Method for installation of dynamic, single-lock anterior cervical plate system having non-detachably fastened and moveable segments
View Patent ↗An anterior cervical plating system having moveable plate segments to vary the overall length of the plate, moveable to allow and/or cause intersegmental compression of vertebral bodies, and coupled together by a non-detachable fastener. The plating system includes locking elements for locking only one bone screw to the plate, instrumentation, and method for installation thereof. The plating system is capable of both passive and active dynamization and the ability to produce the former from the latter.
1. A method comprising:
providing a plate of appropriate length adapted to overlap at least a portion of two adjacent vertebral bodies in the human spine, the plate having at least a first plate segment adapted to be attached to one of the adjacent vertebral bodies to be fused and a second plate segment adapted to be attached to another one of the adjacent vertebral bodies to be fused, the first and second plate segments being in moveable relationship to one another along a longitudinal axis of the plate, the first and second plate segments being fastened together by a fastener being non-detachably attached to at least one of the first and second plate segments so as to prevent complete uncoupling of the first and second plate segments from one another;
inserting at least a first bone screw through the first plate segment of the plate and into one of the adjacent vertebral bodies adjacent the disc space to be fused;
inserting at least a second bone screw through the second plate segment and into the other of the adjacent vertebral bodies adjacent the disc space to be fused;
locking at least one of the bone screws with at least one bone screw lock adapted to lock to the plate only a single bone screw;
tightening the fastener from a first position to a second position to resist movement of the first and second plate segments relative to each other in at least one direction; and
permitting movement of the first and second plate segments attached to the adjacent vertebral bodies in a direction toward one another along the longitudinal axis of the plate and resisting movement of the first and second plate segments in a direction away from one another along the longitudinal axis of the plate when the fastener is in the second position.
2. The method of claim 1 , wherein the permitting movement includes allowing movement of the first and second plate segments of the plate in response to movement of the adjacent vertebral bodies.
3. The method of claim 1 , wherein the permitting movement includes causing movement of the adjacent vertebral bodies by moving the first and second plate segments relative to one another.
4. The method of claim 1 , wherein the permitting movement includes applying a compressive load to the adjacent vertebral bodies.
5. The method of claim 1 , wherein the providing the plate includes providing a plate having at least a third plate segment.
6. The method of claim 1 , further comprising combining the plate with an interbody spinal fusion implant.
7. The method of claim 1 , further comprising combining the plate with a fusion promoting substance.
8. The method of claim 7 , wherein the fusion promoting substance is at least one of bone, hydroxyapatite, bone morphogenetic protein, and genes coding for the production of bone.
9. The method of claim 1 , wherein at least a portion of one of the plate, the at least one bone screw lock, and the bone screws is a bioresorbable material.
10. A method comprising:
providing a plate of appropriate length adapted to overlap at least a portion of two adjacent vertebral bodies in the human spine, the plate having at least a first plate segment adapted to be attached to one of the adjacent vertebral bodies to be fused and a second plate segment adapted to be attached to another one of the adjacent vertebral bodies to be fused, the first and second plate segments being in moveable relationship to one another along a longitudinal axis of the plate, the first and second plate segments being non-detachably fastened together by a fastener being non-detachably attached to at least one of the first and second plate segments so as to prevent complete uncoupling of the first and second plate segments from one another;
applying the plate to the adjacent vertebral bodies with the first and second plate segments being non-detachably fastened together by the fastener prior to the applying of the plate to the adjacent vertebral bodies;
inserting at least a first bone screw through the first plate segment of the plate and into one of the adjacent vertebral bodies adjacent the disc space to be fused;
inserting at least a second bone screw through the second plate segment and into the other of the adjacent vertebral bodies adjacent the disc space to be fused;
locking at least one of the bone screws with at least one bone screw lock adapted to lock to the plate only a single bone screw;
permitting movement of the first and second plate segments attached to the adjacent vertebral bodies relative to one another; and
using an instrument configured to cooperatively engage the fastener and at least a portion of at least one of the first and second plate segments to simultaneously rotate the fastener and move the first and second plate segments relative to one another along the longitudinal axis of the plate.
11. The method of claim 10 , wherein the permitting movement of the first and second plate segments is in only a single direction toward one another.
12. The method of claim 10 , wherein the permitting movement includes allowing movement of the first and second plate segments of the plate in response to movement of the adjacent vertebral bodies.
13. The method of claim 10 , wherein the permitting movement includes limiting the movement of the first and second plate segments relative to one another to sequential increments along the longitudinal axis of the plate.
14. The method of claim 10 , wherein the permitting movement includes causing movement of the adjacent vertebral bodies by using the instrument to move the first and second plate segments relative to one another.
15. The method of claim 14 , wherein the causing movement includes using the instrument to generate a compressive load across the disc space between the adjacent vertebral bodies.
16. The method of claim 10 , further comprising using the instrument to tighten the fastener from a first position to a second position to resist movement of the first and second plate segments relative to each other in at least one direction.
17. The method of claim 10 , further comprising combining the plate with an interbody spinal fusion implant.
18. The method of claim 10 , further comprising combining the plate with a fusion promoting substance.
19. The method of claim 18 , wherein the fusion promoting substance is at least one of bone, hydroxyapatite, bone morphogenetic protein, and genes coding for the production of bone.
20. The method of claim 10 , wherein the providing the plate further comprises providing bone screws for engaging the plate to the cervical spine, wherein at least a portion of one of the plate, the at least one bone screw lock, and the bone screws is a bioresorbable material.