Spinal implant systems and methods

Abstract

A spinal construct includes at least one member defining a first implant cavity and a second implant cavity oriented transversely to the first implant cavity. The at least one member has a surface containing a locking device disposed with the first implant cavity. Systems, implants, surgical instruments, and methods of use are disclosed.

Description

Technical Field

[0001] The present disclosure relates generally to surgical implants for treating spinal disorders and, more particularly, to a surgical system and method for treating spinal disorders. Background Art

[0002] Spinal lesions and disorders, such as scoliosis and other curvature abnormalities, kyphosis, degenerative disc disease, herniated discs, osteoporosis, spondylolisthesis, stenosis, tumors, and fractures can be caused by factors including trauma, disease, and degenerative conditions caused by injury and aging. Spinal disorders often result in symptoms including deformity, pain, nerve damage, and partial or complete loss of mobility.

[0003] Non-surgical treatments such as medication, rehabilitation and exercise may be effective, but may not alleviate the symptoms associated with these conditions. Surgical treatments for these spinal conditions include fusion, fixation, correction, discectomy, laminectomy and implantable prosthesis. As part of these surgical treatments, spinal constructs (such as bone fasteners, spinal rods, connectors and plates) can be used to provide stability to the treatment area. During surgical treatment, one or more rods can be attached to the outside of two or more vertebral members via fasteners to provide stability to the treatment area. The present disclosure describes improvements to these prior arts. Summary of the invention

[0004] In one embodiment, a spinal construct is provided. The spinal construct includes at least one member defining a first implant cavity and a second implant cavity oriented transversely to the first implant cavity. At least one member has a surface comprising a locking device arranged together with the first implant cavity. In some embodiments, systems, implants, surgical instruments and methods are provided.

[0005] In one embodiment, a spinal construct includes at least one connector including a hook defining a first implant cavity and spaced apart arms defining a second implant cavity. Each of the arms includes a temporary locking device engageable with an existing spinal rod that can be placed with the first implant cavity.

[0006] In one embodiment, a method for treating the spine is provided. The method includes the following steps: connecting a lateral member defining a first cavity and a second cavity oriented transverse to the first cavity to an existing lateral rod implant, so that a locking device of the lateral member engages the lateral rod to temporarily fix the lateral rod to the first cavity; connecting an implant support to the lateral member; connecting a contralateral member defining a first cavity and a second cavity transverse to the first cavity of the contralateral member to an existing contralateral rod implant, so that a locking device of the contralateral member engages the contralateral rod to temporarily fix the contralateral rod to the first cavity of the contralateral member; and connecting the implant support to the contralateral member. Other embodiments may include lateral members in which the orientation of the first cavity and the second cavity is variable or set to any angle relative to each other. A pair of lateral members may also face each other, face away from each other, or be in line with each other. BRIEF DESCRIPTION OF THE DRAWINGS

[0007] The present disclosure will become more apparent from the following detailed description in conjunction with the accompanying drawings.

[0008] Figure 1 is a perspective view of components of one embodiment of a system according to principles of the present disclosure;

[0009] Figure 2 yes Figure 1 A side view of the assembly shown in ;

[0010] Figure 3 yes Figure 1 A side view of the assembly shown in ;

[0011] Figure 4 is a perspective view of components of one embodiment of a system according to principles of the present disclosure;

[0012] Figure 5 is a perspective view of components of one embodiment of a system according to principles of the present disclosure;

[0013] Figure 6 is a perspective view of components of one embodiment of a system according to principles of the present disclosure positioned with a vertebra;

[0014] Figure 7 is a perspective view of components of one embodiment of a system according to principles of the present disclosure;

[0015] Figure 8 is a plan view of components of one embodiment of a system according to principles of the present disclosure positioned with a vertebra;

[0016] Fig. 9 is a plan view of components of one embodiment of a system according to principles of the present disclosure positioned with a vertebra;

[0017] Fig.10is a perspective view of components of one embodiment of a system according to principles of the present disclosure positioned with a vertebra;

[0018] Fig.11 is a plan view of components of one embodiment of a system according to principles of the present disclosure positioned with a vertebra;

[0019] Fig.12 yes Fig.11 A perspective view of the components and vertebrae shown in ;

[0020] Fig.13 is a plan view of components of one embodiment of a system according to principles of the present disclosure positioned with a vertebra;

[0021] Fig.14 yes Fig.13 A perspective view of the components and vertebrae shown in ;

[0022] Fig.15 is a perspective view of components of one embodiment of a system according to principles of the present disclosure;

[0023] Fig.16 is a perspective view of components of one embodiment of a system according to principles of the present disclosure;

[0024] Fig.17 is a perspective view of components of one embodiment of a system according to principles of the present disclosure positioned with a vertebra;

[0025] Fig.18 yes Fig.17 The components and lateral views of the vertebrae shown in ;

[0026] Fig.19 is a perspective view of components of one embodiment of a system according to principles of the present disclosure positioned with a vertebra;

[0027] Fig. 20 yes Fig.19 The components and plan views of the vertebrae shown in ;

[0028] Fig.21 is a plan view of components of one embodiment of a system according to principles of the present disclosure positioned with a vertebra;

[0029] Fig. 22 yes Fig.21 A perspective view of the components and vertebrae shown in ;

[0030] Fig.23 yes Fig.21 Partial cross-sectional plan views of the components and vertebrae shown in ;

[0031] Fig.24 yes Fig.21 The components and plan views of the vertebrae shown in ;

[0032] Fig.25 yes Fig.21 A perspective view of the components and vertebrae shown in ;

[0033] Fig.26 yes Fig.21 Partial cross-sectional plan views of the components and vertebrae shown in ;

[0034] Fig. 27 is a perspective view of components of one embodiment of a system according to principles of the present disclosure;

[0035] Fig.28 is a perspective view of components of one embodiment of a system according to principles of the present disclosure positioned with a vertebra;

[0036] Fig.29 is a perspective view of components of one embodiment of a system according to principles of the present disclosure positioned with a vertebra;

[0037] Fig.30 is a perspective view of components of one embodiment of a system according to the principles of the present disclosure positioned with a vertebra; and

[0038] Fig.31 is a perspective view of components of one embodiment of a system in accordance with principles of the present disclosure positioned with a vertebra. DETAILED DESCRIPTION

[0039] Exemplary embodiments of the disclosed surgical systems and related methods of use are discussed in terms of medical devices for treating musculoskeletal disorders, and more particularly, in terms of surgical systems and methods for treating spinal disorders. In some embodiments, the disclosed systems and methods are used for spinal arthrodesis, such as in the cervical, thoracic, lumbar, and / or sacral regions of the spine.

[0040] In some embodiments, the surgical system includes a spinal construct comprising a connector and a cross-linked spinal rod configured for percutaneous insertion. In some embodiments, the connector comprises a hook portion configured to engage with a lateral and / or contralateral spinal rod. In some embodiments, the connector comprises a tab extender configured to facilitate percutaneous insertion. In some embodiments, the connector comprises a temporary locking mechanism such as a temporary locking element to facilitate connection with the lateral and / or contralateral spinal rod. In some embodiments, the surgical system comprises a lateral connector and a contralateral connector to fix the cross-linked spinal rod to the lateral and contralateral spinal rods.

[0041] In some embodiments, the surgical system is used with a method of use, the method of use comprising the step of connecting the tab extender to the connector. In some embodiments, the surgical system is used with a method of use, the method of use comprising the step of percutaneously delivering the connector along a surgical path to connect to the lateral and / or contralateral spinal rod. In some embodiments, the hook portion of the connector engages the lateral and / or contralateral spinal rod. In some embodiments, the connector is temporarily fixed to the lateral and / or contralateral spinal rod. In some embodiments, the surgical system is used with a method of use, the method of use comprising the steps of engaging a measuring device such as a caliper or ruler with the tab extender to determine the length of the cross-linked spinal rod by measuring the distance between the lateral and / or contralateral spinal rods.

[0042] In some embodiments, the present surgical system is used with a method of use comprising the step of inserting a dilator via a lateral approach to provide a pathway for inserting a cross-linked spinal rod. In some embodiments, a trocar and / or chisel engages the dilator to cut and / or disrupt the tissue surface of the vertebra to allow passage of the cross-linked spinal rod. In some embodiments, the trocar and / or chisel is configured to cut and / or disrupt tissue to clear a pathway through the tissue, such as the spinous process and / or supraspinal ligament.

[0043] In some embodiments, the surgical system is used with a method of use, the method comprising the steps of engaging a rod inserter with a cross-linked spinal rod to guide and / or direct the cross-linked spinal rod to engage a connector. In some embodiments, the cross-linked spinal rod is rotated, for example, 180 degrees. In some embodiments, the surgical system is used with a method of use, the method comprising the steps of engaging a driver with a set screw having a connector to secure the cross-linked spinal rod to the connector. In some embodiments, an instrument is engaged with the connector to disconnect a tab from the connector.

[0044] In some embodiments, the present surgical system comprises a spinal construct for use with a method of connecting to a multiaxial screw and rod interconnect. In some embodiments, the interconnect is within a rod slot or rod receiving feature of a multiaxial screw, hook, or other bone attachment anchor, and may be below or above the rod, or around a fixation screw or locking member of the interconnect. In some embodiments, the spinal construct has a low profile and axial size configuration of the connection that reduces the size of the spinal construct while providing versatility of connection. In some embodiments, because the interconnect is within the existing interconnect, the spinal construct reduces stress on the rod construct by removing additional fixation points on the segmented construct. In some embodiments, this connection is useful when cross-linking and extending from the construct, and / or for screw extension connectors.

[0045] The present disclosure can be more easily understood by the following detailed description of the embodiments carried out by reference to the accompanying drawings that form a part of the present disclosure. It should be understood that the present application is not limited to the specific devices, methods, conditions or parameters described and / or shown herein, and the terms used herein are only for the purpose of describing specific embodiments by example, rather than for limitation. In some embodiments, as used in the specification and including the appended claims, the singular forms "a", "an" and "the" include plural numbers, and references to specific numerical values ​​include at least the specific values, unless the context clearly stipulates otherwise. The range can be expressed as from "about" or "approximately" a specific value and / or to "about" or "approximately" another specific value in this article. When expressing such a range, another embodiment includes from the specific value and / or to the specific value. Similarly, when the antecedent "about" is used to express a value as an approximate value, it should be understood that the specific value forms another embodiment. It should also be understood that all spatial references, such as horizontal, vertical, top, upper, lower, bottom, left and right, are only for illustrative purposes and can be changed within the scope of the present disclosure. For example, references to "upper" and "lower" are relative and are used only in context relative to one another and not necessarily "above" and "below."

[0046] As used in the specification and including the appended claims, "treating" or "treatment" of a disease or condition refers to performing a procedure that may include administering one or more drugs to a patient (normal or abnormal human or other mammal), using an implantable device, and / or using an instrument for treating a disease (e.g., a microdiscectomy instrument for removing bulging or herniated discs and / or bone spurs) to alleviate signs or symptoms of the disease or condition. Relief may occur before signs or symptoms of the disease or condition appear as well as after they appear. Thus, treatment includes preventing a disease or undesirable condition (e.g., preventing the disease from occurring in a patient who may be susceptible to the disease but has not yet been diagnosed with the disease). In addition, treatment does not require complete relief of signs or symptoms, does not require a cure, and specifically includes surgery that has only a marginal effect on the patient. Treatment may include inhibiting the disease, such as curbing its development, or alleviating the disease, such as causing regression of the disease. For example, treatment may include reducing acute or chronic inflammation; relieving pain and reducing and inducing regrowth of new ligaments, bones, and other tissues; as an adjunct to surgery; and / or any repair procedure. Also, as used in the specification and including the appended claims, the term "tissue" includes soft tissue, muscle, ligament, tendon, cartilage and / or bone, unless specifically mentioned otherwise.

[0047] The following discussion contains descriptions of surgical systems and related methods of using the surgical systems according to the principles of the present disclosure. Alternative embodiments are also disclosed. Reference is made in detail to the exemplary embodiments of the present disclosure illustrated in the accompanying drawings. Figure 1-5 , components of a surgical system, such as a spinal implant system 10, are shown.

[0048] The components of spinal implant system 10 can be made of biologically acceptable materials suitable for medical applications, including metals, synthetic polymers, ceramics and bone materials and / or their composites. For example, the components of spinal implant system 10 can be made of, for example, stainless steel alloys, aluminum, industrial pure titanium, titanium alloys, grade 5 titanium, superelastic titanium alloys, cobalt-chromium alloys, superelastic metal alloys (for example, Nitinol, superelastic plastic metals, such as GUM ), ceramics and their composites (such as calcium phosphate (e.g., SKELITE TM ), thermoplastics (such as polyaryletherketone (PAEK), including polyetheretherketone (PEEK), polyetherketoneketone (PEKK) and polyetherketone (PEK), carbon-PEEK composites, PEEK-BaSO 4 Polymeric rubber, polyethylene terephthalate (PET)), fabrics, silicone, polyurethane, silicone-polyurethane copolymers, polymeric rubber, polyolefin rubber, hydrogels, semi-rigid and rigid materials, elastomers, rubbers, thermoplastic elastomers, thermosetting elastomers, elastomeric composites, rigid polymers (including polyphenylene, polyamide, polyimide, polyetherimide, polyethylene, epoxy resins), bone materials (including autologous transplants, allogeneic transplants, xenografts or transgenic cortical bone and / or cortical spongy bone and tissue growth or differentiation factors), partially absorbable materials (e.g., composites of metal and calcium-based ceramics, composites of PEEK and calcium-based ceramics, composites of PEEK and absorbable polymers), fully absorbable materials (e.g., calcium-based ceramics such as calcium phosphate, tricalcium phosphate (TCP), hydroxyapatite (HA)-TCP, calcium sulfate or other absorbable polymers such as polylactide, polyglycolide, polytyrosine carbonate, polycaprolactone) and combinations thereof.

[0049] The various assemblies of spinal implant system 10 can have composite, comprise above-mentioned materials, to realize various required characteristics, for example intensity, rigidity, elasticity, compliance, biomechanical property, durability and radiolucency or imaging preference.The assembly of spinal implant system 10 also can be made by heterogeneous material individually or jointly, for example, is made by the combination of two or more above-mentioned materials.The assembly of spinal implant system 10 can be formed as a whole, integrally connected or comprise fastening element and / or instrument, as described herein.

[0050] Spinal implant system 10 can use for example minimally invasive surgery, comprise percutaneous technique, micro open surgical technique and / or open surgical technique, to deliver and introduce instrument and / or implant of for example spinal construct at the surgical site (comprising for example the spinal column with vertebra V) in the patient's body, such as Figures 6 to 31 In some embodiments, a spinal construct may include one or more bone fasteners, spinal rods, connectors, and / or plates.

[0051] The spinal implant system 10 includes a spinal construct 11 that includes components such as a connector 12. The spinal implant system 10 includes a lateral connector 12 that can be engaged with a lateral spinal rod 150 and a connector 12 similar to the connector 12 described herein that can be engaged with a contralateral spinal rod 150a ( Figure 6 ) is engaged with the contralateral connector 12a. As described herein, the transverse spinal rod 152 is configured to connect the connectors 12, 12a and connect the lateral spinal rod 150 and the contralateral spinal rod 150a. In some embodiments, because the interconnections of the spinal rods 150, 150a with the rod 152 are within the existing interconnections of the spinal rods 150, 150a with the vertebrae V, the spinal rods 152 reduce stress on one or more components of the spinal construct including the spinal rods 150, 150a by removing one or more fixation points with the vertebrae V. In some embodiments, the spinal construct may include one or more components.

[0052] The connector 12 includes a surface 14 defining an implant cavity 16, such as Figure 1 As shown. Surface 14 includes a protrusion, such as a hook 18 extending from surface 14. Hook 18 defines a passage 20 configured to capture a spinal implant (e.g., a spinal rod 150 in cavity 16). Passage 20 extends along axis A1. In some embodiments, cavity 16 may have various cross-sectional configurations, such as oval, oblong, triangular, rectangular, square, polygonal, irregular, uniform, non-uniform, variable, tubular and / or conical. In some embodiments, when rod 150 is placed in cavity 16, rod 150 is coaxial or aligned parallel to axis A1. In some embodiments, when rod 150 is placed in cavity 16, rod 150 is placed transversely to axis A1.

[0053] The connector 12 includes a pair of spaced apart arms 30, 32. The arms 30, 32 define a U-shaped implant cavity 34 therebetween that is configured for handling a spinal implant, such as a spinal rod 152. The cavity 34 extends along the axis A2 and transversely to the axis A1, such as Figure 2As shown. In some embodiments, arm 30, arm 32 and / or cavity 34 can be arranged with alternative orientations relative to axis A1, such as vertical and / or other angle orientations such as acute angles or obtuse angles, coaxial and / or can be offset or staggered. In some embodiments, cavity 34 can have various cross-sectional configurations, such as oval, oblong, triangular, rectangular, square, polygonal, irregular, uniform, non-uniform, variable, tubular and / or conical. In some embodiments, when rod 152 is arranged in cavity 34, rod 152 is coaxial or parallel to axis A2. In some embodiments, when rod 152 is arranged in cavity 34, rod 152 is arranged transversely to axis A2.

[0054] The arms 30, 32 each include a thread profile 38 configured to engage a coupling member, such as a set screw 802, to retain the spinal rod 152 within the cavity 34, such as Figure 5 In some embodiments, the arms 30, 32 may be positioned with the coupling member in alternative securing arrangements, such as friction fit, press fit, locking protrusions / recesses, locking keyways, and / or adhesives.

[0055] Arm 30 extends between surface 40 and surface 42. Surface 40 includes a break tab 44 that is frangibly connected to arm 30 at portion 46. Portion 46 is made of a break and / or frangible material such that manipulation of tab 44 relative to arm 30 can break tab 44 along portion 46 and separate it from arm 30 at a predetermined force and / or torque limit, as described herein. Arm 32 extends between surface 50 and surface 52. Surface 50 includes a break tab 54 that is frangibly connected to arm 32 at portion 56. Portion 56 is made of a break and / or frangible material such that manipulation of tab 54 relative to arm 32 can break tab 54 along portion 56 and separate it from arm 32 at a predetermined force and / or torque limit, as described herein.

[0056] In some embodiments, as force and / or torque are applied to tabs 44 and / or tabs 54 and resistance increases, for example, approaching predetermined torque and force limits. In some embodiments, tabs 44 and / or tabs 54 are configured to facilitate reduction of one or more spinal rods using bone fasteners and / or vertebrae, as described herein. Tabs 44, 54 are configured to extend the overall height of bone connector 12 and facilitate handling of one or more spinal rods with cavities 34. In some embodiments, tabs 44, 54 can break and separate at a predetermined force or torque limit, which can be in the range of about 2 Newton meters (Nm) to 8 Nm. In some embodiments, tabs 44, 54 and arms 30, 32 can have the same or alternative cross-sectional configurations, can be made of homogeneous materials or heterogeneously made of different materials, and / or can alternatively be formed of materials having characteristics or properties of a greater degree of plastic deformability, brittle characteristics, and / or fracture properties to facilitate breaking tabs 44, 54 and separating them from arms 30, 32.

[0057] Surface 42 includes a locking device, such as a spring tab 60, which is configured to temporarily lock the spinal rod 150 with the connector 12, as described herein. Tab 60 includes a surface, such as a top 62, which is configured to deflect, snap and / or bias into engagement with the spinal rod 150 to form a friction fit between a surface 160 of the spinal rod 150 and the top 62. Tab 60 extends from surface 42 into cavity 16. Tab 60 deflects inwardly after engagement with the spinal rod 150, so that the resulting bias forms a friction fit between surface 160 and top 62.

[0058] Surface 52 includes a locking device, such as a spring tab 70, which is configured to temporarily lock the spinal rod 150 with the connector 12, as described herein. Tab 70 includes a surface, such as a top 72, which is configured to deflect, snap and / or bias into engagement with the spinal rod 150 to form a friction fit between the surface 160 and the top 72 of the spinal rod 150. Tab 70 extends from surface 52 into cavity 16. Tab 70 deflects inwardly after engagement with the spinal rod 150, so that the resulting bias forms a friction fit between the surface 160 and the top 72. Tabs 60, 70 temporarily lock the connector 12 with the spinal rod 150. Tabs 60, 70 temporarily fix the connector 12 with the spinal rod 150 to maintain the position of the connector 12 during insertion and / or engagement of the spinal rod 152 with the cavity 34. After the spinal rod 152 is positioned with the lumen 34 , the set screw 802 is engaged with the connector 12 to secure the connector 12 and the spinal rod 150 together.

[0059] Tabs 60, 70 are integrally formed with connector 12. In some embodiments, tabs 60, 70 may have various lengths. In some embodiments, all or only a portion of tabs 60, 70 may have a semi-rigid, flexible or elastic configuration and / or have elasticity and / or flexibility similar to the properties from the following materials: for example, fabrics, silicones, polyurethanes, silicone-polyurethanes, copolymers, rubbers, polyolefin rubbers, elastomers, thermoplastic elastomers, thermosetting elastomers, and elastic composites. In some embodiments, tabs 60, 70 provide a selective amount of flexion relative to spinal rod 150. In some embodiments, tabs 60, 70 may have a flexible configuration that includes movement in an upward and / or downward direction. In some embodiments, tabs 60, 70 may be compressible. In some embodiments, tabs 60, 70 may include a plurality of detachably attached or connected portions or sections, such as bands or loops, or may be integrally formed as a single continuous element.

[0060] Spinal rod 152 extends between end 154 and end 156. Figure 4 As shown. End 154 includes a surface 170 defining a groove 172. As described herein, groove 172 is configured to facilitate the connection of surgical instruments such as rod inserter 700. Spinal rod 152 includes a bend C. In some embodiments, spinal rod 152 may have various cross-sectional configurations, such as circular, oval, oblong, triangular, square, polygonal, irregular, uniform, non-uniform, variable, tubular and / or conical. In some embodiments, the thickness defined by spinal rod 152 may increase or decrease uniformly, or have alternating diameter sizes along its length. In some embodiments, spinal rod 152 may have various cross-sectional configurations, such as oval, oblong, triangular, rectangular, square, polygonal, irregular, uniform, non-uniform, variable, tubular and / or conical. In some embodiments, spinal rod 152 may extend in various configurations, such as linear, arched, curved, angled and / or pre-curved, depending on the selected vertebral configuration.

[0061] In some embodiments, all or only a portion of the spinal rod 152 may have a semi-rigid, flexible, or elastic configuration and / or have elasticity and / or flexibility similar to the properties from materials such as fabrics, silicones, polyurethanes, silicone-polyurethanes, copolymers, rubbers, polyolefin rubbers, elastomers, thermoplastic elastomers, thermosetting elastomers, and elastic composites. In some embodiments, the spinal rod 152 may include multiple separately attachable or connected portions or sections, such as bands or loops, or may be integrally formed as a single continuous element.

[0062] In assembly, operation, and use, similar to the systems and methods described herein, the spinal implant system 10 is used in the surgical procedures described herein to treat a condition or injury of an affected segment of the spine including vertebra V, such as Figures 6 to 31 shown.

[0063] In use, in order to treat the affected section of vertebra, the medical practitioner enters the surgical site comprising vertebra V in any appropriate manner (e.g., by cutting and retracting tissue). The spinal implant system 10 comprising spinal construct 11 as described herein can be used for any existing surgical method or technology, comprising open surgery, mini open surgery, minimally invasive surgery and percutaneous surgery implantation, thus by mini cutting or providing a sleeve of protection access to the region to reach vertebra V. Once arriving at the surgical site, the specific surgical procedure for treating spinal disorders is performed. The spinal implant system 10 is then used to enhance surgical treatment.

[0064] An incision is made in the patient and a cutting instrument (not shown) forms a surgical path to the vertebra V. The surgical path is used to implant the components of the spinal implant system 10. A preparation instrument (not shown) may be used to prepare the tissue surface of the vertebra V, as well as to aspirate and irrigate the surgical area.

[0065] Bone fastener 200 engages vertebra V along a lateral side L of vertebra V, such as Figure 6 1. The spinal rod 150 is delivered to a surgical site adjacent to the vertebra V along the surgical path. The spinal rod 150 is placed along the vertebra V with the receiver 202 of the bone fastener 200. In some embodiments, the spinal implant system 10 includes a second set of bone fasteners 200a and a spinal rod 150a delivered to a surgical site adjacent to the contralateral CL of the vertebra V along the surgical path. The spinal rod 150a is placed along the vertebra V with the receiver 202a of the bone fastener 200a.

[0066] As described herein, bone fastener 200 and bone fastener 200a are fixed with vertebra V with side-by-side orientation and / or bilateral arrangement, to stabilize vertebra V and influence growth, to carry out correction treatment to treat spinal pathology.In certain embodiments, one or all of the components of spinal implant system 10 can be assembled in the selected order of parts or delivered or implanted as preassembled device or can be assembled in situ, or the order of the parts of the specific components of spinal implant system 10 can be changed according to practitioner preference, patient anatomical structure or surgical procedure parameters.

[0067] In some embodiments, tab extender 300 is coupled to tabs 44, 54 as described herein. Figure 7As shown, the extender cap 302 is engaged with the tab extender 300. The connector 12 is delivered along a surgical path to be connected to the spinal rod 150, such as Figures 8 to 10 The spinal rod 150 is translated into the cavity 16. The surface 160 compresses the tabs 60, 70 so that the spinal rod 150 snaps into the hook 18. The tips 62, 72 form a friction fit between the surface 160 and the tips 60, 70 to temporarily secure the spinal rod 150 to the hook 16. The ruler 500 can also be used under fluoroscopy, x-ray, or similar imaging techniques to determine the length of the rod 152.

[0068] The tab extender 300a is connected to the tabs 44a, 54a, as shown in FIG. Fig. 9 1. The extender cap 302a engages the tab extender 300a. The connector 12a is delivered along the surgical path to be connected to the spinal rod 150a. Similar to the assembly of the connector 12 described herein, the spinal rod 150a translates into the cavity 16a of the connector 12a. The surface 160a compresses the tabs 60a, 70a so that the spinal rod 150a snaps into the hook 18a. The tops 62a, 72a form a friction fit between the surface 160a and the tops 60a, 70a to temporarily secure the spinal rod 150a to the hook 16a.

[0069] In some embodiments, a measuring device, such as a caliper 400, is used to determine the length of the spinal rod 152. Fig.11 and 12 The caliper 400 is engaged with the tab extenders 300, 300a so that the distance D1 between the connectors 12, 12a can be determined, as shown in FIG. Fig.12 Determining distance D1 provides the length of rod 152 connected to connecting rods 150, 150a via connectors 12, 12a. In some embodiments, ruler 500 is used to determine the length of spinal rod 152, such as Fig.13 and 14 shown.

[0070] In some embodiments, dilator 600 is placed with vertebra V via a lateral approach, such as Figures 17 to 20 As shown. The expander 600 is configured to provide a passage for the spinal rod 152 to engage with the connector 12, 12a. In some embodiments, as Fig.15 The trocar 602 shown and / or Fig.16 The chisel 604 is shown engaged with the dilator 600 to cut and / or disrupt the tissue surface of the vertebra V to allow passage of the spinal rod 152. In some embodiments, the trocar 602 and / or chisel 604 are configured to cut and / or disrupt tissue to clear a passage through the tissue, such as the spinous process and / or supraspinous ligament.

[0071] In some embodiments, the rod inserter 700 engages the groove 172 of the spinal rod 152, such as Figures 21 to 26 As shown. Rod inserter 700 guides and / or directs spinal rod 152 into lumen 34 of connector 12, laterally past vertebra V, and into lumen 34a of connector 12a. In some embodiments, percutaneous endoscopic lumbar discectomy is utilized. Fig.23 As shown, end 154 of spinal rod 152 is disposed with lumen 34, and end 156 of spinal rod 152 is disposed with lumen 34a. Fig. 22 and 23 As shown, the spinal rod 152 is initially inserted so that the apex of the curved portion C is oriented toward the spinal canal. When handling the spinal rod 152 with the lumens 34, 34a, the rod inserter 700 is rotated, for example, 180 degrees to guide the apex of the curved portion away from the spinal canal to resist and / or prevent the spinal rod 152 from hitting the spinal canal, such as Figures 24 to 26 shown.

[0072] In some embodiments, driver 800 is used to engage set screw 802 with connector 12, 12a. Driver 802 guides and / or directs set screw 802 through each of extender caps 302, 302a and tab extenders 300, 300a to engage connector 12, 12a. Set screw 802 engages arms 30, 32 and arms 30a, 32a to secure spinal rod 152 within each of cavities 34, 34a, as shown in FIG. Fig. 27 and 28 In some embodiments, the tab hook anti-torque handle 900 and the tab hook anti-torque sleeve 901 are engaged with the tab extender 300, 300a, as shown. Fig.29 As shown. Handle 900 and sleeve 901 are configured to provide additional leverage to facilitate removal and / or separation of fragile or broken portions of set screw 802 at a selected torque limit. Break handle 902 is disposed with driver 800 and is manipulated to apply force for tightening set screw 802 and for breaking torque limits, such as Fig.30 shown.

[0073] The handle 902, sleeve 901 and / or handle 900 are removed from each of the extenders 300, 300a. The tab disconnector 904 is disposed with each of the extenders 300, 300a, such as Fig.31 As shown. Tab disconnector 904 is manipulated to apply force to tabs 44, 54 and tabs 44a, 54a. When the applied force reaches a selected torque limit, tab disconnector 902 disconnects tabs 44, 54 and tabs 44a, 54a from connectors 12, 12a, respectively.

[0074] In certain embodiments, connector 12,12a can be used for example in the surgical treatment of revision surgery, to revise, repair and / or extend existing spinal column construct, comprise for example bone fastener 200,200a, lateral spinal rod 150 and contralateral spinal rod 150a, as described herein.In certain embodiments, spinal implant system 10 is included in the connector 12,12a used in revision surgery to be connected with existing spinal column construct.In certain embodiments, existing spinal column construct can be included in one or more implants connected with tissue or fixed with tissue in previous or different surgical procedures, and the time and / or duration that they carry out in the same surgical procedure are separated.In certain embodiments, during surgical treatment, spinal implant system 10 can be completely or partially renovated, removed or replaced.

[0075] After finishing the operation, surgical instruments, assembly and non-implanted components of spinal implant system 10 can be removed, and incision is closed.The assembly of spinal implant system 10 can be made of the radiolucent material of for example polymer.Can comprise radioactive marker and be used for identifying under x-ray, perspective, CT or other imaging techniques.In certain embodiments, the use of surgical navigation, microsurgery and image-guided technology can be used for entering, checking and repairing spinal column deterioration or damage by means of spinal implant system 10.In certain embodiments, spinal implant system 10 can comprise one or more in plate, connector and / or bone fastener, for single vertebral level or multiple vertebral levels.

[0076] In certain embodiments, as described herein, spinal implant system 10 comprises one or more undemonstrated fasteners, for spinal column construct being connected with tissue.In certain embodiments, fastener can engage with tissue in various orientations, for example serial, parallel, offset, staggered and / or alternative vertebral levels.In certain embodiments, one or more in the fastener can comprise polyaxial screw, sagittal angle screw, pedicle screw, uniaxial screw, uniplane screw, small bone face screw, set screw, tissue penetration screw, conventional screw, expansion screw, wedge, anchor, button, retainer, buckle, friction fitting, compression fitting, expansion rivet, suture nail, nail, adhesive, pillar, fixed plate and / or pillar.

[0077] In one embodiment, spinal implant system 10 comprises medicament, and described medicament can be placed, packaged, coated or layered in assembly and / or the surface of spinal implant system 10, on or around.In certain embodiments, medicament can comprise bone growth and help material, for example, bone graft, to strengthen the fixation of assembly and / or the surface of spinal implant system 10 and vertebra.In certain embodiments, reagent can comprise one or more therapeutic agents and / or pharmacological agents for release, comprises sustained release, to treat for example pain, inflammation and degeneration.

[0078] It should be understood that various modifications may be made to the embodiments disclosed herein. Therefore, the above description should not be interpreted as limiting, but only as an illustration of various embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the appended claims.

Claims

1. A spinal connector, comprising: a spinal column construct having an upper portion and a lower portion; a pair of spaced-apart arms extending from the upper portion, the arms defining a second implant cavity extending along a second axis, the second implant cavity configured to engage a second spinal rod; a hook extending from the lower portion, the hook having a first implant cavity, the first implant cavity being configured to engage with a first spinal rod, the first implant cavity extending along a first axis, the first axis being transverse to the second axis, wherein the first implant cavity is in communication with the second implant cavity, and the communication between the second implant cavity and the first implant cavity enables the second spinal rod to engage with the first spinal rod; as well as A temporary spinal rod locking device, the temporary spinal rod locking device comprising a pair of spaced-apart spring tabs configured to engage the first spinal rod, the locking device being spaced apart from the hook, the locking device being integrally formed with the upper portion, wherein the first spinal rod directly engages the second spinal rod when the rods are seated in the respective cavities.

2. The spinal connector according to claim 1, wherein: The arm includes a thread form and further includes a set screw configured to engage the thread form and the second spinal rod.

3. The spinal connector according to claim 2, wherein: Engagement of the set screw with the second spinal rod secures the first spinal rod relative to the spinal construct.

4. The spinal connector according to claim 1, wherein: The locking device extends into the first implant cavity.

5. The spinal connector of claim 1, further comprising the second spinal rod disposed in the second implant cavity.

6. The spinal connector of claim 1 further comprising the first spinal rod disposed in the first implant cavity.

7. The spinal connector of claim 1, further comprising the second spinal rod disposed in the second implant cavity and the first spinal rod disposed in the first implant cavity.

8. The spinal connector of claim 7, further comprising a ruler configured to measure a distance between the first spinal rod and the third spinal rod.

9. The spinal connector according to claim 1, wherein: The second implant cavity is positioned between the spring tabs.

10. The spinal connector according to claim 1, wherein: The spinal construct includes a threaded breakaway tab extending from each of the arms.

11. The spinal connector according to claim 1, wherein: The spinal construct includes a break-away tab extender extending from each of the arms, each of the break-away tabs being frangibly coupled to one of the arms.

12. A surgical system comprising: The spinal connector according to claim 1; as well as A second spinal connector, the second spinal connector comprising: a pair of spaced arms defining a third implant cavity, the third implant cavity being configured to engage with the second spinal rod; the second spinal connector comprising: a second hook extending from a lower portion of the second spinal connector, the second hook having a fourth implant cavity configured to engage with the third spinal rod, wherein the fourth implant cavity is in communication with the third implant cavity and the communication between the third implant cavity and the fourth implant cavity enables the second spinal rod to engage with the third spinal rod; the second spinal connector comprising: a second temporary spinal rod locking device, the second temporary spinal rod locking device comprising a pair of spaced spring tabs, the spring tabs being configured to engage with the third spinal rod, the second temporary spinal rod locking device being spaced from the second hook, the second temporary spinal rod locking device being integrally formed with an upper portion of the second spinal connector, wherein when the rod is positioned in the corresponding cavity, the third spinal rod is directly engaged with the second spinal rod.

13. The surgical system of claim 12, further comprising set screws, each of said set screws being threadably engaged with one of said upper portion and said second spinal rod.

14. A spinal construct comprising: upper and lower parts; a pair of spaced apart arms extending from the upper portion, the arms defining a second implant cavity and including a thread form, a breakaway tab frangibly connected to each of the arms, the second implant cavity extending along a second axis; a hook extending from the lower portion, the hook having a first implant cavity configured to engage a first spinal rod, the first implant cavity communicating with a second implant cavity, the first implant cavity extending along a first axis, the first axis being transverse to the second axis; and a temporary spinal rod locking device, the temporary spinal rod locking device comprising a pair of spaced apart spring tabs, each of the spring tabs extending into the first implant cavity, the locking device being spaced apart from the hook, and the locking device being integrally formed with the upper portion; a second spinal rod disposed in the second implant cavity; the first spinal rod disposed in the first implant cavity and engaged with the temporary spinal rod locking device, the second spinal rod in direct contact with the first spinal rod, wherein the communication between the second implant cavity and the first implant cavity enables the second spinal rod to be in direct contact with the first spinal rod; as well as A set screw is configured to engage the thread form and the second spinal rod to secure the first spinal rod and the second spinal rod in the corresponding first implant cavity and the second implant cavity.

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