Horizontal Transvertebral Curvilinear Nail for Spinal Fusion
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Solution Overview
Problem
Conventional pedicle screw placement in spinal fusion surgeries is associated with complications such as misplacement, neural and vascular injury, excessive blood loss, prolonged recovery, and adjacent segmental disease, which are not adequately addressed by recent advances in minimally invasive and stereotactic technologies.
Innovation Solution
The use of Horizontal Transvertebral Curvilinear Nails (HTCNs) that are implanted horizontally across vertebral bodies, avoiding pedicle screws and allowing for rigid or flexible fusion through interconnection with rods, thereby preserving healthy facet joints and pedicles, and enabling salvage procedures for pre-existing pedicle screw fusions.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Strength
If conventional pedicle screw placement is used for spinal fusion, then vertebral fixation strength is achieved, but complications occur including misplacement, neural and vascular injury, excessive blood loss, and adjacent segmental disease
Solution Approach 1:
The patent transitions from the conventional transpedicular approach (posterior-to-anterior through the pedicle) to a lateral transvertebral approach (lateral-to-lateral through the vertebral body). This dimensional change in insertion trajectory avoids the pedicle, neural foramina, and vascular structures, thereby eliminating the risk of neural and vascular injury while maintaining effective vertebral fixation through the denser cortical bone of the vertebral body
2Reliability
If conventional pedicle screw placement is used, then spinal fusion is achieved, but excessive blood loss and prolonged recovery occur
Solution Approach 1:
By changing the insertion dimension from transpedicular to lateral transvertebral, the patent avoids the rich vascular network within the pedicle and adjacent neural foramina. The lateral approach traverses relatively avascular bone tissue, significantly reducing intraoperative blood loss while maintaining fusion reliability through equivalent or superior biomechanical fixation
3Stability of the object's composition
If rigid pedicle screw fixation is used, then spinal stability is achieved, but adjacent segmental disease occurs requiring further fusions
Solution Approach 1:
The patent incorporates dynamic elements into the fixation system through ball-and-socket joints that allow controlled motion at the rod-implant interfaces. This dynamic capability enables the construct to accommodate physiological movement and stress distribution, reducing stress shielding and preventing adjacent segment degeneration while maintaining overall spinal stability
4Strength
If transpedicular screw insertion is used, then vertebral fixation is achieved, but healthy facet joints and pedicles are violated
Solution Approach 1:
The patent employs a lateral transvertebral insertion dimension that approaches the vertebral body from the lateral aspect rather than through the pedicle. This alternative trajectory allows the implant to engage the strong cortical bone of the vertebral body for secure fixation while completely avoiding violation of the pedicle, facet joints, and neural foramina, preserving these healthy anatomical structures
Data Source
AI summary
A horizontal-transvertebral curvilinear nail-screw (HTCN) including a body portion having a first end and a second end, wherein the first end is opposed to the second end; and a head at the first end of the body portion, wherein the body portion has a predetermined curvilinear shape and includes a pointed tip at the second end of the body portion, and a method of surgically implanting universal horizontal-transvertebral curvilinear nail-screws (HTCN) into a plurality of adjacent vertebrae.