Rod introduction apparatus

Abstract

An introduction apparatus for approximating a longitudinal member and an implant to permit fixation therebetween. The introduction apparatus having a gripping nose for securely engaging an implant, a lateral approximation mechanism for laterally aligning an implant and an offset longitudinal member, and a reduction mechanism for reducing the vertical distance between the implant and the longitudinal member. The introduction apparatus is provide with a gripping nose actuated by axial movement of a clamping shaft in an outer sleeve. The clamping shaft further includes an axial cannula for passage of a fastener to the implant.

1. A multiple action insertion apparatus for engaging a longitudinal member and an implant, comprising:
 an implant holder including a first clamping branch and a second clamping branch cooperable with said first clamping branch to hold to an implant;   a reduction mechanism interconnected with said implant holder, said reduction mechanism having a distal end for engaging the longitudinal member, wherein said reduction mechanism urges the longitudinal member into vertical alignment with the implant; and   a lateral approximator mechanism interconnected with said implant holder, said lateral approximator mechanism having a distal end disposed adjacent said first and second clamping branches, said distal end adapted to engage the longitudinal member, wherein said lateral approximator mechanism urges the longitudinal member into lateral alignment with the implant.   
     
     
       2. The insertion apparatus of  claim 1 , wherein said lateral approximator mechanism is a lever arm pivotally connected to said implant holder. 
     
     
       3. The insertion apparatus of  claim 1 , A multiple action insertion apparatus for engaging a longitudinal member and an implant, comprising:
 an implant holder including a first clamping branch and a second clamping branch cooperable with, and movable relative to, said first clamping branch to hold to an implant; 
 a reduction mechanism interconnected with said implant holder, said reduction mechanism having a distal end for engaging the longitudinal member, wherein said reduction mechanism urges the longitudinal member into vertical alignment with the implant; and 
 a lateral approximator mechanism interconnected with said implant holder, said lateral approximator mechanism having a distal end disposed adjacent said first and second clamping branches, said distal end adapted to engage the longitudinal member, wherein said lateral approximator mechanism urges the longitudinal member into lateral alignment with the implant,  
 wherein said implant holder comprises a shaft having a gripping end with a portion, said gripping end defining a first clamping branch and a cooperable second clamping branch, said first and second clamping branches tending to assume an insertion position defining a first distance between said first and second clamping branches, and said first and second clamping branches compressible into a clamping position defining a second distance between said first and second clamping branches, said first distance greater than said second distance; and 
 a sleeve defining an interior channel, said shaft slidably received within said interior channel, said shaft moveable between a first position with said portion extending from said sleeve and a second position with said portion drawn into said sleeve; 
 wherein movement of said shaft within said tubular sleeve from said first position to said second position controls said first and second clamping branches from said insertion position to said clamping position. 
 
     
     
       4. The introduction apparatus of  claim 3 , wherein said reduction apparatus comprises a series of external threads disposed on said shaft and an internally threaded nut rotatably mounted on said sleeve, said internally threaded nut cooperable with said external threads, said sleeve further defining a bearing surface adjacent said gripping end for engaging the longitudinal member, wherein rotation of said nut moves said shaft with respect to said sleeve and urges said bearing surface against the longitudinal member thereby reducing the distance between the longitudinal member and the implant. 
     
     
       5. The introduction apparatus of  claim 4 , wherein the longitudinal member is a rod and said bearing surface is a recessed area on said sleeve. 
     
     
       6. A multiple action insertion apparatus for engaging a longitudinal member and an implant, comprising:
 means for attaching to an implant;   means for lateral approximation of a longitudinal member laterally offset from the implant, said means for lateral approximation interconnected with said means for attaching; and   means for vertical reduction of the longitudinal member vertically offset from the implant, said means for vertical reduction interconnected with said means for attaching, wherein said means for lateral approximation laterally aligns the longitudinal member over the implant and said means for vertical reduction vertically aligns the longitudinal member with the implant.   
     
     
       7. An implant holder for holding an implant adapted to receive a fastener, comprising:
 means for gripping the implant said means for gripping including a gripping end and a handle defining a longitudinal cannula having a distal end adjacent said gripping end, said cannula adapted to receive a fastener cooperable with said implant;   wherein said means for gripping includes a first clamping branch and a second clamping branch defining said gripping end, said first and second clamping branches aligned in a spaced relationship and cooperable to engage the implant, and wherein said handle defines a series of threads opposite said gripping end, and further including a sleeve defining an internal channel adapted to receive at least a portion of said gripping end and said handle, and a nut rotatably mounted on said sleeve, said nut cooperable with said threads on said handle.   
     
     
       8. The implant holder of  claim 7 , wherein said sleeve has a distal end adjacent said gripping end and said sleeve defines a bearing surface adapted to bear against a longitudinal member, wherein rotation of said nut draws said handle into said sleeve and thereby reduces the distance between the implant engaged by said first and second clamping branches and the longitudinal member bearing against said bearing surface of said sleeve. 
     
     
       9. The implant holder of  claim 8 , further including a lateral approximating lever pivotally attached to said sleeve. 
     
     
       10. An implant holder for gripping an implant, comprising:
 a shaft having a gripping end with a portion, said gripping end defining a first clamping branch and a cooperable second clamping branch, said first and second clamping branches tending to assume an insertion position defining a first distance between said first and second clamping branches, and said first and second clamping branches compressible into a clamping position defining a second distance between said first and second clamping branches, said first distance greater than said second distance; and 
 a sleeve defining an interior channel, said shaft slidably received within said interior channel, said shaft moveable between a first position with said portion extending from said sleeve and a second position with said portion drawn into said sleeve; and 
 an actuating mechanism for moving said shaft within said tubular sleeve, said actuating mechanism provided about said tubular sleeve and an actuating force for operating said actuating mechanism applied about the tubular sleeve, 
 wherein movement of said shaft within said tubular sleeve from said first position to said second position controls said first and second clamping branches from said insertion position to said clamping position. 
 
     
     
       11. The implant holder of  claim 10 , wherein said sleeve defines an engagement surface for engaging a longitudinal member to be interconnected with said implant, whereby positioning said shaft in said second position clamps the implant and further movement of said inner shaft into said sleeve urges the implant into alignment with the longitudinal member. 
     
     
       12. The implant holder of  claim 11 , further including means for controlling the position of said shaft within said sleeve wherein said actuator mechanism comprises threads provided about the central opening of said tubular sleeve. 
     
     
       13. The implant holder of  claim 12 , wherein said means for controlling actuator mechanism includes an external thread disposed on said inner shaft and a nut rotatably mounted on said tubular sleeve, said nut having an internal thread corresponding to said external thread, whereby said inner shaft may be drawn into said outer sleeve by rotation of said nut. 
     
     
       14. The implant holder of  claim 11 , wherein said threads on said shaft includes are formed as a series of external threads and said shaft further including includes an internally threaded nut rotatably mounted on said sleeve, said internally threaded nut cooperable with said external threads, wherein rotation of said nut moves said shaft with respect to said sleeve. 
     
     
       15. The implant holder of  claim 14 , further including a lateral approximator lever pivotally engaging said sleeve, said lateral approximator lever having a rod engaging end adapted to engage a laterally offset rod, wherein upon engaging a laterally offset rod, said lateral approximator lever may be pivoted toward said sleeve, thereby positioning the rod adjacent the implant. 
     
     
       16. The implant holder of  claim 15 , wherein said first and second clamping branches each have a distal end and include at least one projection defined on each of said distal ends. 
     
     
       17. The implant holder of  claim 10 , wherein said shaft includes a handle disposed opposite said gripping, said handle utilized to position said shaft within said sleeve. 
     
     
       18. The implant holder of  claim 10 , wherein said shaft is cannulated to slidingly receive a fastening member adapted to be engaged with the implant. 
     
     
       19. The implant holder of  claim 10 , wherein said attachment to said implant is a non-pivotal attachment. 
     
     
       20. The implant holder of  claim 10 , further including a lateral approximator lever pivotally engaging said sleeve, said lateral approximator lever having a rod engaging end adapted to engage a laterally offset rod, wherein upon engaging a laterally offset rod, said lateral approximator lever may be pivoted toward said sleeve, the rod is positioned adjacent the implant. 
     
     
       21. The implant holder of  claim 20 , wherein said lateral approximator lever removably engages said sleeve, whereby said lever may be selectively removed. 
     
     
       22. The implant holder of  claim 10 , wherein said first and second clamping branches each have a distal end and include at least one projection defined on said distal end. 
     
     
       23. The implant holder of  claim 10 , wherein said shaft defines a cannula having a distal end adjacent said first and second clamping branches, said cannula adapted to slidingly receive a fastener, whereby said fastener is delivered through said cannula to said distal end for interengagement with the implant. 
     
     
       24. An implant holder having a rod reduction mechanism for vertically aligning a longitudinal member and an implant, comprising:
 means for gripping the implant; 
 a sleeve having an axis and a distal end adapted to engage the longitudinal member, said sleeve having an axial bore sized to receive said means for gripping, said means for gripping slidably received within said axial bore; and 
 threaded means for axially displacing said sleeve with respect to said means for gripping, whereby a verticalvertically offset longitudinal member is urged into alignment with the implant. 
 
     
     
       25. The implant holder of  claim 24 , wherein said means for gripping are articulating forceps. 
     
     
       26. The implant holder of  claim 24 , wherein said means for axial displacement includes a series of threads disposed on said means for gripping and a nut rotatably mounted on said sleeve and threadedly engagable with said threads. 
     
     
       27. The implant holder of  claim 24 , wherein said means for axial displacement includes a rack disposed on said means for gripping and a pinion pivotally mounted on said sleeve and interengagable with said rack. 
     
     
       28. A method for interconnecting a longitudinal member and an implant adapted to engage the longitudinal member, comprising the steps of:
 providing an introduction apparatus having an attachment mechanism with a cannula and a vertical reduction mechanism; 
 attaching the introduction apparatus to the implant; 
 operating the vertical reduction mechanism, by actuating a threaded engagement mechanism of the vertical reduction mechanism, to force the longitudinal member into alignment with the implant; 
 inserting a fastener through the cannula; 
 interconnecting the fastener and the implant, wherein the longitudinal member is securely attached to the implant; and 
 removing the introduction apparatus. 
 
     
     
       29. A method for interconnecting a longitudinal member and an implant adapted to engage the longitudinal member, comprising the steps of:
 providing an introduction apparatus having an attachment mechanism, a lateral approximation lever, and a vertical reduction mechanism;   attaching the introduction apparatus to the implant;   engaging a laterally offset longitudinal member with one end of the lateral approximator lever;   rotating the lever to urge the longitudinal member into lateral alignment with the implant;   operating the vertical reduction mechanism to force the longitudinal member into vertical alignment with the implant; and   interconnecting the longitudinal member and the implant.   
     
     
       30. The method of  claim 29 , A method for interconnecting a longitudinal member and an implant adapted to engage the longitudinal member, comprising the steps of:
 providing an introduction apparatus having an attachment mechanism, a lateral approximation lever, and a vertical reduction mechanism; 
 attaching the introduction apparatus to the implant; 
 engaging a laterally offset longitudinal member with one end of the lateral approximator lever; 
 rotating the lever to urge the longitudinal member into lateral alignment with the implant; 
 operating the vertical reduction mechanism to force the longitudinal member into vertical alignment with the implant; and 
 interconnecting the longitudinal member and the implant, 
 wherein the providing step includes providing attachment mechanism having a cannula and further including the step of delivering a fastener through the cannula and to the implant prior to interconnecting the longitudinal member and the implant. 
 
     
     
       31. A method for interconnecting a longitudinal member and an implant adapted to engage the longitudinal member, comprising the steps of:
 providing an introduction apparatus having an attachment mechanism with attachment prongs for attaching to the implant, a cannula and a vertical reduction mechanism;   attaching the introduction apparatus to the implant;   operating the vertical reduction mechanism to force the longitudinal member into alignment with the implant;   inserting a threaded fastener through the cannula;   interconnecting the fastener and the implant, wherein the longitudinal member is securely attached to the implant; and   removing the introduction apparatus,   wherein the introduction apparatus further comprises an elongated member that extends through the cannula, the elongated member engaging the fastener in said interconnecting step to cause the fastener to interconnect with the implant.   
     
     
       32. The method of claim 31, wherein the attachment prongs are formed on the proximal end of the cannula. 
     
     
       33. The method of claim 32, wherein the implant is a bone screw. 
     
     
       34. The method of claim 33, wherein the longitudinal member is an implantable rod. 
     
     
       35. The method of claim 32, wherein the elongated member is separate from the vertical reduction mechanism. 
     
     
       36. The method of claim 32, wherein the introduction apparatus further comprises an actuator for operating the vertical reduction mechanism in said operating step, and the actuator connects to the distal end of the cannula about a circumference of the distal end. 
     
     
       37. The method of claim 36, wherein the implant contains a threaded opening that receives the threaded fastener in said interconnecting step. 
     
     
       38. The method of claim 31, wherein the operating and inserting steps take place separately. 
     
     
       39. An implant holder for gripping an implant, comprising:
 a shaft having a gripping end with a portion, said gripping end defining a first clamping branch and a cooperable second clamping branch, said first and second clamping branches tending to assume an insertion position defining a first distance between said first and second clamping branches, and said first and second clamping branches compressible into a clamping position defining a second distance between said first and second clamping branches, said first distance greater than said second distance; and   a sleeve defining an interior channel, said shaft slidably received within said interior channel, said shaft moveable between a first position with said portion extending from said sleeve and a second position with said portion drawn into said sleeve;   wherein movement of said shaft within said tubular sleeve from said first position to said second position controls said first and second clamping branches from said insertion position to said clamping position, and   wherein said implant holder further comprises an actuator for moving said shaft relative to said tubular sleeve, said actuator comprising a first portion engaging a first side of said sleeve and a second portion engaging a second side of said sleeve opposite said first side, said first and second portions moving relative to said shaft to actuate movement of said sleeve.   
     
     
       40. A system for spinal, surgery comprising:
 said implant holder of claim 39;   a series of implants; and   a longitudinal member,   wherein said implant holder grips each of said series of implants, and   wherein the relative movement of said shaft and said tubular sleeve of said implant holder operate to reduce said longitudinal member to connect to an implant of said series of implants.   
     
     
       41. The system of claim 40, wherein said series of bone implants are bone screws and said longitudinal member is a rod. 
     
     
       42. The system of claim 41, wherein said shaft defines a passage through which a fastener for fastening said rod to a bone screw is insertable, while said first and second clamping branches grip said bone screw in the clamping position. 
     
     
       43. The system of claim 42, wherein a distal opening of said sleeve has an arcuate engaging edge for engaging said rod when said shaft and said sleeve are actuated relative to each other, said engaging edge operating to reduce said rod. 
     
     
       44. The system of claim 43, wherein said actuator is symmetrical with respect to opposing sides of said shaft. 
     
     
       45. A system for spinal surgery comprising:
 the insertion apparatus of claim 40;   a series of implants; and   a longitudinal member,   wherein said implant holder grips each of said series of implants, and   wherein the relative movement of said shaft and said tubular sleeve of said implant holder operate to reduce said longitudinal member to connect to an implant of said series of implants.   
     
     
       46. A system for spinal surgery comprising:
 said implant holder of claim 10;   a series of implants; and   a longitudinal member,   wherein said implant holder grips each of said series of implants, and   wherein the relative movement of said shaft and said tubular sleeve of said implant holder operate to reduce said longitudinal member to connect to an implant of said series of implants.