阅读说明：本技术 用于外科植入物延伸件的横向联接件 (Transverse coupling for surgical implant extension ) 是由 雅各布·帕克 安德鲁·多斯特 于 2020-04-09 设计创作，主要内容包括：本发明涉及一种用于连接多个植入物延伸件的横向联接件(100；1000；1000')包括至少第一套筒(310；3100；3100')和第二套筒(410；4100；4100')。所述第一套筒(310；3100；3100')限定第一孔(312),所述第一孔(312)适于轴向接收通过所述第一孔(312)的第一植入物延伸件(20)。所述第二套筒(410；4100；4100')限定第二孔(412),所述第二孔(412)适于轴向接收通过所述第二孔(412)的第二植入物延伸件(20')。所述横向联接件(100；1000；1000')还包括中心壳体。第一轴(320；3200；3200')将所述第一套筒(310；3100；3100')连接到所述中心壳体,并且所述第二轴(420；4200；4200')将所述第二套筒(410；4100；4100')连接到所述中心壳体。所述中心壳体包括至少一个接头,用于将所述中心壳体连接到所述第一和第二轴(320、420；3200、4200；3200'；4200')中的至少一个轴,以允许轴相对于所述中心壳体移动通过一个或多个自由度的可移动布置。(The invention relates to a transverse coupling (100; 1000; 1000') for connecting a plurality of implant extensions, comprising at least a first sleeve (310; 3100; 3100') and a second sleeve (410; 4100; 4100 '). The first sleeve (310; 3100; 3100') defines a first bore (312), the first bore (312) adapted to axially receive a first implant extension (20) through the first bore (312). The second sleeve (410; 4100; 4100') defines a second bore (412), the second bore (412) adapted to axially receive a second implant extension (20') through the second bore (412). The transverse link (100; 1000; 1000') further comprises a central housing. A first shaft (320; 3200; 3200') connects the first sleeve (310; 3100; 3100') to the center housing, and a second shaft (420; 4200; 4200') connects the second sleeve (410; 4100; 4100') to the center housing. The center housing comprises at least one joint for connecting the center housing to at least one of the first and second shafts (320, 420; 3200, 4200; 3200 '; 4200') to allow the shafts to move through a movable arrangement of one or more degrees of freedom relative to the center housing.)

1. A transverse coupling (100; 1000; 1000') for connecting a first implant extension (20) to a second implant extension (20'), the transverse coupling comprising:

a first sleeve (310; 3100; 3100') defining a first bore (312), the first bore (312) adapted to axially receive the first implant extension (20) through the first bore (312);

a second sleeve (410, 4100') defining a second bore (412), said second bore (412) adapted to axially receive said second implant extension (20') through said second bore (412);

a center housing (200; 2000; 2000');

a first shaft (320; 3200; 3200') connecting the first sleeve (310; 3100; 3100') to the center housing (200; 2000; 2000 '); and

a second shaft (420; 4200; 4200') connecting the second sleeve (410; 4100; 4100') to the center housing (200; 2000; 2000'),

at least one of the first shaft (320; 3200; 3200') and the second shaft (420; 4200; 4200') is connected to the center housing (200; 2000; 2000') through a movable joint (230, 240) on the center housing (200; 2000; 2000').

2. A transverse coupling (100; 1000; 1000') according to claim 1, wherein

The center housing (200; 2000; 2000') includes a first joint (230) and a second joint (240);

the first shaft (320; 3200; 3200') connecting the first sleeve (310; 3100; 3100') to the first joint (230) of the center housing (200; 2000; 2000 '); and

the second shaft (420; 4200; 4200') connects the second sleeve (410; 4100; 4100') to the second joint (240) of the center housing (200; 2000; 2000 ').

3. A transverse coupling (100; 1000; 1000') according to claim 2, wherein the first joint (230) comprises a universal ball joint (232), the universal ball joint (232) being pivotable relative to the center housing (200; 2000; 2000').

4. A transverse link (100; 1000; 1000') according to claim 3, wherein the gimballed joint (232) comprises a longitudinal channel (234) and a plurality of spring segments (237) extending around the longitudinal channel (234).

5. A transverse coupling (100; 1000; 1000') according to claim 4, wherein the first shaft (320; 3200; 3200') is axially displaceable through the longitudinal channel (234) of the first joint (230).

6. The transverse coupling (100; 1000; 1000') according to claim 3 or 4, wherein the first shaft (320; 3200; 3200') comprises a first sleeve end (322) attached to the first sleeve (310; 3100; 3100'), and a first free end (324) opposite the first sleeve end (322), the first free end (324) comprising a first stop (326) to limit axial displacement of the first shaft (320; 3200; 3200') through the longitudinal channel (234), and/or wherein the first shaft (320; 3200; 3200') is rotatable in the longitudinal channel (234) of the first joint (230), and/or wherein the first shaft (320; 3200; 3200') comprises a first shaft cross-section with a first abutment face (425), and the longitudinal channel (234) comprises a channel cross-section with a first abutment edge (255), the first abutment edge (255) is configured to abut the first abutment surface (425) during rotation of the first shaft (320; 3200; 3200') relative to the longitudinal channel (234) and limit the range of rotation of the first shaft (320; 3200; 3200').

7. The transverse coupling (100; 1000; 1000') according to one of the preceding claims, wherein the second joint (240) comprises a cylindrical through hole (244), the cylindrical through hole (244) passing through the center housing (200; 2000; 2000').

8. The transverse coupling (100; 1000; 1000') according to claim 7, wherein the second shaft (420; 4200; 4200') is axially displaceable through the through-bore (244) of the second joint (240), and/or wherein the second shaft (420; 4200; 4200') comprises a second sleeve end (422) attached to the second sleeve (410; 4100; 4100'), and a second free end (424) opposite the second sleeve end (422), the second free end (424) comprising a second stop (426) to limit axial displacement of the second shaft (420; 4200; 4200') through the through-bore (244) of the second joint (240), and/or wherein the second shaft (420; 4200; 4200') is rotatable in the through-bore (244) of the second joint (240), and/or wherein the second shaft (420; 4200; 4200') comprises a second shaft cross-section having a second abutment face, and the through-hole (244) comprises a through-hole cross-section having a second abutment edge configured to abut the second abutment surface during rotation of the second shaft (420; 4200; 4200') relative to the longitudinal channel (234) and limit the range of rotation of the second shaft (420; 4200; 4200').

9. A transverse coupling (100; 1000; 1000') according to any of the preceding claims, wherein the center housing (200; 2000; 2000') comprises an upper portion (210), a lower portion (220) separate from the upper portion (210), and an adjustment screw (260) extending through the upper portion (210) and the lower portion (220).

10. The transverse coupling (100; 1000; 1000') according to claim 9, wherein the upper portion (210) and the lower portion (220) of the center housing (200; 2000; 2000') form an adjustable clamp in which the first shaft (320; 3200; 3200') is releasably secured in the first joint (230) and the second shaft (420; 4200; 4200') is releasably secured in the second joint (240), and/or wherein the adjustment screw (260) includes an external thread (263) and the lower portion of the center housing (200; 2000; 2000') defines a bore (221) having an internal thread (223), the external thread (263) mating with the internal thread (223).

11. The transverse coupling (100; 1000; 1000') according to claim 10, wherein the clamp is adjustable to a locked state in response to rotation of the adjustment screw (260), wherein the upper portion (200) and the lower portion (220) of the center housing (200; 2000; 2000') are drawn together to the locked state to compress the first joint (230) and the second joint (240) and lock the position of the first shaft (320; 3200; 3200') and the second shaft (420; 4200; 4200') relative to the center housing (200; 2000; 2000'), and/or wherein the clamp is adjustable to an unlocked state in response to rotation of the adjustment screw (260), wherein the upper portion (210) and the lower portion (220) of the center housing (200); 2000; 2000') to allow the first shaft (320; 3200; 3200') and the second shaft (420; 4200, mixing the raw materials; 4200') is arranged relative to the center housing (200; 2000; 2000') are moved.

12. The transverse coupling (100; 1000; 1000') according to one of the preceding claims, wherein at least one of the first sleeve (310; 3100; 3100') and the second sleeve (410; 4100; 4100') defines a sleeve axis (316) and a chamber (314).

13. The transverse coupling (100; 1000; 1000') of claim 12, wherein the at least one of the first sleeve (310; 3100; 3100') and the second sleeve (410; 4100; 4100') includes a locking ring (330) defining a locking ring axis (332), the locking ring (330) being translatable in the chamber (314) in a direction transverse to the sleeve axis (316).

14. The transverse coupling (100; 1000; 1000') of claim 13, wherein the locking ring (330) is translatable relative to the at least one of the first and second sleeves (310; 3100; 3100') and (410; 4100; 4100') between a locked position in which the locking ring axis (332) is offset from the sleeve axis (316) by a first distance (D1) and a released position in which the locking ring axis (332) is offset from the sleeve axis (316) by a second distance (D2), the first distance (D1) being greater than the second distance (D2), and/or wherein the at least one of the first and second sleeves (310; 3100; 3100') and (410; 4100; 4100') includes a spring element (318) in the chamber (314), the spring element (314) applying a biasing force to the locking ring (330) to urge the locking ring (330) towards the locked position, and/or wherein the locking ring (330) includes a protrusion (334), the protrusion (334) extending radially inward into the bore (312), the protrusion (334) being positioned in the bore (312) to releasably engage one of the first and second implant extensions (20, 20') when the locking ring (330) is in the locked position, and/or wherein the locking ring (330) includes a release lug (338), the release lug (338) extending radially outward and away from the locking ring axis (332), at least one of the first and second sleeves (310, 4100') defining a channel (317) into which the release lug (338) extends, wherein the release lug (338) preferably protrudes through the through slot (317) in an exposed position in which the release lug (338) is depressible against the biasing force of the spring element (318) to displace the locking ring (330) towards the release position.

15. The transverse link (1000, 1000') according to one of the preceding claims, further comprising: a third sleeve (5100, 5100') defining a third bore adapted to axially receive a third implant extension therethrough; a third shaft (5200; 5200') connecting the third sleeve to the center housing (2000; 2000'); preferably a fourth sleeve (6100') defining a fourth bore adapted to axially receive a fourth implant extension therethrough; and preferably a fourth shaft (6200') connecting the fourth sleeve to the center housing (2000').

Technical Field

The present invention relates generally to surgical instruments and more particularly to a transverse link connecting between two surgical implant extensions.

Background

Surgical procedures sometimes require the use of bone implants, a portion of which is attached to bone within an incision and a portion of which extends through the incision and out of the patient's body. For example, a bone implant may be attached to bone within an incision, and some types of implant extensions may extend out of the incision. The term "extension" as used herein may refer to any elongate body protruding from a bone implant external to the body of a patient, including but not limited to an elongate section of the implant designed to be disconnected from the implant after surgery is complete, or a separate attachment such as a tube removably connected to the bone implant. One object of the extension is to provide a structure that can distribute forces over the implant and the bone to which the implant is anchored. For example, a force applying instrument may be attached to an extension and manipulated in a manner to apply a force to a bone through the extension and bone implant. Such forces may be applied to the extension and implant to correct the position or orientation of the bone relative to other bones.

The bone implant with the extension member may be used in procedures to correct abnormal curvature of the spine. In spinal surgery, a pair of bone anchors, referred to as "pedicle screws," are attached to each side of the vertebral body. Pedicle screws may be used to apply force to a vertebral body and to connect the vertebral body to a fixation element, such as a fixation rod. It is often necessary to correct abnormal curvature of the spine by applying force to multiple pedicle screws simultaneously. For example, it may be desirable to apply corrective forces to multiple pedicle screws attached to a single segment in the spine. At other times, it may be desirable to apply one or more corrective forces to multiple segments simultaneously. In the latter case, it may be desirable to apply one force to one pair of pedicle screws at one segment while applying another force to another pair of pedicle screws at a different segment.

Applying force to multiple extensions in a coordinated manner can be very difficult. Each extension extends from the patient at a unique angle and orientation. Thus, each extension may require an adjustment force applied in a particular direction different from the adjacent extension. The spacing between the extensions may also be very limited, making it difficult to attach a separate instrument to each extension. In addition, a procedure that adjusts multiple segments simultaneously may be very difficult because it may require different forces to be applied to four or more elongate members simultaneously, in which case two or more surgeons may need to work together in a carefully coordinated manner.

Disclosure of Invention

The inventors have developed an instrument that allows a surgeon to apply forces to multiple bone implants in a coordinated but simplified manner. This is achieved by a cross-link coupling or bridge interconnecting a plurality of extensions together. The transverse link may be removably connected to the plurality of extensions and allow for adjustment forces to be applied to the plurality of bone implants in a coordinated manner. This allows the surgeon to apply a single adjustment force to multiple bone implants simultaneously through the transverse link.

In one beneficial aspect of the present disclosure, a transverse link is configured for connecting a first implant extension to a second implant extension. The transverse link includes a first sleeve, a second sleeve, and a center housing. The first sleeve defines a first bore adapted to axially receive a first implant extension therethrough. The second sleeve defines a second bore adapted to axially receive a second implant extension therethrough. A first shaft connects the first sleeve to the center housing and a second shaft connects the second sleeve to the center housing.

In another advantageous aspect of the present disclosure, the center housing includes a first joint and a second joint. In this arrangement, a first shaft connects the first sleeve to the first connector of the center housing and a second shaft connects the second sleeve to the second connector of the center housing.

In another advantageous aspect of the present disclosure, the first joint comprises a ball-and-socket joint that is pivotable relative to the center housing.

In another beneficial aspect of the present disclosure, a ball-and-socket joint includes a longitudinal passage and a plurality of spring segments extending around the longitudinal passage.

In another beneficial aspect of the present disclosure, the first shaft is axially displaceable through the longitudinal passage of the first joint.

In another beneficial aspect of the present disclosure, the first shaft includes a first sleeve end attached to the first sleeve, and a first free end opposite the first sleeve end, the first free end including a first stop to limit axial displacement of the first shaft through the longitudinal channel.

In another beneficial aspect of the present disclosure, the first shaft is rotatable in the longitudinal channel of the first joint.

In another advantageous aspect of the present disclosure, the first shaft includes a first shaft cross-section having a first abutment surface, and the longitudinal channel includes a channel cross-section having a first abutment edge. The first abutment edge is configured to abut the first abutment surface during rotation of the first shaft relative to the longitudinal channel and limit the range of rotation of the first shaft.

In another advantageous aspect of the present disclosure, the second joint includes a cylindrical through bore passing through the center housing.

In another advantageous aspect of the present disclosure, the second shaft is axially displaceable through the through bore of the second joint.

In another advantageous aspect of the disclosure, the second shaft includes a second sleeve end attached to the second sleeve, and a second free end opposite the second sleeve end, the second free end including a second stop to limit axial displacement of the second shaft through the through-hole of the second joint.

In another advantageous aspect of the present disclosure, the second shaft is rotatable in the through hole of the second joint.

In another beneficial aspect of the present disclosure, the second shaft includes a second shaft cross-section having a second abutment surface, and the through-hole includes a through-hole cross-section having a second abutment edge configured to abut the second abutment surface and limit the range of rotation of the second shaft during rotation of the second shaft relative to the longitudinal channel.

In another advantageous aspect of the present disclosure, the center housing includes an upper portion, a lower portion separate from the upper portion, and an adjustment screw extending through the upper and lower portions.

In another advantageous aspect of the present disclosure, the upper and lower portions of the center housing form an adjustable clamp that releasably secures the first shaft in the first joint and releasably secures the second shaft in the second joint.

In another advantageous aspect of the present disclosure, the clamp is adjustable to a locked condition in response to rotation of the adjustment screw, wherein the upper and lower portions of the center housing are drawn together to the locked condition to compress the first and second joints and lock the position of the first and second shafts relative to the center housing.

In another advantageous aspect of the present disclosure, the clamp is adjustable to an unlocked state in response to rotation of the adjustment screw, wherein the upper and lower portions of the center housing are spread apart in the unlocked state to allow the first and second shafts to move relative to the center housing.

In another advantageous aspect of the present disclosure, the adjustment screw includes an external thread, and the lower portion of the center housing defines a bore having an internal thread, the external thread mating with the internal thread.

In another beneficial aspect of the present disclosure, at least one of the first sleeve and the second sleeve defines a sleeve axis and a chamber.

In another advantageous aspect of the present disclosure, at least one of the first and second sleeves includes a locking ring defining a locking ring axis, the locking ring being translatable in the chamber in a direction transverse to the sleeve axis.

In another beneficial aspect of the present disclosure, the locking ring is translatable relative to at least one of the first and second sleeves between a locked position in which the locking ring axis is offset from the sleeve axis by a first distance and a released position in which the locking ring axis is offset from the sleeve axis by a second distance, the first distance being greater than the second distance.

In another advantageous aspect of the disclosure, at least one of the first and second sleeves includes a spring element in the chamber that applies a biasing force to the locking ring to urge the locking ring toward the locked position.

In another beneficial aspect of the present disclosure, the locking ring includes a protrusion extending radially inward into the bore, the protrusion being positioned in the bore to releasably engage one of the first and second implant extensions when the locking ring is in the locked position.

In another beneficial aspect of the present disclosure, the locking ring includes release lugs that extend radially outward and away from the locking ring axis, and at least one of the first and second sleeves defines channels into which the release lugs extend.

In another advantageous aspect of the disclosure, the release lug protrudes through the through slot in an exposed position in which the release lug is depressible against the biasing force of the spring element to displace the locking ring towards the release position.

In another beneficial aspect of the present disclosure, a transverse link is configured for connecting a first implant extension to a second implant extension. The transverse link includes a first sleeve, a second sleeve, and a center housing. The first sleeve defines a first bore adapted to axially receive a first implant extension therethrough. The second sleeve defines a second bore adapted to axially receive a second implant extension therethrough. A first shaft connects the first sleeve to the center housing and a second shaft connects the second sleeve to the center housing. At least one of the first shaft and the second shaft is connected to the center housing by a movable joint on the center housing.

In another beneficial aspect of the present disclosure, the transverse link includes a third sleeve defining a third bore adapted to axially receive a third implant extension therethrough. The transverse link also includes a third shaft connecting the third sleeve to the center housing.

In another beneficial aspect of the present disclosure, the transverse link includes a fourth sleeve defining a fourth bore adapted to axially receive a fourth implant extension therethrough. The cross-link also includes a fourth shaft connecting the fourth sleeve to the center housing.

Drawings

The invention, together with the detailed description, will be best understood when read in conjunction with the accompanying drawings. The drawings illustrate exemplary and non-limiting embodiments of the invention and depict elements that may be combined and arranged as shown or in any other combination and/or arrangement as contemplated by one of ordinary skill in the art.

Fig. 1 is an elevation view of a transverse coupling attached to two extensions attached to two bone implants anchored in bone, respectively, according to one example of the present disclosure;

FIG. 2 is a perspective view of the transverse link of FIG. 1;

FIG. 3 is a top view of the transverse link of FIG. 1;

FIG. 4 is an exploded elevation view of an assembly of the transverse link of FIG. 1;

FIG. 5 is a perspective view of a subassembly of the assembly of the transverse link of FIG. 4;

FIG. 6 is a cross-sectional view of the assembly of the transverse link of FIG. 1 shown in a first adjustment position;

FIG. 7 is a cross-sectional view of the assembly of the transverse link of FIG. 6 shown in a second adjustment position;

FIG. 8 is a top view of the sleeve of the transverse link of FIG. 1 shown in a first operational state;

FIG. 9 is a side cross-sectional view of the sleeve of FIG. 8;

FIG. 10 is a top view of the sleeve of FIG. 8 shown in a second operational state;

FIG. 11 is an enlarged perspective view in section of the transverse link of FIG. 1 showing the locking element in a first operative condition;

FIG. 12 is another enlarged perspective view of a section of the transverse link of FIG. 1 showing the locking element in a second operational state;

FIG. 13 is a perspective view of a transverse link according to another example of the present disclosure;

FIG. 14 is a top view of the transverse link according to FIG. 13;

FIG. 15 is a perspective view of a transverse link according to another example of the present disclosure; and

fig. 16 is an exploded perspective view of the transverse link according to fig. 15.

Detailed Description

As described above, a transverse link according to the present disclosure may be attached to two or more extensions mounted on a pedicle screw. For example, a single transverse link may be attached to a pair of extensions that are attached to a vertebral body to manipulate the vertebral body in a procedure known as "single segment torquing. Alternatively, a first transverse link may be attached to a first pair of extensions attached to a first vertebral body, and a second transverse link may be attached to a second pair of extensions attached to a second vertebral body. A first force may then be applied to the first pair of extensions through the first transverse link and a second force may be simultaneously applied to the second pair of extensions through the second transverse link to adjust the first and second vertebral bodies relative to each other in a single segment twist. In addition, transverse links may be attached to a mass of two or more vertebral bodies to adjust the vertebral body mass in an "integral" twist.

Referring now to the drawings, and in particular to FIG. 1, a transverse link 100 is shown according to one example. The transverse coupling 100 is removably mountable to a variety of different bone implants and extensions. As noted above, the extension may be part of the implant itself, or a separate component attached to the implant, such as a surgical instrument. In this example, the transverse coupler 100 will be described in conjunction with a first extension member in the form of a first spinal rod anchor 20 and a second extension member in the form of a second spinal rod anchor 20'. The first spinal rod anchor 20 is attached to the first pedicle screw 30 and the second spinal rod anchor 20 'is attached to the second pedicle screw 30'.

A first pedicle screw 30 is anchored in a first pedicle P of vertebral body B through a first incision I. Similarly, a second pedicle screw 30' is anchored in a second pedicle P ' of vertebral body B through a second incision I '. In this arrangement, the transverse link 100 can receive the adjustment force F from the force applying instrument 50 and transmit the adjustment force to the vertebral body B via the first and second spinal rod anchors 20, 20 'and the first and second pedicle screws 30, 30'. The transverse link 100, the rod holder 20 and the rod holder 20' together form a rigid structure. The adjustment force may be applied directly to the structure or may be applied by other instruments attached to the structure. For example, the transverse link 100 may receive an adjustment force by applying a force directly to one or both of the rod holders 20, 20'. Alternatively, the cross-link 100 may receive the adjustment force by applying a force to the adjustment screw 260 on the cross-link. Force may be applied to the adjustment screw 260 by a force applying instrument attached to a central knob 261 on the adjustment screw.

The first and second pedicle screws 30, 30 'are spaced apart and extend from their respective cuts I, I' in different trajectories. Thus, the first and second spinal rod anchors 20, 20 'are also spaced apart and extend from their respective cutouts I, I' in different trajectories. The proximal ends of the first and second spinal rod anchors 20, 20 'are separated by a unique spacing S and the different trajectories of the first and second spinal rod anchors define an angular offset a between their respective longitudinal axes X, X'. The transverse link 100 has a plurality of adjustable components to accommodate the spacing S and angular offset α between the first and second rod holders 20, 20'. These adjustable assemblies, which will be described in more detail, can move relative to each other through one or more degrees of freedom to accommodate an infinite number of angular offsets between spacing and extension.

Referring to fig. 2-4, the transverse link 100 includes a center housing 200, a first attachment assembly 300, and a second attachment assembly 400. The first attachment assembly 300 is removably mountable to the first spinal rod holder 20 and the second attachment assembly 400 is removably mountable to the second spinal rod holder 20'. The center housing 200 interconnects the first attachment assembly 300 and the second attachment assembly 400 in an adjustable configuration that allows lateral coupling to accommodate different spacing and angular offsets between the extensions.

The first attachment assembly 300 includes a first sleeve 310 defining a first bore 312. The first bore 312 is adapted to axially receive the first rod holder 20 therethrough. The transverse link 100 further includes a second sleeve 410 defining a second bore 412, the second bore 412 adapted to axially receive the second rod holder 20' therethrough. The center housing 200 includes an upper housing portion 210 and a lower housing portion 220. The upper housing portion 210 and the lower housing portion 220 are interconnected together in a clamping arrangement. In this clamping arrangement, the upper and lower housing portions 210, 220 define a first joint 230 and a second joint 240.

The first attachment assembly 300 includes a first shaft 320 that extends outwardly and away from the first sleeve 310. The first joint 230 slidingly connects the first shaft 320 to the center housing 200. In a similar arrangement, the second attachment assembly 400 includes a second shaft 420 that extends outwardly and away from the second sleeve 410. The second joint 240 slidingly couples the second shaft 420 to the center housing 200.

The first joint 230 includes a gimbaled ball joint 232 that is pivotable relative to the center housing 200. The ball joint 232 defines a longitudinal passage 234 extending through the ball joint. The longitudinal channel 234 receives the first shaft 320 of the first attachment assembly 300 in a linear sliding relationship. This linear sliding relationship allows the first shaft 320 to move axially in a first degree of freedom relative to the center housing 200 through the longitudinal channel 234. First shaft 320 may also be axially rotatable in a second degree of freedom relative to longitudinal channel 234.

The ball joint 232 is sandwiched between the upper housing portion 210 and the lower housing portion 220 of the center housing 200. The upper housing portion 210 has a concave bearing surface 212 and the lower housing portion 220 has a concave bearing surface 222 opposite the concave bearing surface 212. The ball joint 232 slidingly engages the bearing surfaces 212, 222 to pivot in place between the upper housing portion 210 and the lower housing portion 220. In this arrangement, the ball joint 232 may pivot between the upper housing portion 210 and the lower housing portion 220. When the first shaft 320 is received in the longitudinal channel 234, the first shaft may pivot relative to the center housing 200 through a third degree of freedom that is independent of the first and second degrees of freedom.

The upper housing portion 210 and the lower housing portion 220 form two halves of a clamp to control the displacement of the first shaft 320 in the first joint 230. In particular, the upper housing portion 210 and the lower housing portion 220 may be clamped together to exert a compressive force on the ball joint 232. The longitudinal channel 234 has a first end 236 and a second end 238 opposite the first end. The first slot array 233 intersects a first end 236 of the longitudinal channel 234 and the second slot array 235 intersects a second end 238. The slots 233, 235 form a flexible spring segment 237 that encircles the longitudinal channel 234. The spring segment 237 is compressible under stored energy in the locked condition. In the locked state, the first shaft 320 cannot move axially or rotate through the longitudinal channel 234 and the ball joint 232 cannot pivot between the upper and lower housing portions 210, 220. When some of the compressive force on the ball joint 234 is removed, the stored energy in the spring segments 237 is released, causing the spring segments to extend radially outward. As the spring segments 237 extend outward, they move toward a relaxed state in which at least some of the clamping force on the first shaft is removed. This removal of the clamping force allows the first shaft 320 to move axially through the longitudinal channel 234. Removing the compressive force on the ball joint 232 also allows the ball joint to again pivot between the upper and lower housing portions 210, 220 of the center housing 200.

The first shaft 320 has a first sleeve end 322 attached to the first sleeve 310. The first shaft 320 also has a first free end 324 opposite the first sleeve end 322. The first free end 324 includes a first stop 326 to limit axial displacement of the first shaft 320 through the longitudinal channel 234.

The first shaft 320 defines a first shaft axis 321 that is parallel to the longitudinal axis of the longitudinal channel 234. When the first shaft 320 is not clamped in the ball joint 232, the first shaft may rotate about the longitudinal axis 321 in its longitudinal channel 234 in a second degree of freedom.

The second fitting 240 includes a cylindrical through-hole 244 defined between the upper housing portion 210 and the lower housing portion 220. Upper housing portion 210 forms a recessed surface 214 and lower housing portion 220 forms a recessed surface 224. The groove surfaces 214, 224 form two halves of the through-hole 244 and form the through-hole when the upper and lower housing portions 210, 220 are joined together. Second shaft 420 is axially moveable in a first degree of freedom through bore 244 of second joint 240, similar to first shaft 320 in longitudinal channel 234. Further, the second shaft 420 defines a second shaft axis 421 that is parallel to the longitudinal axis of the through-hole 244. Thus, the second shaft 420 is rotatable in the through hole about the second shaft axis 421 in a second degree of freedom.

The second shaft 420 has a second sleeve end 422 attached to the second sleeve 410 and a second free end 424 opposite the second sleeve end. The second free end 424 includes a second stop 426 to limit axial displacement of the second shaft 420 through the through-hole 244 of the second connector 240.

Shafts according to the present disclosure may be rotated 360 degrees about their longitudinal axis (if desired) to first adjust the orientation of their respective sleeves. However, in many applications, a full 360 degree rotation is not necessary, as the sleeve does not need to rotate to a large extent. Accordingly, an accessory assembly according to the present disclosure may have a rotation limiter to limit the axial range of rotation of the shaft.

Referring now to fig. 5-7, one example of a rotation limiter is shown between the second shaft 420 and the through bore 244. The second shaft 420 has a truncated cylindrical shape defining a first cylindrical surface 423 and a first abutment surface 425. The first cylindrical surface 423 and the first abutment surface 425 form a truncated circle or "D" shaped shaft cross-section 427. The through hole 244 has a similar D-shaped cross-section 251 with a first cylindrical edge 253 and a first abutment edge 255. The first abutment surface 425 is configured to abut the first abutment edge 255 during rotation of the second shaft 420 relative to the through bore 244. When the first abutment surface 425 abuts the first abutment edge 255, the first abutment edge prevents the second shaft 420 from rotating further in this rotational direction.

The first abutment surface 425 may abut the first abutment edge 255 in two opposite directions as shown in fig. 6 and 7. The orientation of 40 degrees apart in fig. 6 and 7 represents the limit of axial rotation of the second shaft 420. Although not shown, it should be understood that the first shaft 320 and the longitudinal channel 234 may have the same or similar abutment surfaces and abutment edges, respectively, which limits the relative rotation of the first shaft to within 40 degrees. It should also be understood that a rotation limiter according to the present disclosure may also be configured to allow a smaller or larger axial range of rotation and need not limit rotation to 40 degrees.

A sleeve and shaft according to the present disclosure may be interconnected with a fixed joint, fixing the orientation of the sleeve relative to the shaft. Alternatively, a sleeve and shaft according to the present disclosure may be interconnected with one or movable joints, allowing the sleeve to articulate in one or more degrees of freedom relative to the shaft. The movable joint allows the sleeve to tilt or pivot in one or more planes relative to its respective axis to more easily adapt the locking collar to the position and angle of the extension. In this example, the first sleeve 310 is connected to the sleeve end 322 of the first shaft 320 by a pin connection 343. The second sleeve 410 is connected to the sleeve end 422 of the second shaft 420 by a foot-stand joint 441, which in turn is connected to the second sleeve by a pin connection 443. The sleeve end 322 of the first shaft 320 also has a bend 325, the bend 325 providing a fixed angular offset between the free end 324 of the first shaft and the first sleeve 310.

The upper housing portion 210 and the lower housing portion 220 are interconnected by fasteners that hold the upper housing portion and the lower housing portion together in a clamping arrangement. The cross-link according to the present disclosure may utilize various fasteners to interconnect the upper and lower housing portions in a clamping arrangement, including but not limited to threaded bolts, cam bolts, and other connectors suitable for drawing the upper and lower housing portions together and spreading them apart. In this example, as shown in fig. 4, the upper housing portion 210 and the lower housing portion 220 are connected to each other by an adjustment screw 260. The adjustable screw 260 extends through an upper bore 211, the upper bore 211 extending through the upper housing 210. When the upper and lower housing portions are assembled, the upper bore 211 is axially aligned with the lower bore 221 in the lower housing portion 220. The lower bore 221 has internal threads 223, and the internal threads 223 mate with external threads 263 on the adjustment screw 260. In this arrangement, the adjustment screw 260 is free to be inserted axially through the upper bore 211 into the lower bore 221 until the external threads 263 engage the internal threads 223 in the lower bore. The adjustment screw 260 may then be rotated to engage the external threads 263 with the internal threads 223 and axially advance the adjustment screw into the lower bore.

Referring to the top view shown in fig. 3, the adjustment screw 260 may be rotated in a clockwise direction to draw the upper and lower housing portions 210, 220 together and into a clamped state. In the clamped state, the first shaft 320 and the second shaft 420 are fully fixed to resist all movement relative to the center housing 200. That is, the upper housing portion 210 and the lower housing portion 220 are drawn together such that the first shaft 320 is frictionally locked in the ball joint 232 and cannot move axially or rotate in any direction relative to the ball joint. Further, the ball joint 232 is compressed by the upper housing portions 210, 220 such that the ball joint is frictionally locked between the concave bearing surfaces 212, 222 and cannot pivot in any direction between the upper and lower housing portions. Further, the second shaft 420 is frictionally locked between the groove surface 214 and the groove surface 224 such that the second shaft 420 cannot move axially or rotate in any direction relative to the center housing 200.

The adjustment screw 260 may also be rotated in a counterclockwise direction to loosen the connection between the upper and lower housing portions 210, 220 such that the upper and lower housing portions are in a released state. In the released state, the upper housing portion 210 and the lower housing portion 220 have more freedom to expand, minimizing friction on the ball joint 232, the first shaft 320, and the second shaft 420, and overcoming the friction by applying manual force on the shafts to move them relative to the center housing 200.

The cross-link according to the present disclosure preferably includes one or more components that prevent the upper housing portion from twisting or moving loosely relative to the lower housing portion and the adjustment screw when the upper and lower housings are not in a clamped state. In this example, a wave spring 270 is interposed between the adjustment screw 260 and the upper housing portion 210. The wave spring 270 is compressed under stored energy between the adjustment screw 260 and the upper housing portion 210. The energy stored in the wave spring 270 exerts a constant pressure on the upper housing portion 210 in the direction of the lower housing portion 220 to maintain constant contact of the upper housing portion with the first shaft 320 and the second shaft 420. This constant contact prevents the upper housing portion 210 from twisting, rattling or otherwise moving in a loose manner about the adjustment screw 260 even when the adjustment screw is loosened and the upper and lower housings are in a released state.

The transverse link according to the present disclosure may also have various components for securing the components and preventing disassembly of the components. In this example, a nut 280 is attached to the narrow end of the adjustment screw 260 to prevent the upper and lower housing portions 210, 220 from being detached from the other components. A nut 280 shown in fig. 2 and 4 is attached to the narrow end of the adjustment screw 260 by welding. It will be appreciated that various types of fasteners may be used to prevent disassembly. These fasteners may be connected to the adjustment screw by welding, threaded connections, locking pins, or various other types of connections.

Referring now to fig. 8-12, the first sleeve 310 and the second sleeve 410 will be described in more detail. The sleeves 310, 410 are designed to slide over and lock to a pair of extensions to interconnect the extensions together as a unit. A sleeve according to the present disclosure may have one or more design features to accommodate different types of extensions, different types of locking mechanisms, or other design variables. In this example, the first and second sleeves 310, 410 are identical, and many of the same components are visible in the drawings in both sleeves. Accordingly, only the features of the sleeve 310 will be described with the understanding that the same features exist in the sleeve 410.

The first sleeve 310 includes a hollow shell 311, the hollow shell 311 having an upper shell section 313 and a lower shell section 319. Upper and lower casing sections 313, 319 are joined together to define a hollow chamber 314 therebetween. The hollow cavity 314 is substantially closed around the perimeter of the first sleeve 310, but is open to the first aperture 312. The first bore 312 has a perimeter that coincides with a circle and defines a sleeve axis 316 passing through the center of the circle.

The first sleeve 310 has a floating locking ring 330 received within the chamber 314. The locking ring 330 is translatable within the chamber 314 between a locked position locking the first sleeve 310 to the extension and a released position allowing the first sleeve to slide up and down the extension. The locking ring 330 defines an opening 331, the opening 331 having a circumference coincident with a circle and a locking ring axis 332 passing through the center of the circle. The locking ring axis 332 is parallel to the sleeve axis 316.

The locking ring 330 is translatable in the chamber 314 in a direction transverse to the sleeve axis 316. In the locked position, as shown in FIG. 8, the locking ring axis 332 is offset from the sleeve axis 316 by a first distance D1. In the release position, as shown in FIG. 10, the lock ring axis 332 is offset from the sleeve axis 316 by a second distance D2. When the locking ring 330 is moved to the locked position, the opening 331 is less aligned with the first aperture 312. When the locking ring 330 is moved to the release position, the opening 331 moves inwardly toward the center housing 200 such that the opening is more aligned with the first aperture 312. In other words, the first distance D1 associated with the locked position is greater than the second distance D2 associated with the released position. If desired, the locking ring 330 may be disposed in the first sleeve 310 in such a manner that when the locking ring is moved to the release position, the locking ring axis 332 is coaxially aligned with the sleeve axis 316, in which case the second distance D2 would be zero. The locking ring 330 may also be arranged in the first sleeve 310 in such a way that the locking ring axis 332 is moved past the sleeve axis 316 to be positioned closer to the center housing 200 than the sleeve axis, in which case D2 will be negative. Any of these arrangements is suitable as long as movement of the locking ring 310 to the release position moves the protrusion away from the sleeve axis 316 and toward the center housing 200.

The first sleeve 310 includes a spring element 318 in a chamber 311. The spring element 318 is held in compression between the locking ring 330 and the inner wall 315 of the chamber 311. In this arrangement, the spring element 318 applies a biasing force radially inwardly of the sleeve axis 316 to urge the locking ring towards the locked position. A sleeve according to the present disclosure may include various spring elements that exert a biasing force on the locking ring, including but not limited to coil springs, disc springs, and leaf springs. In this example, the spring element 318 is a wave spring. The locking ring 330 includes a protrusion 334 that extends radially inward into the opening 331. The protrusion 334 is positioned to releasably engage a locking feature, such as a locking groove or stop, on the extension when the protrusion is in the locked position. The projection 334 has a front edge 335, a rear edge 336, and a sliding edge 337 between the front and rear edges. Each of the edges 334, 335 and 336 is used to lock and unlock the first sleeve 310 from the extension. The front edge 335 is designed to contact the top edge of the extension when the first sleeve 310 is initially placed on top of the extension. During initial placement, the locking ring 330 is urged by the spring element 318 to a locked position in which the protrusion 334 protrudes into the first aperture 312. The front edge 335 has a chamfered surface 339, the chamfered surface 339 abutting the upper edge of the extension when the first sleeve 310 is lowered onto the extension. As the first sleeve 310 is advanced down the extension, the orientation of the chamfered face 339 and the floating arrangement of the locking ring 330 causes the locking ring to deflect against the biasing force of the spring element 318 and toward the center housing 200. This causes the protrusion 334 to temporarily move out of the locked position into the unlocked position. The locking ring 330 deflects until the sliding edge 337 contacts the outer geometry of the extension. Fig. 11 shows the first sleeve 310 and locking ring 330 pushed down the extension E with the sliding edge 335 abutting the exterior of the extension.

The first sleeve 330 may be advanced downward around the outer geometry of the extension until the outer geometry of the extension prevents further advancement of the first sleeve. For example, the outer geometry of the extension may have a widened section that cannot fit through the opening 331 in the locking ring 330. Thus, the widened section may stabilize the first sleeve 330 without moving any further downward extension. The extension may further include an opening or window positioned to engage the protrusion 334 to prevent the first sleeve 310 from inadvertently reversing or moving up the extension. In this design, the first sleeve 330 is advanced downward over the extension until the locking ring 330 engages the widened geometry, at which point the protrusions 334 align with the cutouts or windows. The size of the cutout or window is the same as or slightly larger than the size of the protrusion 334 so that the protrusion can snap into the cutout or window when the stored energy in the spring element 318 is released. Once the tabs 334 enter the cutouts or windows, the rear edge 336 abuts the upper edge of the windows, preventing the locking ring 330 and the first sleeve 310 from moving back on the extension. Fig. 12 shows the first sleeve 310 and the locking ring 330 further advanced downwardly over the extension E, with the projections 334 snapping inwardly into the windows W, and with the rear edge 336 abutting the top edge of the windows to prevent the first sleeve from inverting and moving the extension upwardly.

A sleeve according to the present disclosure may have one or more release mechanisms to move the locking ring out of the locked position and allow the sleeve to be removed from the extension. In this example, the locking ring 330 includes release lugs 338, the release lugs 338 extending radially outward away from the locking ring axis 332. The cartridge housing 311 defines through slots 317 into which the release lugs 338 extend. The release lugs 338 project from the through slots 317 at exposed locations on the exterior of the first sleeve 310. In this exposed position, the release lug 338 is depressible against the biasing force of the spring element 318 to displace the locking ring 330 toward the release position. This moves the protrusion 334 out of the window or cutout in the extension such that the first sleeve 310 is no longer prevented from being lifted and removed from the extension. To remove the first sleeve 310 from the extension, the user may depress and hold the release ledge 338 inwardly toward the sleeve axis 316 and lift the first sleeve until the protrusion 334 is over the window or cutout. Once the protrusion 334 is over the window or cutout, the user may continue to depress the release ledge 338 as the first sleeve 310 is lifted from the extension. Alternatively, the user may release the release tab 338, at which point the sliding edge 337 will abut the exterior of the extension and slide along the exterior geometry of the extension until the first sleeve 310 is removed.

Although the present disclosure is directed to particular embodiments, the present disclosure is not intended to be limited to the details shown. Rather, various modifications, combinations, substitutions and/or rearrangements of the components and features thereof as set forth herein may be made without departing from the disclosure, and any such modifications, combinations, substitutions and/or rearrangements are intended to be within the scope and range of equivalents of the claims and without departing from the disclosure.

For example, as shown in the transverse link 100 in fig. 2 and 3, a transverse link according to the present disclosure may have a single pair of bushings with associated coupling shafts interconnected by a center housing. Alternatively, a transverse link according to the present disclosure may have two or more pairs of sleeves with associated shafts interconnected by a central housing. Embodiments in which two or more pairs of sleeves have associated coupling shafts and center housings may be represented by a plurality of transverse links 100 attached together in parallel. In a parallel arrangement, the transverse link 100 shown in fig. 3 may be attached to a second transverse link, which is located above it in the figure, and to a third transverse link, which is located below it in the figure. The three transverse links may be interconnected by a connector interconnecting the adjustment screws or other components of the transverse links.

A cross-link according to the present disclosure may also have a single center housing as shown in fig. 3, but three or more attachment assemblies connected to the center housing.

For example, fig. 13 and 14 show a transverse link 1000 having a first attachment assembly 3000 (having a first sleeve 3100 and a first shaft 3200), a second attachment assembly 4000 (having a second sleeve 4100 and a second shaft 4200), and a third attachment assembly 5000 (having a third sleeve 5100 and a third shaft 5200), all connected to a center housing 2000. The first, second and third attachment assemblies 3000, 4000 and 5000 are arranged to surround the center housing 2000 to connect the center housing to three different implants or extensions.

Fig. 15 and 16 show another transverse link 1000 'having a first attachment assembly 3000' (having a first sleeve 3100 'and a first shaft 3200'), a second attachment assembly 4000 '(having a second sleeve 4100' and a second shaft 4200'), a third attachment assembly 5000' (having a third sleeve 5100 'and a third shaft 5200') and a fourth attachment assembly 6000 '(having a fourth sleeve 6100' and a fourth shaft 6200'), all connected to a center housing 2000'. The first, second, third and fourth attachment assemblies 3000', 4000', 5000' and 6000' are arranged around the center housing 2000' to connect the center housing to four different implants or extensions.

It should be understood that embodiments in accordance with the present disclosure may include five or more attachment assemblies attached to a single center housing. Further, it will be understood that embodiments in accordance with the present disclosure may have one or more attachment assemblies that are removably connected to the center housing. An attachment assembly that is detachable from the central housing allows the lateral couplings to be modified and adapted to the number of implants or extensions that need to be coupled to a single housing.

The present invention according to a first aspect relates to a transverse coupling 100 for connecting a first implant extension 20 to a second implant extension 20'; 1000, parts by weight; 1000', the cross-link 100; 1000, parts by weight; 1000' comprises: a first sleeve 310; 3100; 3100' defining a first bore 312, the first bore 312 adapted to axially receive a first implant extension 20 through the first bore 312; a second sleeve 410; 4100, and (c) a step (d); 4100', defining a second bore 412, the second bore 412 adapted to axially receive a second implant extension 20' through the second bore 412; a center housing 200; 2000; 2000' comprising a first connector 230 and a second connector 240; a first shaft 320; 3200; 3200', which connects the first sleeve 310; 3100; 3100' is connected to the center housing 200; 2000; 2000'; and a second shaft 420; 4200, mixing the raw materials; 4200', which connects the second sleeve 410; 4100, and (c) a step (d); 4100' is connected to the center housing 200; 2000; 2000' of the second connector 240.

According to a second aspect of the invention, the transverse link 100; 1000, parts by weight; 1000' is further characterized in that the first joint 230 comprises a ball-and-socket joint 232, the ball-and-socket joint 232 being movable relative to the center housing 200; 2000; 2000' pivot.

According to a third aspect of the invention, the transverse link 100; 1000, parts by weight; 1000' also features a gimbaled ball joint 232 that includes a longitudinal channel 234 and a plurality of spring segments 237 extending around the longitudinal channel 234.

According to a fourth aspect of the invention, the transverse link 100 according to the third aspect; 1000, parts by weight; 1000' is further characterized by a first shaft 320; 3200; 3200' is axially displaceable through the longitudinal channel 234 of the first joint 230.

According to a fifth aspect of the invention, the transverse link 100 according to the third or fourth aspect; 1000, parts by weight; 1000' is further characterized by a first shaft 320; 3200; 3200' includes attaching to a first sleeve 310; 3100; 3100', and a first free end 324 opposite the first sleeve end 322, the first free end 324 including a first stop 326 to limit the first shaft 320; 3200; 3200' is displaced by the progression of the longitudinal channel 234.

According to a sixth aspect of the invention, the transverse link 100 according to the third, fourth or fifth aspect; 1000, parts by weight; 1000' is further characterized by a first shaft 320; 3200; 3200' is rotatable in the longitudinal channel 234 of the first joint 230.

According to a seventh aspect of the invention, the transverse link 100 according to the third, fourth, fifth or sixth aspect; 1000, parts by weight; 1000' is further characterized by a first shaft 320; 3200; 3200' comprises a first shaft cross-section having a first abutment face 425 and the longitudinal channel 234 comprises a channel cross-section having a first abutment edge 255, the first abutment edge 255 being configured to abut against the first shaft 320; 3200; 3200' abuts the first abutment surface 425 during rotation relative to the longitudinal channel 234 and constrains the first shaft 320; 3200; 3200'.

According to an eighth aspect of the invention, the transverse link 100 according to the previous aspect; 1000, parts by weight; 1000' is further characterized by a second connector 240 cylindrical through bore 244, the cylindrical through bore 244 passing through the center housing 200; 2000; 2000'.

According to a ninth aspect of the invention, the transverse link 100 according to the eighth aspect; 1000, parts by weight; 1000' is further characterized by a second shaft 420; 4200, mixing the raw materials; 4200' is axially displaceable through the through bore 244 of the second connector 240.

According to a tenth aspect of the invention, the transverse link 100 according to the eighth or ninth aspect; 1000, parts by weight; 1000' is further characterized by a second shaft 420; 4200, mixing the raw materials; 4200' includes attachment to the second sleeve 410; 4100, and (c) a step (d); 4100', and a second free end 424 opposite the second sleeve end 422, the second free end 424 including a second stop 426 to limit the second shaft 420; 4200, mixing the raw materials; 4200' is axially displaced by the through bore 244 of the second adapter 240.

According to an eleventh aspect of the invention, the transverse link 100 according to the eighth, ninth or tenth aspect; 1000, parts by weight; 1000' is further characterized by a second shaft 420; 4200, mixing the raw materials; 4200' is rotatable in the through hole 244 of the second connector 240.

According to a twelfth aspect of the invention, the transverse link 100 according to the eighth, ninth, tenth or eleventh aspect; 1000, parts by weight; 1000' is further characterized by a second shaft 420; 4200, mixing the raw materials; 4200' includes a second shaft cross-section having a second abutment surface, and the through-hole 244 includes a through-hole cross-section having a second abutment edge configured to abut against the second shaft 420; 4200, mixing the raw materials; 4200' abuts the second abutment surface during rotation relative to the longitudinal channel 234 and constrains the second shaft 420; 4200, mixing the raw materials; 4200' rotation range.

According to a thirteenth aspect of the invention, the transverse link 100 according to one of the previous aspects; 1000, parts by weight; 1000' is further characterized by a center housing 200; 2000; 2000' includes an upper portion 210, a lower portion 220 separate from the upper portion 210, and an adjustment screw 260 extending through the upper portion 210 and the lower portion 220.

According to a fourteenth aspect of the invention, the transverse link 100 according to the thirteenth aspect; 1000, parts by weight; 1000' is further characterized by a center housing 200; 2000; 2000' forms an adjustable clamp that releasably holds the first shaft 320; 3200; 3200' is fixed in the first joint 230 and releasably holds the second shaft 420; 4200, mixing the raw materials; 4200' is fixed in the second joint 240.

According to a fifteenth aspect of the invention, the transverse link 100 according to the fourteenth aspect; 1000, parts by weight; 1000' is further characterized in that the clamp is adjustable to a locked state in response to rotation of the adjustment screw 260, wherein the center housing 200; 2000; 2000' are drawn together in the locked condition to compress the first and second joints 230 and 240 and lock the first shaft 320; 3200; 3200' and a second shaft 420; 4200, mixing the raw materials; 4200' relative to the center housing 200; 2000; 2000' position.

According to a sixteenth aspect of the invention, the transverse link 100 according to the fourteenth or fifteenth aspect; 1000, parts by weight; 1000' is further characterized in that the clamp is adjustable to an unlocked state in response to rotation of the adjustment screw 260, wherein the center housing 200; 2000; 2000' are deployed in the unlocked state to allow the first shaft 320; 3200; 3200' and a second shaft 420; 4200, mixing the raw materials; 4200' relative to the center housing 200; 2000; 2000' move.

According to a seventeenth aspect of the invention, the transverse link 100 according to the thirteenth, fourteenth, fifteenth or sixteenth aspect; 1000, parts by weight; 1000' is further characterized in that the adjustment screw 260 includes external threads 263 and the center housing 200; 2000; 2000' defines a bore 221 having internal threads 223, with external threads 263 mating with the internal threads 223.

According to an eighteenth aspect of the invention, the transverse link 100 according to the previous aspect; 1000, parts by weight; 1000' is further characterized by a first sleeve 310; 3100; 3100' and a second sleeve 410; 4100, and (c) a step (d); 4100' at least one sleeve defines a sleeve axis 316 and a chamber 314.

According to a nineteenth aspect of the invention, the transverse link 100 according to the eighteenth aspect; 1000, parts by weight; 1000' is further characterized by the first sleeve 310; 3100; 3100' and a second sleeve 410; 4100, and (c) a step (d); 4100' includes a locking ring 330 defining a locking ring axis 332, the locking ring 330 being translatable in the chamber 314 in a direction transverse to the sleeve axis 316.

According to a twentieth aspect of the invention, the transverse link 100 according to one of the previous aspects; 1000, parts by weight; 1000' is further characterized in that the locking ring 330 is movable relative to the first sleeve 310; 3100; 3100' and a second sleeve 410; 4100, and (c) a step (d); 4100' translates between a locked position in which the lockring axis 332 is offset from the sleeve axis 316 by a first distance D1, and a released position in which the lockring axis 332 is offset from the sleeve axis 316 by a second distance D2, the first distance D1 being greater than the second distance D2.

According to a twenty-first aspect of the invention, the transverse link 100 according to the nineteenth or twentieth aspect; 1000, parts by weight; 1000' is further characterized by the first sleeve 310; 3100; 3100' and a second sleeve 410; 4100, and (c) a step (d); 4100' includes a spring element 318 in the chamber 314, the spring element 318 exerting a biasing force on the locking ring 330 to urge the locking ring 330 toward the locked position.

According to a twenty-second aspect of the invention, the transverse link 100 according to the nineteenth, twentieth or twenty-first aspect; 1000, parts by weight; 1000 'is further characterized in that the locking ring 330 includes a protrusion 334, the protrusion 334 extending radially inward into the bore 312, the protrusion 334 being positioned in the bore 312 to releasably engage one of the first implant extension 20 and the second implant extension 20' when the locking ring 330 is in the locked position.

According to a twenty-third aspect of the invention, the transverse link 100 according to the nineteenth, twentieth, twenty-first or twenty-second aspect; 1000, parts by weight; 1000' further characterized in that the locking ring 330 includes release lugs 338, the release lugs 338 extending radially outward and away from the locking ring axis 332, the first sleeve 310; 3100; 3100' and a second sleeve 410; 4100, and (c) a step (d); 4100' defines a through slot 317 into which the release lug 338 extends.

According to a twenty-fourth aspect of the invention, the transverse link 100 according to the twenty-third aspect; 1000, parts by weight; 1000' is further characterized by release lugs 338 projecting through channels 317 in an exposed position in which release lugs 338 can be depressed against the biasing force of spring elements 318 to displace locking ring 330 toward the released position.

According to an alternative twenty-fifth aspect, the present invention relates to a transverse coupling 100 for connecting a first implant extension 20 to a second implant extension 20'; 1000, parts by weight; 1000', the transverse link comprising: a first sleeve 310; 3100; 3100' defining a first bore 312, the first bore 312 adapted to axially receive a first implant extension 20 through the first bore 312; a second sleeve 410; 4100, and (c) a step (d); 4100', defining a second bore 412, the second bore 412 adapted to axially receive a second implant extension 20' through the second bore 412; a center housing (200; 2000; 2000'); a first shaft 320; 3200; 3200', which connects the first sleeve 310; 3100; 3100' is connected to the center housing 200; 2000; 2000'; and a second shaft 420; 4200, mixing the raw materials; 4200', which connects the second sleeve 410; 4100, and (c) a step (d); 4100' is connected to the center housing 200; 2000; 2000', a first shaft 320; 3200; 3200' and a second shaft 420; 4200, mixing the raw materials; 4200' passing at least one shaft through the center housing 200; 2000; 2000' is connected to the center housing 200; 2000; 2000'.

According to a twenty-sixth aspect, a transverse link 1000 according to the twenty-fifth aspect; 1000' further includes a third sleeve 5100; 5100', the third sleeve 5100; 5100' defines a third bore adapted to axially receive a third implant extension therethrough; and a third shaft 5200; 5200', the third shaft 5200; 5200' connecting the third sleeve to the center housing 2000; 2000'.

According to a twenty-seventh aspect, the transverse link 1000' according to the twenty-sixth aspect further features a fourth sleeve 6100', the fourth sleeve 6100' defining a fourth aperture adapted to axially receive a fourth implant extension therethrough; and a fourth shaft 6200', which fourth shaft 6200' connects the fourth sleeve to the center housing 2000 '.