Spinal Reduction Instrument for Single-Position Pedicle Fixation
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Solution Overview
Problem
Existing surgical techniques require repositioning patients between lateral and prone positions during single position spine surgery, increasing operative time and posing challenges, especially in pathologies like spondylolisthesis, necessitating methods and instruments for single position surgery in a wide variety of spinal conditions.
Innovation Solution
The use of guide assemblies and reduction instruments that facilitate spinal procedures such as lateral lumbar interbody fusion and posterior fixation while maintaining the patient in a lateral decubitus position, utilizing navigated guidance systems and orthogonal tilt sensors to accurately place pedicle screws and perform leveraged reductions.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If traditional open surgical techniques are used to access the spine, then surgical target site accessibility is improved, but patient morbidity and hospitalization duration increase
Solution Approach 1:
The surgical approach is segmented into two separate access paths: a lateral trans-psoas approach for interbody fusion and a posterior approach for fixation. This allows each approach to be optimized independently, with the lateral approach providing direct access to the intervertebral space and the posterior approach providing access to the pedicles, thereby achieving surgical goals with minimal tissue disruption
Solution Approach 2:
The patent uses intermediate structures such as the transverse process and psoas muscle as mediators to access the surgical target. The lateral trans-psoas approach utilizes these intermediate structures to reach the intervertebral space without requiring large incisions or extensive tissue displacement, thus reducing patient morbidity while maintaining surgical accessibility
2Adaptability or versatility
If patient repositioning from lateral decubitus to prone position is performed, then posterior fixation can be achieved, but operative time significantly increases
Solution Approach 1:
The patent merges two separate surgical procedures (lateral lumbar interbody fusion and posterior fixation) into a single continuous procedure performed in one patient position. By using the lateral decubitus position for both the lateral trans-psoas approach and the posterior fixation, the need for patient repositioning is eliminated, thereby completing comprehensive spinal surgery without increasing operative time
Solution Approach 2:
The lateral decubitus position is shown to serve multiple functions: it provides optimal access for the lateral trans-psoas interbody fusion approach and simultaneously provides adequate access for posterior pedicle screw fixation. This multi-functionality of a single patient position allows both surgical objectives to be achieved without repositioning, eliminating time loss
3Productivity
If single position spine surgery is performed, then operative time is reduced, but ability to address complex pathologies like spondylolisthesis is limited
Solution Approach 1:
The patent adds a lateral dimension to traditional posterior spine surgery by incorporating the lateral trans-psoas approach. This dimensional change allows access to the anterior column and intervertebral space from the side while maintaining the patient in a lateral position, thereby enabling management of complex pathologies like spondylolisthesis with the same efficiency as conventional multi-position surgery
Data Source
AI summary
A spinal procedure includes attaching a first reduction instrument to a first guide assembly and a second guide assembly. The first reduction instrument includes a fixed attachment assembly and a translating attachment assembly that cooperatively interfaces the fixed attachment assembly. The first guide assembly is attached to a first pedicle and the second guide assembly is attached to a second pedicle. The first reduction instrument is moved to reduce an orientation of the spine, while imaging a reduction of the orientation of the spine. An angle and position of the first reduction instrument is locked upon achieving a desired reduction. The spine may then be fused.