Method and associated instrumentation for installation of spinal dynamic stabilization system
View Patent ↗In one embodiment, a spinal stabilization apparatus includes a vertebral anchor having a head portion and a bone attachment portion. An elongate, flexible guide is removably coupled to the head portion of the vertebral anchor and has a channel extending longitudinally thereof and communicating with a slot in the head portion of the anchor. An elongate cord may be received within the channel to facilitate inserting and securing a spacer between pairs of anchors installed into adjacent vertebrae of a person's spine.
1. A method of installing a spinal stabilization construct, comprising:
installing first and second vertebral anchors onto first and second vertebrae, respectively, each vertebral anchor having an upwardly open channel adapted to receive a flexible connecting element extending between the first and second vertebrae;
mounting first and second access members onto the first and second vertebral anchors, respectively, each access member having a cannula to provide access to the channel of the respective vertebral anchor;
inserting the connecting element through a slot in the first access member;
advancing the flexible connecting element from the slot in the first access member into the channel of the first vertebral anchor;
securing the flexible connecting element to the channel of the first vertebral anchor with a first fastener;
positioning a spacer on the connecting element adjacent the first vertebral anchor;
inserting the flexible connecting element through a slot in the second access member;
translating a tool along an exterior of the second access member without rotation to advance the flexible connecting element along the slot in the second access member into the channel in the second vertebral anchor;
positioning the spacer between the vertebral anchors; and
securing the flexible connecting element to the channel of the second vertebral anchor with a second fastener.
2. The method of claim 1 , wherein positioning the spacer between the vertebral anchors includes:
pushing the spacer into position between the vertebral anchors with the tool.
3. The method of claim 2 , wherein the tool includes a lateral portion extending transverse to a longitudinal axis of the tool for contacting the spacer.
4. The method of claim 3 , wherein the lateral portion is a flange including an arcuate surface.
5. The method of claim 4 , wherein the arcuate surface contacts an outer surface of the spacer.
6. The method of claim 1 , wherein the tool is a tubular member slidably disposed around the second access member.
7. The method of claim 1 , further comprising:
tensioning the connecting element after securing the flexible connecting element to the channel of the first vertebral anchor and prior to securing the flexible connecting element to the channel of the second vertebral anchor.
8. The method of claim 1 , further comprising:
distracting the first and second vertebrae during positioning of the spacer between the vertebral anchors.
9. The method of claim 1 , wherein securing the flexible connecting element to the channel of the first vertebral anchor with the first fastener includes passing the first fastener through the first access member percutaneously to the first vertebral anchor, and securing the flexible connecting element to the channel of the second vertebral anchor with the second fastener includes passing the second fastener through the second access member percutaneously to the second vertebral anchor.