Granted Patent B2

US 12,376,886 · App. 18/048,760 · Granted Aug 5, 2025

Inventors: Roger P. Jackson (Prairie Village, KS); James L. Surber (Kansas City, KS)

A61B17/702A61B17/68A61B17/7008A61B17/7032A61B17/7037A61B17/7076

Abstract

Claims (57)

1. A pivotal bone anchor assembly for securing an elongate rod to a bone of a patient with tooling, the pivotal bone anchor assembly comprising:

a receiver comprising a lower body defining a cavity communicating with bottom surface of the receiver through a bottom opening and a pair of upright arms extending upwardly from the lower body with opposed inwardly facing surfaces defining an open channel configured to receive the elongate rod and having a closure-mating structure formed therein, the open channel communicating with the cavity to define a central bore, the cavity including a lower locking region with a lower sidewall defining a first diameter and an upper expansion region with an upper sidewall defining a second diameter that is greater than the first diameter, the central bore including a horizontal interference structure protruding inwardly and extending at least partially circumferentially around the central bore between the upper expansion region and the closure-mating structure;

a shank having an upper end portion and a bone anchoring portion extending distally from the upper end portion and configured to attach to the bone, the upper end portion being up-loadable into the cavity of the receiver through the bottom opening with the shank being initially pivotable with respect to the receiver;

a retaining structure postionable within the upper expansion region of the cavity prior to the upper end portion of the shank being received in the cavity and including an upper insert-engaging portion and a lower expansion portion with a lower opening, the lower expansion portion being initially secured in the upper expansion region with the lower opening centralized and spaced above the lower locking region and bottom opening of the receiver, and being operable to expand and capture the upper end portion of the shank upon its uploading through the bottom opening and the lower opening:

a compression insert positionable into the receiver prior to the shank and including an upwardly-facing surface sized and shaped to engage the elongate rod, opposite exterior side surfaces configured to have an initial overlapping arrangement with the horizontal interference structure that inhibits downward movement of the compression insert within the central bore of the receiver, and a recess formed into a lower portion of the compression insert configured to receive and overlappingly engage the upper insert-engaging portion of the retaining structure; and

a closure top configured for positioning entirely within the central bore of the receiver above the compression insert and in engagement with the closure mating structure to apply a downward pressure toward the compression insert and the upper end portion of the shank until an angular orientation of the shank relative to the receiver is locked with the closure top,

wherein after the upper end portion of the shank is captured within the lower expansion portion of the retaining structure and prior to locking with the closure top, the compression insert is configured for forcible downward displacement within the receiver by direct engagement with the tooling to push the exterior side surfaces at least partially through the horizontal interference structure so as to inhibit the compression insert from moving back up within the central bore of the receiver, and

wherein after the forced downward displacement of the compression insert within the central bore, the shank is configured to remain pivotable with respect to the receiver until the angular orientation of the shank relative to the receiver is locked with the closure top.

2. The pivotal bone anchor assembly of claim 1 , wherein the retaining structure is non-pivotal with respect to the receiver after the capture of the upper end portion of the shank.

3. The pivotal bone anchor assembly of claim 1 , wherein upward movement of the retaining structure during the uploading of the upper end portion of the shank is restricted by the overlapping engagement between the upper insert-engaging portion of the retaining structure and the lower portion of the compression insert.

4. The pivotal bone anchor assembly of claim 1 , wherein the lower expansion portion of the retaining structure includes at least one gap or slot extending entirely through a thickness thereof and from a top surface to a bottom surface.

5. The pivotal bone anchor assembly of claim 1 , wherein the upper insert-engaging portion of the retaining structure extends above a top of the upper end portion of the shank captured within the lower expansion portion of the retaining structure.

6. The pivotal bone anchor assembly of claim 1 , wherein after the forcible downward displacement of the compression insert within the receiver, the pivotal bone anchor assembly is configured for unlocked but non-floppy pivotal angular positioning of the shank relative to the receiver.

7. The pivotal bone anchor assembly of claim 1 ,

wherein the compression insert is configured to be pulled back up within the receiver after removal of the closure top so as to release the locked angular orientation between the shank and the receiver.

8. The pivotal bone anchor assembly of claim 1 , wherein the retaining structure includes an inner surface configured to frictionally engage the upper end portion of the shank upon its capture with the cavity of the receiver to allow for an unlocked but non-floppy angular positioning of the shank with respect to the receiver prior to the forcible downward displacement of the compression insert.

9. The pivotal bone anchor assembly of claim 1 , wherein the upper end portion of the shank is at least partially spherical.

10. The pivotal bone anchor assembly of claim 1 ,

wherein the open channel further comprises U-shaped surfaces on both sides of the central bore configured to receive the elongate rod; and

wherein the horizontal interference structure extends circumferentially around the central bore to the U-shaped surfaces.

11. The pivotal bone anchor assembly of claim 1 , wherein the closure-mating structure further comprises a helically wound guide and advancement structure.

12. A pivotal bone anchor assembly and system for securing an elongate rod to a bone of the patient, the pivotal bone anchor assembly comprising:

a receiver having a lower body defining a lower portion of a central bore communicating with bottom surface of the receiver through a bottom opening, and a pair upright arms with opposed interior surfaces that define an open channel configured to receive the elongate rod, the central bore extending upward from the bottom opening through the open channel to tops of the upright arms and including a discontinuous closure-mating structure adjacent the tops of the upright arms and an integral horizontal interference structure protruding inwardly and extending at least partially circumferentially around the central bore below the closure-mating structure;

a shank having an upper end portion and an anchor capture portion extending distally from the upper end portion and configured to attach to the bone, the upper end portion being up-loadable into the central bore through the bottom opening with the shank being initially pivotable with respect to the receiver;

a compression insert positionable within the central bore prior to the shank and having an upper surface configured to engage the elongate rod, a lower recess formed into a lower portion, and opposite exterior side surfaces having an initial overlapping arrangement with the horizontal interference structure that inhibits downward movement of the compression insert within the central bore of the receiver; and

a retaining structure positionable with the lower portion of the central bore prior to the shank, the retaining structure including an upper insert-engaging portion receivable into the lower recess of the compression insert and a lower expansion portion with a lower opening, the lower expansion portion being initially secured in the lower portion of the central bore, with the lower opening centralized and spaced above the bottom opening of the receiver, and being operable to expand therein to capture the upper end portion of the shank upon its uploading through the bottom opening; and

a closure top configured for positioning entirely within the central bore of the receiver above the compression insert and in engagement with the closure mating structure to apply a downward pressure toward the compression insert and the upper end portion of the shank until an angular orientation of the shank relative to the receiver is locked with the closure top,

wherein after the upper end portion of the shank is captured within the lower expansion portion of the retaining structure and prior to locking with the closure top, the compression insert is configured for forcible downward displacement within the receiver by direct engagement with the tooling to push the exterior side surfaces at least partially through the horizontal interference structure so as to inhibit the compression insert from moving back up within the central bore of the receiver, and

wherein after the forced downward displacement of the compression insert within the central bore, the shank is configured to remain pivotable with respect to the receiver until the angular orientation of the shank relative to the receiver is locked with the closure top.

13. The pivotal bone anchor assembly of claim 12 ,

wherein the open channel further comprises U-shaped surfaces on both sides of the central bore configured to receive the elongate rod; and

wherein the horizontal interference structure extends circumferentially around the central bore to the U-shaped surfaces.

14. The pivotal bone anchor assembly of claim 12 ,

wherein after the forcible downward displacement of the compression insert within the receiver, the pivotal bone anchor assembly is configured for unlocked but non-floppy pivotal angular positioning of the shank relative to the receiver.

15. The pivotal bone anchor assembly of claim 14 , wherein the compression insert is configured to be pulled back up within the receiver after removal of the closure top so as to release the locked angular orientation between the shank and the receiver.

16. A method of assembling a pivotal bone anchor assembly configured to secure an elongate rod to a bone of a patient with tooling and a closure top, the method comprising:

positioning a compression insert in a receiver prior to a shank,

the receiver having a lower body defining a lower portion of a central bore communicating with bottom surface of the receiver through a bottom opening, and a pair upright arms with opposed interior surfaces that define an open channel configured to receive the elongate rod, the central bore extending upward from the bottom opening through the open channel to tops of the upright arms and including a discontinuous closure-mating structure adjacent the tops of the upright arms, a lower locking region with a lower sidewall defining a first diameter adjacent the bottom opening, an upper expansion region with an upper sidewall defining a second diameter that is greater than the first diameter, and a horizontal interference structure protruding inwardly and extending at least partially circumferentially around the central bore between the upper expansion region and the closure-mating structure,

the shank having an upper end portion and an anchor capture portion extending distally from the upper end portion configured to attach to the bone, the upper end portion being up-loadable into the central bore through the bottom opening, and

the compression insert having an upper surface configured to engage the elongate rod, a lower recess formed into a lower portion, and opposite exterior side surfaces having an initial overlapping arrangement with the horizontal interference structure that inhibits downward movement of the compression insert within the central bore of the receiver; and

positioning a retaining structure in the upper expansion region of the central bore prior to the shank, the retaining structure including an upper insert-engaging portion receivable into the lower recess of the compression insert and a lower expansion portion with a lower opening, the lower expansion portion being initially secured in the upper expansion region with the lower opening centralized and spaced above the lower locking region and bottom opening of the receiver, and being operable to expand and capture the upper end portion of the shank upon its uploading through the bottom opening and the lower opening,

wherein after the upper end portion of the shank is uploaded through the bottom opening of the receiver and into capture by the retaining structure, the compression insert is configured for forcible downward displacement within the receiver by direct engagement with the tooling to push the exterior side surfaces at least partially through the horizontal interference structure so as to inhibit the compression insert from moving back up within the central bore of the receiver, and

wherein after the forced downward displacement of the compression insert within the central bore, the shank is configured to remain pivotable with respect to the receiver until the angular orientation of the shank relative to the receiver is locked with the closure top.

17. The method of claim 16 ,

wherein the open channel further comprises U-shaped surfaces on both sides of the central bore configured to receive the elongate rod; and

wherein the horizontal interference structure extends circumferentially around the central bore to the U-shaped surfaces.

18. The method of claim 16 , wherein the lower expansion portion of the retaining structure includes at least one gap or slot extending entirely through a thickness thereof and from a top surface to a bottom surface.

19. A method of assembling a pivotal bone anchor assembly configured to secure an elongate rod to a bone of a patient with tooling and a closure top, the method comprising:

positioning a compression insert in a receiver,

the receiver having a lower body defining a lower portion of a central bore communicating with bottom surface of the receiver through a bottom opening, and a pair upright arms extending upward from the lower body with opposed interior surfaces that define an open channel configured to receive the elongate rod, the central bore extending upward from the bottom opening through the open channel to tops of the upright arms and including a discontinuous closure-mating structure adjacent the tops of the upright arms, a circumferentially extending interference a lower locking region with a lower sidewall defining a first diameter adjacent the bottom opening, an upper expansion region with an upper sidewall defining a second diameter that is greater than the first diameter, and a horizontal interference structure protruding inwardly and extending at least partially circumferentially around the central bore between the upper expansion region and the closure-mating structure, and

the compression insert having an upper surface configured to engage the elongate rod, a lower recess formed into a lower portion, and opposite exterior side surfaces having an initial overlapping arrangement with the horizontal interference structure that inhibits downward movement of the compression insert within the central bore of the receiver;

positioning a retaining structure in the upper expansion region of the central bore of the receiver, the retaining structure including an upper insert-engaging portion receivable into the lower recess of the compression insert and a lower expansion portion with a lower opening, the lower expansion portion being initially secured in the upper expansion region with the lower opening centralized and spaced above the lower locking region and bottom opening of the receiver;

uploading an upper end portion of a shank into the central bore of the receiver through the bottom opening, with the expandable lower portion of the retaining structure expanding within the upper expansion region to capture the upper end portion of the shank within the central bore with the shank being initially pivotable with respect to the receiver, the shank including an anchor portion extending distally from the upper end portion and configured to attach to the bone; and

forcibly downwardly displacing the compression insert in the receiver by direct engagement with the tooling to push the exterior side surfaces at least partially through the horizontal interference structure so as to inhibit the compression insert from moving back up within the central bore of the receiver,

wherein after the forced downward displacement of the compression insert within the central bore, the shank is configured to remain pivotable with respect to the receiver until the angular orientation of the shank relative to the receiver is locked with the closure top.

20. The method of claim 19 , wherein after the forcible downward displacement of the compression insert within the receiver, the pivotal bone anchor assembly is configured for unlocked but non-floppy pivotal angular positioning of the shank with respect to the receiver until the angular orientation of the shank relative to the receiver is locked with the closure top.

21. The method of claim 19 , wherein the retaining structure is non-pivotal with respect to the receiver after the capture of the upper end portion of the shank.

Assignments (1)

Continuity (24)

References Cited (155)