Spinal fixation system
This application describes surgical instruments and implants, including a rod reduction instrument, for building a posterior fixation construct across one or more segments of the spinal column. Extension guides are provided that attach to bone anchors implanted within the spine. The extension guides have a guide channel that align with a rod channel in the anchor to help direct the rod to the anchor. The rod reducer may be passed through the interior of the guide assemblies with a distal end arranged in a first position allowing the distal end to pass through the guide. Once through the guide the distal end may be expanded to provide dual contact on the rod at each end of the bone anchor rod channel.
1. A reducer adapted for use with a spinal fixation system, the spinal fixation system including at least one spinal rod configured to span the distance between at least two vertebrae, at least two bone anchors each having a threaded anchor element, a housing configured to receive the spinal rod therein, and a lock screw adapted to mate with the housing to secure the spinal rod therein, and at least one guide assembly attachable to the bone anchor and configured to guide the spinal rod into the housing, the reducer comprising:
a connector configured to securely but releasably connect the reducer to the at least one guide assembly;
a reduction shaft that translates relative to the connector;
a central shaft that extends through the reduction shaft and translates relative to the reduction shaft,
wherein the reduction shaft has a distal end that transitions from a first arrangement having a first diameter to a second arrangement having a second diameter greater than the first diameter, wherein the distal end of the reduction shaft includes a pair of reduction legs configured to translate axially relative to a longitudinal axis of the reduction shaft, wherein the reduction shaft includes a lower shaft that mates with the pair of reduction legs such that the reduction legs translate with the lower shaft along the longitudinal axis and an upper shaft that threadedly engages with interior threading on the connector, and wherein the connector includes a body and a reduction handle that is translationally fixed to the body but rotationally free such that rotating the reduction handle causes the upper shaft to translate relative to the connector.
2. The reducer of claim 1 , wherein the connector includes a guide cavity configured to receive a proximal end of the at least one guide member.
3. The reducer of claim 2 , wherein the connector includes spring locks that extend into the guide cavity to lock connector to the at least one guide member.
4. The reducer of claim 1 , wherein the central shaft includes a distal working end with a distal portion having a third diameter that is greater than a fourth diameter of a proximal portion of the distal working end.
5. The reducer of claim 4 , wherein the reduction legs each include at least one concave surface with a diameter approximating the third diameter and at least one concave surface with a diameter approximating the fourth diameter.
6. The reducer of claim 5 , wherein translating the central shaft relative to the reduction shaft causes the at least one concave surface with the diameter approximating the fourth diameter to align with the distal portion having the third diameter.
7. The reducer of claim 6 , wherein the distal end of the central shaft includes a lock screw interface.
8. The reducer of claim 7 , wherein in the first arrangement, rod contacting surfaces of the reduction legs are situated proximally to the lock screw interface of the central shaft.
9. The reducer of claim 8 , wherein in the second arrangement, the rod contacting surfaces of the reduction legs are situated distally to the lock screw interface of the central shaft.
10. The reducer of claim 1 , wherein the upper shaft threadedly mates with the reduction handle such that rotation of the reduction handle causes the upper shaft to translate through the connector.
11. The reducer of claim 1 , wherein the lower shaft and the reduction legs are coupled to the upper shaft and configured to translate with the upper shaft relative to the connector.
12. The reducer of claim 1 , wherein the central shaft comprise a proximal grip fixedly attached at or near a proximal end thereof, the proximal grip is configured to be manipulated to rotate the central shaft and to translate the central shaft in proximal or distal directions relative to the reduction shaft thereby facilitating delivery of a lock screw at a distal end of the central shaft.
13. The reducer of claim 1 , wherein the lower shaft comprises a pair of axial cutout portions at a distal end thereof, through which the reduction legs extend radially when in the second arrangement.
14. The reducer of claim 1 , wherein at least part of the reduction shaft is sized and shaped to pass through a central passage of the at least one guide assembly.
15. The reducer of claim 1 , wherein the reduction legs are sized and shaped to pass through a central passage of the at least one guide assembly in at least the first arrangement.
16. The reducer of claim 1 , wherein the reduction handle is at a proximal end of the connector, and wherein the reduction handle is proximal to the connector body.