Screw tower and rod resetting tool

Abstract

The present invention relates to a screw tower and rod reduction tool. The system includes a screw tower, an instrument, and a housing. The instrument includes a drive shaft longitudinally extendable through the screw tower, and a threaded sleeve mounted on a proximal portion of the drive shaft. The housing includes one or more retaining members couplable to the screw tower, and a threaded button threadably couplable to the threaded sleeve. The threaded sleeve is rotatable about a longitudinal axis to longitudinally push the drive shaft relative to the screw tower.

Description

TECHNICAL FIELD

[0001] Embodiments of the present application generally relate to spinal fixation devices, and more particularly to a screw tower and rod reduction tool. BACKGROUND

[0002] Spinal fixation devices can be anchored to a particular portion of a vertebra. Such spinal fixation devices can include, for example, a shank portion that can be coupled to the vertebra, and a head portion having a receiving element. A fixation rod can be positioned through the receiving element and locked in place by tightening the head portion. While known spinal fixation systems have proven effective, some rod reducers can be difficult, tedious, and / or time consuming to use. SUMMARY

[0003] According to some examples of the inventive concepts described herein, a system can be provided to provide a rod reduction tool. The system includes a screw tower, an instrument, and a housing. The instrument includes a drive shaft that is longitudinally extendable through the screw tower, and a threaded sleeve mounted on a proximal portion of the drive shaft. The housing includes one or more retaining members that are couplable to the screw tower, and a threaded button that is threadably couplable to the threaded sleeve. The threaded sleeve is rotatable about a longitudinal axis to longitudinally push the drive shaft relative to the screw tower.

[0004] According to other examples of the inventive concepts described herein, a method can be provided to provide a rod reduction tool. The method includes longitudinally extending a drive shaft through a screw tower, mounting a threaded sleeve on a proximal portion of the drive shaft, coupling a housing to the screw tower using one or more retaining members, and threadably coupling the housing to the threaded sleeve using a threaded button such that the threaded sleeve is rotatable about a longitudinal axis to longitudinally push the drive shaft relative to the screw tower.

[0005] This Summary is provided to introduce a selection of concepts in a simplified form that are further described below in the. Other methods and related systems, and corresponding methods and computer program products according to examples of the inventive subject matter will be apparent to persons skilled in the art upon consideration of the following detailed description and accompanying drawings. This Summary is not intended to identify key features or essential features of the claimed subject matter, nor is it intended to be used as an aid in determining the scope of the claimed subject matter. BRIEF DESCRIPTION OF DRAWINGS

[0006] The accompanying drawings, included to provide a further understanding of the present disclosure and constitute a part of this application, illustrate certain non-limiting examples of the inventive concepts. In the drawings:

[0007] Figure 1 is a side view of an example screw tower;

[0008] Figure 2 isFigure 1 a front view of the screw tower shown;

[0009] Figure 3 Figure 1 a cross-sectional view of the screw tower shown;

[0010] Figure 4 Figure 1 an exploded perspective view of the screw tower shown;

[0011] Figure 5 a cross-sectional view of another example screw tower;

[0012] Figure 6 Figure 5 an exploded perspective view of the instrument shown;

[0013] Figure 7 a side view of an example instrument usable with a screw tower such as the screw tower shown in Figure 1 or Figure 5 ;

[0014] Figure 8 Figure 7 an exploded perspective view of the instrument shown;

[0015] Figure 9 a cross-sectional view of another example instrument usable with a screw tower such as the screw tower shown in Figure 1 or Figure 5 ;

[0016] Figure 10 Figure 9 a distal end view of the instrument shown;

[0017] Figure 11 a proximal end view of an example screw tower such as the screw tower shown in Figure 1 or Figure 5 ;

[0018] Figure 12 a partially transparent side view of an example housing usable with a screw tower such as the screw tower shown in Figure 1 or Figure 5 ; and / or an instrument such as the instrument shown in Figure 7 or Figure 9 ;

[0019] Figure 13 Figure 12 a partially transparent front view of the housing shown;

[0020] Figure 14 Figure 12 a partially transparent exploded perspective view of the housing shown;

[0021] ​​​​​​​Figure 15 It can be used to track one or more objects (such as...) Figure 1 or Figure 5 The screw tower shown, Figure 7 or Figure 9 The instruments and / or shown Figure 12 A block diagram of an example tracking system (shown in the diagram);

[0022] Figure 16 It is a perspective view of an exemplary object that can be tracked, including exemplary tracking markers;

[0023] Figure 17 yes Figure 16 A perspective view of objects arranged in a partially overlapping manner;

[0024] Figure 18 yes Figure 16 The perspective view shown is of objects arranged in an exemplary manner.

[0025] Figure 19 It is a perspective view of another exemplary object that can be tracked, including exemplary tracking markers;

[0026] Figure 20 It can be used to track one or more objects (such as...) Figure 1 or Figure 5 The screw tower shown, Figure 7 or Figure 9 The instruments and / or shown Figure 12 A block diagram of an example computing system (shown in the diagram);

[0027] Figure 21 This is a schematic diagram of an exemplary tracking array and a rod equipped with a navigation array in a first stage, in which the tracking array is coupled to a first screw tower and the rod equipped with the navigation array extends through the first screw tower;

[0028] Figure 22 yes Figure 21 The diagram shows a tracking array and a rod equipped with a navigation array in the second stage, in which the tracking array is connected to a second screw tower and the rod equipped with the navigation array extends through the first and second screw towers.

[0029] Figure 23 It is used to locate one or more objects (such as...) Figure 21 and Figure 22 A schematic diagram of an exemplary visual aid (shown as a rod equipped with a navigation array);

[0030] Figure 24 This is a flowchart illustrating an exemplary method of providing a lever reset tool, as an example of the subject matter of the present invention;

[0031] Figure 25 is a front view of an assembly including a pedicle screw, a screw tower (such as the screw tower shown in Figure 1 or Figure 5 ), an instrument (such as the instrument shown in Figure 7 or Figure 9 ), and a housing (such as the housing shown in Figure 12 ).

[0032] Figure 26 is a side view of the assembly shown in Figure 25 ; and

[0033] Figure 27 is a perspective view of the assembly shown in Figure 25 .

[0034] The drawings are not necessarily to scale, depict examples and are not intended to limit the scope of the disclosure. The detailed description is presented largely for purposes of clarity and exemplification, and is not intended to limit the scope of the disclosure. With reference to the appended drawings, the following detailed description provides examples of apparatuses, systems, and methods in accordance with the present disclosure. Like numbers refer to like elements throughout. DETAILED DESCRIPTION

[0035] The present disclosure relates to medical devices, and more particularly to screw towers and rod reduction tools. Examples described herein include screw towers, instruments, and housings. The instrument includes a drive shaft that is longitudinally extendable through the screw tower, and a threaded sleeve mounted on a proximal portion of the drive shaft. The housing includes one or more retaining members that are couplable to the screw tower, and a threaded button that is threadably couplable to the threaded sleeve. The threaded sleeve is rotatable about a longitudinal axis to longitudinally push the drive shaft relative to the screw tower. Examples described herein enable efficient, user-friendly, and / or efficient ways to attach screw towers, reduce fixation rods, and / or insert locking caps. While examples described herein are described with respect to pedicle screws, those of ordinary skill in the art will understand and appreciate that the example systems and methods can be used with other types of fastening mechanisms.

[0036] Turning now to the drawings, Figures 1 to 4 an example screw tower 100 that can be used to hold or engage a screw (e.g., a pedicle screw) for implantation of the screw via a minimally invasive incision is shown. The screw tower 100 can include, for example, an elongated tube that defines a distal opening 102 for receiving a screw at a distal end 104, a proximal opening 106 for receiving one or more instruments, rods, implants, etc. at a proximal end 108, and a channel 110 extending longitudinally (e.g., along the Y-axis) therebetween.

[0037] In some examples, the screw tower 100 includes an outer sleeve 120 whose size, shape, and / or configuration are designed to engage as part of the screw. For example, the outer sleeve 120 may include a first wall 122 and a second wall 124 opposite to the first wall 122, such that the head features of the screw (e.g., the lip of a tulip-shaped piece) can be laterally positioned therebetween. In some examples, the first wall 122 and / or the second wall 124 may be cantilevered, allowing the outer sleeve 120 to be engaged with the screw using a cantilever snap-fit ​​engagement. For example, when the head feature of the screw is pushed toward the distal end 104 of the sleeve 120 in a proximal direction (e.g., in the negative Y direction), the first wall 122 and / or the second wall 124 may deflect or unfold to allow the head feature to move therebetween in a proximal direction, and return or snap back to a neutral configuration when the head feature leaves a portion 126 (e.g., a ridge or lip) of the first wall 122 and / or the second wall 124, such that a portion 126 of the first wall 122 and / or the second wall 124 is positioned in an undercut and / or opening defined by the head feature of the screw. Alternatively, the sleeve 120 may be engaged or coupled to the screw using any arrangement or mechanism that provides a quick, robust, and reliable connection. For example, in some examples, the outer sleeve 120 may be selectively rotated to engage the screw tower 100 to the screw by positioning portions 126 of the first wall 122 and / or the second wall 124 in an undercut or opening defined by the head features of the screw, and / or to disengage the screw tower 100 from the screw by spacing portions 126 of the first wall 122 and / or the second wall 124 from the undercut or opening defined by the head features of the screw.

[0038] like Figure 3 and Figure 4 As shown, the screw tower 100 may include an inner sleeve 130 coaxial with the outer sleeve 120. In some examples, the inner sleeve 130 may be sized, shaped, and / or configured to engage a portion of a screw coupled to the outer sleeve 120 at its distal end 104 to “lock” or rigidly secure the screw in place relative to the screw tower 100. For example, when the inner sleeve 130 moves or pushes in a distal direction (e.g., along the positive Y direction) and the outer sleeve 120 is coupled to the screw, a head feature may be longitudinally clamped between a mating portion 132 (e.g., a tab or protrusion) of the inner sleeve 130 and a portion 126 of the first wall 122 and / or the second wall 124. In some examples, the mating portion 132 of the inner sleeve 130 may include one or more mating features sized, shaped, and / or configured to be received in one or more recesses and / or openings at the screw head. Additionally or alternatively, the mating portion 132 of the inner sleeve 130 may include one or more mating features whose size, shape, and / or configuration are designed to receive one or more tabs and / or protrusions at the head of the screw.

[0039] In some examples, the inner nut 134 can be used to move or push the inner sleeve 130 longitudinally relative to the outer sleeve 120. For example... Figure 3 and Figure 4 As shown, nut 134 can be threaded to outer sleeve 120 such that nut 134 can rotate about a longitudinal axis in a first direction (e.g., clockwise) to move in a distal direction and / or in a second direction opposite to the first direction (e.g., counterclockwise) to move in a proximal direction (e.g., in the negative Y direction). In some examples, retaining clips or rings 136 may be used to engage inner sleeve 130 to nut 134 such that longitudinal movement of inner sleeve 130 and nut 134 relative to each other is prevented or restricted, while free rotation relative to each other is permitted. In this way, nut 134 can be selectively rotated to longitudinally translate inner sleeve 130 relative to outer sleeve 120. For example, the relative orientation of outer sleeve 120 and inner sleeve 130 can be maintained to ensure that screw tower 100 includes one or more longitudinal channels 138 defined therein. For example, as Figure 2 , Figure 3 and Figure 4 As shown, a channel 138 may be circumferentially defined between the first wall 122 and the second wall 124 of the outer sleeve 120 (e.g., along the circumference of the outer sleeve 120). The channel 138 defined in the outer sleeve 120 may be aligned with a channel 138 defined in the inner sleeve 130 to allow one or more rods to extend laterally through the screw tower 100. In some examples, the channel 138 may be open at the distal end 104 of the outer sleeve 120 and / or the inner sleeve 130, such that one or more laterally extending rods may be received at the distal end 104 of the screw tower 100 and translated proximally (e.g., along the negative Y direction) through the channel 138.

[0040] The screw tower 100 can include one or more control features 140 for controlling the relative movement between the outer sleeve 120 and the inner sleeve 130. In some examples, the control features 140 can limit the amount or degree of allowable movement between the outer sleeve 120 and the inner sleeve 130. For example, the control features 140 can include one or more openings 142 defined in the outer sleeve 120, one or more longitudinal slots 144 defined in the inner sleeve 130, and one or more pins 146 that can extend through the openings 142 and / or the longitudinal slots 144. The size, shape, and / or configuration of the openings 142 can be designed such that the outer sleeve 120 is restricted or prevented from moving rotationally (e.g., about the Y-axis) or longitudinally (e.g., along the Y-axis) relative to the pins 146 when the pins 146 extend therethrough. The size, shape, and / or configuration of the longitudinal slots 144 can be designed such that the inner sleeve 130 is restricted or prevented from moving rotationally (e.g., about the Y-axis) relative to the pins 146 while being free to move longitudinally (e.g., along the Y-axis) relative to the pins 146 the length of the longitudinal slots 144 when the pins 146 extend therethrough. For another example, the control features 140 can include one or more longitudinal slots 148 defined in the outer sleeve 120 and one or more tabs and / or protrusions 150 of the inner sleeve 130 that are configured to extend radially outward through the longitudinal slots 148. The size, shape, and / or configuration of the longitudinal slots 148 can be designed such that the outer sleeve 120 is restricted or prevented from moving rotationally (e.g., about the Y-axis) relative to the protrusions 150 while being free to move longitudinally (e.g., along the Y-axis) relative to the protrusions 150 the length of the longitudinal slots 148 when the protrusions 150 extend therethrough.

[0041] In some examples, the control features 140 can be selectively disengaged to allow relative movement between the outer sleeve 120 and the inner sleeve 130. For example, the pin 146 can be extracted or removed from the opening 142 defined in the outer sleeve 120 and the longitudinal slot 144 defined in the inner sleeve 130 such that the walls defining the opening 142 and / or the longitudinal slot 144 do not engage the pin 146 as the outer sleeve 120 and / or the inner sleeve 130 are moved. For another example, the first wall 122 and / or the second wall 124 of the outer sleeve 120 can be deflected or unfolded such that the protrusion 150 at the distal portion of the inner sleeve 130 is extracted or removed from the longitudinal slot 148 at the distal portion of the outer sleeve 120 and thus does not engage the first wall 122 and / or the second wall 124 as the outer sleeve 120 and / or the inner sleeve 130 are moved. For yet another example, the protrusion 150 at the proximal portion of the inner sleeve 130 is moved or pushed radially inward such that the protrusion 150 is extracted or removed from the longitudinal slot 148 at the proximal portion of the outer sleeve 120 and thus does not engage the first wall 122 and / or the second wall 124 as the outer sleeve 120 and / or the inner sleeve 130 are moved. In some examples, a separate tool can be used to selectively disengage one or more of the control features 140 to allow the screw tower 100 to be at least partially disassembled (e.g., for sterilization and / or cleaning).

[0042] Figure 5 and Figure 6 Another example screw tower 160 is shown that can be used to hold or engage a screw for implantation of the screw via a minimally invasive incision. As shown from Figure 3 and Figure 4 With Figure 5 and Figure 6 Comparison can be made to Figure 5 and Figure 6 The screw tower 160 shown is substantially similar to the screw tower 100 shown in Figure 3 and Figure 4 The screw tower 160 differs in that it includes an inner nut 164 (e.g., inner nut 134) having a compressible flange 166. The compressible flange 166 is configured to engage the inner surface of the inner sleeve 130 such that longitudinal movement of the inner sleeve 130 and the nut 164 relative to one another is prevented or limited while being free to rotate relative to one another. In this way, Figure 5 and Figure 6 The nut 164 shown can be selectively rotated to longitudinally translate the inner sleeve 130 relative to the outer sleeve 120. As Figure 5 and Figure 6As shown, nut 164 can be threaded to outer sleeve 120 such that nut 164 can rotate about longitudinal axis in a first direction (e.g., clockwise) to move in a distal direction and / or in a second direction opposite to the first direction (e.g., counterclockwise) to move or push inner sleeve 130 in a proximal direction (e.g., in the negative Y direction).

[0043] Figure 7 and Figure 8 A device 200 is shown that can be used to reset a rod and / or insert a locking cap into a screw. The screw may include or be coupled to a tulip-shaped piece on which the rod can be positioned, and the locking cap can be used to secure the rod within the tulip-shaped piece. The device 200 may extend longitudinally between a proximal end 108 and a distal end 104 and / or be used with a screw tower 100 (in... Figures 1 to 4 (As shown in the figure). In some examples, the device 200 includes a drive shaft or inner shaft 210 whose size, shape, and / or configuration are designed to push or drive a rod that extends laterally in a distal direction (e.g., along the positive Y direction) through a longitudinal channel 138 of the screw tower 100. For example, the rod can be pushed or driven by extending the inner shaft 210 through the channel 110 of the screw tower 100 to position the distal end 104 of the inner shaft 210 at or near the rod and to move or push the inner shaft 210 in a distal direction.

[0044] like Figure 7 and Figure 8 As shown, the cap pusher 212 may be mounted on or coupled to the distal portion of the inner shaft 210. The size, shape, and / or configuration of the cap pusher 212 may be designed to engage and apply force to the locking cap, such that the locking cap can be coupled to the tulip-shaped piece (e.g., for securing a rod therein). In some examples, the device 200 may include or be used with an indicator indicating the position of the rod to ensure that the rod is reset before the locking cap is coupled to the tulip-shaped piece.

[0045] In some examples, the inner shaft 210 and the cap pusher 212 can be configured to engage the rod and the locking cap, respectively, simultaneously. For example, the inner shaft 210 can extend through an opening in the locking cap to directly contact the rod, and the distal end 104 of the inner shaft 210 can be longitudinally spaced apart or offset from the distal end 104 of the cap pusher 212, such that the inner shaft 210 and the cap pusher 212 are configured to contact the rod and the locking cap, respectively. In some examples, the instrument 200 can include one or more biasing members 214 (e.g., springs) that absorb or mitigate forces exerted on the locking cap during rod reduction (e.g., by the cap pusher). The biasing members 214 can be housed in, for example, a hidden cap 216 coupled to the inner shaft 210. The hidden cap 216 can include an opening sized, shaped, and / or configured to allow the inner shaft 210 and the cap pusher 212 to longitudinally extend therethrough. In some examples, a retaining ring 218 can be positioned at a distal portion of the inner shaft 210 to facilitate retaining the locking cap to the instrument 200. The retaining ring 218 can be coupled to the distal portion of the inner shaft 210, for example, via a friction fit.

[0046] As shown in Figure 7 and Figure 8 The instrument 200 can include a threaded sleeve 220 mounted on or coupled to a proximal portion of the inner shaft 210. The inner shaft 210 is free to rotate and / or translate independently of the threaded sleeve 220. The threaded sleeve 220 can be sized, shaped, and / or configured to engage a shoulder 222 of the inner shaft 210 for moving or pushing the inner shaft 210 in a distal direction (e.g., along the positive Y direction). In some examples, a washer 224 can be positioned longitudinally between the inner shaft 210 and the threaded sleeve 220 to facilitate reducing friction and / or distributing forces exerted therebetween.

[0047] A drive nut 230 can be coupled to a distal end 104 of the threaded sleeve 220 for rotating the threaded sleeve 220. The drive nut 230 can push the threaded sleeve 220 to rotate about the longitudinal axis. A coupling mechanism 232 can be used to couple the drive nut 230 to the threaded sleeve. The coupling mechanism 232 can be, but is not limited to, an assembly screw.

[0048] Figure 9 and Figure 10 Another example instrument 240 that can be used to reduce a rod and / or insert a locking cap onto a screw is shown. As can be appreciated from Figure 7 and Figure 8 In comparison to Figure 9 and Figure 10 As can be appreciated, Figure 9 and Figure 10 The instrument 240 shown in Figure 7 and Figure 8 is substantially similar to the instrument 200 shown in Figure 10As shown, inner shaft 250 of instrument 240 includes one or more keyed features 252 at a radially outer surface thereof. Keyed features 252 can be configured to engage a radially inner surface of a screw tower (e.g., screw tower 100 or 160). For example, as shown, screw tower 100 can include one or more keyed features 254 that are complementary to keyed features 252 of instrument 240. In this way, when inner shaft 250 extends through passage 110 of screw tower 100, keyed features 252 and 254 can engage one another. Keyed features 252 and 254 provide anti-rotation properties by cooperating with screw tower 100. This, in turn, limits or prevents cross threading of drive nut 230 (e.g., under heavy reduction loads). Figure 11

[0049] Figures 12 to 14 A selective threaded engagement housing 300 that can be used to selectively move and / or position screw tower 100 and / or instrument 200 is shown. In some examples, housing 300 includes an opening that is sized, shaped, and / or configured to receive proximal end 108 of screw tower 100. Housing 300 can include one or more retention members or tower clamps 310 that are configured to selectively engage or clamp to a proximal portion of screw tower 100. In some examples, each tower clamp 310 is pivotable about a respective lever 312 to move between an engaged position in which a portion of tower clamp 310 (e.g., a ridge or lip) engages an outer surface of screw tower 100 so as to facilitate preventing or limiting longitudinal movement of screw tower 100 and housing 300 relative to one another, and a disengaged position in which the portion of tower clamp 310 is spaced apart from screw tower 100 such that screw tower 100 and housing 300 are free to move longitudinally relative to one another.

[0050] Housing 300 can include a threaded knob 320 that is configured to engage or mate with threaded sleeve 220 of instrument 200. Threaded knob 320 can include, for example, an opening 322 that is sized, shaped, and / or configured to receive threaded sleeve 220 therethrough. In some examples, opening 322 can be at least partially defined by a threaded wall 324. In this way, a drive force for rod reduction can be achieved by selectively rotating threaded sleeve 220 while housing 300 is rigidly fixed to screw tower 100 (e.g., via tower clamps 310) and threaded coupled to instrument 200 (e.g., via threaded sleeve 220).

[0051] ​In some examples, the threaded button 320 can be moved laterally across the housing 300 to allow for variable reset. For example, moving the threaded button 320 in a first lateral direction (e.g., radially outward) causes the threaded wall 324 to engage the outer surface of the threaded sleeve 220, allowing the threaded sleeve 220 to move distally by rotation about the longitudinal axis in a first direction (e.g., clockwise) and / or proximally by rotation about the longitudinal axis in a second direction opposite to the first direction (e.g., counterclockwise). On the other hand, moving the threaded button 320 in a second lateral direction (e.g., radially inward) causes the threaded wall 324 to be spaced apart from the threaded sleeve 220, allowing the instrument 200 and the housing 300 to move freely relative to each other (e.g., for quick adjustment).

[0052] like Figure 14 As shown, housing 300 may include one or more biasing members 328 (e.g., springs) that push the tower clamp 310 and / or threaded button 320 into an engaged position, thereby supporting or facilitating mechanical thread reset via rotation of threaded sleeve 220. Additionally or alternatively, button pin 326 may be positioned to prevent or limit movement of threaded button 320 in a second lateral direction (e.g., toward a disengaged position). Furthermore, to facilitate preventing or limiting movement of threaded button 320 in the second lateral direction during heavy reset loads, the proximal portion of threaded button 320 may include a shallow flange configured to engage or lock onto the outer surface of housing 300 when a heavy reset load is applied. In some examples, threaded wall 324 may include a square thread profile that facilitates increased axial force (e.g., for rod reset) and / or reduced friction between threaded wall 324 and the outer surface of threaded sleeve 220 (e.g., when threaded button 320 moves laterally).

[0053] The housing 300 may be clamped onto the turret 100 before the instrument 200 is inserted into the housing 300, or after the instrument 200 has at least partially extended through the housing 300. In some examples, the housing 300 may include or be coupled to a counter-torque instrument, a compressor / traction instrument, and / or other turret-operated instruments.

[0054] Figure 15An example tracking system 400 is shown that can be used to track one or more objects, such as the screw tower 100, the instrument 200, and / or the enclosure 300. The system 400 includes one or more position sensors 410 that can be positioned and / or oriented to have a direct line of sight to a surgical area. In some examples, the position sensors 410 can be positioned on a stand that is configured to move, orient, and support the position sensors 410 in a desired position and / or orientation. The position sensors 410 can include any suitable camera (e.g., infrared camera, dual focus camera, stereo photogrammetry camera, etc.) that is configured to scan a given measurement volume and detect light and / or other electromagnetic waves from a plurality of tracking markers 420 in order to determine a position of the tracking markers 420 in the given measurement volume.

[0055] In some examples, the tracking markers 420 can be mounted or otherwise secured to an object that is to be tracked during a surgical procedure (e.g., the screw tower 100, the instrument 200, the enclosure 300). Such objects can include, but are not limited to, robots (e.g., at an end effector), surgical tools, and / or patient tracking devices that are directly secured to a patient. In some examples, electromagnetic waves from the tracking markers 420 can be detected over time in order to monitor a position and / or movement of one or more marker objects (e.g., an object having a tracking marker 420 coupled thereto).

[0056] The tracking markers 420 can function as unique identifiers that can be tracked in three dimensions (e.g., using stereo photogrammetry). The tracking markers 420 can include active tracking markers (e.g., infrared light emitting diodes (LEDs)) that are activated by an electrical signal to emit light and / or other electromagnetic waves, and / or passive tracking markers (e.g., retro-reflective markers) that reflect light and / or other electromagnetic waves emitted by an illuminator on the position sensor 410 or other suitable device. In some examples, the tracking markers 420 can include reflective markers, radio-opaque markers, and / or optical markers. The tracking markers 420 can have appropriate shapes, including spherical, spheroidal, cylindrical, cubic, cuboid, etc.

[0057] The computer 430 can receive and process information from the position sensors 410 in order to present information to a user using a display 432 and / or a speaker 434. In some examples, the computer 430 can include a processor circuit 440 (also referred to as a processor) coupled with an input interface circuit 442 (also referred to as an input interface), an output interface circuit 444 (also referred to as an output interface), and / or a memory circuit 446 (also referred to as a memory). The memory 446 can include computer readable program code that, when executed by the processor 440, causes the processor 440 to perform operations in accordance with the embodiments disclosed herein. According to other examples, the processor 440 can include a memory such that a separate memory circuit (e.g., the memory 446) is not needed.

[0058] The processor 440 can receive input through the input interface 442 and / or provide output through the output interface 444. For example, the processor 440 can receive position sensor data associated with one or more tracking markers 420 from the position sensor 410 through the input interface 442 and / or present position information to a user using the display 432 and / or the speaker 434 through the input interface 442. In some examples, the position and / or orientation of a marker object can be presented to a user relative to a three-dimensional image of patient anatomy.

[0059] Figures 16 to 18 An example first object 500 marked with an example first stripe cluster 502 and an example second object 510 marked with an example second stripe cluster 512 are shown. In some examples, the computer 430 can be configured to distinguish between tracking markers 420 (e.g., the first stripe cluster 502, the second stripe cluster 512) by differentiating between inter-stripe spacing (e.g., longitudinal spacing between stripes of a cluster). For example, the first stripe cluster 502 has a first inter-stripe spacing and the second stripe cluster 512 has a second inter-stripe spacing that is greater than the first inter-stripe spacing.

[0060] Each object can be marked at multiple locations. For example, the first stripe cluster 502 is present in two different locations of the first object 500 and the second stripe cluster 512 is present in two different locations of the second object 510. In some examples, the computer 430 can be configured to distinguish between objects (e.g., the first object 500, the second object 510) by differentiating between marker types and inter-cluster spacing (e.g., longitudinal spacing between clusters). For example, the first object 500 has a first inter-cluster spacing and the second object 510 has a second inter-cluster spacing that is greater than the first inter-cluster spacing.

[0061] The first stripe cluster 502 and the second stripe cluster 512 can each be configured to uniquely identify the respective object (e.g., the first object 500 and the second object 510, respectively). For example, the computer 430 can be configured to identify the first object 500 based on the first stripe cluster 502 and / or identify the second object 510 based on the second stripe cluster 512.

[0062] When searching the tracked frames for the tracking markers 420, the computer 430 can compare the tracked frames to a geometric model of a stripe cluster (e.g., the first stripe cluster 502, the second stripe cluster 512) treating the stripe cluster as a unique marker. Because the computer 430 is searching for a match to a plurality of parameters including a cylindrical shape with a predetermined diameter and a stripe with a predetermined curvature in a sequence of a predetermined number (e.g., five) spanning a predetermined longitudinal length, even if a portion of an object is occluded, the computer 430 can still be able to identify the object.Figure 17 As shown, the computer 430 can also find a match and locate the center thereof, even though the tracking marker 420 is partially blocked. That is, the different inter-stripe spacing and / or inter-cluster spacing allows the computer 430 to easily distinguish the tracking marker 420 and / or object while also finding the accurate location. For example, in the case of the first object 500, the computer 430 can find a match for the tracking marker 420 and locate the center thereof, even though the tracking marker 420 is partially blocked by the second object 510. In the case of the second object 510, the computer 430 can find a match for the tracking marker 420 and locate the center thereof, even though the tracking marker 420 is partially blocked by the first object 500. Figure 17 As shown on the second object 510, the comparison to the geometric model can take into account the curvature of the visible stripes and determine that the visible portion of the tracking marker 420 represents the right half of the tracking marker 420. In this way, the example methods described herein can allow different elements to be distinguished from one another, even though they are in close proximity or partially overlapping.

[0063] In some examples, multiple trackable objects (e.g., the first object 500 and the second object 510) can be used to form a dynamic reference library (DRB) that is attached to a patient and / or used as a reference in relation to other tracking objects. To make an object a navigation element, it can be shaped or marked in a unique way. In one embodiment, the object can be painted with contrasting (e.g., black and white) stripes on its axis, or have a slight variation in diameter such that the cross-section is raised or indented and appears as stripes, with a consistent amount of spacing between the stripes. For example, the spacing between the stripes can be 1 millimeter (mm) in one element and 2 mm in another element. Segments or groups of the stripes can have a predetermined number of total stripes such that the computer 430 can locate the precise longitudinal position of a cluster of stripes, providing accuracy along the axis of the element and perpendicular to the axis. If the position sensor 410 is tracking multiple elements simultaneously, the different inter-stripe spacing allows the computer 430 to distinguish the elements. In other words, the frequency of the stripes can identify the tracking marker 420 from other tracking markers 420, and the cluster of stripes can provide the coordinates of the tracking marker 420.

[0064] Figure 19 An object 520 is shown with stripes 522 of different thickness, a single stripe 524 between clusters of stripes 522, and the contrast of the dark object 520 relative to the white or silver stripes 522 and 524 (e.g., retro-reflective tape). In some embodiments, the unique identification of the object 520 can be a function of the stripe frequency and / or the stripe thickness. Additionally or alternatively, the stripe 524 between clusters can help improve tracking accuracy and / or localization robustness. Figure 19The color configuration shown can help increase contrast in the surgical environment while visually separating object 520 from the background. Applying local colors such as red, green, and / or blue to object 520 can also provide additional feedback to the surgeon and / or system. The exemplary method described herein has the advantage of encoding more information and being compatible with existing discrete and continuous linear barcode design principles. Additionally, the exemplary method allows implanted hardware (e.g., screw tower 100, instrument 200, housing 300) to be used as a navigation array, thereby allowing for sequential transfer of registration as additional screws during placement and maintaining better accuracy.

[0065] Figure 20 An example computing system 600 configured to perform one or more computational operations is shown. Although this document refers to computer 430 (in...) Figure 15 The present disclosure illustrates and describes some examples of computing systems 600 used with computer 430, but aspects of the present disclosure can be operated with any computing system (e.g., position sensor 410) that executes instructions to perform operations and functions associated with computing system 600. Computing system 600 is merely one example of a computing environment for performing one or more computational operations and is not intended to impose any limitation on the scope or functionality of the invention.

[0066] In some examples, computing system 600 includes system memory 610 (e.g., computer storage medium) and processor 620 coupled to system memory 610. Processor 620 may include one or more processing units (e.g., in a multi-core configuration). Although processor 620 is shown separate from system memory 610, the examples of this disclosure contemplate that system memory 610 may be on processor 620, such as in some embedded systems.

[0067] System memory 610 stores data and computer-executable instructions associated with one or more users, tracked objects, position sensors 410, and / or tracking tags 420, and processor 620 is programmed or configured to execute computer-executable instructions for implementing aspects of the present invention using, for example, computer 430. System memory 610 includes one or more computer-readable media that allow processor 620 to store and / or retrieve information such as computer-executable instructions and other data.

[0068] By way of example, and not limitation, computer-readable media can include computer storage media and communication media. Computer storage media is tangible and non-transitory; communication media is intangible and modulated data signals. For example, system memory 610 can include computer storage media in the form of volatile and / or non-volatile memory, such as read-only memory (ROM) and random-access memory (RAM) or memory storage consisting of solid state memory (SSS), which can be used to store information when the computing device 600 is operating. Computer storage media excludes signals per se.

[0069] A user or operator can enter commands and other input into computing system 600 through one or more input devices 630 coupled to processor 620. Input devices 630 are configured to receive information. Exemplary input devices 630 include, but are not limited to, a pointing device (e.g., a mouse, trackball, touchpad, joystick), a keyboard, game controller, controller, microphone, camera, gyroscope, accelerometer, position detector, and electronic digitizer (e.g., on a touch screen). Information such as text, images, video, audio, etc. can be presented to a user via one or more output devices 640 coupled to processor 620. Output devices 640 are configured to transmit information. For example, output devices 640 include, but are not limited to, a monitor, projector, printer, speaker, vibrating component. In some examples, output devices 640 are integrated with input devices 630 (e.g., a capacitive touch screen panel, a controller including a vibrating component).

[0070] One or more network components 650 can be used to operate computing system 600 in a networked environment using one or more logical connections. Logical connections include, for example, a local area network, a wide area network, and the Internet. Network components 650 allow processor 620 to, for example, transmit information to and / or receive information from one or more remote devices, such as another computing system or one or more remote computer storage media. Network components 650 can include network adapters, such as wired or wireless network adapters or wireless data transceivers.

[0071] Examples described herein help reduce the amount of soft tissue damage during surgery (e.g., orthopedic spinal and neurosurgical procedures), which can result in less pain, faster recovery time, and / or lower likelihood of infection. For example, Figure 21 A percutaneous screw is shown.

[0072] Figure 21 and Figure 22An example tracking array 700 and a rod 710 equipped with a navigation array are shown extending laterally across an upper portion of one or more screws 712 (e.g., tulip of a pedicle screw) and one or more screw towers (e.g., screw towers 100 or 160) coupled to the upper portion of the screws 712. As shown, Figure 21 the tracking array 700 can be coupled to a first screw tower 714 at a first stage. Once the rod 710 is extended through the first screw tower 714, the tracking array 700 can be uncoupled from the first screw tower 714 and coupled to a second screw tower 716 at a second stage, as shown. Figure 22

[0073] The tracking array 700 and the rod 710 each include a plurality of markers 720 that can be tracked (e.g., using the position sensor 410) during the first and second stages to enable determination of the relative position of the rod 710 and the first screw tower 714 (e.g., using the computer 430). In this way, the rod 710 can be extended through the first screw tower 714 and the second screw tower 716 using feedback from the tracking system 400. For example, as shown, Figure 23 the display 432 can assist in positioning the rod 710 by showing a distance 722 to the first screw tower 714 or the second screw tower 716 and an alignment 724 of the rod 710 relative to an opening (e.g., longitudinal channel 138) defined in the first screw tower 714 or the second screw tower 716. Although Figures 21 to 22 The tracking array 700 and the rod 710 are shown each including a plurality of arms and a spherical marker at an end portion of each arm, the tracking array 700 and / or the rod 710 can include one or more tracking markers 420 for tracking the rod 710, the screws 712, the first screw tower 714, and / or the second screw tower 716.

[0074] Figure 24 An example method 800 of providing rod reduction is shown. As shown, Figure 21 and Figure 22 the rod 710 can extend laterally across an upper portion of the screws 712 and a screw tower (e.g., screw tower 100 or 160) coupled to the upper portion of the screws 712. As shown, Figures 25 to 27 the screw tower 100 can be rigidly and / or robustly coupled to the screws 712 to allow for screw manipulation or compression / distraction. In some examples, a drive shaft (e.g., inner shaft 210) is extended longitudinally through the screw tower 100 at operation 810. For example, a distal end 104 of the drive shaft can be inserted into a proximal opening 106 of the screw tower 100 and moved in a distal direction. At operation 820, a threaded sleeve 220 can be installed on a proximal portion of the drive shaft to form the instrument 200.

[0075] ​At operation 830, the housing 300 can be coupled to the screw tower 100 using one or more retaining members (e.g., tower clip 310). At operation 840, the housing 300 can be threaded to the threaded sleeve 220 using the threaded button 320. The threaded sleeve 220 can be rotated about the longitudinal axis to push the drive shaft longitudinally relative to the screw tower 100. The drive shaft can protrude through the locking cap, allowing the instrument 200 to achieve rod reduction without exerting additional force on the locking cap, thereby mitigating the likelihood of premature damage to the locking cap and / or the tulip. In some examples, the screw tower 100, the instrument 200, and / or the housing 300 can be marked and used as a positioning and / or guiding device for insertion of an interconnection rod.

[0076] The examples mentioned above allow for quick and robust connection to bone screws and tulips, and also allow for connection of a reduction instrument in a small footprint. The internal variable reduction is not only robust, but also does indeed keep the outer diameter of the screw tower slender, thereby minimizing the incision size. The following instrument can also work with other instruments to allow for other technically related steps, including but not limited to: rod measurement, rod passage, rod reduction, locking cap attachment and tightening, compression, and distraction. The following embodiments represent a method that can be used to hold pedicle screws to a tower-based instrument; a tube-based device allows for rod passage, rod reduction, and locking cap delivery and tightening after screw implantation. The reduction embodiments can allow for free movement reduction, followed by mechanical assisted reduction to save time by allowing for certain internal component specific orientations or intermittent functions that are not possible in all minimally invasive screw instrument systems. Additionally, the potential ability to use instruments from other currently available Globus systems can reduce the number of devices needed in the operating room, can simplify the procedure, and can also reduce operating room time due to potentially more simplified techniques.

[0077] This written description uses examples to disclose aspects of the disclosure, and also to enable any person skilled in the art to practice the aspects, including making or using the systems described above, and performing or using the methods described above. The aspects of the disclosure have been described with respect to various examples and their associated operations, and it will be apparent that modifications and variations are possible without departing from the scope of the disclosure as defined in the appended claims. That is, aspects of the disclosure are not limited to the specific examples described herein, and all that is contained in the above description and shown in the accompanying drawings should be interpreted in an illustrative and not a restrictive sense. For example, the examples described herein can be implemented and utilized in conjunction with other examples and applications, or applied to other examples and applications, without departing from the scope of the disclosure. Thus, aspects of the disclosure are not intended to be limited to the above description and / or drawings, but rather are to be accorded the widest scope consistent with the principles and features disclosed herein.

[0078] It should be understood that the disclosure, in its application to the construction of details and / or the arrangement of components set forth in the description or illustrated in the drawings is by way of example and not limiting. As such, any feature described herein and / or illustrated in any of the drawings can be referenced and / or claimed in combination with any other feature described herein and / or illustrated in any of the drawings, according to the principles of the present disclosure. One skilled in the art will recognize that the examples provided herein have many useful alternatives and fall within the scope of the present disclosure.

[0079] The teachings of the present disclosure can be used and practiced in other implementations and in various ways, and in connection with various implementations, and that the disclosure can include components not described herein but that would still be within the scope of the present disclosure. For example, the components of the systems described herein and / or the operations of the methods described herein can be used independently and separately from other components and / or operations described herein. Further, the present disclosure contemplates combinations of the described features and / or operations in all possible variations thereof. Additionally, the present disclosure contemplates that the described features and / or operations of any of the configurations, examples, and / or implementations described herein can be implemented in hardware, software, firmware, or any combination thereof and can be implemented in one or more computer programs or code.

[0080] From the foregoing description, it will be apparent that one or more of the block diagrams described herein can represent conceptual views of illustrative circuitry embodying the principles of the disclosure and that the various examples can be implemented in hardware and / or as computer program instructions stored on non-transitory machine-readable storage media. The computer program instructions can be executed by a processor of a general-purpose computer, a special purpose computer, and / or other programmable data processing apparatus to produce a machine, such that the instructions, which execute via the processor of the computer and / or other programmable data processing apparatus, transform and control transistors, values stored in memory locations, and other hardware components within such

[0081] Unless otherwise defined, all terms (including technical and scientific terms) used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this inventive concept belongs. It will be further understood that terms, such as those defined in commonly used dictionaries, should be interpreted as having a meaning that is consistent with their meaning in the context of the specification and relevant art and should not be interpreted in an overly legal sense unless expressly so defined herein.

[0082] In introducing elements of the present disclosure or the aspects thereof, the articles "a," "an," "the" and "said" are intended to mean that there are one or more of the elements. The terms "comprising," "including," "containing," and "having" and the like are intended to be inclusive and mean that there can be additional elements other than the listed elements. The term "exemplary" is intended to mean that a particular example is used as an example and not necessarily as a preferred or advantageous example. The phrase "one or more of the following: A, B, and C" means "at least one of A and / or at least one of B and / or at least one of C." The term "and / or" includes any and all combinations of one or more of the associated listed items. It will be understood that, although the terms "first," "second," "third," etc. can be used herein to describe various elements / operations, these elements / operations should not be limited by these terms since such elements / operations can be numbered in a different order in another embodiment. These terms are used only to distinguish between one element / operation from another element / operation. Thus, a first element / operation in some embodiments can be termed a second element / operation in other embodiments without departing from the teachings of the inventive concept. Furthermore, as used herein the common shorthand "e.g." originating from the Latin phrase "exempli gratia" can be used to introduce or specify one or more general examples of a previously mentioned item and is not intended to limit such item. The common shorthand "i.e." originating from the Latin phrase "id est" can be used to specify a particular item from a more general recitation.

[0083] Furthermore, it should be understood that the wording and terminology used herein are for descriptive purposes and should not be considered limiting. The use of the terms “comprising,” “including,” or “having,” and variations thereof throughout this document, means to include the items listed below and their equivalents and additional items. Unless otherwise specified or limited, the terms “installation,” “connection,” “support,” and “linkage,” and variations thereof, are used extensively and include both direct and indirect installation, connection, support, and linking. Furthermore, “connection” and “linkage” are not limited to physical or mechanical connections or links. Additionally, when an element is referred to as “connected,” “linked,” or “responding,” and variations thereof to another element, that element may be directly connected, linked, or responding to the other element, or an intermediary element may be present. Conversely, when an element is referred to as “directly connected,” “directly linked,” or “directly responding,” and variations thereof to another element, no intermediary element is present. Furthermore, as used herein, “connection,” “linkage,” “responding,” or variations thereof may include wireless links, connections, or responses.

[0084] The scope of this invention is defined by the claims, but may include other examples that would occur to a person skilled in the art. Such other examples are intended to be within the scope of the claims if they have structural elements that are not different from the literal language of the claims, or if they include equivalent structural elements that are not substantially different from the literal language of the claims.

Claims

1. A system comprising: Screw tower; The device includes a drive shaft capable of extending longitudinally through the screw tower, and a threaded sleeve mounted on a proximal portion of the drive shaft. as well as The housing includes one or more retaining members capable of being coupled to the screw turret, and a threaded button capable of being threadedly coupled to the threaded sleeve, wherein the threaded sleeve is rotatable about a longitudinal axis to longitudinally push the drive shaft relative to the screw turret. The screw tower includes an outer sleeve and an inner sleeve, the outer sleeve including a wall and a longitudinal slot defined in the wall, the inner sleeve including a protrusion configured to extend radially outward through the longitudinal slot, and the wall being configured to deflect such that the protrusion is removed from the longitudinal slot.

2. The system of claim 1, wherein the screw tower includes an outer sleeve defining an opening, an inner sleeve defining a longitudinal slot, and a pin capable of extending through the opening and the longitudinal slot.

3. The system of claim 1, wherein the screw tower includes an inner sleeve and an inner nut, the inner nut being configured to move the inner sleeve along the longitudinal axis.

4. The system of claim 1, wherein the screw tower includes an outer sleeve, an inner sleeve, and an inner nut, the inner nut being threaded to the outer sleeve, the inner nut being selectively rotatable about the longitudinal axis to translate the inner sleeve relative to the outer sleeve along the longitudinal axis.

5. The system of claim 1, wherein the screw tower includes an inner sleeve, the inner sleeve including a mating portion configured to engage the head features of the screw.

6. The system of claim 1, wherein the instrument includes a cap pusher and a biasing member located between the cap pusher and the drive shaft.

7. The system of claim 1, wherein the instrument includes a cap pusher mounted on a distal portion of the drive shaft, and a concealed cap defining an opening through which the cap pusher and the drive shaft extend.

8. The system of claim 1, wherein the threaded button is movable between an engaged position and a disengaged position, wherein in the engaged position the threaded button is engaged with the threaded sleeve, and in the disengaged position the threaded button is spaced apart from the threaded sleeve.

9. A system comprising: Screw tower; The device includes a drive shaft capable of extending longitudinally through the screw tower, and a threaded sleeve mounted on a proximal portion of the drive shaft. as well as The housing includes one or more retaining members capable of being coupled to the screw turret, and a threaded button capable of being threadedly coupled to the threaded sleeve, wherein the threaded sleeve is rotatable about a longitudinal axis to longitudinally push the drive shaft relative to the screw turret. The screw tower includes an outer sleeve and an inner sleeve, the outer sleeve defining a longitudinal slot, and the inner sleeve including a protrusion configured to extend radially outward through the longitudinal slot, the protrusion being configured to move radially inward such that the protrusion is removed from the longitudinal slot.

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