Swinging fixed bridge

Abstract

A rotatable fixed bridge as described herein can include a first end securable to a reference and defining at least a portion of a first joint, a second end securable to an anchor and defining at least a portion of a second joint, and a bridge member extending between and securable in rotation to the first and second ends, the bridge member being rotatable relative to an axis and including a central portion offset from the axis.

Description

TECHNICAL FIELD

[0001] The present technology relates generally to surgical hardware, and more particularly to hardware for preventing patient movement during a surgical procedure. BACKGROUND

[0002] During a surgical procedure, a patient is typically positioned on an operating table or chair. Whether due to normal bodily functions, including autonomic and non-autonomic processes and / or reactions, or external stimuli, such as a surgical intervention, one or more anatomical features of the patient can move relative to the operating table or surgical chair, relative to another external reference, and / or relative to another anatomical feature.

[0003] A surgical procedure can involve the use of any number of surgical tools, including tools configured for cutting, abrading, roughening, cleaning, and otherwise interacting with soft and / or hard tissue, as well as tools configured for implant insertion. Such tools can be held and manipulated by a surgeon, held by a passive mechanical clamp or robotic arm while being manipulated by a surgeon, held and manipulated by a robotic arm controlled by a surgeon, or held and manipulated by a robotic arm under autonomous control, for example. SUMMARY

[0004] A rotatable fixed bridge according to one embodiment of the present disclosure includes a first end that is securably connectable to a reference and defines at least a portion of a first joint, a second end that is securably connectable to an anchor and defines at least a portion of a second joint, and a bridge member that extends between and is rotatably secured to the first and second ends, the bridge member being rotatable relative to an axis and including a central portion that is offset from the axis.

[0005] At least one of the first and second joints can include a ball and a socket. The central portion can be arranged substantially parallel to the axis. The central portion can be curved. The first end can include a bridge adapter. The bridge adapter can include a locking screw. The bridge member maintains a relative position of the first end to the second end that is independent of a rotational position of the bridge member relative to the first and second ends. The bridge member can include a radiolucent material. The radiolucent material can be polyether ether ketone. The bridge member can include an end portion that is substantially perpendicular to the central portion.

[0006] A fixation system according to another embodiment of the disclosure includes a rotatable fixed bridge. The rotatable fixed bridge includes a reference portion interface that is securable to a reference portion, an anchor interface that is securable to an anchor, and a bridge member. The bridge member includes a first end portion that is rotatably secured to the reference portion interface, a second end portion that is rotatably secured to the anchor interface, and a central portion that extends between the first end portion and the second end portion, the central portion being offset from an axis of rotation of the bridge member.

[0007] At least one of the reference portion interface and the anchor interface can include a ball or a socket. The bridge member can be configured to maintain a constant relative position of the reference portion interface and the anchor interface independent of a rotational position of the bridge member about the axis. At least the central portion of the bridge member can be made of a radiolucent material. The reference portion interface can include a ball and an adapter configured to partially define a socket that holds the ball. The reference portion can be one of a surgical robot, a structure for supporting a patient, or a portion of a building. The fixation system can also include an anchor, and the anchor can be securable to a portion of a patient's spine.

[0008] A method of securing a spine to an external reference portion according to yet another embodiment of the disclosure includes securing an anchor interface of a rotatable fixed bridge to an anchor, securing a reference portion interface of the rotatable fixed bridge to the external reference portion, rotating a bridge member of the rotatable fixed bridge relative to the anchor interface and the reference portion interface to a first angular position without changing a position of the anchor interface relative to the reference portion interface, the bridge member including a central portion that is offset from an axis of rotation of the bridge member, and rotating the bridge member to a second angular position different from the first angular position without changing the position of the anchor interface relative to the reference portion interface.

[0009] Securing the reference portion interface to the external reference portion can include securing a bridge adapter to the external reference portion. Securing the anchor interface to the anchor can include securing a ball of the anchor interface into a socket of the anchor.

[0010] The specifics of one or more aspects of the disclosure are set forth in the accompanying drawings and description below. Other features, objects, and advantages of the techniques described in this disclosure will be apparent from the description and drawings, and from the claims.

[0011] The phrases "at least one", "one or more", and "and / or", as used herein, are open-ended expressions that are intended to have the same meaning as the term "comprising" or an equivalent thereof used in the same manner in the Dictionaiy of American English. That is, the phrases "at least one", "one or more", or "and / or", as used herein, are intended to cover any and all combinations, including single use of the elements following such phrases. For example, the phrases "at least one of A, B, and C", "at least one of A, B, or C", "one or more of A, B, and C", "one or more of A, B, or C", and "A, B, and / or C" mean A alone, B alone, C alone, A and B together, A and C together, B and C together, or A, B, and C together. n , Y1-Y m , and Z1-Z o , when each of A, B, and C refers to an element selected from the group consisting of X, Y, and Z, the phrase means a single element selected from X, Y, and Z, a combination of elements selected from the same group (e.g., X1and X2), and a combination of elements selected from two or more groups (e.g., Y1and Z o ).

[0012] The term "a" or "an" entity refers to one or more of that entity. As such, the terms "a" (or "an"), "one or more" and "at least one" can be used interchangeably herein. It is also to be noted that the terms "comprising", "including", and "having" can be used interchangeably.

[0013] The foregoing is a simplified summary of the disclosure to provide an understanding of some aspects of the disclosure. The summary is neither an extensive overview of the disclosure nor a definition of its key or important elements. Its sole purpose is to present some selected concepts of the disclosure in a simplified form as an introduction to the more detailed description of the disclosure that follows. As will be appreciated, other aspects, embodiments, and configurations of the disclosure can utilize one or more of the features set forth above or described below in connection with the presently described aspects, embodiments, and configurations.

[0014] Many additional features and advantages of the present application will be apparent from the embodiments description provided below. BRIEF DESCRIPTION OF DRAWINGS

[0015] The accompanying drawings, which are incorporated in and form a part of the specification, illustrate several examples of the present disclosure. Together with the description, these drawings help to explain the principles of the present disclosure. The drawings illustrate preferred and alternative examples by which the disclosure can be practiced. Additional features and advantages will be apparent from the following detailed description of various aspects, embodiments, and configurations of the disclosure, as illustrated by the drawings referenced below.

[0016] Figure 1A fixed system according to at least one embodiment of the present disclosure is depicted;

[0017] Figure 2 A fixed system according to at least another embodiment of the present disclosure is depicted;

[0018] Figure 3 An exploded perspective view of a rotatable fixed bridge according to at least one embodiment of the present disclosure is provided; and

[0019] Figure 4 is a flowchart of a method according to at least one embodiment of the present disclosure. DETAILED DESCRIPTION

[0020] It should be understood that various aspects disclosed herein can be combined in different combinations than the combinations expressly presented in the description and accompanying drawings. It should also be understood that, depending on the example or embodiment, certain acts or events of any of the processes described herein can be performed in a different sequence, can be added, merged, or left out altogether (for example, all described acts or events should not necessarily be necessarily performed). In addition, while certain aspects of this disclosure are described as being performed by a single module or unit for purposes of clarity, it should be understood that the methods of this disclosure can be performed by a combination of units or modules associated with, for example, computing devices and / or medical devices, including medical imaging devices.

[0021] In one or more examples, one or more steps of the described methods, processes, and techniques can be implemented in hardware, software, firmware, or any combination thereof. If implemented in software, the functions can be stored as one or more instructions or code on a computer-readable medium and executed by a hardware-based processing unit. Computer-readable media can include non-transitory computer-readable media, which corresponds to a tangible medium such as data storage media (e.g., RAM, ROM, EEPROM, flash memory, or any other medium that can be used to store desired program code in the form of instructions or data structures and that can be accessed by a computer).

[0022] The instructions can be executed by one or more processors, such as one or more digital signal processors (DSPs), general purpose microprocessors (e.g., Intel Core i3, i5, i7, or i9 processors; Intel Celeron processors; Intel Xeon processors; Intel Pentium processors; AMD Ryzen processors; AMD Athlon processors; AMD Phenom processors; Apple A10 or 10X Fusion processors; Apple A11, A12, A12X, A12Z, or A13 Bionic processors; or any other general purpose microprocessors), application specific integrated circuits (ASICs), field programmable logic arrays (FPGAs), or other equivalent integrated or discrete logic circuitry. Accordingly, the term “processor” as used herein can refer to any of the foregoing structure or any other physical structure suitable for implementation of the described techniques. Also, the

[0023] Before any embodiments of the present disclosure are explained in detail, it is to be understood that the present disclosure is not limited in its application to the details of construction and the arrangement of components set forth in the following description or illustrated in the accompanying drawings. The present disclosure is capable of other embodiments and of being practiced or being carried out in various ways. Also, it is to be understood that the phraseology and terminology used herein is for the purpose of description and should not be regarded as limiting. The use of “including,” “comprising” or “having” and variations thereof herein is meant to encompass the items listed thereafter and equivalents thereof as well as additional items. Furthermore, the present disclosure can be used with one or more aspects of the present disclosure. Unless otherwise expressly stated, the use of one or more aspects of the present disclosure does not preclude the presence of additional aspects of the present disclosure. Moreover, the use of “for example,” “e.g.,” “for instance,” “like,” or “such as,” or variations thereof herein, is meant to be non-limiting and is used merely for the purpose of illustration. Furthermore, unless otherwise expressly stated, the use of “about” in connection with a stated value is meant to encompass the stated value ± 10 percent.

[0024] Embodiments of the present disclosure can be used for any surgical procedure. During a spinal surgical procedure, for example only, segmental motion of the vertebrae can reduce the accuracy of the guidance when using a guided stereotactic positioning system, such as robotics or navigation. Bone mounted platforms or other anchors connected to the spinal anatomy and to a reference system can be used to limit this relative motion. The bone mounted platforms or other anchors can include a spinous process clamp or pin, a posterior superior iliac spine (PSIS) pin, and a bridge type instrument. The reference system can include one or more navigation reference units and / or a robot system mounted on the operating table.

[0025] During robotic and / or navigated spinal surgery, a desired tool trajectory can collide with the bone mounting platform, thus preventing or eliminating the introduction of instruments or implants into the spinal anatomy. Additionally, the bone mounting platform can block the surgeon's line of sight to the anatomy, or block the navigation system's line of sight to the navigation fiducial.

[0026] The rotatable fixation bridge described herein is designed to maintain the end positions of the bridge while allowing the middle portion of the bridge to rotate, thus reducing or completely avoiding collisions of the bridge with the desired tool trajectory and / or line of sight issues. The rotation of the middle portion of the bridge maintains the position of the anatomical feature relative to the fiducial to which it is connected.

[0027] As more fully described below, the rotatable fixation bridge according to at least some embodiments of the present disclosure can be rigid, can include two concentric rotational hinges, can be made of a radiolucent material (e.g., polyether ether ketone or PEEK) or a thermoplastic resin with carbon fiber reinforcement, can be designed for cleaning and sterilization to allow for reuse, and can include one or more portions of one or more ball and socket joints to facilitate its adjustability.

[0028] Referring first to Figure 1 The fixation system 10 according to at least one embodiment of the present disclosure includes a rotatable fixation bridge 100, a fiducial 200, and an anchor 300. The system 10 can be used to fix an anatomical feature of a patient to the fiducial 200 in order to advantageously maintain or substantially maintain the relative positions of the patient's anatomical feature and the fiducial 300 during a surgical procedure.

[0029] The anchor 300, which can be any known bone mounting platform or anchor, including, for example, a clamp (e.g., a spinous process clamp), a screw (e.g., a Schanz screw), a pin (e.g., a spinous process pin, a PSIS pin), and / or a bridging instrument, can be fixed to one or more vertebrae of the spinal column or any other anatomical element suitable for receiving the anchor 300. The anchor 300 can securely clamp one or more outer surfaces of the anatomical feature, and / or can extend into and / or through the anatomical feature. In some embodiments, the anchor 300 can be screwed into the anatomical feature. The anchor 300 provides a rigid connection between the rotatable fixation bridge 100 and the anatomical feature.

[0030] The fiducial 200 can be, for example, a surgical robot or a component thereof. In some embodiments, the fiducial 200 is a base of a surgical robot, which can include one or more robotic arms extending from the base and usable in connection with a surgical procedure performed on a patient. In such embodiments, the surgical robot can operate autonomously or based on (wholly or partially) user input from a surgeon or other user. Successful operation of the surgical robot can depend on the surgical robot maintaining a known, fixed (or at least substantially fixed) position relative to the patient, or relative to a target anatomical feature of the patient or relative to a surgical site within the patient. The target anatomical feature can or can not be the anatomical feature to which the anchor 300 is connected.

[0031] In some embodiments, the fiducial 200 can be a structure that supports a patient, such as a surgical table or chair, a platform, or any other structure. Alternatively, the fiducial 200 can be a ceiling, a wall, a floor, or any other portion of a building. In such embodiments, fixation of the patient (or one or more anatomical features of the patient) can be useful or desirable to facilitate proper functioning and / or use of the surgical navigation system, or to maintain registration between two or more of the coordinate systems of the surgical navigation system, a separate coordinate system of the patient, and / or another separate coordinate system of a surgical robot. Additionally or alternatively, fixation of the patient (or one or more anatomical features of the patient) can be used or desired to reduce the risk of active or unconscious movement of the patient during a surgical procedure for which significant accuracy and / or precision is desired, regardless of whether the surgical procedure is performed by a surgeon, a surgical robot, or a combination thereof.

[0032] In some embodiments, the fiducial 200 can be an anatomical feature of the patient. For example, the patient’s pelvis, sacrum, or lower vertebrae can serve as a fiducial for higher vertebrae. Thus, in these embodiments, the rotatable fixation bridge 100 provides stability between different anatomical structures while increasing access to anatomical features surrounding the rotatable fixation bridge 100.

[0033] The rotatable fixation bridge 100 includes a bridge adapter 104, a locking screw 108, a first extension 112, a first end portion 116, a central portion 120, a second end portion 124, and a second extension 128. Rotatable fixation bridges 100 according to other embodiments of the present disclosure can include more or fewer components than those described herein with reference to FIG. 1. Figure 1 The rotatable fixation bridge 100 includes a bridge adapter 104, a locking screw 108, a first extension 112, a first end portion 116, a central portion 120, a second end portion 124, and a second extension 128. Rotatable fixation bridges 100 according to other embodiments of the present disclosure can include more or fewer components than those described herein with reference to FIG. 1.

[0034] The bridge adapter 104 can be shaped to complement the base 204 of the reference portion 200. More specifically, the bridge adapter 104 can include a plate or member shaped to receive or be received by the base 204. The bridge adapter 104 can be made of any metal, metal alloy, plastic, or other material or any combination thereof suitable for securely fixing the rotatable fixed bridge 100 to the reference portion 200. The bridge adapter 104 can include one or more locking screws 108 for securely fixing the bridge adapter 104 to the base 204 and thus to the reference portion 200. Additionally or alternatively, the bridge adapter 104 can be configured to connect to the base 204 via a press fit, a snap fit, an interlocking fit, or any other connection method and / or mechanism. The bridge adapter 104 can form or define at least a portion of a socket in which a ball of the rotatable fixed bridge 100, such as the first ball 132 of the bridge 100 of FIG. 1, is received and fixed. Figure 3

[0035] The first extension 112 extends between the ball or other object or mechanism securely fixed to the reference portion 200 by the bridge adapter 104 and the first end portion 116. Notably, the connection between the first extension 112 and the first end portion 116 does not allow translational movement of the first end portion 116 relative to the axis of the first extension 112, but rather allows relative rotational movement. In other words, when the bridge adapter 104 is fixed to the reference portion 200, the first extension 112 is securely fixed relative to the reference portion 200, but the first end portion 116 can rotate about the first extension 112 (and thus about the axis 114 defined at least in part by the first extension 112).

[0036] In some embodiments, the first end portion 116 can be locked in a particular angular position relative to the first extension 112, either by one or more complementary protrusions and detents along the interface between the first extension 112 and the first end portion 116, or using a pin and / or a set screw, or due to friction between the first extension 112 and the first end portion 116, or otherwise.

[0037] The central portion 120 connects the first end portion 116 to the second end portion 124 to form a bridge member. The central portion 120 is offset from the rotational axis 114 of the bridge member. The axis 114 can be defined, for example, by the coaxial axes of the first extension 112 and the second extension 128. In some embodiments, the rotatable fixed bridge 100 can use a ball and socket joint to connect the first end portion 116 to the second end portion 124. Figure 1 ​The illustrated rotational hinges are in addition to those rotational hinges that include the cylindrical first extension 112 received by the hole in the first end portion 116 and the cylindrical second extension 128 received by the hole in the second end portion 124, respectively. In such embodiments, the rotational hinges of the rotatable fixed bridge 100 can be concentric and / or coaxial, and can define a rotational axis 114 of the rotatable fixed bridge 100.

[0038] The central portion 120 can be substantially straight or linear, as illustrated. Figure 1 The central portion 120 can be substantially parallel to the rotational axis 114, as also illustrated. Figure 1 In some embodiments, the central portion 120 can not be substantially parallel to the rotational axis 114. For example, the central portion 120 can continuously curve from the first end portion 116 to the second end portion 124. In such embodiments, the central portion 120 can have a constant radius of curvature, or a varying radius of curvature. The central portion 120 can include a curve that extends in substantially the same plane as the first end portion 116 and the second end portion 124, or the curve can extend in different planes. In other words, the central portion 120 can curve in a plane that is parallel to, but does not include, the rotational axis 114. In yet other embodiments, the central portion 120 can include one or more curved portions and / or one or more straight portions.

[0039] In some embodiments, whether to include a straight central portion 120 or a curved central portion 120 for a rotatable fixed bridge 100 can depend on the nature of the surgical procedure for which the bridge member is selected. For example, a curved central portion 120 can advantageously provide a large unobstructed area between the first end portion 116 and the second end portion 124 compared to a straight central portion 120, and thus can be more desirable when the rotatable fixed bridge 100 is to extend, for example, directly over a surgical site.

[0040] In some embodiments, the central portion 120 can not be readily distinguishable from the first end portion 116 and the second end portion 124 (e.g., by a change in angle or curvature, or otherwise). In other embodiments, the central portion 120 can be perpendicular to at least a portion of the first end portion 116 and / or at least a portion of the second end portion 124.

[0041] The central portion 120 can be offset from the axis 114 by a maximum distance measured between the axis 114 and a surface of the central portion 120 facing the axis 114, and is about 1 / 2 inch, or about 1 inch, or about 2 inches, or about 3 inches. In some embodiments, the central portion 120 can be offset from the axis 114 by a maximum distance in a range of between about 1 / 2 inch to about 12 inches, or in a range of between about 1 inch to about 8 inches, or in a range of between about 1 inch to about 5 inches. Nonetheless, the present disclosure includes rotatable fixed bridges 100 having central portions 120 offset from the axis 114 by any distance.

[0042] The offset of the central portion 120 from the axis 114 can be determined in whole or in part by the length of the first end portion 116 and the second end portion 124 (e.g., when the central portion 120 is straight or linear, as shown in Figure 1 The offset of the central portion 120 from the axis 114 can be determined in whole or in part by the length of the first end portion 116 and the second end portion 124 (e.g., when the central portion 120 is straight or linear, as shown in

[0043] The central portion 120 can have a length of between about 1 inch to about 30 inches, or a distance of between about 2 inches to about 20 inches, or a distance of between about 3 inches to 12 inches. The central portion 120 can be about 16 inches long, or about 12 inches long, or about 8 inches long. In some embodiments, the central portion 120 can be adjustable between two lengths or a plurality of lengths. In such embodiments, the central portion 120 can be securely fixable or lockable at each length of the plurality of lengths, such that once set at a particular length, the length of the central portion 120 does not change unintentionally. The central portion 120 according to such embodiments can include one or more telescoping members, and / or one or more folding members, and / or one or more selectively attachable or detachable members.

[0044] The central portion 120 can be or can include a handle so that a surgeon or other user can grasp the central portion 120 and rotate the central portion 120 about the axis 114 between the first rotational position and the second rotational position. As noted above, in some embodiments, the central portion 120 (together with the first end portion 116 and the second end portion 124) can be locked in a plurality of rotational or angular positions relative to the first extension 112 and the second extension 128 (and thus relative to the reference portion 200, the anchor 300, and the patient to which the anchor 300 is fixed). In such embodiments, the central portion 120 (together with the first end portion 116 and the second end portion 124) can be placed in a first angular or rotational position and locked in place to prevent further inadvertent movement thereof, then unlocked, moved to a second angular or rotational position, and again locked in place to prevent further inadvertent movement thereof.

[0045] In some embodiments of the present disclosure, the central portion 120 (together with the first end portion 116 and the second end portion 124) can be held in a given angular or rotational position about the axis 114 by frictional fit only (rather than by, for example, a mechanical locking mechanism).

[0046] Figure 2 A fixation system 20 is shown that is substantially similar to the fixation system 10, except that the second end portion 124 of the rotatable fixation bridge 100 includes a socket 126. The socket 126 is fixedly secured to the second end portion 124 and is configured to receive a ball that is rigidly fixed to an anchor. In other words, whereas the rotatable fixation bridge 100 of the fixation system 10 includes a second extension 128 that supports a ball (e.g., the second ball 160 of the anchor 300) that is received by a socket in the anchor 300, the rotatable fixation bridge 100 of the fixation system 20 includes a socket 126 that is adapted to receive (and secure in a fixed position) a ball of an anchor, such as the anchor 300. Figure 3

[0047] ​Using a mechanical ball and socket joint to secure the rotatable fixed bridge 100 to the reference portion 200 and / or the anchor 300 advantageously enables the rotatable fixed bridge 100 to be oriented as desired, independent of the position of the anchor 300 relative to the reference portion 200 (and thus independent of the anatomical feature to which the anchor 300 is securely connected in the patient). In other words, assuming the base 204 faces generally toward the anchor 300 (or the ball or socket of the anchor 300 faces generally toward the base 204), the rotatable fixed bridge can be positioned to extend from the base 204 toward the anchor 300 (or from the anchor 300 toward the base 204) at any of a plurality of angles. Conversely, if the rotatable fixed bridge 100 can only be securely fixed to the base 204 and / or to the anchor 300 at one angle or at one of several predetermined angles, the reference portion 200 and the anchor 300 can only be secured to each other at a corresponding one relative position or at corresponding several relative positions. This, in turn, can result in increased workload for the surgeon and / or one or more other users of the fixation system 10 and / or the fixation system 20, who can need to spend additional time positioning the reference portion 200 relative to the anchor 300 so that the rotatable fixed bridge 100 can be secured therebetween.

[0048] Nonetheless, the present disclosure includes fixation systems in which the rotatable fixed bridge 100 is securely fixed to the reference portion 200 and / or the anchor 300 using a mechanical ball and socket joint, a hinged joint, a saddle joint, or any other joint or connection mechanism that is fixed or securable in or to at least one particular position. In some embodiments, at least a portion of any such joint (e.g., the ball or socket) can be part of the rotatable fixed bridge 100.

[0049] Figure 3 An exploded view of the rotatable fixed bridge 100 is shown, in accordance with at least some embodiments of the present disclosure. Figure 3 The rotatable fixed bridge 100 of FIG. 1 includes the bridge adapter 104, the locking screw 108, the first extension 112, the bridge member 130 including the first end portion 116, the center portion 120, and the second end portion 124, and the second extension 128, all as described above. Figure 3 Also shown are the first ball 132, the bore 134, the swivel base 136 of the first extension 112, the cap 140 and the cap 152, the screw 144 and the screw 148, the swivel base 156 of the second extension 128, the second ball 160, the pin 164, the set screw 168, and the bore 172.

[0050] Each of the first ball 132 and the second ball 160 is adapted to be received by a corresponding socket. The first ball 132 is configured to be received by a socket of the reference portion 200, which can be defined at least in part by a seat 204 on or in the reference portion 200. The socket can also be defined at least in part by the bridge adapter 104, such that when the bridge adapter 104 is secured to the seat 204, a complete socket is defined in which the first ball 132 is secured. The pins 164, driven by the set screw 168, are configured to extend through the bridge adapter 104 and into the socket that receives the first ball 132, so as to engage the first ball 132 and lock the first ball 132 in a fixed position relative to the reference portion 200. In some embodiments, multiple pins 164, set screws 168, and / or other devices can be used to lock the first ball 132 in a particular orientation within the socket. Also in some embodiments, once the bridge adapter 104 is secured to the seat 204 (or otherwise secured to the reference portion 200), the bridge adapter 104 is configured to lock the first ball 132 in a particular orientation within the socket.

[0051] The bridge adapter 104 includes a hole 134 that is sized to allow the first extension 112 to pass therethrough, but to prevent the first ball 132 from passing therethrough. The hole 134 thus defines an opening of the socket that receives the first ball 132, and enables the first ball 132 to be secured within the socket while still being connected (e.g., via the first extension 112) to the first end portion 116.

[0052] The first extension 112 is rotatably secured to the first end portion 116 via a rotating base 136. The rotating base 136 is a cylindrical portion of the first extension 112 that is sized to fit within a corresponding hole 172 of the first end portion 116. The rotating base 136 has a diameter that is less than the maximum width or diameter of the first extension 112. With the rotating base 136 extending through the hole 172, a cap 140 can be secured to the rotating base 136 with a screw 144. Once so assembled, the wider portion of the first extension 112 and the cap 140 abut an axial side (e.g., a side perpendicular to the axis 114) of the first end portion 116, and prevent translational motion of the first end portion 116 (relative to the first extension 112) in a dimension parallel to the axis 114, while the rotating base 136 prevents translational motion of the first end portion 116 (relative to the first extension 112) in any other dimension. The first end portion 116 can still be rotated about the rotating base 136, however.

[0053] Similarly, the second ball 160 is configured to be received by a socket of the anchor 300. One or more set screws or other devices (not shown) can be used to lock the second ball 160 in a particular orientation within the socket of the anchor 300.

[0054] The second extension 112 is rotatably fixed to the second end portion 124 via a rotating base 156. The rotating base 156 is a cylindrical portion of the first extension 112, the dimensions of which are adapted to fit into a corresponding hole in the second end portion 124. Figure 3 (Not visible in the center). The rotating base 156 has a diameter smaller than the maximum width or maximum diameter of the second extension 128. As the rotating base 156 extends through the hole in the second end portion 124, the cap 144 can be secured to the rotating base 156 with screws 148. Once assembled in this way, the wider portion of the second extension 116 and the cap 152 abut against the axial side (e.g., the side perpendicular to axis 114) of the second end portion 124 and prevent the second end portion 124 from translating in a dimension parallel to axis 114 (relative to the second extension 128), while the rotating base 156 prevents the second end portion 124 from translating in any other dimension (relative to the second extension 128). However, the second end portion 124 can still rotate about the rotating base 156.

[0055] During assembly, the first ball 132 (in some embodiments, together with the first extension 112, bridge adapter 104, locking screw 108, pin 164, and / or fixing screw 168) defines a first end or reference interface of the rotatable fixed bridge 100, and the second ball 160 (in some embodiments, together with the second extension 128 and any other components of the rotatable fixed bridge 100 for securing the second ball 160 to the socket of the anchor 300) defines a second end or anchor interface of the rotatable fixed bridge 100. In embodiments of this disclosure, where one or both of the first ball 132 and the second ball 160 are replaced by a socket, the socket near the first end portion 116 (together with any other components for securing the ball of the reference portion 200 in the socket) will define the first end portion or reference interface, and the socket near the second end portion 124 will define the second end portion or anchor interface. Whether the rotatable fixed bridge 100 is fixed to the base portion 200 and / or the anchor 300 by a connector or a connecting mechanism, the portion of the rotatable fixed bridge 100 that allows the rotatable fixed bridge 100 to be fixed to the base portion 200 includes a first end or base portion interface, and the portion of the rotatable fixed bridge 100 that allows the rotatable fixed bridge 100 to be fixed to the anchor 300 includes a second end or anchor portion interface.

[0056] Each of the various components of the rotatable fixation bridge 100 can be made of metal, metal alloy, plastic, composite material, any other suitable material that enables the component to achieve the purposes described herein, and / or any combination of the foregoing. In some embodiments, one or more components of the rotatable fixation bridge 100 can be made of a radiolucent material, such as polyether ether ketone (PEEK), polyetherimide, or a thermoplastic resin with carbon fiber reinforcement. In other embodiments, none of the components of the rotatable fixation bridge 100 are radiolucent. The materials from which the various components of the rotatable fixation bridge 100 are made can be selected to enable the rotatable fixation bridge and / or one or more portions thereof to be cleaned, sterilized (whether by heat, chemical treatment, or otherwise), and / or reused. Additionally and / or alternatively, the materials from which the various components of the rotatable fixation bridge 100 are made can be selected to ensure that the rotatable fixation bridge is sufficiently robust to withstand any anticipated size of force during a surgical procedure.

[0057] A rotatable fixation bridge as described herein, such as the rotatable fixation bridge 100, advantageously maintains the relative position of its first end (which can be connected to, for example, a surgical robot or other reference) and its second end (which can be connected to, for example, an anchor that in turn is connected to an anatomical feature of a patient), independent of the rotational position of the bridge member relative to the first and second ends. Thus, if during a surgical procedure in which the rotatable fixation bridge is used, the bridge member of the rotatable fixation bridge creates an obstacle to achieving a desired tool trajectory or obtaining a desired image or viewing along a desired line of sight, the bridge member can simply be rotated to a different angular position, thereby removing the obstacle and allowing the desired tool trajectory to be achieved, or the desired image to be obtained or the desired line of sight to be viewed.

[0058] Referring now to Figure 4 The method 400 of fixing an anatomical feature to an external reference includes securely fixing the anchor interface of the rotatable fixation bridge to an anchor (step 404). Securely fixing can include securely fixing the ball of the anchor interface into the socket of the anchor. Additionally or alternatively, securely fixing can include fixing the anchor interface to the anchor with one or more bolts, screws, or other mechanical fasteners. The anchor can be the same as or similar to the anchor 300 and / or any clamp, screw, or pin described herein, and / or can be any other device that can be securely fixed to an anatomical feature.

[0059] The method 400 also includes securely fixing the reference portion of the rotatable fixed bridge to an external reference portion (step 408). The external reference portion can be the same as or similar to the reference portion 200 and / or any other reference portion described herein. Securely fixing can include securely fixing a ball, such as the first ball 132, into a socket. Securely fixing can include fixing a bridge adapter, such as the bridge adapter 104, to the external reference portion (or to a base thereof, such as the base 204). Securely fixing can include threading a locking screw, such as the locking screw 108, through the bridge adapter and into the external reference portion, and / or driving a pin, such as the pin 164, into the first ball 132 using a set screw, such as the set screw 168, to fix the ball, such as the first ball 132, into a particular position within the socket.

[0060] The method 400 also includes rotating the bridge member of the rotatable fixed bridge to a first angular position relative to the anchor interface and the reference portion interface (step 412). The bridge member includes a central portion that is offset from an axis of rotation of the bridge member. This rotation does not change the position of the anchor interface relative to the reference portion interface. However, because the bridge member includes a central portion that is offset from an axis of rotation of the bridge member, the rotation causes at least the central portion to assume a first position that is unique relative to a position of at least the central portion when the bridge member is rotated to any other angular position relative to the anchor interface and the reference portion interface.

[0061] The method 400 also includes rotating the bridge member to a second angular position that is different from the first angular position (step 416). Here again, the rotation does not change the position of the anchor interface relative to the reference portion interface, and thus maintains the position of the anchor (and the anatomical feature to which the anchor is connected, whether a vertebra or other spinal feature or any other anatomical feature) relative to the reference portion interface. Additionally, because the bridge member includes a central portion that is offset from an axis of rotation of the bridge member, the rotation causes at least the central portion to assume a second unique position that is different from the first unique position. Thus, if the bridge member or a portion thereof presents an obstacle to achieving a desired tool trajectory, or obtaining a desired image, or any other aspect of a given surgical procedure when in the first angular position, the bridge member can be rotated to the second angular position, thereby removing the obstacle and enabling the desired tool trajectory to be achieved, the desired image to be obtained, or any other step of the surgical procedure that was prohibited due to the position of the bridge member to be performed.

[0062] As can be appreciated based on the above disclosure, the present disclosure encompasses methods having fewer steps than Figure 4 and methods having more steps than Figure 4 and the steps identified in the corresponding description. In some embodiments, one or more steps of the method 400 can be repeated one or more times.

[0063] A rotatable fixed bridge according to embodiments of the present disclosure, such as rotatable fixed bridge 100, advantageously enables the bridge member to be moved from at least one first position to at least one second position without affecting the relative position of the datum to the anatomical feature to which the datum is connected via the bridge member (and, for example, the anchor and other components of the rotatable fixed bridge). Thus, any registration between the datum and the anatomical feature can be maintained while saving time and money that might otherwise be spent by adjusting the relative position of the datum and the anchor / anatomical feature (e.g., moving an un-rotatable bridge out of the way) and then repeating any registration process.

[0064] The foregoing discussion has been presented for the purpose of illustration and description. The foregoing is not intended to limit the disclosure to one or more forms disclosed herein. In the foregoing DETAILED DESCRIPTION, for purposes of simplicity, the various features of the disclosure are grouped together into one or more aspects, embodiments, and / or configurations. The features of the aspects, embodiments, and / or configurations of the disclosure may be combined in alternative aspects, embodiments, and / or configurations other than those discussed above. The methods of the disclosure are not to be interpreted as reflecting the intention of the applicant to claim a broader patent than is claimed. Rather, the intent is to draft a claim that clearly allows the claimant the claim it deserves. Accordingly, the following claims are hereby incorporated into this DETAILED DESCRIPTION by this reference, with each claim as written being considered independent of all other claims in this application for patent.

[0065] Further, while the description has included description of one or more aspects, embodiments, and / or configurations and certain variations and modifications, other variations, combinations, and modifications are within the scope of the disclosure, e.g., as can be within the skill and knowledge of those in the art, after understanding the present disclosure. It is intended to obtain rights which include alternative aspects, embodiments, and / or configurations to the extent permitted, including alternate, unrecited, or equivalent structures, functions, means, or steps to the extent permitted having regard to the scope of the claims and equivalents thereto, regardless of whether any portion of such alternative, unrecited, or equivalent structures, functions, means, or steps was disclosed and regardless of whether the same was referred to in the summary of the application.

Claims

1. A rotatable fixed bridge comprising: a first end capable of being securely connected to a reference and defining at least a portion of a first joint; a second end capable of being securely connected to an anchor and defining at least a portion of a second joint; a bridge member extending between and rotatably secured to the first and second ends, the bridge member being rotatable relative to an axis and including a central portion offset from the axis; a bridge adapter shaped to receive a base of the reference or a plate received by the base to complement the base to securely fix the rotatable fixed bridge to the reference; and a first extension extending between the bridge adapter and the first end, the first extension being rotatably secured to the first end by a first rotational base.

2. The rotatable fixed bridge of claim 1, wherein at least one of the first and second joints comprises a ball and socket.

3. The rotatable fixed bridge of claim 1, wherein the central portion is arranged substantially parallel to the axis.

4. The rotatable fixed bridge of claim 1, wherein the central portion is curved.

5. The rotatable fixed bridge of claim 1, wherein the bridge adapter comprises a locking screw.

6. The rotatable fixed bridge of claim 1, wherein the bridge member maintains a relative position of the first end to the second end independent of a rotational position of the bridge member relative to the first and second ends.

7. The rotatable fixed bridge of claim 1, wherein the bridge member comprises a radiolucent material.

8. The rotatable fixed bridge of claim 7, wherein the radiolucent material is polyether ether ketone.

9. The rotatable fixed bridge of claim 1, wherein the bridge member includes an end portion substantially perpendicular to the central portion.

10. A fixation system comprising: a rotatable fixed bridge comprising: a reference interface capable of being securely fixed to a reference; an anchor interface capable of being securely fixed to an anchor; and a bridge member comprising: a first end portion rotatably secured to the reference interface; a second end portion rotatably secured to the anchor interface; a central portion extending between the first and second end portions, the central portion being offset from a rotational axis of the bridge member; and a bridge adapter shaped to receive a base of the reference or a plate received by the base to complement the base to securely fix the rotatable fixed bridge to the reference; and a first extension extending between the bridge adapter and the first end, the first extension being rotatably secured to the first end by a first rotational base. ​ 11. The fixation system of claim 10, wherein at least one of the reference interface and the anchor interface comprises a ball or a socket.

12. The fixation system of claim 10, wherein the bridge member is configured to maintain a constant relative position of the reference interface and the anchor interface independent of a rotational position of the bridge member about the axis.

13. The fixation system of claim 10, wherein at least the central portion of the bridge member is made of a radiolucent material.

14. The fixation system of claim 10, wherein the reference interface comprises a ball and an adapter configured to partially define a socket that holds the ball.

15. The fixation system of claim 10, wherein the reference portion is one of a surgical robot, a structure for supporting a patient, or a portion of a building.

16. The fixation system of claim 10, further comprising the anchor, and wherein the anchor is securely attachable to a portion of a patient’s spine.

17. A method of using the rotatable fixation bridge of claim 1 to secure a spine to an external reference portion, comprising: securely fixing an anchor interface of the rotatable fixation bridge to an anchor; securely fixing a reference interface of the rotatable fixation bridge to an external reference portion; rotating a bridge member of the rotatable fixation bridge to a first angular position relative to the anchor interface and the reference interface without changing a position of the anchor interface relative to the reference interface, the bridge member including a central portion that is offset from an axis of rotation of the bridge member; and rotating the bridge member to a second angular position different from the first angular position without changing the position of the anchor interface relative to the reference interface.

18. The method of claim 17, wherein securely fixing the reference interface to the external reference portion comprises securely fixing a bridge adapter to the external reference portion.

19. The method of claim 17, wherein securely fixing the anchor interface to the anchor comprises securely fixing a ball of the anchor interface into a socket of the anchor. ​

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