# US 2015/0148845 A1 · Spinal stabilization systems and methods

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- Number: US 2015/0148845 A1
- Document ID: US20150148845A1
- Status: Published application
- Kind: A1
- Application number: 14/603,677
- Filed: 2015-01-23
- Published: 2015-05-28
- Earliest claimed: 2002-10-30
- Assignees: Zimmer Spine, Inc.
- Applicants: Zimmer Spine, Inc.
- Inventors: Michael E. Landry; Larry T. Khoo; Erik J. Wagner; Charles R. Forton; Robert J. Jones
- Web page: https://patentgrep.com/patent/US20150148845A1

## CPC

- A61B 17/7037: {wherein pivoting is blocked when the rod is clamped}
- A61B 17/00234: {for minimally invasive surgery (A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)}
- A61B 17/1604: {Chisels; Rongeurs; Punches; Stamps}
- A61B 17/1671: {for the spine}
- A61B 17/1703: {using imaging means, e.g. by X-rays}
- A61B 17/1757: {for the spine}
- A61B 17/701: {Longitudinal elements with a non-circular, e.g. rectangular, cross-section (A61B17/7005, A61B17/7007 take 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 17/7032: {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 17/708: {with tubular extensions coaxially mounted on the bone anchors}
- 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 17/7083: {Tools for guidance or insertion of tethers, rod-to-anchor connectors, rod-to-rod connectors, or longitudinal elements}
- 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 17/8605: {Heads, i.e. proximal ends projecting from bone}
- A61B 17/861: {specially shaped for gripping driver}
- A61B 17/8863: {Apparatus for shaping or cutting osteosynthesis equipment by medical personnel}
- A61B 17/8897: {Guide wires or guide pins}
- A61B 17/1655: {for tapping}
- A61B 17/8866: {for gripping or pushing bones, e.g. approximators (joint distractors A61B17/025)}
- A61B 17/8875: {Screwdrivers, spanners or wrenches}
- A61B 2017/0256: {for the spine}
- A61B 2090/031: {torque limiting}
- A61B 2090/037: {with a frangible part, e.g. by reduced diameter}
- A61B 2090/061: {for measuring dimensions, e.g. length}
- A61B 2090/062: {penetration depth}
- Y10S 606/914: Toolkit for installing or removing spinal positioner or stabilizer
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- Y10S: TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS

## Abstract

A spinal stabilization system may be formed in a patient. In some embodiments, a minimally invasive procedure may be used to form a spinal stabilization system in a patient Bone fastener assemblies may be coupled to vertebrae Each bone fastener assembly may include a bone fastener and a collar. The collar may be rotated and/or angulated relative to the bone fastener. Detachable members may be coupled to the collar to allow for formation of the spinal stabilization system through a small skin incision. The detachable members may allow for alignment of the collars to facilitate insertion of an elongated member in the collars. An elongated member may be positioned in the collars and a closure member may be used to secure the elongated member to the collars.

## Claims

### Claim 1

A delivery device for delivering a spinal rod to a bone anchor, comprising:
an inner member having proximal and distal ends and a lumen extending therebetween, the distal end being configured to releasably engage a collar of a bone anchor, wherein the inner member has a first slot formed therein, the first slot having an opening at a distal end of the inner member and extending a first slot length toward the proximal end of the inner member;
an outer member disposed over at least a portion of the inner member, the outer member having proximal and distal ends and a lumen extending therebetween, the distal end of the outer member being configured to maintain engagement of the distal end of the inner member with the collar, wherein the outer member has a second slot formed therein aligned with the first slot, the second slot having an opening at the distal end of the outer member and extending a second slot length toward the proximal end of the outer member, the first slot length and the second slot length sized to span at least from a skin incision in a patient to the distal ends of the inner member and the outer member, respectively, such that the first slot and the second slot may be accessible from outside of the patient when the delivery device is engaged to the collar of a bone anchor inserted in a bone of the patient; and
a connection mechanism configured to threadingly connect the inner member to the outer member, wherein the connection mechanism includes external threading on the inner member;
wherein the lumen of the inner member and the lumen of the outer member are sized to pass a threaded closure mechanism configured to threadingly engage the collar of the bone anchor therethrough, and wherein the delivery device is configured such that after the delivery device is engaged to the bone anchor, the closure mechanism may be inserted through the inner member and threaded onto the collar of the bone anchor.

### Claim 2 (depends on 1)

The delivery device of claim 1, wherein the inner member is removable and replaceable from the outer member to facilitate cleaning of the inner member.

### Claim 3 (depends on 1)

The delivery device of claim 1, wherein the distal end of the outer member includes one or more projections configured to maintain engagement of the distal end of the inner member with the collar.

### Claim 4 (depends on 1)

A spinal stabilization system comprising:
the delivery device of claim 1;
the collar having a proximal end, a distal end and a recess for receiving a spinal rod, the collar having internal threading, wherein the proximal end is configured for releasably engaging the distal end of the inner member; and
the bone anchor having a proximal head and a distal bone engaging portion, the head configured to be received within the collar.

### Claim 5 (depends on 4)

The system of claim 4, wherein the bone anchor is configured for polyaxial movement relative to the collar when the head is seated within the collar.

### Claim 6

A spinal stabilization system, comprising:
a collar having a proximal end, a distal end and a recess for receiving a spinal rod, the collar having internal threading;
a bone anchor having a proximal head and a distal bone engaging portion, the head configured to be received within the collar;
an outer member having proximal and distal ends and a lumen extending therebetween;
an inner member disposed at least partially within the lumen of the outer member, the inner member having proximal and distal ends and a lumen extending therebetween, the distal end being configured to releasably engage the collar, wherein the distal end of the inner member is held in contact with the collar when the inner and outer members are connected to each other and connected to the collar; and
a connection mechanism configured to threadingly connect the inner member to the outer member, wherein the connection mechanism includes external threading on the inner member;
wherein the lumen of the inner member and the lumen of the outer member are sized to pass a threaded closure mechanism configured to threadingly engage the internal threading of the collar therethrough, and wherein the inner and outer members are configured such that after the inner and outer members are engaged to the collar, the closure mechanism may be inserted through the inner member and threaded onto the collar.

### Claim 7 (depends on 6)

The system of claim 6, wherein the inner member has a first slot formed therein, the first slot having an opening at a distal end of the inner member and extending a first slot length toward the proximal end of the inner member.

### Claim 8 (depends on 7)

The system of claim 7, wherein the outer member has a second slot formed therein aligned with the first slot, the second slot having an opening at the distal end of the outer member and extending a second slot length toward the proximal end of the outer member, the first slot length and the second slot length sized to span at least from a skin incision in a patient to the distal ends of the inner member and the outer member, respectively, such that the first slot and the second slot may be accessible from outside of the patient when the inner and outer members are engaged to the collar and the bone anchor is inserted into a bone of the patient.

### Claim 9 (depends on 6)

The system of claim 6, wherein the inner member is removable and replaceable from the outer member to facilitate cleaning of the inner member.

### Claim 10 (depends on 6)

The system of claim 6, wherein the distal end of the outer member includes one or more projections configured to maintain engagement of the distal end of the inner member with the collar.