Spinal implant systems and methods

Abstract

The spinal structure includes a body defining a transverse axis. The body includes a wall disposed between a first implant cavity and a second implant cavity. The body further defines a first opening communicating with the first implant cavity and a second opening communicating with the second implant cavity. The first opening defines a first axis and the second opening defines a second axis. At least one of the first axis and the second axis is arranged in a substantially non-vertical orientation relative to the transverse axis. Systems, surgical instruments, implants, and methods are disclosed.

Description

Technical Field

[0001] The present disclosure relates generally to medical devices for treating musculoskeletal disorders, and more particularly to spinal implant systems and methods for treating the spine. Background Art

[0002] Spinal pathologies and disorders, such as scoliosis, kyphosis and other curvature abnormalities, 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, however, may not alleviate the symptoms associated with these conditions. The surgical treatments for these spinal conditions include correction, fusion, fixation, discectomy, laminectomy and implantable prostheses. As part of these surgical treatments, spinal structures comprising vertebral rods are generally used to provide stability to the treatment area. During healing, the rods transfer stress from the damaged or defective area to perform appropriate correction and generally provide support for the vertebral members. During surgical treatment, one or more rods and bone fasteners may be delivered to the surgical site. The rods may be attached to the outside of two or more vertebral members via fasteners. The present disclosure describes improvements to these prior arts. Summary of the invention

[0004] In one embodiment, a spinal structure is provided. The spinal structure includes a body defining a transverse axis. The body includes a wall arranged between a first implant cavity and a second implant cavity. The body also defines a first opening communicating with the first implant cavity and a second opening communicating with the second first implant cavity. The first opening defines a first axis and the second opening defines a second axis. At least one of the first axis and the second axis is arranged in a substantially non-vertical orientation relative to the transverse axis. In some embodiments, systems, surgical instruments, implants, and methods are disclosed.

[0005] In one embodiment, a spinal structure includes a connector including a body that can be connected to tissue and defines a transverse axis. The body includes a wall arranged between a first implant cavity and a second implant cavity. The body also defines a first opening that is connected to the first implant cavity and a second opening that is connected to the second implant cavity. The first opening defines a first axis and the second opening defines a second axis. At least one of the first axis and the second axis is arranged in a substantially non-perpendicular orientation relative to the transverse axis. The first spinal rod may be arranged with a first implant cavity. The first connecting member may be arranged with a first opening and may be arranged with a first opening and engaged with the first spinal rod. The second spinal rod may be arranged with a second implant cavity. The second connecting member may be arranged with a second opening and engaged with the second spinal rod.

[0006] In one embodiment, a spinal construct includes a body that can be connected to tissue and defines a transverse axis. The body includes a wall disposed between a first closed implant cavity and a second implant cavity. One end of a spinal rod is disposed in the closed implant cavity. The body further defines an opening that is in communication with the cavity. The opening defines a first axis that is disposed in a substantially non-perpendicular orientation relative to the transverse axis. BRIEF DESCRIPTION OF THE DRAWINGS

[0007] The present disclosure will become more apparent through detailed description in conjunction with the following drawings, in which:

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

[0009] Figure 2 yes Figure 1 A perspective view of components of a system;

[0010] Figure 3 yes Figure 2 a side cross-sectional view of the components shown in;

[0011] Figure 4 yes Figure 2 A side view of the components shown in ;

[0012] Figure 5 yes Figure 1 a side cross-sectional view of the components shown in ;

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

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

[0015] Figure 8 yes Figure 7 A perspective view of the components shown in ;

[0016] Fig. 9 yes Figure 7 A top view of the components shown;

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

[0018] Fig.11 yes Fig.10 A cross-sectional view of the components shown in ;

[0019] Fig.12 yes Fig.11 A cross-sectional view of the components shown in ;

[0020] Fig.13 yes Fig.10 a top view of the components shown; and

[0021] Fig.14 yes Fig.10 Another perspective view of the components shown in . DETAILED DESCRIPTION

[0022] 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.

[0023] In some embodiments, the surgical system of the present invention includes a spinal structure with a connector. In some embodiments, the connector includes a tulip hybrid cross-linking connector. In some embodiments, the connector includes a top-loaded spinal rod passage and a side-loaded spinal rod passage. The connector is configured to connect a spinal rod to a spinal structure, and the spinal structure includes, for example, a bone screw and a spinal rod. In some embodiments, the connector defines a transverse axis and includes a first implant cavity and a second implant cavity. In some embodiments, at least one of the implant cavities is configured for a side-loaded spinal rod. In some embodiments, the connector includes an opening communicated with the first implant cavity and an opening communicated with the second implant cavity.

[0024] In some embodiments, the connector includes a second opening angled toward the first opening to facilitate insertion of the connector through a small incision in the patient's body. In some embodiments, the connector is used with cortical screw trajectory surgery. In some embodiments, the connector facilitates connecting a spinal rod with a diameter of 4.75 mm by utilizing an angled second opening for connecting a set screw at a side-loaded spinal rod. In some embodiments, the opening for the set screw is angled and not oriented perpendicular to the transverse axis of the connector, such as being directly arranged in the connector. In some embodiments, the opening for the set screw is arranged in a substantially parallel relationship. In some embodiments, the opening for the set screw is angled and not parallel. In some embodiments, the first set screw opening axis is arranged at an angle relative to the transverse axis of the connector, and the second set screw opening axis is oriented perpendicular to the transverse axis of the connector, such as being directly arranged in the connector. In some embodiments, the connector includes only one set screw opening, which is angled relative to the transverse axis of the connector. In some embodiments, the surgical system of the present invention includes a spinal structure having a connector having convergent angled set screw openings to facilitate a midline cortical bone screw trajectory. In some embodiments, this configuration maintains the surgical instrument in the same orientation throughout the surgical procedure while minimizing tissue exposure.

[0025] In some embodiments, one or all components of the surgical system can be disposable, peel-wrap, pre-packaged sterile devices. One or all components of the system can be reusable. The system can be configured as a kit with multiple sized and configured components.

[0026] In some embodiments, the surgical system of the present disclosure can be used to treat spinal disorders, such as degenerative disc disease, disc herniation, osteoporosis, spondylolisthesis, spondylolisthesis, stenosis, scoliosis and other curvature abnormalities, kyphosis, tumors and fractures. In some embodiments, the surgical system of the present disclosure can be used in conjunction with other skeletons and bone-related applications, and the applications include those associated with diagnosis and therapy. In some embodiments, the disclosed surgical system can be used alternatively in surgical treatments in which the patient is in a prone or supine position, and / or various surgical approaches (including anterior, posterior, posterior midline, direct lateral, posterior lateral and / or anterolateral approaches) are used to reach the spine, as well as to reach other body regions. The surgical system of the present disclosure can also be used alternatively in conjunction with surgical operations for treating the lumbar spine, cervical spine, thoracic spine, sacrum and pelvic regions of the spine. The surgical system of the present disclosure can also be used in animals, bone models and other non-biological matrices, such as in training, testing and demonstration.

[0027] The surgical system of the present disclosure can be more easily understood by the following detailed description of the embodiments in conjunction with 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, and are not intended to be limiting. In some embodiments, as used in the specification and including the appended claims, the singular forms "a", "an" and "the" include plural numbers, and unless the context clearly stipulates, references to specific numerical values ​​include at least the specific value. The range can be expressed herein as from "about" or "approximately" a specific value and / or to "about" or "approximately" another specific value. When expressing this range, another embodiment includes from a specific value and / or to another specific value. Similarly, when a value is expressed as an approximate value by using the antecedent "about", 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 used only in context and are not necessarily "higher" and "lower."

[0028] As used in the specification and including the appended claims, "treating" or "treatment" of a disease or condition refers to performing a procedure, which 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 the disease (e.g., a microdiscectomy instrument for removing bulging or herniated discs and / or bone spurs) in an effort to alleviate the signs or symptoms of the disease or condition. Relief may occur before and after the onset of signs or symptoms of the disease or condition. Thus, treatment includes preventing the 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 procedures that have 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 reconstructive surgery. In some embodiments, as used in the specification and including the appended claims, unless expressly mentioned otherwise, the term "tissue" includes soft tissue, ligaments, tendons, cartilage, and / or bone.

[0029] The following discussion includes a description of a surgical system including a spinal construct, related components, and methods of using the surgical system 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.

[0030] The components of the 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 composites thereof. For example, the components of the spinal implant system 10 can be made, individually or collectively, of materials such as stainless steel alloys, aluminum, commercially pure titanium, titanium alloys, grade 5 titanium, superelastic titanium alloys, cobalt-chromium alloys, superelastic metal alloys (e.g., Nitinol, superelastic metals such as GUM, etc.). ), 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.

[0031] The various components of spinal implant system 10 can have material composites, including the above materials, to achieve various desired characteristics, such as strength, rigidity, elasticity, compliance, biomechanical properties, durability and radiolucency or imaging preferences. The components of spinal implant system 10 can also be manufactured from heterogeneous materials individually or collectively, such as manufactured from a combination of two or more of the above materials. The components of spinal implant system 10 can be formed in a single piece, integrally connected or include fastening elements and / or instruments, as described herein.

[0032] The spinal implant system 10 includes a spinal construct including a connector 12. In some embodiments, the connector 12 is configured to connect a first spinal rod 152 to a bone screw 160 and a second spinal rod 150, such as Figure 1 , 5 and 6.

[0033] The connector 12 includes a body 14 defining a transverse axis X1 such as Figure 3 The main body 14 includes a wall 18 ( Figure 2 ). Wall 18 includes a surface 22 defining a cavity, such as a receiver 24, such as Figure 2 Receiver 24 includes a pair of spaced arms 26, 28 defining an implant cavity, such as a passageway 30 therebetween. Passageway 30 is configured for top loading of a spinal implant, such as spinal rod 150, as shown. Figure 1 shown.

[0034] The arms 26, 28 each extend perpendicularly to the axis X1. Figure 1 . In some embodiments, the arms 26 and / or the arms 28 may be arranged in alternating orientations relative to the axis X1, such as transverse and / or other angular orientations, such as acute or obtuse angles, coaxial and / or offset or staggered. The arms 26, 28 each include an arcuate outer surface extending between a pair of side surfaces. In some embodiments, at least one of the outer and side surfaces of the arms 26, 28 has at least one notch or cavity therein configured to receive an insertion tool, a compression instrument, and / or an instrument for manipulating the connector 12.

[0035] The passage 30 is substantially U-shaped. In some embodiments, all or only a portion of the passage 30 may have an alternative cross-sectional configuration, such as a closed, V-shaped, W-shaped, oval, rectangular, triangular, square, polygonal, irregular, uniform, non-uniform, offset, staggered, and / or tapered configuration. In some embodiments, the surface 48 may include a gripping element or surface, such as, for example, one or more surfaces that are rough, arched, wavy, meshed, porous, semi-porous, dimpled, and / or textured to facilitate engagement with the spinal rod 150. The passage 30 defines an axis A1 extending transversely to the axis X1. In some embodiments, the axis A1 may be arranged in an alternating orientation relative to the axis X1, such as, for example, parallel, perpendicular, and / or angular orientations, such as, for example, acute or obtuse, coaxial, and / or may be offset or staggered.

[0036] The receiver 24 includes a threaded surface 32 defining an opening 34. The opening 34 extends along the axis X2, as shown in FIG. Figure 3As shown. Axis X2 is arranged in a direction substantially perpendicular to axis X1. In some embodiments, axis X2 is arranged in an alternating orientation relative to axis X1, such as, for example, transverse and / or other angular orientations, such as, for example, acute or obtuse, coaxial and / or may be offset or staggered. Opening 34 is arranged to communicate with passage 30 to facilitate fixation of spinal rod 150 with connector 12.

[0037] Surface 32 is configured to engage with a coupling member, such as a set screw 200, to retain spinal rod 150 within passage 30. In some embodiments, surface 32 can be arranged with set screw 200 in an alternative fixing configuration, such as a friction fit, a press fit, locking protrusions / recesses, a locking keyway, and / or an adhesive. In some embodiments, all or only a portion of surface 32 can have an alternative surface configuration to enhance engagement with a spinal rod and / or set screw, such as a rough, arched, wavy, lattice-like, porous, semi-porous, recessed, and / or textured configuration.

[0038] The set screw 200 is configured to engage the spinal rod 150 to facilitate fixation and / or locking of the spinal rod 150 with the receiver 24. The set screw 200 can be arranged with the receiver 24 between an unlocked orientation, wherein the spinal rod 150 is translatable relative to the connector 12, and a locked orientation, wherein the set screw 200 fixes the spinal rod 150 with the connector 12.

[0039] The body 14 includes an extension 40. The extension 40 includes an end 42 that forms a receiver 44. The receiver 44 includes a surface 46 that defines an implant cavity, such as a passage 48. The receiver 44 includes an arcuate configuration, such as a hook-shaped wall 50 that defines the passage 48 and is configured to capture the spinal rod 152. The receiver 44 is configured to facilitate side loading of the spinal rod 152 with the connector 12.

[0040] As described herein, passage 48 is configured for side loading of spinal rod 152. In some embodiments, passage 48 is arranged to be separate and remote from passage 30. In some embodiments, passage 48 is arranged in a side-by-side orientation relative to passage 30. In some embodiments, passage 48 is arranged in a parallel orientation relative to passage 30. In some embodiments, passage 48 is arranged transverse to passage 30. In some embodiments, passage 48 can be arranged in various orientations, such as, for example, perpendicular, transverse, and / or angular orientations, such as acute or obtuse angles, relative to passage 30. In some embodiments, passage 48 can be arranged to be offset or staggered from passage 30.

[0041] In some embodiments, passage 48 can have various cross-sectional configurations, such as, for example, oval, elliptical, triangular, rectangular, square, polygonal, irregular, uniform, non-uniform, deformable, and / or tapered. In some embodiments, surface 48 can include gripping elements or surfaces, such as, for example, rough, arched, wavy, meshed, porous, semi-porous, dimples, and / or textures, to facilitate engagement with spinal rod 152. Passage 48 includes an axis A2 extending transverse to axis X1. In some embodiments, axis A2 can be arranged in alternating orientations relative to axis X1, such as, for example, transverse, perpendicular, and / or other angular orientations, such as, for example, acute or obtuse, coaxial, and / or can be offset or staggered.

[0042] The extension 40 includes a surface 60 defining an opening 62. The opening 62 extends between an end 64 and an end 66 and extends along the axis X3, as shown in FIG. Figure 3 . Axis X3 is arranged in a substantially non-perpendicular orientation relative to axis X1. In some embodiments, axis X3 can be arranged in an alternating orientation relative to axis X1, such as, for example, transverse, perpendicular, and / or other angular orientations, such as, for example, acute or obtuse, coaxial, and / or offset or staggered. Opening 62 is arranged to communicate with passage 48 to facilitate fixation of spinal rod 152 to connector 12.

[0043] Axis X3 is arranged in a non-parallel orientation relative to axis X2, such as Figure 3 As shown. The opening 62 is oriented so that the end 64 is angled toward the opening 34 to facilitate insertion of the connector 12. This configuration facilitates insertion of the connector 12 into the patient through a smaller surgical incision formed during surgery. In some embodiments, the connector 12 can be used with a cortical screw trajectory procedure. In some embodiments, the connector 12 facilitates each connecting rod 150 having a 4.75 mm diameter by utilizing the angled opening 62 for connecting the positioning screws 202 at the side-loaded spinal rod 152. The converging angled positioning screws 200, 202 facilitate a midline cortical bone screw trajectory that maintains the orientation of the instrument throughout the procedure while minimizing tissue exposure.

[0044] Surface 60 is configured to engage with a coupling member, such as a set screw 202, to retain spinal rod 152 within passage 48. In some embodiments, surface 60 can be arranged with set screw 202 in an alternative fixing configuration, such as a friction fit, a press fit, locking protrusions / recesses, a locking keyway, and / or an adhesive. In some embodiments, all or only a portion of surface 60 can have an alternative surface configuration to enhance engagement with a spinal rod and / or set screw, such as a rough, arched, wavy, lattice-like, porous, semi-porous, recessed, and / or textured configuration.

[0045] The set screw 202 is configured to engage the spinal rod 152 to facilitate fixation and / or locking of the spinal rod 152 with the receiver 44. The set screw 202 can be arranged with the receiver 44 between an unlocked orientation, wherein the spinal rod 152 is translatable relative to the connector 12, and a locked orientation, wherein the set screw 202 fixes the spinal rod 152 with the connector 12.

[0046] In some embodiments, spinal implant system 10 may include one or more connectors 12, such as those described herein, and / or fixation elements, which may be adopted with a single vertebral level or multiple vertebral levels. In some embodiments, connector 12 engages with vertebrae in various orientations, such as serial, parallel, offset, staggered and / or alternating vertebral levels. In some embodiments, connector 12 may be configured to multiaxial screws, radially angled screws (sagittal angulation screw), pedicle screws, uniaxial screws, uniplane screws, fixation screws, anchors, tissue penetration screws, conventional screws, expansion screws. In some embodiments, connector 12 is used together with wedges, anchors, buttons, clips, snaps, friction fittings, compression fittings, expansion rivets, staples, nails, adhesives, posts, connectors, fixation plates and / or posts.

[0047] In assembly, operation and use, a spinal implant system 10 similar to the systems and methods described herein is used in conjunction with surgical procedures, such as corrective treatment of applicable conditions or injuries to the affected segment of the spine and adjacent areas within the body. Spinal implant system 10 may be modified, removed or replaced in whole or in part.

[0048] In use, to treat selected portions of vertebrae V, including vertebrae V1, V2, such as Figure 6 As shown, the medical practitioner obtains access to the surgical site including the vertebra V in any appropriate manner, such as by incision and retraction of tissue. In some embodiments, the spinal implant system 10 can be used for any existing surgical method or technology, including open surgery, mini-open surgery, minimally invasive surgery, and percutaneous surgery implantation, whereby the vertebra V can be approached through a miniature incision or a cannula providing a protected access to the area. Once the surgical site is approached, a specific operation can be performed to treat a spinal disorder.

[0049] An incision is made in the patient and a cutting instrument (not shown) forms a surgical path for implanting the components of spinal implant system 10. A preparation instrument (not shown) may be used to prepare the tissue surface of vertebra V, as well as for aspiration and irrigation of the surgical area.

[0050] Bone fastener 160 is engaged with vertebra V along the side L of vertebra V, as shown in FIG. Figure 61. The bone screw 160 is manipulated to drive, torque, insert, or otherwise connect the bone screw 160 to the vertebra V. The spinal rod 150 is delivered along the surgical path to the surgical site adjacent to the vertebra V. The spinal rod 150 is arranged with the bone screw 160 along the vertebra V. The connector 12 is arranged adjacent to the spinal rod 150. Each connector 12 is manipulated to arrange the spinal rod 150 having the passage 30 from the top loading direction.

[0051] The spinal rod 150 is secured to the receiver 24 by engaging the set screw 200 with the surface 32 of the opening 34. The set screw 34 is engaged with a surgical instrument, such as a driver (not shown), which advances the set screw 200 along X2 to engage the surface 32 in a locked orientation, as described herein. The driver engages the set screw 200 to secure the spinal rod 150 with the receiver 24 and attach the spinal rod 150 to the vertebra V.

[0052] The spinal rod 152 is delivered to the surgical site adjacent to the vertebra V along the surgical path. The spinal rod 152 is arranged with the passage 48 from the side loading orientation. The positioning screw 202 is arranged with the opening 62 and engages with the surface 60 along the axis X3. The positioning screw 202 is engaged with a surgical instrument such as a driver (not shown), which advances the positioning screw 202 into the opening 62 in a non-locking orientation, as described herein. The spinal rod 152 is translatable relative to the connector 12 to position the spinal rod 152 relative to the spinal rod 150 and the connector 12. The driver engages the positioning screw 202 to fix the spinal rod 152 with the connector 12 and is used to connect the spinal rod 152 with the vertebra V. In some embodiments, the spinal rod 152 is configured to share the load applied to the spinal rod 150. In some embodiments, the spinal rod 152 is configured to extend the spinal rod 150 to the adjacent vertebral level. The spinal rod 152 is configured to increase support and strength to the spinal implant system 10 along the vertebra V.

[0053] In some embodiments, the spinal implant system 10 includes a second set of connectors 12, bone screws 160 and spinal rods 150, 152 (not shown), which are delivered to the surgical site on the contralateral side of the adjacent vertebra V along the surgical path. A set of connectors 12, bone screws 160 and spinal rods 150, 152 are connected to the contralateral side of the vertebra V, similar to the lateral L described herein. As described herein, the spinal structure of the spinal implant system 10 as described herein is fixed with the vertebra V in a side-by-side orientation and / or bilateral arrangement to stabilize the vertebra V and affect growth for corrective treatment to treat spinal pathology. In some embodiments, one or all of the components of the spinal implant system 10 can be delivered or implanted in a selected order of assemblies or as a preassembled device or can be assembled in situ, or the order of assemblies of specific components of the spinal implant system 10 can vary according to practitioner preferences, patient anatomical structures, or surgical procedure parameters.

[0054] After the procedure is completed, the surgical instruments, components and non-implanted components of the spinal implant system 10 can be removed from the surgical site, and the incision can be closed. One or more components of the spinal implant system 10 can be made of a radiolucent material such as a polymer. Radioactive markers can be included for identification under X-rays, fluoroscopy, CT or other imaging techniques. In some embodiments, with the aid of the spinal implant system 10, surgical navigation, microsurgery and image-guided techniques can be used to enter, observe and repair spinal degeneration or damage.

[0055] In some embodiments, spinal implant system 10 comprises reagent, and described reagent can be arranged, packaged, coated or layered in, on or around the parts and / or surface of spinal implant system 10.In some embodiments, reagent can comprise bone growth promoting material, such as bone graft, to strengthen the fixation of bone fastener relative to vertebra.In some embodiments, described medicament can comprise one or more therapeutic agents and / or pharmacological agents, for release (including sustained release) to treat, for example, pain, inflammation and degeneration.

[0056] In one embodiment, if Figure 7-9 As shown, similar to the systems and methods described herein, spinal implant system 10 includes a connector 212 similar to connector 12 described herein.

[0057] The connector 212 includes a body 214 defining a transverse axis X4, such as Figure 7 2. Body 214 includes wall 218. Wall 218 includes surface 222 that defines a portion of a cavity, such as a receiver 224 similar to receiver 24 described herein. Receiver 224 includes a pair of spaced arms 226, 228 that define an implant cavity, such as a passage 230 therebetween. As described herein, passage 230 is configured for side loading of spinal rod 150. Arms 226, 228 each extend along axis X5 in a non-perpendicular orientation relative to axis X4, such as Figure 7 shown.

[0058] Receiver 224 includes a threaded surface 232 defining an opening 234. Opening 234 extends along axis X5 so that opening 234 extends X5 in a non-perpendicular direction relative to axis X4. In some embodiments, axis X5 can be arranged in an alternating orientation relative to axis X4, such as, for example, transverse, vertical, and / or other angular orientations, such as, for example, acute or obtuse, coaxial, and / or can be offset or staggered. Opening 234 is arranged to communicate with passage 230 to facilitate fixation of spinal rod 150 with connector 212. Surface 232 is configured to engage with set screw 200, as described herein, to retain spinal rod 150 within passage 230.

[0059] The body 214 includes an extension 240. The extension 240 includes an end 242 that forms a receiver 244. The end 244 includes a surface 246 that defines a passage 248. The receiver 244 includes a hook-shaped wall 250 that defines the passage 248 and is configured to capture the spinal rod 152. The receiver 244 is configured to facilitate side loading of the spinal rod 152.

[0060] As described herein, the passage 248 is configured for side loading of the spinal rod 152. In some embodiments, the passage 248 is separated from the passage 230 and arranged separately. In some embodiments, the passage 248 is arranged in a side-by-side orientation relative to the passage 230. In some embodiments, the passage 248 is arranged in a parallel orientation relative to the passage 230. In some embodiments, the passage 248 is arranged transverse to the passage 230. In some embodiments, the passage 248 can be arranged in various orientations, such as, for example, vertically, transversely, and / or angularly oriented relative to the passage 230, such as at an acute angle or an obtuse angle. In some embodiments, the passage 248 is arranged to be offset or staggered from the passage 230. In some embodiments, the passage 248 can have various cross-sectional configurations, such as, for example, oval, elliptical, triangular, rectangular, square, polygonal, irregular, uniform, non-uniform, deformable, and / or conical. In some embodiments, the surface 248 may include gripping elements or surfaces such as, for example, roughened, arcuate, wavy, meshed, porous, semi-porous, dimples, and / or textures to facilitate engagement with the spinal rod 152.

[0061] The extension 240 includes a surface 260 defining an opening 262. The opening 262 extends between an end 264 and an end 266 and extends along the axis X6, as shown in FIG. Figure 7 . Axis X6 is arranged in a substantially non-perpendicular orientation relative to axis X4. In some embodiments, axis X6 can be arranged in an alternating orientation relative to axis X4, such as, for example, transverse, vertical and / or other angular orientations, such as, for example, acute or obtuse, coaxial and / or can be offset or staggered. Opening 262 is arranged to communicate with passage 248 to facilitate fixation of spinal rod 152 to connector 212. Axis X6 is arranged in a parallel orientation relative to axis X4, so that opening 234 is arranged parallel to opening 262. Opening 262 is oriented so that end 264 is angled toward opening 234 to facilitate insertion of connector 212 through a smaller incision in the patient's body, as described herein.

[0062] The surface 260 is configured to engage with the set screw 202, as described herein, to retain the spinal rod 152 within the passage 248. The set screw 202 is configured to engage with the spinal rod 152 to facilitate fixation and / or locking of the spinal rod 152 with the receiver 244. The set screw 202 and the receiver 244 are arranged between an unlocked orientation, wherein the spinal rod 152 is translatable relative to the connector 212, and a locked orientation, wherein the set screw 202 secures the spinal rod 152 with the connector 212.

[0063] In one embodiment, if Figure 10-14 As shown, similar to the systems and methods described herein, spinal implant system 10 includes a connector 312 similar to connector 12 described herein.

[0064] The connector 312 includes a body 314 defining a transverse axis X7, such as Fig.10 314. The body 314 includes a wall 318. The wall 318 includes a surface 322 that defines a portion of a cavity, such as a closed receiver 324. In some embodiments, the receiver 324 includes a passage 330 for disposing an end of the spinal rod 150. In some embodiments, the spinal rod 150 is integrally formed with the receiver 324. In some embodiments, the spinal rod 150 is integrally connected to the receiver 324. In some embodiments, the spinal rod 324 is connected to the receiver 324 by a fastening element and / or an instrument.

[0065] The body 314 includes an extension 340. The extension 340 includes an end 342 that forms a receiver 344. The receiver 344 includes a surface 346 that defines a passage 348. The receiver 344 includes a hook-shaped wall 350 that defines the passage 348 and is configured to capture the spinal rod 152. The receiver 344 is configured to facilitate side loading of the spinal rod 152.

[0066] As described herein, the passage 348 is configured for side loading of the spinal rod 152. In some embodiments, the passage 348 positions the spinal rod 152 apart and away from the spinal rod 150. In some embodiments, the passage positions the spinal rod 152 in a side-by-side orientation relative to the spinal rod 150. In some embodiments, the passage 348 positions the spinal rod 152 in a parallel orientation relative to the spinal rod 150. In some embodiments, the passage 348 positions the spinal rod 152 transverse to the spinal rod 150. In some embodiments, the passage 348 can position the spinal rod 152 in various orientations, such as, for example, perpendicular, transverse, and / or angular orientations, such as, for example, at an acute or obtuse angle, relative to the spinal rod 150. In some embodiments, the passage 348 can position the spinal rod 152 offset or staggered from the spinal rod 150. In some embodiments, the passage 348 can have various cross-sectional configurations, such as, for example, oval, elliptical, triangular, rectangular, square, polygonal, irregular, uniform, non-uniform, deformable, and / or tapered. In some embodiments, the surface 348 may include gripping elements or surfaces such as, for example, roughened, arcuate, wavy, meshed, porous, semi-porous, dimples, and / or textures to facilitate engagement with the spinal rod 152.

[0067] Extension 340 includes a threaded surface 360 ​​defining an opening 362, such as Fig.12 The opening 362 extends between the end 364 and the end 366 and extends along the axis X8, as shown in FIG. Fig.12 . Axis X8 is arranged in a substantially non-perpendicular orientation relative to axis X7. In some embodiments, axis X8 can be arranged in an alternating orientation relative to axis X7, such as, for example, vertical, transverse, and / or other angular orientations, such as, for example, acute or obtuse, coaxial, and / or can be offset or staggered. Opening 362 is arranged to communicate with passage 348 to facilitate fixation of spinal rod 152 with connector 312. Opening 362 is oriented so that end 364 is angled toward receiver 324 to facilitate insertion of connector 312 through a smaller incision in the patient's body, as described herein.

[0068] Surface 360 ​​is configured to engage with set screw 202, as described herein, to retain spinal rod 152 within passage 348. Set screw 202 is configured to engage spinal rod 152 to facilitate fixation and / or locking of spinal rod 152 with receiver 344. Set screw 202 can be arranged with receiver 344 between an unlocked orientation, wherein spinal rod 152 is translatable relative to connector 212, and a locked orientation, wherein set screw 202 secures spinal rod 152 with connector 312.

[0069] It should be understood that various modifications may be made to the embodiments in the present disclosure. Therefore, the above description should not be interpreted as limiting, but merely as an example of various embodiments. Those skilled in the art may envision other modifications within the scope and spirit of the appended claims.

Claims

1. A spinal structure, comprising a connector, wherein the connector comprises: a body defining a transverse axis, the body including a wall disposed between a first passageway configured for top loading of a first spinal rod and a second passageway configured for side loading of a second spinal rod, The body further defines a first opening in communication with the first passage and a second opening in communication with the second passage, the first opening defining a first axis and the second opening defining a second axis, wherein the first axis is arranged in a perpendicular orientation relative to the transverse axis and the second axis is arranged in a non-perpendicular orientation relative to the transverse axis, Wherein the second opening is angled toward the first opening to facilitate insertion of the connector through a small incision.

2. The spinal construct of claim 1, wherein the body includes a threaded surface defining the first opening.

3. The spinal construct of claim 2, wherein the body includes a threaded surface defining the second opening.

4. The spinal construct of claim 1 wherein the body includes a receiver having spaced-apart arms defining the first passageway.

5. The spinal construct of claim 1 wherein the body includes an arcuate receiver having a hook-like configuration defining the second implant cavity.

6. The spinal construct of claim 1, further comprising a coupling member disposed with the first opening and engageable with a spinal rod disposed with the first implant cavity.

7. The spinal construct of claim 6, further comprising a coupling member disposed with the second opening and engaged with a spinal rod disposed with the second implant cavity.

8. The spinal construct of claim 1 wherein the pathways are arranged in a side-by-side orientation.

9. The spinal construct of claim 1, wherein the first passageway is adjacent to and spaced apart from the second passageway.

10. The spinal construct of claim 1 wherein the passageways are arranged in a substantially parallel orientation.

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