WO1996000530A1 - Reversible bone screw lock - Google Patents

Reversible bone screw lock Download PDF

Info

Publication number
WO1996000530A1
WO1996000530A1 PCT/US1995/008315 US9508315W WO9600530A1 WO 1996000530 A1 WO1996000530 A1 WO 1996000530A1 US 9508315 W US9508315 W US 9508315W WO 9600530 A1 WO9600530 A1 WO 9600530A1
Authority
WO
WIPO (PCT)
Prior art keywords
spring
screw
cannula
side openings
bone
Prior art date
Application number
PCT/US1995/008315
Other languages
French (fr)
Inventor
Douglas W. Kohrs
Original Assignee
Spinetech, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Spinetech, Inc. filed Critical Spinetech, Inc.
Priority to EP95926154A priority Critical patent/EP0767631B1/en
Priority to DE69519732T priority patent/DE69519732T2/en
Priority to AT95926154T priority patent/ATE198266T1/en
Priority to AU30012/95A priority patent/AU3001295A/en
Priority to DK95926154T priority patent/DK0767631T3/en
Publication of WO1996000530A1 publication Critical patent/WO1996000530A1/en
Priority to GR20000402868T priority patent/GR3035178T3/en

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8685—Pins or screws or threaded wires; nuts therefor comprising multiple separate parts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/74—Devices for the head or neck or trochanter of the femur
    • A61B17/742—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8872—Instruments for putting said fixation devices against or away from the bone
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A61B2017/00867—Material properties shape memory effect
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0409—Instruments for applying suture anchors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B2017/8655—Pins or screws or threaded wires; nuts therefor with special features for locking in the bone

Definitions

  • This invention relates to a locking bone screw that is reversible.
  • Bone screws are used in a great variety of applications to fix bones, bone fragments, or to act as an anchor for bone plates, rods, etc. In some applications, it is critical to prevent the screws from backing out, since their position may be near vessels, nerves or other implant components which could be damaged. Many attempts have been made to create a usable locking bone screw.
  • the present invention provides a simple cannulated bone screw that includes at least one side opening.
  • a spring is inserted into the cannula while a prong is able to spring out of a side opening into the surrounding bone.
  • the presence of the spring ends in the bone makes screw-out very unlikely since the spring ends must carve out its own threads.
  • the cannula may include guides to make alignment of the spring ends with the side holes easier.
  • any bone screw design may be used which may be cannulated and made with side openings.
  • FIG. 1 is a perspective view of a bone screw, lock spring
  • FIG. la is an end view of the screw showing the cannula and guides;
  • FIG. 2 shows a typical bone break in need of repair;
  • FIG. 3 shows the bone of Fig. 2 being prepared for a screw;
  • FIG. 4 shows insertion of the bone screw typically with an alien wrench;
  • FIG. 5 shows insertion of a spring into the cannula after the bone screw is fully seated;
  • FIG. 6 is a cross-section view of lines 6.6 of Fig. 5 showing the spring insertion
  • Fig. 6a is a view similar to Fig. 6 showing the spring ends projecting through side holes;
  • FIG. 7 shows a variant having four spring ends and side openings
  • FIG. 8 is an end view of the bone of Fig. 7 showing multiple cannula spring guides
  • FIG. 9 is a perspective view showing a bone screw lock with the four pronged spring to be positioned.
  • FIG. 10 is a perspective view showing two 4-pronged bone screws to be positioned.
  • Fig. 1 shows a bone screw 10, spring 12, and inserting tool 14 of the invention.
  • bone screws 10 include a cannula 16 and a head 18 which accepts an alien wrench driver.
  • the shaft 11 of the screw 10 is threaded as shown.
  • the cannula 16 is preferably formed with spring guides 20, 22 which makes it easier to insert the spring and to align the spring 12 in the cannula.
  • the cannula 16 preferably extends throughout the length of the screw to allow a spring 12 to pass from one end and out the other.
  • the cannula 16 may extend only from the head partially down the length of the screw 10.
  • FIG. 1 An insertion tool 14 with a U-shaped end 32 is pushed into the cannula, engaging the spring 12 and depressing it further into the cannula 16.
  • FIG. 2-7 it will be seen that a bone fracture of bone segments 34, 36 may be readily joined with the invention.
  • an opening 50 is formed in the bone which may be countersunk 52 as shown.
  • the bone screw 10, preferably with spring 12 pre-inserted (in the springs' compressed stage), is threaded into the bone with an alien wrench or similar device to torque the screw into place as shown in Figures 5-7.
  • the inserting tool or any device that can contact the spring 12 and depress it down the cannula 16 is employed.
  • the inserting tool 14 as shown has a u-shaped end 32 that catches the spring 12 readily.
  • the spring 12 is depressed down the cannula 16 until the spring ends 28, 30 are able to pass out through the side openings 24, 26 as shown in Figure 6a.
  • the spring 12 is constructed such that the ends 28, 30 will be forced outwardly into the bone and will actually extend into the bone further than the tapped threads. This helps to lock the bone screw 10 in place, since the spring ends 28, 30 would need to tear out through bone or twist out to form an enlarged thread or groove to loosen.
  • Figures 7-9 show that the bone screws 10 of the invention may have multiple springs 12, spring guides 38, 40 in addition to guides 20, 22; and additional side openings.
  • the spring 12 may be formed as a single unit with four projecting ends, each of which would pass through a matching side opening. It should be apparent that a single spring end up to many spring ends may be employed.
  • Figure 10 shows a bone screw 10 having two separate side openings 44,
  • a spring 12 may be inserted until the spring ends 28 project through opening 44 to lock into bone. If the depth of the screw must be readjusted, but not removed, the spring is simply depressed down the shaft to disengage the lock. The screw could then be positioned deeper and the spring would be advanced down to opening 46 to relock. This also makes it easy to reuse the screw if it needs to be removed for repositioning.
  • the bone screw and spring may be formed from any biocompatible material such as is well known in the art. Stainless steels, titanium and nitinol alloys are examples for both the screw body and the spring.
  • the spring may be formed to provide more or less outward spring force.
  • any bone screw that may be cannulated may be modified to benefit from this invention.
  • bone screws intended for use in cancellous bone may use this invention.
  • Procedures that may employ the inventive devices include bone plate fixation generally, pedicle screw use, tibial tray fixation, cervical plate fixation, total hip acetabular cup fixation and intramedullary rod fixation.
  • the present disclosure is an exemplification of the principles of the invention and is not intended to limit the invention to the particular embodiments illustrated.

Abstract

A medical bone screw (10) including a lock to lessen the possibility of pull-out or screw-out. The screw (10) may be any bone screw including a cannula (16). A wire spring (12) is inserted partially into the cannula (16) prior to use. Once in position, the wire spring (12) is pushed further down the cannula (16) until its ends may project out side openings (24, 26) in the screw. These projections (30) lock the screw (10) in place. Further depression of the wire spring (12) disengages the projections (30) so the screw (10) may be removed.

Description

REVERSIBLEBONE SCREWLOCK
Background of the Invention 1. Field of the Invention
This invention relates to a locking bone screw that is reversible. 2. Description of the Related Art
Bone screws are used in a great variety of applications to fix bones, bone fragments, or to act as an anchor for bone plates, rods, etc. In some applications, it is critical to prevent the screws from backing out, since their position may be near vessels, nerves or other implant components which could be damaged. Many attempts have been made to create a usable locking bone screw.
Most are quite complicated and are not readily removable when desired. Positive locking of bone screws is very desirable, since in some applications, even minor pull- out or screw-out could cause contact with a vital structure in the body. Even of greater need is a positively locking bone screw which could be removed if desired. The art described in this section is not intended to constitute an admission that any patent, publication or other information referred to herein is "prior art" with respect to this invention, unless specifically designated as such. In addition, this section should not be construed to mean that a search has been made or that no other pertinent information as defined in 37 C.F.R. § 1.56(a) exists.
Summary of the Invention
The present invention provides a simple cannulated bone screw that includes at least one side opening. A spring is inserted into the cannula while a prong is able to spring out of a side opening into the surrounding bone. The presence of the spring ends in the bone makes screw-out very unlikely since the spring ends must carve out its own threads.
It is possible to remove or reposition bone screws of this invention. One simply needs to depress the spring further down the cannula to disengage the spring ends. The screw may then be removed and repositioned. One or more spring ends and matching side openings may be employed.
The cannula may include guides to make alignment of the spring ends with the side holes easier. Generally, any bone screw design may be used which may be cannulated and made with side openings. Brief Description of the Drawings
A detailed description of the invention is hereafter described with specific reference being made to the drawings in which: FIG. 1 is a perspective view of a bone screw, lock spring;
FIG. la is an end view of the screw showing the cannula and guides; FIG. 2 shows a typical bone break in need of repair; FIG. 3 shows the bone of Fig. 2 being prepared for a screw; FIG. 4 shows insertion of the bone screw typically with an alien wrench; FIG. 5 shows insertion of a spring into the cannula after the bone screw is fully seated;
FIG. 6 is a cross-section view of lines 6.6 of Fig. 5 showing the spring insertion;
Fig. 6a is a view similar to Fig. 6 showing the spring ends projecting through side holes;
FIG. 7 shows a variant having four spring ends and side openings; FIG. 8 is an end view of the bone of Fig. 7 showing multiple cannula spring guides;
FIG. 9 is a perspective view showing a bone screw lock with the four pronged spring to be positioned; and
FIG. 10 is a perspective view showing two 4-pronged bone screws to be positioned.
Description of the Preferred Embodiments With reference to the figures, Fig. 1 shows a bone screw 10, spring 12, and inserting tool 14 of the invention. As seen in Fig. la, bone screws 10 include a cannula 16 and a head 18 which accepts an alien wrench driver. The shaft 11 of the screw 10 is threaded as shown. The cannula 16 is preferably formed with spring guides 20, 22 which makes it easier to insert the spring and to align the spring 12 in the cannula. The cannula 16 preferably extends throughout the length of the screw to allow a spring 12 to pass from one end and out the other. The cannula 16 may extend only from the head partially down the length of the screw 10.
Intermediate the ends of the bone screw 10 are a pair of opposing side openings 24, 26 which communicate with the cannula 16. The spring 12 as shown in Fig. 1 , 5, 6, 6a has two ends 28, 30 (See FIG. 5) which are positioned in spring guides 20, 22 of the cannula 16. An insertion tool 14 with a U-shaped end 32 is pushed into the cannula, engaging the spring 12 and depressing it further into the cannula 16. With reference to Figures 2-7, it will be seen that a bone fracture of bone segments 34, 36 may be readily joined with the invention. As shown in Figure 3, an opening 50 is formed in the bone which may be countersunk 52 as shown. The bone screw 10, preferably with spring 12 pre-inserted (in the springs' compressed stage), is threaded into the bone with an alien wrench or similar device to torque the screw into place as shown in Figures 5-7.
Once the bone screw 10 is at the desired depth, the inserting tool, or any device that can contact the spring 12 and depress it down the cannula 16 is employed. The inserting tool 14 as shown has a u-shaped end 32 that catches the spring 12 readily. The spring 12 is depressed down the cannula 16 until the spring ends 28, 30 are able to pass out through the side openings 24, 26 as shown in Figure 6a. The spring 12 is constructed such that the ends 28, 30 will be forced outwardly into the bone and will actually extend into the bone further than the tapped threads. This helps to lock the bone screw 10 in place, since the spring ends 28, 30 would need to tear out through bone or twist out to form an enlarged thread or groove to loosen. Figures 7-9 show that the bone screws 10 of the invention may have multiple springs 12, spring guides 38, 40 in addition to guides 20, 22; and additional side openings. The spring 12 may be formed as a single unit with four projecting ends, each of which would pass through a matching side opening. It should be apparent that a single spring end up to many spring ends may be employed. Figure 10 shows a bone screw 10 having two separate side openings 44,
46 that are spaced apart along the shaft. In this form, a spring 12 may be inserted until the spring ends 28 project through opening 44 to lock into bone. If the depth of the screw must be readjusted, but not removed, the spring is simply depressed down the shaft to disengage the lock. The screw could then be positioned deeper and the spring would be advanced down to opening 46 to relock. This also makes it easy to reuse the screw if it needs to be removed for repositioning.
If the bone screw needs to be removed for any reason, other locking bone screws are nearly impossible to remove. With the device of the invention, one simply depresses the spring 12 further down the cannula 16 so the spring ends 28, 30 re-enter the cannula and are held fully inside the device.
The bone screw and spring may be formed from any biocompatible material such as is well known in the art. Stainless steels, titanium and nitinol alloys are examples for both the screw body and the spring. The spring may be formed to provide more or less outward spring force.
Any bone screw that may be cannulated may be modified to benefit from this invention. Primarily, bone screws intended for use in cancellous bone may use this invention. While this invention may be embodied in many different forms, there are shown in the drawings and described in detail herein specific preferred embodiments of the invention. Procedures that may employ the inventive devices include bone plate fixation generally, pedicle screw use, tibial tray fixation, cervical plate fixation, total hip acetabular cup fixation and intramedullary rod fixation. The present disclosure is an exemplification of the principles of the invention and is not intended to limit the invention to the particular embodiments illustrated.
This completes the description of the preferred and alternate embodiments of the invention. Those skilled in the art may recognize other equivalents to the specific embodiment described herein which equivalents are intended to be encompassed by the claims attached hereto.

Claims

WHAT IS CLAIMED IS:
1. A reversible locking bone screw comprising: (a) a threaded shaft including a head at one end for turning said screw, said screw including a cannula extending from said head into said threaded shaft;
(b) a pair of opposing side openings formed through said threaded shaft to communicate with said cannula;
(c) a spring wire shaped to define a vee have two spring ends normally spring- biased away from each other, each spring end of which may extend through said side openings;
(d) said cannula including opposing spring guide grooves extending from said head to said side openings for guiding said spring ends to said side openings, said cannula extending from said head to below said side openings such that said spring wire may be inserted past said side openings such that no portion of said spring wire extends through a side opening.
2. The reversible locking bone screw of Claim 2 wherein said shaft includes a second pair of side openings spaced directly below said first side openings.
PCT/US1995/008315 1994-06-30 1995-06-30 Reversible bone screw lock WO1996000530A1 (en)

Priority Applications (6)

Application Number Priority Date Filing Date Title
EP95926154A EP0767631B1 (en) 1994-06-30 1995-06-30 Reversible bone screw lock
DE69519732T DE69519732T2 (en) 1994-06-30 1995-06-30 Bone screw with reversible closure
AT95926154T ATE198266T1 (en) 1994-06-30 1995-06-30 BONE SCREW WITH REVERSIBLE CLOSURE
AU30012/95A AU3001295A (en) 1994-06-30 1995-06-30 Reversible bone screw lock
DK95926154T DK0767631T3 (en) 1994-06-30 1995-06-30 Lockable bone screw lock
GR20000402868T GR3035178T3 (en) 1994-06-30 2000-12-29 Reversible bone screw lock

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US08/268,281 1994-06-30
US08/268,281 US5478342A (en) 1994-06-30 1994-06-30 Reversible bone screw lock

Publications (1)

Publication Number Publication Date
WO1996000530A1 true WO1996000530A1 (en) 1996-01-11

Family

ID=23022259

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1995/008315 WO1996000530A1 (en) 1994-06-30 1995-06-30 Reversible bone screw lock

Country Status (10)

Country Link
US (1) US5478342A (en)
EP (1) EP0767631B1 (en)
AT (1) ATE198266T1 (en)
AU (1) AU3001295A (en)
DE (1) DE69519732T2 (en)
DK (1) DK0767631T3 (en)
ES (1) ES2153899T3 (en)
GR (1) GR3035178T3 (en)
PT (1) PT767631E (en)
WO (1) WO1996000530A1 (en)

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EP0767631A4 (en) 1998-03-25
GR3035178T3 (en) 2001-04-30
DE69519732T2 (en) 2001-06-07
AU3001295A (en) 1996-01-25
ATE198266T1 (en) 2001-01-15
DK0767631T3 (en) 2001-02-12
PT767631E (en) 2001-05-31
EP0767631A1 (en) 1997-04-16
ES2153899T3 (en) 2001-03-16
DE69519732D1 (en) 2001-02-01
US5478342A (en) 1995-12-26
EP0767631B1 (en) 2000-12-27

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