Subcutaneous Screw Tether Insertion for Minimally Invasive Spinal Stabilization
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Solution Overview
Problem
Conventional spinal surgeries often require large incisions, extensive tissue retraction, leading to long recovery times, patient discomfort, increased risk of infection, and high expenses due to the need for muscle and ligament detachment and reattachment.
Innovation Solution
A method and apparatus involving subcutaneous screws with channels for tethers, allowing percutaneous insertion and tensioning of tethers between vertebrae to stabilize the spine, utilizing guidewires, trocars, sheaths, or cannulated rods for minimally invasive procedures.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If conventional spinal surgery methods are used with large incisions and extensive tissue retraction, then spinal stabilization can be achieved, but recovery time increases, patient discomfort increases, and infection risk increases
Solution Approach 1:
The surgical procedure is segmented into percutaneous steps where screws are inserted through separate small incisions rather than one large incision. Each screw placement is an independent minimal-access procedure, allowing spinal stabilization to be achieved through multiple small interventions rather than extensive open surgery.
Solution Approach 2:
Guidewires and trocars serve as intermediary tools that enable precise placement of screws through small percutaneous incisions. These intermediaries allow the surgeon to navigate and position fixation elements without requiring large incisions or extensive tissue retraction, thus maintaining stabilization reliability while reducing surgical trauma.
2Reliability
If conventional spinal surgery with extensive tissue retraction is performed, then spinal stabilization is achieved, but patient discomfort and infection risk increase
Solution Approach 1:
The surgical approach is divided into multiple percutaneous insertion points, each with its own small incision. This segmentation limits the exposure of internal tissues to the external environment, reducing the surface area vulnerable to contamination and lowering overall infection risk while still achieving comprehensive spinal stabilization.
Solution Approach 2:
Percutaneous guides and trocars act as sterile barriers and precise conduits that minimize direct contact between surgical instruments and deep tissue structures. This intermediary approach reduces the risk of introducing pathogens into the surgical site while maintaining accurate screw placement for reliable stabilization.
3Loss of time
If minimally invasive percutaneous methods are used for screw insertion, then recovery time and infection risk are reduced, but the complexity of tether insertion through subcutaneous screw heads increases
Solution Approach 1:
The screw heads are pre-configured with subcutaneous positioning and integrated tether insertion features during the manufacturing stage. This preliminary design ensures that the tether can be inserted through the screw head structure without requiring complex additional instrumentation or procedures, thus maintaining minimal invasiveness while managing insertion complexity.
Solution Approach 2:
The screw design integrates multiple functions: structural fixation, percutaneous insertion capability, and built-in tether passage. This multi-functionality eliminates the need for separate tether insertion instruments or additional incisions, reducing overall procedural complexity despite the minimally invasive approach.
Data Source
AI summary
A method of securing vertebrae includes inserting a first pedicle screw into a first pedicle of a first vertebra. The first pedicle screw includes a first channel running perpendicular to a first central axis of the first pedicle screw. The first pedicle screw has a first engagement structure. The method further includes inserting a second pedicle screw into a second pedicle of a second vertebra. The second pedicle screw includes a second channel running perpendicular to a second central axis of the second pedicle screw. The second pedicle screw has a second engagement structure. The method also includes inserting a guidewire through the first and second channels, threading a tether attached to an end of the guidewire through the first and second channels, securing the tether to the first pedicle screw, applying tension to the tether, and securing the tether to the second pedicle screw.