System and method for cervical midline fixation
View Patent ↗Devices and methods for enhancing the effectiveness of spinal stabilization, and particularly that of cervical spinal stabilization, are provided herein. More specifically, methods and systems are disclosed for effectively positioning occipital plates and spinal fixation assemblies within target vertebrae, while also reducing any associated patient trauma (e.g., muscle stripping, tissue damage, etc.). The systems and methods can utilize trans-lamina delivery of the spinal fixation assemblies to allow for the positioning of the fixation elements along the midline of the patient's spine.
1. A spinal fixation assembly, comprising:
a housing having an anterior base and a pair of arms extending posteriorly therefrom, the pair of arms defining a slot therebetween configured to seat a spinal fixation element, the slot extending along a longitudinal axis of the housing and configured to be aligned with a midline of the spine;
the housing having a central axis perpendicular to the longitudinal axis and extending through the base and the slot;
an anchor-receiving opening formed in one of the pair of arms and extending between the slot and a concave bone contacting surface of the arm adjacent the base; and
an anchor member having a head positionable within the anchor-receiving opening and a shank configured to engage bone;
wherein the anchor-receiving opening is disposed entirely on one side of the central axis and configured such that when the head of the anchor member is completely disposed within the housing, the head is disposed entirely on one side of the central axis and the shank extends anteriorly and laterally away from the housing at an acute angle relative to the central axis.
2. The assembly of claim 1 , wherein the anchor-receiving opening is defined by an internal surface of the housing.
3. The assembly of claim 2 , wherein the internal surface of the housing is configured to engage a head of the anchor member.
4. The assembly of claim 3 , wherein the internal surface of the housing is substantially spherical to allow for polyaxial movement of the anchor member.
5. The assembly of claim 1 , wherein the base has a bone contacting surface adjacent the anchor-receiving opening.
6. The assembly of claim 5 , wherein the bone contacting surfaces of the arm and the base are configured to sit on the lamina.
7. The assembly of claim 1 , wherein the pair of arms comprise a first arm and a second arm disposed on opposed sides of the central axis relative to one another.
8. The assembly of claim 7 , wherein the second arm includes a window formed therethrough, the window being configured to provide access to a driver for manipulating an anchor member disposed through the anchor receiving opening in the first arm.
9. The assembly of claim 1 , wherein the anchor-receiving opening is angled relative to the central axis to permit the anchor member to be implanted within the vertebra in a trans-lamina orientation.
10. The system of claim 1 , wherein, when the head of the anchor member is completely disposed within the housing and a spinal fixation element is locked within the housing, a portion of the head of the anchor member lies flush with the slot and the locked spinal fixation element applies a force to the anchor member that fixes a position of the anchor member with respect to the housing.
11. A spinal fixation system, comprising:
a housing having a base and first and second arms extending therefrom, the first and second arms defining a slot therebetween, the slot extending along a longitudinal axis of the housing and being configured to be aligned with a midline of a subject's spine, the housing having a central axis perpendicular to the longitudinal axis and extending through the base and the slot;
a spinal fixation element configured to be disposed in the slot such that the spinal fixation element extends along the midline of the subject's spine;
an anchor member configured to be disposed through an anchor-receiving opening extending through the first arm between the slot and a bone contacting surface of the first arm; and
a closure mechanism configured to threadably engage the first and second arms for securing the spinal fixation element within the slot;
wherein, when the closure mechanism threadably engages the first and second arms such that the spinal fixation element and the head of the anchor member are secured within the housing, and the head of the anchor member is completely disposed within the housing, the central axis extends through a center of the closure mechanism and through the spinal fixation element, the head of the anchor member is disposed entirely on one side of the central axis, and a shank of the anchor member extends away from the housing at an acute angle relative to the central axis.
12. The system of claim 11 , wherein the anchor member comprises at least one of a screw configured to be imbedded in a lamina and a hook configured to be hooked onto a lamina.
13. The system of claim 11 , further comprising a fin coupled to the spinal fixation element, the fin having one or more holes to which tissue can be attached.
14. The system of claim 11 , wherein inner surfaces of the first and second arms have threads for threadably engaging the closure mechanism.
15. The system of claim 11 , wherein, when the closure element threadably engages the first and second arms and locks a spinal fixation element disposed in the slot, the spinal fixation element applies a force to the anchor member and fixes a position of the anchor member with respect to the housing.