Systems and methods for pedicle screw stabilization of spinal vertebrae

1 . A system for stabilizing spinal vertebrae through a skin incision, comprising:

a first screw having a first screw head;

a second screw having a second screw head;

a bent first extension configured to be removably coupled with the first screw at a distal end of the bent first extension, the bent first extension comprising:

a distal portion extending along a first axial centerline and configured to be removably coupled with the first screw at a distal end of the distal portion;

a proximal portion extending from a proximal end of the distal portion along a second axial centerline, wherein the proximal portion of the bent first extension extends at a nonzero angle away from the distal portion of the bent first extension;

a wall and a first passageway extending through at least the distal portion of the bent first extension along a length of the distal portion of the bent first extension such that the wall of the distal portion of the bent first extension at least partially surrounds the first passageway of the distal portion of the bent first extension; and

a first opening extending through the wall of the bent first extension and positioned at least partially at a proximal end of the distal portion and positioned at least partially at a distal end of the proximal portion; and

a straight second extension configured to be removably coupled with the second screw at a distal end of the straight second extension, the straight second extension comprising:

a distal portion extending along a third axial centerline and a proximal portion coaxially aligned with the third axial centerline;

a wall and a second passageway extending through the straight second extension along the third axial centerline of the straight second extension such that the wall of the straight second extension at least partially surrounds the second passageway;

wherein:

the first opening and the wall of the bent first extension adjacent to the first opening are sized and configured such that, when the straight second extension is advanced through the first opening, the straight second extension is at least partially restrained within the first opening, the straight second extension is positionable at an acute angle relative to the first axial centerline of the bent first extension, and the first passageway remains open; and

the distal portion of the bent first extension is collinear with an axial centerline of the first screw.

2 . The system of claim 1 , wherein the bent first extension and straight second extension have a tubular shape.

3 . The system of claim 1 , wherein an inside size of the wall of the bent first extension adjacent to the first opening in the bent first extension is greater than an outside size of at least a portion of the wall of the straight second extension such that at least a portion of the straight second extension can be passed through the first opening of the bent first extension at an acute angle relative to the first axial centerline of the bent first extension and be at least partially surrounded by the wall of the bent first extension.

4 . The system of claim 1 , wherein:

the inside cross-sectional size of the proximal portion of the bent first extension is also greater than an outside cross-sectional size of at least the distal portion of the straight second extension so that at least the distal portion of the straight second extension can be advanced completely through the first opening of the bent first extension.

5 . The system of claim 1 , wherein the first opening in the bent first extension passes through the wall of the bent first extension at an angle that is acute to the first axial centerline of the distal portion of the bent first extension.

6 . The system of claim 1 , wherein the first opening comprises a first cutout in a first side of the wall and a second cutout in a second side of the wall of the bent first extension, wherein:

the second side of the wall is opposite to the first side of the wall;

the second cutout is separate from the first cutout such that the first and second cutouts are not overlapping or connected; and

the second cutout is positioned closer to the distal end of the bent first extension than the first cutout.

7 . The system of claim 1 , wherein the bent first extension and the straight second extension are configured such that, in an operable state wherein the straight second extension is advanced through the first opening in the bent first extension, moving a proximal end of the bent first extension either toward or away from a proximal end of the straight second extension will cause the straight second extension to hinge about an edge of the first opening and rotate relative to bent first extension about the edge of the first opening in the bent first extension so as to cause the distal end of the straight second extension to move toward or away from the distal end of the bent first extension, respectively.

8 . The system of claim 1 , wherein the first axial centerline of at least the distal portion of the bent first extension is approximately collinear with an axial centerline of the first screw.

9 . The system of claim 1 , wherein the third axial centerline of at least the distal portion of the straight second extension is approximately collinear with an axial centerline of the second screw.

10 . The system of claim 1 , wherein the straight second extension is configured to be removably inserted through the first opening of the bent first extension.

11 . The system of claim 1 , wherein the proximal portion and the distal portion of the straight second extension extend along the third axial centerline of the straight second extension.

12 . The system of claim 1 , wherein the distal portion of the bent first extension has a first length and the proximal portion of the bent first extension has a second length, wherein the second length is approximately the same as the first length.

13 . The system of claim 1 , wherein the first opening comprises a distal edge, wherein, in an operable state, the distal edge contacts the straight second extension such that the straight second extension can be rotated about the distal edge relative to the bent first extension.

14 . The system of claim 1 , wherein the system is configured such that, in an operable state when the first screw is implanted within a vertebra, the distal portion of the bent first extension extends from the first screw to a height level with or below a skin incision and such that the proximal portion of the bent first extension extends away from the skin incision.

15 . A system for bone stabilization, comprising:

a first screw comprising a first screw head; and

a first guiding element configured to extend away from the first screw, wherein the first guiding element comprises:

a distal portion comprising a partially enclosed tubular body extending a first length along a first longitudinal axis between at least an intermediate portion of the first guiding element and a distal end of the first guiding element, wherein a distal end of the distal portion is configured to engage with and be collinear with the first screw head;

an opening extending through the intermediate portion of the first guiding element, the opening being completely enclosed by a wall of the first guiding element, the opening oriented at an angle relative to the first longitudinal axis of the distal portion of the first guiding element; and

a proximal portion extending a second length between a proximal end of the first guiding element and the intermediate portion of the first guiding element along a second longitudinal axis, wherein the proximal portion extends at a nonzero angle relative to the distal portion so that the proximal portion is not collinear with the first longitudinal axis;

wherein;

the opening is positioned at least partially at a proximal end of the distal portion and positioned at least partially at a distal end of the proximal portion; and

the second length is approximately the same as the first length.

16 . The system of claim 15 , further comprising:

a second screw comprising a second screw head; and

a second guiding element configured to extend away from the second screw;

wherein, in an operable state, the system is configured such that the second guiding element passes through the opening of the first guiding element.

17 . The system of claim 16 , wherein the second guiding element comprises:

a distal portion comprising a partially enclosed tubular body extending along a third longitudinal axis between at least an intermediate portion of the second guiding element and a distal end of the second guiding element, wherein the distal end of the second guiding element is configured to engage with the second screw head, and

an opening extending through the second guiding element, the opening extending at an angle to the third longitudinal axis.

18 . The system of claim 15 , wherein the first guiding element is a bent body.

19 . A system for bone stabilization, comprising:

a plurality of guiding elements, wherein at least one of the plurality of guiding elements comprises:

a distal portion comprising a partially enclosed tubular body extending a first length along a first longitudinal axis between at least an intermediate section of the at least one of the plurality of guiding elements and a distal end of the at least one of the plurality of guiding elements, wherein a distal end of the distal portion is configured to engage and be collinear with a first screw head;

an opening extending through the at least one of the plurality of guiding elements, the opening oriented at an angle relative to the first longitudinal axis of the distal portion; and

a proximal portion extending a second length along a second longitudinal axis between a proximal end of the at least one of the plurality guiding elements and the intermediate portion of the at least one of the plurality of guiding elements, wherein the proximal portion extends at a nonzero angle away from the distal portion; and

wherein the opening is sized and configured to allow for passage of another guiding element therethrough;

wherein the opening is positioned at least partially at a proximal end of the distal portion and positioned at least partially at a distal end of the proximal portion; and wherein the second length is approximately the same as the first length;

wherein at least one other guiding element of the plurality of guiding elements comprises:

a partially enclosed tubular body extending at least between an intermediate portion of the at least one other guiding element and a distal end of the at least one other guiding element, wherein the distal end of the at least one other guiding element is configured to engage with a second screw head.

20 . The system of claim 19 , wherein the at least one guiding element is a bent body.