Spinal therapy device with fixated distraction distance
Assemblies for implantation across one or more spinal motion segments to allow for control of the distance between bone anchors. Control of distance between bone anchors may be provided by one inter-anchor element pushing the pair of bone anchors apart and a second inter-anchor element pulling the pair of bone anchors together. Control of distance between bone anchors may be provided through use of dissimilar thread pitch. Compression of intervertebral disc space through controlled movement of a pair of anchored bone anchors towards one another.
1. An assembly for implantation across two spinal vertebrae comprising:
an externally threaded distal anchor for engagement with a distal vertebra;
an externally threaded proximal anchor for engagement with a proximal vertebra;
a spanning component that is threadedly engaged with the proximal anchor and extends into an interior of the distal anchor, wherein the spanning component may be rotated to set a minimum distance between a distal end of the proximal anchor and a proximal end of the distal anchor; and
a compression inducing element adapted to:
extend into an open interior of the spanning component;
engage a shoulder within an interior of the proximal anchor, the shoulder facing a proximal end of the proximal anchor;
engage a threaded bore within an interior of the distal anchor; and
receive rotational input at a driver engagement section at a proximal end of the compression inducing element accessible via a proximal end of the proximal anchor such that a driver engaged with the driver engagement section of the compression inducing element has a capacity to reduce a distance between the distal anchor and the proximal anchor by pulling the distal anchor towards the proximal anchor, and wherein the shoulder within the interior of the proximal anchor is part of a component threadedly engaged to the interior of the proximal anchor.
2. The assembly of claim 1 wherein the spanning component imposes the minimum distance between the distal anchor and the proximal anchor, the minimum distance selected from a range of different possible minimum distances enabled by a capacity of the spanning component to move via threaded engagement relative to a threaded portion of the interior of the proximal anchor.
3. The assembly of claim 2 where the range of different possible minimum distances is broad enough to allow imposition of a hyper-distraction distance between the distal anchor and the proximal anchor to allow delivery of material into a hyper-distracted space between the distal vertebra and the proximal vertebra before using the compression inducing element to reduce the distance between the distal anchor and the proximal anchor and thus reduce the distance between the distal vertebra and the proximal vertebra.
4. The assembly of claim 2 wherein the compression inducing element limits the distance between the distal anchor and the proximal anchor to not exceed the minimum distance imposed by the spanning component.
5. The assembly of claim 1 wherein the distal anchor is adapted to engage two adjacent vertebrae.
6. The assembly of claim 5 where the distal anchor is adapted to distract an intervertebral disc space between the two adjacent vertebrae through a use of dissimilar thread pitch.
7. The assembly of claim 1 wherein a portion of the spanning component extending into the interior of the distal anchor is fluted to reduce contact area between the spanning component and the distal anchor.
8. The assembly of claim 1 wherein a portion of the spanning component extending into the interior of the distal anchor is adapted to reduce surface contact between the portion of the spanning component and the interior of the distal anchor.
9. The assembly of claim 1 wherein the spanning component has at least one lateral port in fluid communication with a proximal end of the spanning component so that the spanning component may be used as a conduit to deliver material between the distal vertebra and the proximal vertebra.
10. The assembly of claim 1 wherein:
the spanning component has a spanning component driver engagement section at a distal end;
the distal anchor has a distal anchor driver engagement section at a proximal end; and
the spanning component driver engagement section has a relationship with the distal anchor driver engagement section such that one driver tip could be inserted from the proximal end to simultaneously engage both the spanning component driver engagement section and the distal anchor driver engagement section to allow both to be torqued, and wherein another driver tip could be used that would be capable to engage the spanning component driver engagement section but not the distal anchor driver engagement section such that the spanning component may be rotated without driving the distal anchor.
11. The assembly of claim 1 wherein the proximal vertebra is a portion of a sacrum.
12. The assembly of claim 1 wherein a proximal end of the proximal anchor is adapted to engage a counter-torque tube.
13. An assembly for implantation across two spinal vertebrae comprising:
an externally threaded distal anchor for engagement with a distal vertebra;
an externally threaded proximal anchor for engagement with a proximal vertebra;
a spanning component that is threadedly engaged with the proximal anchor and extends into an interior of the distal anchor, the spanning component may be rotated to set a minimum distance between a distal end of the proximal anchor and a proximal end of the distal anchor; and
a compression inducing element adapted to:
extend into an open interior of the spanning component;
engage a shoulder within an interior of the proximal anchor, the shoulder facing a proximal end of the proximal anchor; and
threadedly engage an interior of the distal anchor such that rotation of the compression inducing element while threadedly engaged with the interior of the distal anchor has a capacity to reduce a distance between the distal anchor and the proximal anchor, and wherein the shoulder within the interior of the proximal anchor is part of a component threadedly engaged to the interior of the proximal anchor.
14. The assembly of claim 13 wherein the spanning component imposes the minimum distance between the distal anchor and the proximal anchor, the minimum distance selected from a range of different possible minimum distances enabled by a capacity of the spanning component to move via threaded engagement relative to a threaded portion of the interior of the proximal anchor.
15. The assembly of claim 14 where the range of different possible minimum distances is broad enough to allow imposition of a hyper-distraction distance between the distal anchor and the proximal anchor to allow delivery of material into a hyper-distracted space between the distal vertebra and the proximal vertebra before using the compression inducing element to reduce the distance between the distal anchor and the proximal anchor and thus reduce the distance between the distal vertebra and the proximal vertebra.
16. The assembly of claim 14 wherein the compression inducing element limits the distance between the distal anchor and the proximal anchor to not exceed the minimum distance imposed by the spanning component.
17. The assembly of claim 13 wherein the distal anchor is adapted to engage two adjacent vertebrae.
18. The assembly of claim 17 where the distal anchor is adapted to distract an intervertebral disc space between the two adjacent vertebrae through a use of dissimilar thread pitch.
19. The assembly of claim 13 wherein a portion of the spanning component extending into the interior of the distal anchor is fluted to reduce contact area between the spanning component and the distal anchor.
20. The assembly of claim 13 wherein a portion of the spanning component extending into the interior of the distal anchor is adapted to reduce surface contact between the portion of the spanning component and the interior of the distal anchor.
21. The assembly of claim 13 wherein the spanning component has at least one lateral port in fluid communication with a proximal end of the spanning component so that the spanning component may be used as a conduit to deliver material between the distal vertebra and the proximal vertebra.
22. The assembly of claim 13 wherein:
the spanning component has a spanning component driver engagement section at a distal end;
the distal anchor has a distal anchor driver engagement section at a proximal end; and
the spanning component driver engagement section has a relationship with the distal anchor driver engagement section such that one driver tip could be inserted from the proximal end to simultaneously engage both the spanning component driver engagement section and the distal anchor driver engagement section to allow both to be torqued, and wherein another driver tip could be used that would be capable to engage the spanning component driver engagement section but not the distal anchor driver engagement section such that the spanning component may be rotated without driving the distal anchor.
23. The assembly of claim 13 wherein the proximal vertebra is a portion of a sacrum.
24. The assembly of claim 13 wherein a proximal end of the proximal anchor is adapted to engage a counter-torque tube.
25. An assembly for insertion across an intervertebral space in a spine via a trans-sacral access channel, the assembly comprising:
a distal anchor for threaded engagement with a more distal vertebral body;
a proximal anchor for threaded engagement with a more proximal vertebral body separated from the more distal vertebral body by an intervertebral disc space;
a spanning component with an external thread adapted to engage an internal thread within the proximal anchor so that a distal end of the spanning component can be selectively advanced beyond a distal end of the proximal anchor to limit movement of the distal anchor towards the proximal anchor; and
a compression inducing element with a distal end that passes through a bore in the spanning component and engages a threaded bore in the distal anchor, the compression inducing element having a distal facing shoulder which engages a proximal facing shoulder within the proximal anchor so that rotation of the compression inducing element draws the distal anchor towards the proximal anchor to decrease distraction of the intervertebral space by decreasing a distance between the distal anchor and the proximal anchor until limited by the spanning component.
26. The assembly of claim 25 wherein the spanning component imposes a minimum distance between the distal anchor and the proximal anchor, the minimum distance selected from a range of different possible minimum distances enabled by a capacity of the spanning component to move via threaded engagement relative to a threaded portion of an interior of the proximal anchor.
27. The assembly of claim 26 where the range of different possible minimum distances is broad enough to allow imposition of a hyper-distraction distance between the distal anchor and the proximal anchor to allow delivery of material into a hyper-distracted space between the distal vertebra and the proximal vertebra before using the compression inducing element to reduce the distance between the distal anchor and the proximal anchor and thus reduce the distance between the distal vertebra and the proximal vertebra.
28. The assembly of claim 26 wherein the compression inducing element limits the distance between the distal anchor and the proximal anchor to not exceed the minimum distance imposed by the spanning component.
29. The assembly of claim 25 wherein the distal anchor is adapted to engage two adjacent vertebrae.
30. The assembly of claim 29 where the distal anchor is adapted to distract an intervertebral disc space between the two adjacent vertebrae through a use of dissimilar thread pitch.
31. The assembly of claim 25 wherein a portion of the spanning component extending into an interior of the distal anchor is fluted to reduce contact area between the spanning component and the distal anchor.
32. The assembly of claim 25 wherein a portion of the spanning component extending into an interior of the distal anchor is adapted to reduce surface contact between the portion of the spanning component and an interior of the distal anchor.
33. The assembly of claim 25 wherein the spanning component has at least one lateral port in fluid communication with a proximal end of the spanning component so that the spanning component may be used as a conduit to deliver material between the distal vertebra and the proximal vertebra.
34. The assembly of claim 25 wherein: the spanning component has a spanning component driver engagement section at a distal end; the distal anchor has a distal anchor driver engagement section at a proximal end; and the spanning component driver engagement section has a relationship with the distal anchor driver engagement section such that one driver tip could be inserted from the proximal end to simultaneously engage both the spanning component driver engagement section and the distal anchor driver engagement section to allow both to be torqued, and wherein another driver tip could be used to engage the spanning component driver engagement section but not the distal anchor driver engagement section such that the spanning component may be rotated without driving the distal anchor.
35. The assembly of claim 25 wherein the proximal vertebra is a portion of a sacrum.
36. The assembly of claim 25 wherein a proximal end of the proximal anchor is adapted to engage a counter-torque tube.