Patient-Mounted Surgical Support With Polyaxial Anchor Locking
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Solution Overview
Problem
Existing surgical access devices inadequately support surgical instruments, often moving relative to the patient or impeding surgical procedures, particularly in orthopedic and neurologic surgeries like spinal fusion, due to inadequate anchoring and interference with pedicle screw implantation.
Innovation Solution
A patient-mounted surgical support that couples to an implanted anchor, providing an adjustable and selectively lockable platform for securing surgical instruments, such as a tissue retractor, with features like polyaxial adjustment and a drag force mechanism to maintain instrument position relative to the anchor.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If a surgical access device is anchored to a surgical table, then it provides stable support, but it moves relative to the patient when the patient moves and may impede surgical procedures
Solution Approach 1:
The patent introduces an intermediary anchor implanted in the patient's bone (such as the ilium) that serves as a stable reference point fixed to the patient's anatomy. The surgical access device couples to this patient-mounted anchor rather than being anchored to the surgical table, eliminating the relative movement problem while maintaining stability. The anchor acts as a mediator between the device and the patient's body, providing a moving reference frame that travels with the patient.
2Ease of operation
If pedicle screws with receiver heads are implanted before intervertebral disc work, then access to the disc space is improved, but the receiver heads and extension posts block access to the intervertebral disc space
Solution Approach 1:
The patent segments the pedicle screw system into two separate components: a lower-profile implantable anchor that can be placed in the bone, and a separate receiver head that can be coupled to the anchor. This segmentation allows the anchor to be implanted without blocking the disc space, while the receiver head can be added later when needed for disc work, eliminating the blockage problem while maintaining access.
Solution Approach 2:
The patent changes the dimensional profile of the anchor by making it lower-profile and offset from the longitudinal axis of the pedicle screw. This dimensional change allows the anchor to be implanted without interfering with the intervertebral disc space access, separating the anchoring function from the disc space occupation.
3Adaptability or versatility
If a surgical support is made adjustable with polyaxial movement, then it adapts to different surgical needs, but it requires complex locking mechanisms to maintain position
Solution Approach 1:
The patent implements a dynamic locking mechanism that allows the surgical support to transition between locked and unlocked states. The lock body can be moved along the elongate body to engage with indexing features at desired positions, allowing polyaxial adjustment when unlocked and stable positioning when locked. This dynamic mechanism provides adaptability while maintaining simplicity through straightforward engagement features.
Data Source
AI summary
Surgical support instruments are described herein that can couple to, e.g., an implanted anchor and provide a platform for coupling other surgical implements thereto. In one embodiment, an instrument can include an elongate body having opposed projections extending laterally from a distal portion thereof that can at least partially surround a shank of an implantable anchor such that a longitudinal axis of the elongate body is laterally offset from a longitudinal axis of the anchor. The instrument can further include a lock configured to exert a drag force on a head of the anchor to control polyaxial movement of the instrument relative to the anchor. Further, a proximal portion of the elongate body can be configured to receive a retractor assembly including a plurality of tissue manipulating implements and selectively lock the retractor assembly at any of a plurality of positions along a length of the elongate body.