9 (depends on 1)

The assembly of claim 1, wherein the distal portion of the wing is configured to be separated from a proximal facing surface of a bone into which the bone anchor is configured to be inserted.

### Claim 10

A bone anchor coupling, comprising:
a body having a proximal portion, a distal portion, and a wing spanning therebetween along a proximal-distal axis;
wherein the proximal portion includes a central opening formed therein;
wherein the distal portion includes a plurality of auxiliary bone anchor openings, each of the plurality of auxiliary bone anchor openings being configured to receive an auxiliary bone anchor therein,
wherein each of the plurality of auxiliary bone anchor openings defines a central longitudinal axis extending therethrough, with each central longitudinal axis extending at an angled trajectory relative to the proximal-distal axis to define a specified trajectory of insertion of an auxiliary bone anchor passed through each of the plurality of auxiliary bone anchor openings; and
wherein a distal surface of the proximal portion terminates proximal to a proximal surface of the distal portion.

### Claim 11 (depends on 10)

The coupling of claim 10, wherein the central opening is configured to receive a closure mechanism therethrough to couple the body to a receiver member of a bone anchor.

### Claim 12 (depends on 11)

The coupling of claim 11, further comprising a counter bore formed about the central opening in a distal-facing surface of the proximal portion to accommodate a radially extending shoulder portion of the closure mechanism.

### Claim 13 (depends on 10)

The coupling of claim 10, wherein the central longitudinal axis of each of the plurality of auxiliary bone anchor openings is obliquely angled relative to a central axis of the central opening.

### Claim 14 (depends on 13)

The coupling of claim 13, wherein the proximal-distal axis and the central axis of the central opening are substantially parallel to one another, with the central axis of each of the plurality of auxiliary bone anchor openings being obliquely angled relative to the proximal-distal axis within a first plane that extends perpendicular to a second plane in which the proximal-distal axis and the central axis of the central opening lie.

### Claim 15 (depends on 14)

The coupling of claim 14, wherein the central longitudinal axis of each of the plurality of auxiliary bone anchor openings is obliquely angled relative to the proximal-distal axis within the second plane to define an insertion trajectory of the auxiliary bone anchor passed through each of the plurality of auxiliary bone anchor openings.

### Claim 16 (depends on 10)

The coupling of claim 10, wherein the distal portion extends outward from the wing at a perpendicular angle with respect to a proximal-distal axis of the wing.

### Claim 17 (depends on 10)

The coupling of claim 10, wherein a width of the distal portion measured between a superior end and an inferior ends of the distal portion is greater than a width of the proximal portion measured between a superior end and an inferior end of the proximal portion.

### Claim 18 (depends on 17)

The coupling of claim 17, wherein:
one of the superior end of the proximal portion or the inferior end of the proximal portion aligns in a common plane respectively with one of the superior end of the distal portion or the inferior end of the distal portion, and
one of the superior end of the distal portion is positioned superior to the superior end of the proximal portion or the inferior end of the distal portion is positioned inferior to the inferior end of the proximal portion.

### Claim 19 (depends on 18)

The coupling of claim 18, wherein the wing further comprises a recessed lead-in portion into a first auxiliary bone anchor opening of the plurality of auxiliary bone anchor openings that is positioned superior to the superior end of the proximal portion or inferior to the inferior end of the proximal portion.

### Claim 20 (depends on 10)

The coupling of claim 10, wherein a superior end of each of the plurality of auxiliary bone anchor openings is distal to an inferior end of each of the plurality of auxiliary bone anchor openings.

### Claim 21 (depends on 10)

The coupling of claim 10, wherein a superior end of each of the plurality of auxiliary bone anchor openings is proximal to an inferior end of each of the plurality of auxiliary bone anchor openings.

### Claim 22 (depends on 10)

The coupling of claim 10, wherein each of the auxiliary bone anchor openings have an interlocking interface configured to facilitate a variable angle locking connection with the auxiliary bone anchor.

### Claim 23 (depends on 10)

The coupling of claim 10, wherein a central longitudinal axis of the first auxiliary bone anchor opening and a central longitudinal axis of the second auxiliary bone anchor opening are each biased between about 46 and about 60 degrees from the proximal-distal axis.