Translational instrumentation for spondylolisthesis and scoliosis reduction
An instrument includes a distraction mechanism having a proximal end and an opposed distal end. The distal end includes opposed first and second end members. A first vertebral endplate spreader includes a proximal spreader section mounted to the first end member of the distraction mechanism. The first spreader also includes a distal spreader section operatively connected to the proximal spreader section for lateral movement relative to the proximal spreader section. A second vertebral endplate spreader is mounted to the second end member of the distraction mechanism. The distraction mechanism is configured and adapted to distract the spreaders apart and to retract the spreaders together along a distraction axis. The distal spreader section of the first spreader is configured to move relative to the second spreader in a lateral direction relative to the distraction axis for correction of vertebral alignment, as in treatment of spondylolisthesis, scoliosis, and the like.
1 . A method of correcting vertebral alignment comprising:
engaging a distal spreader section of a first vertebral endplate spreader to a first vertebra;
engaging a distal spreader section of a second vertebral endplate spreader to a second vertebra proximate to the first vertebra;
distracting the first and second vertebral endplate spreaders apart along a distraction axis to distract the first and second vertebrae from one another; and
translating the distal spreader section of the first vertebral endplate spreader relative to the second vertebral endplate spreader proximally or distally relative to the distraction axis for correction of alignment of the first and/or second vertebrae;
wherein the first and second vertebral endplate spreaders each comprise:
a proximal spreader section configured to be mounted to an end member of a distraction mechanism; and
the distal spreader section operatively connected to the proximal spreader section for proximal and/or distal movement relative to the proximal spreader section, wherein the distal spreader section is configured and adapted to simultaneously engage both an endplate and a side surface of a vertebra (anterior or lateral) to distract and proximally and/or distally move the vertebra upon proximal and/or distal movement of the distal spreader section.
2 . The method of claim 1 , wherein the distraction mechanism comprises a handle portion opposite the end member.
3 . The method of claim 1 , wherein the steps of engaging the first and second vertebral endplate spreaders to the vertebrae include approaching the vertebrae with the spreaders from an anterior approach.
4 . The method of claim 1 , wherein the step of translating includes moving the superior of the two vertebrae in a posterior direction to correct a listhesis condition of the vertebrae.
5 . The method of claim 1 , wherein the step of translating includes moving the superior of the two vertebrae in an anterior direction to correct a retrolisthesis condition of the vertebrae.
6 . The method of claim 1 , wherein the steps of engaging the first and second spreaders to the vertebrae include approaching the vertebrae with the spreaders from a lateral approach.
7 . The method of claim 6 , wherein the step of translating includes moving the two vertebrae relative to one another in a lateral direction to correct a lateral slippage condition of the vertebrae related to scoliosis.
8 . The method of claim 1 , further comprising a pair of guides engaged with the proximal and distal spreader sections to maintain a parallel relationship between the proximal and distal spreader sections during relative proximal and/or distal travel of the proximal and distal spreader sections.
9 . The method of claim 8 , wherein the guides are mounted to the distal spreader section and are slideably engaged to the proximal spreader section.
10 . The method of claim 1 , further comprising a linear actuator engaged with the proximal and distal spreader sections to actuate relative proximal and/or distal travel of the proximal and distal spreader sections.
11 . The method of claim 10 , wherein the linear actuator includes a threaded screw engaged to threads in the proximal spreader section and rotatably engaged with the distal spreader section so that rotation of the threaded screw adjusts separation of the proximal and distal spreader sections for relative proximal and/or distal travel thereof.
12 . The method of claim 1 , wherein at least one of the proximal and distal spreader sections includes a bone screw passage for accommodating a bone screw to engage the distal spreader section to a vertebra.
13 . The method of claim 12 , wherein engaging the distal spreader section of either the first or second vertebral endplate spreader comprises advancing a bone screw through the bone screw passage and at least partially into the vertebra.
14 . The method of claim 12 , wherein engaging the distal spreader section of both the first and second vertebral endplate spreaders comprises advancing first and second bone screws through the respective bone screw passages and at least partially into the first and second vertebrae, respectively.
15 . The method of claim 1 , wherein the distal spreader section includes at least one tong for engaging a vertebral endplate.
16 . The method of claim 15 , wherein the distal spreader section includes a pair of tongs for engaging a vertebral endplate.
17 . The method of claim 1 , further comprising translating the distal spreader section of the second vertebral endplate spreader relative to the first vertebral endplate spreader proximally or distally relative to the distraction axis for correction of alignment of the first and/or second vertebrae.
18 . The method of claim 1 , wherein the distraction mechanism operates in a first plane and the distal spreader section defines a second plane that is perpendicular to the first plane.
19 . The method of claim 18 , wherein the distal spreader section includes a pair of tongs that lie in the second plane.
20 . The method of claim 1 , wherein engaging the distal spreader section of either the first or second vertebral endplate spreader does not comprise the use of a bone screw.