Spinal fixation tool set and method
View Patent ↗A tool set for implanting a rod in a human spine in conjunction with bone screws includes a pair of end guide tools that receive opposite ends of the rod in channels and under manipulation by a surgeon facilitate transport of the rod toward the bone screws attached to the guide tools. Each end guide tool includes a laterally extending, rigid, rod holding structure located near a bottom surface thereof. Intermediate guide tools having pass-through slots are utilized to guide the rod to the bone screws at intermediate locations. For bone screw implantation, the end guide tools and intermediate guide tools are assembled with a driver. The driver is coaxial with the respective guide tool and rotatingly mateable thereto. The driver includes a stem and a nut-type fastener, the stem receivable in the guide tool. The fastener allows for rotation of the bone screw without rotating the attached guide tool. For reducing a rod into the bone screw, a rod pusher is deployed that is coaxial with a respective guide tool and includes an outer sleeve that abuts the rod as the sleeve is translated along the guide tool and toward the bone screw. A method utilizing the tool set allows a surgeon to percutaneously implant the bone screws and the rod in the patient.
1. A tool set for implanting a rod in a patient using at least one spinal implant, the tool set comprising:
first and second end guide tools, each guide tool further comprising:
i. an elongate body having a longitudinal axis, an outer surface and a channel with a channel opening extending laterally through the outer surface and along the longitudinal axis for a length of the guide tool, the channel and channel opening sized and shaped for side loading and receiving of an end of the rod; and
ii. a spinal implant engaging structure near a bottom of the body,
wherein the spinal implant engaging structure includes first and second opposed projections projecting into the channel, the projections sized and shaped to be received in cooperating engagement structures in the spinal implant for releasable attachment thereto, and each of the projections has an upwardly projecting lip sized and shaped to be received in an upwardly projecting inner recess of the spinal implant engagement structure.
2. The tool set of claim 1 further comprising at least one intermediate guide tool having first and second elongate legs defining an elongate through-slot sized and shaped for receiving the rod therethrough, and a second opposed spinal implant engaging structure disposed near a bottom of the legs.
3. The tool set of claim 2 wherein the second spinal implant engaging structure includes third and fourth opposed projections, the third projection disposed on the first leg and the fourth projection disposed on the second leg, the third and fourth projections projecting inwardly from the respective legs and sized and shaped to be received in cooperating tool engagement structures in the spinal implant for releasable attachment thereto.
4. The tool set of claim 3 wherein the through-slot is sized and shaped to allow for manual flexing of the intermediate guide tool legs to increase a distance between the third and fourth projections during insertion of the intermediate guide tool on the spinal implant, the third and fourth projections being in inwardly biasing snap-on relation to the spinal implant at the spinal implant tool engagement structure.
5. The tool set of claim 4 wherein the third and fourth projections each have an upwardly projecting lip sized and shaped to be received in an upwardly projecting inner recess of the spinal implant tool engagement structure.
6. The tool set of claim 2 further comprising a driving tool attachable to the intermediate guide tool, the driving tool receivable in the through-slot and operably attachable to the spinal implant for rotating and driving the spinal implant into bone.
7. The tool set of claim 2 further comprising a rod pusher attachable to the intermediate guide tool, the rod pusher having a sleeve and a driving end, the sleeve receivable over the first and second legs and operably attachable at an upper end of the intermediate guide tool for rotating thereabout, with the rotational movement of the sleeve also translating the driving end along the first and second legs.
8. The tool set of claim 2 further comprising
a) an elongate torquing tool having a handle and a stem receivable in the through-slot of the intermediate guide tool and attachable to an implant fastener; and
b) an elongate anti-torque tool having a handle and a sleeve receivable over the first and second legs of the intermediate guide tool, the sleeve sized and shaped to seat upon and abut against a rod at either side of the intermediate guide tool body, precluding any rotational movement of the anti-torque tool relative to the intermediate guide tool.
9. The tool set of claim 1 further comprising a driving tool separately attachable to each of the first and second end guide tools, the driving tool receivable in the channel and operably attachable to the spinal implant for rotating and driving the spinal implant into bone.
10. The tool set of claim 9 wherein each of the end guide tools has an outer guide and advancement structure and the driving tool has a fastener, a stem and a driving structure disposed at a lower end of the stem, the driving structure for rotating and driving the spinal implant into bone, the fastener having an inner guide and advancement structure, the fastener being freely rotatable with respect to the stem and the inner guide and advancement structure rotatingly mateable with the outer guide and advancement structure.
11. The tool set of claim 10 wherein the driving structure is an internal surface forming a socket for receiving an upper portion of the spinal implant.
12. The tool set of claim 1 further comprising a rod pusher separately attachable to each of the first and second end guide tools, the rod pusher having a sleeve and a driving end, the sleeve receivable over the elongate body and operably attachable to the body for rotating thereabout, with the rotational movement of the sleeve also translating the driving end along the body.
13. The tool set of claim 12 wherein each of the end guide tools has an outer guide and advancement structure and the rod pusher has an inner guide and advancement structure mateable to the outer guide and advancement structure.
14. The tool set of claim 1 wherein each of the end guide tools has a narrow slot disposed opposite the channel opening, the narrow slot and channel opening cooperating to allow manual flexing of the guide tool body to increase a distance between the first and second projections during insertion of the guide tool on the spinal implant, the projections being in inwardly biasing snap-on relation to the spinal implant at the spinal implant engagement structures.
15. The tool set of claim 1 further comprising:
a) an elongate torquing tool having a handle and a stem receivable in the channel of each of the end guide tools and attachable to an implant fastener; and
b) an elongate anti-torque tool having a handle and a sleeve receivable over the body of each of the end guide tools, the sleeve sized and shaped to seat upon and abut against a rod at either side of the guide tool body, precluding any rotational movement of the anti-torque tool relative to the end guide tool.