阅读说明：本技术 内部断开式固定螺钉和起子 (Internal break type fixing screw and screwdriver ) 是由 W·A·雷扎切 于 2020-04-17 设计创作，主要内容包括：提供一种用于将固定螺钉接合到植入物的方法。所述方法包含外科手术器械。所述外科手术器械可包含具有细长刚性结构的轴,以及定位在所述外科手术器械的远端上的起子头部。所述起子头部可包含在所述外科手术器械的纵向方向上延伸的至少一个凹槽或至少一个突起部,以及至少部分地定位在所述起子头部内的销。所述销可被配置成在横向方向上从所述起子头部展开和缩回。(A method for engaging a set screw to an implant is provided. The method includes a surgical instrument. The surgical instrument may include a shaft having an elongated rigid structure, and an elevator head positioned on a distal end of the surgical instrument. The elevator head may include at least one recess or at least one protrusion extending in a longitudinal direction of the surgical instrument, and a pin positioned at least partially within the elevator head. The pin may be configured to deploy and retract in a lateral direction from the driver head.)

1. A surgical instrument, comprising:

a shaft having an elongated rigid structure, and

an elevator head positioned at a distal end of the surgical instrument,

wherein the elevator head comprises at least one recess or at least one protrusion extending in the longitudinal direction of the surgical instrument and a pin positioned at least partially within the elevator head, and

wherein the pin is configured to deploy and retract in a lateral direction from the driver head.

2. The surgical instrument of claim 1, further comprising a handle positioned on an end of the surgical instrument opposite the elevator head.

3. The surgical instrument of claim 1, wherein the at least one groove is configured to interlock with at least one groove positioned on an inner surface of an opening of a set screw.

4. The surgical instrument of claim 1, wherein the at least one protrusion is configured to interlock with at least one groove positioned on an inner surface of an opening of a set screw.

5. The surgical instrument of claim 1, wherein the elevator head is configured to retain at least one broken break-away head of a break-away set screw.

6. The surgical instrument of claim 1, wherein the elevator head is configured to hold a plurality of disconnected breakaway heads.

7. The surgical instrument of claim 1, wherein a distal portion of the pin positioned in the deployed state extends beyond an outer surface of the elevator head.

8. The surgical instrument of claim 7, wherein the distal end portion of the pin positioned in the deployed state is configured to prevent at least one broken breakaway head of a breakaway set screw from sliding off of the elevator head.

9. A system for engaging a set screw to an implant, the system comprising:

a set screw comprising a breakaway head and threaded portions coupled together via a breakaway area,

wherein the breakaway head includes at least one interlocking portion; and

a surgical instrument comprising:

a shaft having an elongated rigid structure, and

an elevator head positioned at a distal end of the surgical instrument,

wherein the driver head comprises at least one interlocking portion extending in a longitudinal direction of the surgical instrument and a pin positioned at least partially within the driver head,

wherein the at least one interlocking portion of the driver head is configured to interlock with the at least one interlocking portion of the breakaway head, and

wherein the pin is configured to deploy and retract in a lateral direction from the driver head.

10. The system of claim 9, wherein the surgical instrument further comprises a handle positioned on an end of the surgical instrument opposite the elevator head.

11. The system of claim 9, wherein the at least one interlocking portion of the breakaway head comprises a groove, and wherein the at least one interlocking portion of the driver head comprises a protrusion.

12. The system of claim 9, wherein the at least one interlocking portion of the breakaway head comprises a protrusion, and wherein the at least one interlocking portion of the driver head comprises a recess.

13. The system of claim 9, wherein when the at least one interlocking portion of the driver head interlocks with the at least one interlocking portion of the breakaway head, the driver head is configured to break the breakaway head away from the threaded portion upon rotation.

14. The system of claim 9, wherein the set screw further comprises a recessed area positioned on an inner surface of the set screw opposite the breakaway area.

15. The system of claim 14, wherein the recessed area is formed in a shape that is complementary to a shape of a distal portion of the pin.

16. The system of claim 14, wherein a distal portion of the pin is configured to be inserted into the recessed area of the set screw.

17. The system of claim 16, wherein the distal portion of the pin positioned in the deployed state is configured to prevent the breakaway head broken off of the set screw from sliding off of the driver head.

18. The system of claim 14, wherein a distal portion of the pin positioned in a deployed state extends beyond an outer surface of the driver head, and wherein the distal portion of the pin is configured to be inserted into the recessed area of the set screw.

19. The system of claim 9, wherein the driver head is configured to retain the breakaway head when the breakaway head is broken away from the set screw.

20. The system of claim 9, wherein the driver head is configured to hold a plurality of disconnected breakaway heads.

Background

Some surgeons may prefer to use a break-away set screw (break off set screw) when securing the rod to the collar of the spinal implant. Break-away set screws may be preferred, for example, to avoid under-torquing and over-torquing of the set screw, loosening of the set screw, fracture of the set screw, or fracture of the screw or vertebra. The break-away set screw may be, for example, an external hex break-away set screw. An example of a polyaxial screw including a breakaway screw is set forth in U.S. patent No. 5,797,911, which is incorporated herein by reference in its entirety. However, in some cases, due to geometric interference issues, an external hex break-off set screw cannot be used. To accommodate interference issues, set screws having internal drive features, such as hexagonal recesses or hexagonal raised (hex lobe) recesses in the distal end of the set screw, may be used. However, when the breakaway head with the internal drive feature is separated from its set screw, the internal drive feature prevents the separated breakaway head from stacking on the magazine (magazine) of the breakaway driver. Further, for the case where multiple types of screws are used in a single configuration, it can be cumbersome to repeatedly switch the break-away driver or the drill bit of the break-away driver to accommodate various sizes of set screws and internal driver features.

Disclosure of Invention

The present disclosure relates generally to spinal stabilization systems, and more particularly to surgical instruments for spinal stabilization systems.

In one or more embodiments, the disclosed technology relates to a surgical instrument that includes a shaft having an elongated rigid structure and an elevator head positioned on a distal end of the surgical instrument. In one or more instances, the elevator head may include at least one recess or at least one protrusion extending in a longitudinal direction of the surgical instrument, and a pin positioned at least partially within the elevator head. In one or more instances, the pin can be configured to deploy and retract in a lateral direction from the driver head.

In one or more embodiments, the disclosed technology relates to a system for engaging a set screw to an implant. In one or more instances, the system can include a set screw including a breakaway head and threaded portions coupled together via a breakaway zone. In one or more instances, the breakaway head can include at least one interlocking portion. In one or more instances, the system may include a surgical instrument. In one or more instances, the surgical instrument can include a shaft having an elongated rigid structure, and an elevator head positioned on a distal end of the surgical instrument. In one or more instances, the elevator head may include at least one interlocking portion extending in a longitudinal direction of the surgical instrument and a pin positioned at least partially within the elevator head. In one or more instances, the at least one interlocking portion of the driver head can be configured to interlock with the at least one interlocking portion of the breakaway head. In one or more instances, the pin can be configured to deploy and retract in a lateral direction from the driver head.

The foregoing and other objects, features and advantages of the invention will be apparent from the following more particular descriptions of exemplary embodiments of the invention as illustrated in the accompanying drawings wherein like reference numbers generally represent like parts of the disclosure.

Drawings

The following drawings illustrate specific embodiments of the present disclosure and therefore do not limit the scope of the disclosure. The drawings are not drawn to scale and are intended to be used in conjunction with the explanations in the following detailed description.

Fig. 1A is a side view showing an embodiment of a break-away driver. FIG. 1B shows an enlarged view of an embodiment of the magazine holding section.

Fig. 2A is a side view showing an embodiment of the break-away driver. Fig. 2B shows an enlarged view of an embodiment of the distal end of the break-away driver.

Fig. 3A is an isometric view of an embodiment of a universal set screw. Fig. 3B is another isometric view of an embodiment of a universal set screw.

Fig. 4A is a cross-sectional side view of an embodiment of a breakaway driver inserted into a universal set screw. Fig. 4B is a cross-sectional top view of an embodiment of the breakaway driver inserted into the universal set screw taken along a-a in fig. 4A.

Fig. 5A, 5B, 5C and 5D show examples of universal set screws engaged with various implants.

Fig. 6 is a perspective view of an embodiment of a breakaway driver adapter.

Fig. 7 is a perspective view of another embodiment of a breakaway driver.

Detailed Description

The following discussion omits or only briefly describes certain conventional features associated with spinal stabilization systems that will be apparent to those skilled in the art. It should be noted that the various embodiments are described in detail with reference to the drawings, wherein like reference numerals represent like parts and assemblies throughout the several views. Reference to various embodiments does not limit the scope of the claims attached hereto. Additionally, any examples set forth in this specification are intended to be non-limiting and set forth only some of the many possible embodiments for the appended claims. In addition, particular features described herein can be used in each of the various possible combinations and permutations in combination with other described features.

Unless otherwise specifically defined herein, all terms should be given their broadest possible interpretation, including meanings implied from the specification and meanings understood by those skilled in the art and/or meanings as defined in dictionaries, papers, etc. It must also be noted that, unless otherwise indicated, the singular forms "a," "an," and "the" include plural referents and the terms "comprises" and/or "comprising" when used in this specification specify the presence of stated features, elements, and/or components, but do not preclude the presence or addition of one or more other features, steps, operations, elements, components, and/or groups thereof.

Embodiments of the present disclosure relate generally to, for example, spinal stabilization systems, and more particularly to surgical instruments for use in spinal stabilization systems. Embodiments of the devices and methods are described below with reference to the drawings.

It should be understood that the various aspects disclosed herein may be combined in different combinations than those specifically presented in the specification and drawings. It will also be understood that, depending on the example, certain acts or events of any process or method described herein can be performed in a different order, may be added, merged, or omitted entirely (e.g., all described acts or events may not be necessary for performing the techniques).

Fig. 1A is a side view showing an embodiment of a breakaway driver 100. Fig. 1B shows an enlarged view of an embodiment of the magazine holding section 106. Fig. 2A is a side view showing an embodiment of a breakaway driver 100. Fig. 2B shows an enlarged view of an embodiment of the distal end of the break-away driver 100. Fig. 3A is an isometric view of an embodiment of a break-away set screw, such as a universal break-away set screw 110 ("set screw 110"). Fig. 3B is another isometric view of an embodiment of set screw 110. Fig. 4A is a cross-sectional side view of an embodiment of a breakaway driver 100 inserted into a set screw 110 ("set screw 110"). Fig. 4B is a cross-sectional top view of an embodiment of the breakaway driver 100 inserted into the set screw 110 taken along a-a in fig. 4A. Fig. 3A, 3B, 3C, and 3D illustrate examples of set screws 110 engaged with various implants.

In one or more embodiments, breakaway driver 100 includes an optional handle 102; a driver head, such as a magazine holding portion 106; and a shaft 104. The shaft 104 may be an elongated rigid member configured to connect the handle 102 and the magazine holding portion 106. The handle 102 and the magazine holding portion 106 may be disposed at opposite ends of the shaft 104. In one or more instances, the shaft 104 can have a linear shape. In one or more other instances, the shaft 104 can have a curved shape. In one or more instances, the handle 102 may be secured to the shaft 104. In one or more other instances, the handle 102 can be removably attached to the shaft 104. The handle 102 may provide a grip for a user to manipulate the magazine holding portion 106.

The shaft 104 and the magazine holding portion 106 may be individually or collectively made of materials such as stainless steel alloys, commercially pure titanium, titanium alloys, grade 5 titanium, superelastic titanium alloys, cobalt chromium alloys, stainless steel alloys, and combinations thereof.

At one orIn various embodiments, magazine holding portion 106 can be an elongated rigid member disposed on the distal end of breakaway driver 100. The magazine holding portion 106 can include a pin 206 configured to be deployed and/or retracted from within the magazine holding portion 106, as shown in fig. 2A and 2B. In one or more instances, the pin 206 can be configured to be perpendicular to the longitudinal direction L of the magazine holding portion 106₁Deployment and/or retraction. In one or more other instances, the pin 206 can be configured to be in the transverse direction L of the magazine holding portion 106₂Upper deployment and/or retraction.

In one or more instances, the pin 206 may be spring loaded. For example, the elongated member 230 of the pin 206 may extend through the dividing wall 228, with the first end 224 of the pin 206 being located on one side of the dividing wall 228 and the second end 226 of the pin 206 being located on an opposite side of the dividing wall 228. In one or more instances, the elongate member 230 can be a cylindrical rigid member and can have a diameter that is less than the diameter of the second end 226. The portion of the first end 224 of the pin 206 may contain a force F that prevents the pin 206 from being generated by the spring 208₁Is fully withdrawn from the stop member 210 of the magazine holding portion 106. The second end 226 of the pin 206 may include a hemispherical shape 226a on a distal portion of the second end 226 and a flat surface 226b on a proximal portion of the second end 226. The flat surfaces 226b may be located on both sides of the elongated member 230. The pin 206 may be inserted through the spring 208, with one end of the spring 208 configured to contact the dividing wall 228 and an opposite end of the spring 208 configured to contact the flat surface 226b of the second end 226. The spring 208 may be configured to apply a force F to the flat surface 226b₁To move a portion of the second end 226 beyond the outer surface 232 of the magazine holding portion 106.

In one or more embodiments, set screw 110 includes a threaded portion 110a and a breakaway head 110b coupled to each other via a breakaway area 202. The threaded portion 110a may have external threads that surround the outer surface 232 of the set screw 110. The threaded portion 110a may be configured to attach to a collar, such as collar 306, 308, 310, and/or 312, and capture the longitudinal member 304. Set screw 110 may be sized to fit within the collar.

The breakaway area 202 may extend circumferentially around the outer surface 232 of the set screw 110. In one or more instances, the recessed area 204 may be formed on a side of the breakaway head 110b opposite the breakaway area 202. In one or more instances, the recessed region 204 may extend circumferentially around the inner surface 222 of the set screw 110. In one or more other instances, the recessed region 204 may extend circumferentially and intermittently around the inner surface 222 of the set screw 110. The recessed area 204 may be large enough to receive a portion of the second end 226 of the set screw 110. For example, the recessed area 204 may be configured to receive the hemispherical portion 226a of the second end 226. In one or more instances, the surface 238 of the recessed area 204 may be formed in a curved shape. The curved shape may be configured to correspond to the hemispherical portion 226a of the second end 226. In one or more other instances, the surface 238 of the recessed region 204 may be formed in a semi-trapezoidal shape.

In one or more instances, at least a portion of the second end 226 of the pin 206 can be configured to extend beyond the outer surface 232 of the magazine holding portion 106 in the deployed state. In the retracted state, the pin 206 may be received within the magazine holding portion 106. In one or more instances, the pin 206 can be aligned to protrude through a portion of the recess 108 of the magazine holding portion 106. In one or more other instances, the pin 206 can be aligned to protrude through a portion of the outer surface 232 of the magazine holding portion 106 that does not include the groove 108.

In one or more instances, the diameter of the magazine holding portion 106 can be large enough to fit tightly within the opening 234 of the breakaway head 110b of the set screw 110. For example, the diameter of the magazine holding portion 106 can be large enough so that a portion of the distal end of the magazine holding portion 106 can fit within at least a portion of the breakaway head 110 b. The outer circumferential surface 232 of the magazine holding portion 106 may be corrugated or formed in a hexagonal convex shape such that a plurality of grooves, such as the groove 108, may be circumferentially disposed about the outer surface 232 of the magazine holding portion 106. The groove 108 may be in the longitudinal direction L of the magazine holding portion 106₁And an upper extension. Recess 108 may be configured to align breakaway driver 100 within recess 236 of set screw 110. The groove 108 may serve as a holding portion for the broken breakaway head along the magazineA guide member to which the branch 106 slides. The groove 108 may be formed in the magazine holding portion 106 in various shapes, such as an arc or curved shape, a square shape, a triangular shape, or the like, when viewed from a top view of the magazine holding portion 106. In one or more instances, adjacent grooves 108 may be separated by a protrusion. In one or more other instances, the magazine holding portion 106 includes only one recess.

The inner surface 222 of the breakaway head 110b can be corrugated or hexagonally convex in shape such that the plurality of protrusions 236 are positioned in the longitudinal direction L of the breakaway head 110b₂And is circumferentially disposed about the inner surface 222 of the breakaway head 110 b. In one or more instances, adjacent protrusions 236 can be separated by a groove. In one or more instances, the plurality of protrusions 236 on the inner surface 222 of the breakaway head 110b can be configured to interlock with the plurality of recesses 108 disposed about the magazine holding portion 106. In addition, the plurality of recesses formed by the projections 236 of the breakaway head 110b can be configured to interlock with the plurality of projections formed by the recesses 108 of the magazine holding portion 106. By interlocking the plurality of protrusions 236 of the breakaway head 110b with the magazine holding portion 106, the set screw 110 may be prevented from rotating about the magazine holding portion 106 in a clockwise or counterclockwise manner. In one or more instances, the interlocking portion of the breakaway head can be the protrusion 236 and the interlocking portion of the magazine holding portion 106 can be the recess 108. In one or more instances, the interlocking portion of the breakaway head can be a groove and the interlocking portion of the magazine holding portion 106 can be a protrusion.

In one or more embodiments, the opening 234 of the breakaway head 110 can be larger than the opening 242 of the threaded portion 110 a. In one or more instances, the inner surface 240 of the threaded portion 110a may be corrugated or hexagonally convex in shape such that the plurality of protrusions 244 are positioned in the longitudinal direction L of the threaded portion 110a₂And is circumferentially disposed about the inner surface 240 of the breakaway head 110 a. In one or more instances, after the breakaway head 110b is broken away from the threaded portion 110a, another screwdriver may be inserted into the opening 242 of the threaded portion 110a to tighten or screwThe set screw 110 is loosened.

In one or more embodiments, the magazine holding portion 106 can be configured to break the breakaway head 110b from the threaded portion 110a of the set screw 110. In one or more examples, the set screw 110 may be secured into an implant, such as a UNI screw 318, a multi-axial screw 320, a reduction head multi-axial screw 322 (RMAS) or an extended tab MAS 324, as shown in fig. 3A-3D. The implant may be secured to a bony structure, such as a vertebra. To disconnect the break-away head 110b from the threaded portion 110a of the set screw 110, the user inserts the magazine holding portion 106 into the opening 234 of the break-away head 110b such that the inner surface 222 of the break-away head 110b interlocks with the outer surface 232 of the magazine holding portion 106, as described above. After interlocking the breakaway head 110b with the magazine holding portion 106 in the circumferential direction, the user can turn the handle 102 in a clockwise or counterclockwise manner, thereby rotating the shaft 104 and the magazine holding portion 106. The breakaway head 110b may break away from the threaded portion 110a of the set screw 110 under a certain amount of torque generated by rotating the breakaway driver 100 in the set screw 110. In one or more instances, the breakaway head 110b can break away from the threaded portion 110a with a torque in a range of between 8 newton meters (Nm), or about 8 Nm to 12Nm, or about 12 Nm.

In one or more embodiments, the magazine holding portion 106 can be configured to hold one or more broken off heads, such as broken off heads 112, 114, 116, 118, 120, 122, and 124. In one or more instances, the magazine holding portion 106 can be sized to hold one or more broken off breakaway heads. For example, the magazine holding portion 106 can be long enough to hold at least six broken off breakaway heads. In another example, the magazine holding portion 106 can be sized to hold eight broken breakaway heads. When each breakaway head is broken off from the set screw, the broken breakaway heads can be stacked on top of each other such that the first broken breakaway head is positioned at the top of the stack, followed by the next first broken breakaway head.

As the magazine holding portion 106 is inserted into the opening 234 of the set screw 110, the recess 108 of the magazine holding portion 106 aligns with the recess 236 of the breakaway head 110b and the spring 208 is configured in the deployed state. As the magazine holding portion 106 is inserted into the opening 234 of the set screw 110, the curved bottom 216 of the second end 226 contacts the tapered distal end 220 of the breakaway head 110 b. The tapered distal end 220 may taper downwardly toward the center of the breakaway head 110 b. As the magazine holding portion 106 is inserted deeper into the break-away head 110b, the tapered distal end 220 and/or the inner surface 222 may force the pin 206 to retract within the magazine holding portion 106, thereby compressing the spring 208. When the pin 206 reaches the recessed area 204, the spring 208 forces the pin 206 into a deployed state in which the pin 206 enters the recessed area 204.

For the case where the breakaway head 110b is broken away from the threaded portion 110a, the curved upper surface 218 of the second end 226 protrudes far enough to prevent the separated breakaway head 110b from slipping out of the magazine holding portion 106. In the case where the second breakaway head is separated from the second set screw, the separated second breakaway head forces the first separated breakaway head 110b to slide upward along the magazine holding portion 106. As each separate breakaway head is added to the magazine holding portion 106, the separate breakaway heads can be stacked on top of each other.

Fig. 6 is a perspective view of an embodiment of a breakaway driver adapter 200. In one or more embodiments, the breakaway driver adapter 200 is an elongated member that includes a magazine holding portion 106 disposed on one end of the breakaway driver adapter 200 and a driver receiver 202 disposed on an opposite end of the breakaway driver adapter 200. Magazine holding portion 106 of breakaway driver adapter 200 includes one or more features that are the same as or similar to magazine holding portion 106 of breakaway driver 100. Therefore, the description of such features is not repeated. In one or more instances, the driver receiver 202 is configured in an external shape to achieve a reliable, non-slip engagement with a multi-bit driver. For example, the driver receiver 202 may be formed as an 1/4 inch hex bit with the insertion end 204 inserted into the bit receiving portion of a multi-bit driver. The driver receiver 202 may be removably coupled to the multi-bit driver such that other breakaway driver adapters configured to engage different shaped set screws may be inserted into the multi-bit driver.

Fig. 7 is a perspective view of another embodiment of a breakaway driver 300. In one or more embodiments, the break-away driver 300 includes a magazine holding portion 106 disposed on one end of the break-away driver 300 and an optional handle 102 disposed on the opposite end of the break-away driver 300. The magazine holding portion 106 and handle 102 of the breakaway driver 300 include one or more features that are the same as or similar to the magazine holding portion 106 and handle 102 of the breakaway driver 100. Therefore, the description of such features is not repeated.

In one or more instances, the breakaway driver 300 includes a shaft 104. The shaft 304 may be an elongated rigid member configured to connect the handle 102 and the magazine holding portion 106. The handle 102 and the magazine holding portion 106 may be disposed at opposite ends of the shaft 304. In one or more instances, the shaft 304 can have a linear shape. In one or more other instances, the shaft 304 may have a curved shape.

The shaft 304 includes a first shaft portion 306a removably coupled with a second shaft portion 306 b. In one or more instances, the magazine holding portion 106 can be coupled with the first shaft portion 306 a. The shaft 304 and the magazine holding portion 106 may be individually or collectively made from materials such as stainless steel alloys, commercially pure titanium, titanium alloys, grade 5 titanium, superelastic titanium alloys, cobalt chromium alloys, stainless steel alloys, and combinations thereof. In one or more instances, the handle 102 may be secured to the second shaft portion 306 b. In one or more other instances, the handle 102 can be removably attached to the second shaft portion 306 b. In one or more embodiments, the first shaft portion 306a and the magazine holding portion 106 can be manufactured together, and the second shaft portion 306b can be manufactured separately from the first shaft portion 306a and the magazine holding portion 106. Subsequently, the first shaft portion 306a and the second shaft portion 306b may be coupled together, thereby forming the shaft 304. In one or more instances, the first shaft portion 306a includes a protrusion 302a configured to fit within a receiving portion 302b of the second shaft portion 306 b. In some cases, the protrusion 302a may have a threaded end configured to mate with a threaded end of the receiving portion 302 b. In some other cases, the protrusion 302a may snap fit within the receiving portion 302 b. In one or more other instances, the second shaft portion 306b includes a protrusion 302a configured to fit within the receiving portion 302b of the first shaft portion 306 a.

As used herein, the term "about" with respect to a numerical value means plus or minus 10% of the numerical value of the number being used.

The above described features and functions, and alternatives, may be combined in many other different systems or applications. Various alternatives, modifications, variations, or improvements may be made by those skilled in the art, each of which is also intended to be encompassed by the disclosed embodiments.