Systems and methods for spinal rod insertion and reduction
View Patent ↗A guide assembly includes a spinal screw assembly having a bone screw and a spinal rod holder; and a spinal rod guide having first and second elongated arc portions defining a pair of longitudinal slots extending along the first and second arc portions, each of the first and second arc portions further defining at least one recess extending transversely from each of the longitudinal slots, the at least one recess configured to receive at least a portion of a reduction tool to enable reduction of a spinal rod received within the spinal rod holder.
1. A guide assembly comprising:
a reduction tool;
a spinal rod guide comprising an upper threaded portion, the upper threaded portion configured to threadingly receive a threaded portion of the reduction tool;
a spinal screw assembly comprising a bone screw and a spinal rod holder, the spinal rod holder comprising an intermediate threaded portion and a lower threaded portion;
a fastener, the fastener configured to be threadingly received by the intermediate and lower threaded portions and to engage a surface of a spinal rod;
wherein the spinal rod guide and the intermediate threaded portion are detachably coupled to the remainder of the spinal rod holder such that the intermediate and lower threaded portions of the spinal rod holder enable a user to thread the fastener along both the intermediate threaded portion and the lower threaded portion of the spinal rod holder in a continuous manner prior to detachment of the spinal rod guide and the intermediate threaded portion from the remainder of the spinal rod holder; and
wherein an end of the reduction tool is configured to engage the fastener such that the threaded portion of the reduction tool disengages the upper threaded portion of the spinal rod guide prior to the fastener engaging the intermediate threaded portion of the spinal rod holder.
2. The guide assembly of claim 1 , wherein the spinal rod guide comprises first and second arc portions defining first and second slots extending along a longitudinal axis of the spinal rod guide, wherein the first and second arc portions are configured to break away with the intermediate threaded portion at a fracture joint upon a predetermined amount of torque being applied to the first and second arc portions about the longitudinal axis.
3. The guide assembly of claim 2 , wherein each of the first and second arc portions are coupled to the spinal rod holder by a welded joint between each of the first and second arc portions and the spinal rod holder.
4. The guide assembly of claim 2 , wherein the fracture joint comprises a plurality of struts being provided on surface of the spinal rod holder.
5. The guide assembly of claim 2 , wherein the spinal rod guide comprises a ring member joining the first and second arc portions and defining at least a portion of the upper threaded portion.
6. The guide assembly of claim 1 , wherein the spinal rod guide comprises first and second arc portions comprising internal surfaces defining a recess configured to receive the threaded portion of the reduction tool after the threaded portion of the reduction tool disengages the upper threaded portion of the spinal rod guide, thereby enabling longitudinal movement of the threaded portion of the reduction tool within the recess as the fastener engages the intermediate threaded portion of the spinal rod holder.
7. The guide assembly of claim 6 , wherein the upper threaded portion of the spinal rod guide has a greater thread pitch than the intermediate threaded portion of the spinal rod holder, and wherein the intermediate threaded portion of the spinal rod holder has substantially the same thread pitch as the lower threaded portion of the spinal rod holder.
8. The guide assembly of claim 1 , wherein the spinal rod guide comprises first and second arc portions extending from a pair of seating surfaces of the spinal rod holder, and wherein the fastener is configured to enable a user to thread the fastener along the intermediate and lower threaded portions to secure the spinal rod proximate the seating surfaces of the spinal rod holder.
9. A spinal rod installation kit comprising:
a spinal rod guide comprising an upper threaded portion;
a spinal screw assembly comprising a spinal screw and a spinal rod holder, the spinal rod holder defining an intermediate threaded portion, a lower threaded portion, and at least one seating surface;
a fastener configured to threadingly engage the intermediate and lower threaded portions of the spinal rod holder to move a spinal rod toward the at least one seating surface;
a reduction tool configured to threadingly engage the upper threaded portion of the spinal rod guide and comprising an end portion configured to engage the fastener, the reduction tool enabling continuous threading of the fastener within the intermediate threaded portion of the spinal rod holder and the lower threaded portion of the spinal rod holder by way of manipulation of the reduction tool; and
wherein the reduction tool disengages the upper threaded portion prior to the fastener engaging the intermediate threaded portion.
10. The kit of claim 9 , wherein the spinal rod guide comprises an internal recess configured to enable longitudinal movement of a threaded portion of the reduction tool as the fastener engages the intermediate threaded portion.
11. The kit of claim 9 , wherein the spinal rod guide comprises a pair of arc portions extending from a ring portion at a first end and extending from the spinal rod holder at a second end.
12. The kit of claim 11 , wherein each of the pair of arc portions is coupled to the spinal rod holder via a welded joint.
13. The kit of claim 12 , wherein a plurality of struts extends longitudinally along the spinal rod holder between the intermediate and lower threaded portions to define a fracture joint, and wherein adjacent struts are divided by notches.
14. The kit of claim 12 , wherein the fracture joint is configured to break upon application of a predetermined amount of torque.
15. A method of reducing a spinal rod, the method comprising:
securing a spinal rod guide assembly to a vertebral body, the spinal rod guide assembly comprising a spinal rod guide, a spinal rod holder coupled to the spinal rod guide, and
a spinal screw extending through the spinal rod holder and into the vertebral body;
positioning a spinal rod within the spinal rod guide;
positioning a fastener onto an end of a reduction tool and positioning the end of the reduction tool and the fastener within the spinal rod guide;
rotating the reduction tool such that a threaded portion of the reduction tool engages and subsequently disengages an upper threaded portion of the spinal rod guide;
further rotating the reduction tool such that, after the threaded portion of the reduction tool disengages the upper threaded portion of the spinal rod guide, the fastener engages an intermediate threaded portion of the spinal rod holder and a lower threaded portion of the spinal rod holder in a continuous threading manner, thereby seating the spinal rod within the spinal rod holder.
16. The method of claim 15 , wherein the spinal rod guide comprises a pair of arc portions extending from a circumferentially closed top to the spinal rod holder.
17. The method of claim 15 , wherein the spinal rod holder comprises at least one fracture joint comprising a plurality of struts provided between the intermediate and lower threaded portions.
18. The method of claim 15 , further comprising applying a torque to the spinal rod guide to fracture the struts.