Magnetically actuateable rod insertion for minimally invasive surgery
The present disclosure describes a spinal fixation system comprising a telescoping spinal rod, as well as methods of its use and a guide tower for use therewith. The telescoping rod can be extended after it has been inserted into the patient below the fascia, which permits it to be extended in the sub-fascial space.
1. A guide tower assembly for guiding a spinal rod into position from a first bone anchor to a second bone anchor, the guide tower assembly comprising:
an elongate tower member having a proximal end, a distal end, and a longitudinal axis;
a lumen running from the proximal end to the distal end of the elongate tower member;
a longitudinal slot that connects to the lumen; a bone anchor engagement member configured to reversibly fasten the first bone anchor to the elongate tower member;
a first rod holder having a first rod engagement feature and a first translating shaft connected to the first rod engagement feature, wherein the first translating shaft is capable of translating along the longitudinal axis relative to the elongate tower member; and
a second rod holder having a second rod engagement feature and a second translating shaft connected to the second rod engagement feature, wherein the second translating shaft is capable of translating along the longitudinal axis relative to the elongate tower member.
2. The guide tower assembly of claim 1 , wherein the second translating shaft is capable of translating at a different velocity than a velocity of translation of the first translating shaft.
3. The guide tower assembly of claim 1 , wherein the first rod engagement feature and the second rod engagement feature are configured to engage the spinal rod until the spinal rod is seated in the first bone anchor.
4. The guide tower assembly of claim 3 , wherein the spinal rod is configured to be telescoping between an extended configuration and a collapsed configuration, wherein the spinal rod has a first longitudinal length in the collapsed configuration and a second longitudinal length in the extended configuration, and wherein the first longitudinal length is less than the distance between a vertebral pedicle and an adjacent vertebral pedicle.
5. The guide tower assembly of claim 4 , wherein the spinal rod is configured to elongate and contract to a longitudinal length in a range from the first longitudinal length to the second longitudinal length upon receipt of a remote signal external to the patient.
6. The guide tower assembly of claim 5 , wherein the remote signal is a rotating magnetic field.
7. The guide tower assembly of claim 1 , wherein one or both of the first translating shaft and the second translating shaft is a threaded shaft operatively connected to a first shaft magnet, such that rotation of the first shaft magnet causes the threaded shaft to translate.
8. The guide tower assembly of claim 1 , wherein the first rod holder and the second holder are configured to allow the spinal rod to be inserted in a first direction, and reoriented to a second direction to be seated in the first bone anchor, wherein the first direction and the second direction are not parallel to each other.
9. The guide tower assembly of claim 1 , wherein the first translating shaft includes a first longitudinal length that is different than a second longitudinal length of the second translating shaft during insertion of the spinal rod.
10. The guide tower assembly of claim 1 , wherein the spinal rod is telescoping in two opposite directions.
11. A guide tower assembly for guiding a telescoping spinal rod into position from a first bone anchor to a second bone anchor, the guide tower assembly comprising:
an elongate tower member having a proximal end, a distal end, and a longitudinal axis;
a lumen running from the proximal end to the distal end of the elongate tower member;
a longitudinal slot that connects to the lumen; a bone anchor engagement member configured to reversibly fasten the first bone anchor to the elongate tower member;
a first rod holder having a first rod engagement feature at a distal end of the first rod holder and a first translating shaft connected to the first rod engagement feature,
wherein the first translating shaft is capable of translating along the longitudinal axis relative to the elongate tower member, and
wherein the first rod engagement feature is configured to engage a first end of the telescoping spinal rod for rod insertion; and
a second rod holder having a second rod engagement feature at a distal end of the second rod holder and a second translating shaft connected to the second rod engagement feature,
wherein the second translating shaft is capable of translating along the longitudinal axis relative to the elongate tower member and wherein the second rod engagement feature is configured to engage a second end opposite the first end of the telescoping spinal rod for rod insertion.
12. The guide tower assembly of claim 11 , wherein the second translating shaft is capable of translating at a different velocity than a velocity of translation of the first translating shaft.
13. The guide tower assembly of claim 11 , wherein the first rod engagement feature and the second rod engagement feature are configured to engage the spinal rod until the spinal rod is seated in the first bone anchor.
14. The guide tower assembly of claim 13 , wherein the spinal rod is configured to be telescoping between an extended configuration and a collapsed configuration, wherein the spinal rod has a first longitudinal length in the collapsed configuration and a second longitudinal length in the extended configuration, and wherein the first longitudinal length is less than the distance between a vertebral pedicle and an adjacent vertebral pedicle.
15. The guide tower assembly of claim 14 , wherein the spinal rod is configured to elongate and contract to a longitudinal length in a range from the first longitudinal length to the second longitudinal length upon receipt of a remote signal external to the patient.
16. The guide tower assembly of claim 15 , wherein the remote signal is a rotating magnetic field.
17. The guide tower assembly of claim 11 , wherein one or both of the first translating shaft and the second translating shaft is a threaded shaft operatively connected to a first shaft magnet, such that rotation of the first shaft magnet causes the threaded shaft to translate.
18. The guide tower assembly of claim 11 , wherein the first rod holder and the second holder are configured to allow the spinal rod to be inserted in a first direction, and reoriented to a second direction to be seated in the first bone anchor, wherein the first direction and the second direction are not parallel to each other.
19. The guide tower assembly of claim 11 , wherein the first translating shaft includes a first longitudinal length that is different than a second longitudinal length of the second translating shaft during insertion of the spinal rod.
20. The guide tower assembly of claim 11 , wherein the spinal rod is telescoping in two opposite directions.