Translational instrumentation for spondylolisthesis and scoliosis reduction
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Solution Overview
Problem
Existing spinal fusion procedures for spondylolisthesis lack instrumentation capable of combining distraction of the disc space and correction of vertebral misalignment, particularly from anterior and lateral approaches, with risks of nerve root injuries and limited fusion rates.
Innovation Solution
A distraction mechanism with vertebral endplate spreaders that allow for simultaneous distraction and lateral repositioning of vertebrae, using a dual-end member design with lateral actuation capability, enabling correction of vertebral alignment through an anterior or lateral approach.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Adaptability or versatility
If conventional spinal fusion procedures are used, then vertebral alignment can be corrected, but distraction of the disc space and correction of listhesis cannot be performed simultaneously
Solution Approach 1:
The patent combines distraction and correction functions into a single integrated instrument. The vertebral alignment correction instrument includes a distraction mechanism with spreaders that can simultaneously distract the disc space and correct vertebral misalignment, eliminating the need for separate instruments and procedures.
Solution Approach 2:
The instrument is designed with multi-functionality to perform both distraction and alignment correction. The spreaders can be positioned and actuated to achieve disc space distraction while the same instrument structure enables lateral repositioning of vertebrae, making it a universal tool for multiple spinal correction tasks.
2Manufacturing precision
If posterior reduction techniques using pedicle screw and rod systems are used, then vertebral alignment can be corrected, but nerve root traction injuries occur
Solution Approach 1:
The instrument performs preliminary distraction of the disc space before correction of vertebral misalignment. By first creating space and then gradually repositioning the vertebrae, the system reduces sudden movements that could cause nerve root traction injuries while maintaining precise alignment correction.
Solution Approach 2:
The correction process is made dynamic and gradual through the actuation mechanism. The spreaders can be incrementally adjusted to slowly reposition vertebrae rather than forcing sudden correction, allowing nerve roots to accommodate the movement and reducing injury risk while achieving precise alignment.
3Reliability
If anterior approach with direct disc removal is used, then fusion rates can be enhanced, but simultaneous distraction and correction cannot be performed
Solution Approach 1:
The instrument merges the functions of disc space distraction and vertebral alignment correction into a single device that can be used during anterior approach surgery. This allows the surgeon to maintain the benefits of anterior fusion while adding the capability for simultaneous distraction and correction.
Solution Approach 2:
The instrument is segmented into multiple functional components including proximal and distal spreaders that can be independently positioned and actuated. This segmentation allows the device to perform distraction and correction functions simultaneously while maintaining adaptability for different surgical scenarios.
4Adaptability or versatility
If motion sparing technologies are used, then milder cases can be treated, but combination of distraction and correction instrumentation is unavailable
Solution Approach 1:
The instrument provides universal applicability across different treatment scenarios from mild to severe cases. The same device can be used for motion sparing technologies in milder cases or for more aggressive correction when needed, providing versatility without requiring multiple specialized instruments.
Data Source
AI summary
An instrument includes a distraction mechanism having a proximal end and an opposed distal end. The distal end includes opposed first and second end members. A first vertebral endplate spreader includes a proximal spreader section mounted to the first end member of the distraction mechanism. The first spreader also includes a distal spreader section operatively connected to the proximal spreader section for lateral movement relative to the proximal spreader section. A second vertebral endplate spreader is mounted to the second end member of the distraction mechanism. The distraction mechanism is configured and adapted to distract the spreaders apart and to retract the spreaders together along a distraction axis. The distal spreader section of the first spreader is configured to move relative to the second spreader in a lateral direction relative to the distraction axis for correction of vertebral alignment, as in treatment of spondylolisthesis, scoliosis, and the like.