Medical installation tool

Abstract

An installation tool that is useful for the efficient and effective placement of an article, such as an artificial disc, between adjacent vertebral bodies is provided. The installation tool can be provided as a kit having modular components which allow the surgeon to select from among a variety of components to assemble an installation tool that is optimized for its intended use. The installation tool of the invention generally includes a pair of opposed levers, each of which has a proximal handle portion and a distal portion. A fulcrum is disposed between the two levers to enable proper operation of the tool. The tool further includes a pusher block that is positioned between the two levers and is selectively movable between an initial location distal of the fulcrum and a final location adjacent the distal end of the levers. The pusher block includes a proximal end, a distal end, and a bore extending at least partially therethrough. A pusher rod, which facilitates movement of a pusher block, has a distal end extending into the bore in the pusher block and a proximal, handle end.

What is claimed is: 
     
       1. A medical device installation kit, comprising:
 a pair of opposed levers, each lever having a proximal handle portion and a distal portion;   a fulcrum disposed between the opposed levers for allowing pivotal movement of the levers with respect to each other; and   a plurality of prosthesis installation assemblies adapted to be slidably disposed between the levers and slidably coupled to the fulcrum such that each prosthesis installation assembly is movable between a first, proximal position and a second, distal position, each assembly including a handle portion effective to move the prosthesis installation assembly between the first and second positions, and a distal prosthesis effecting element adapted to place a prosthesis between adjacent bone structures.   
     
     
       2. The medical device installation kit of  claim 1 , wherein one of the prosthesis installation assemblies comprises:
 a pusher block having a proximal end, a distal end, and a bore extending therethrough;   a pusher rod slidably disposed between the levers and extending through the bore in the pusher block; and   a grasping element effective to releasably engage a prosthesis.   
     
     
       3. The medical device installation kit of  claim 2 , wherein the grasping element has an elongate proximal portion adapted to fit within the bore of the distal end of the pusher block, and a distal portion having opposed first and second components which are movable between a first, open position, and a second, closed position that is effective to engage a prosthesis. 
     
     
       4. The medical device installation kit of  claim 3 , wherein a distal end of the rod threadingly engages the bore of the pusher block and wherein rotation of the rod in a first direction is effective to cause the elongate proximal portion of the grasping element to move proximally within the bore of the pusher block and move the first and second components to the second, closed position while rotation of the rod in a second direction is effective to cause the elongate proximal portion of the grasping element to move distally out of the bore of the pusher block and move the first and second components to the first, open position. 
     
     
       5. The medical device installation kit of  claim 1 , wherein one of the prosthesis installation assemblies comprises a pusher rod having a proximal handle portion, and distal portion having a distal tip adapted to positively engage a prosthesis. 
     
     
       6. The medical device installation kit of  claim 5 , wherein the prosthesis installation assembly further includes a pusher block having a proximal end, a distal end, and a bore extending therethrough, the distal portion of the pusher rod extending through the bore in the pusher block. 
     
     
       7. The medical device installation kit of  claim 1 , wherein one of the prosthesis installation assemblies comprises:
 a pusher rod having an externally threaded first distal portion and an externally threaded second distal portion, the second distal portion having a diameter greater than a diameter of the first distal portion and being positioned proximal to the first distal portion;   a pusher block having a bore extending entirely therethrough having a threaded proximal opening that is threadingly matable with the second distal portion of the rod, and a distal opening having a diameter less than the diameter of the second distal portion of the rod; and   a chamber disposed between the proximal and distal openings and having a diameter greater than the diameter of the second distal portion of the rod.   
     
     
       8. The medical device installation kit of  claim 7 , wherein the rod is freely rotatable when the second distal portion is disposed within the chamber of the pusher block. 
     
     
       9. The medical device installation kit of  claim 8 , wherein the first distal portion of the rod is adapted to positively engage a prosthesis. 
     
     
       10. The medical device installation kit of  claim 1 , wherein one of the prosthesis installation assemblies comprises:
 a pusher block having a proximal end, a distal end, and a bore extending therethrough, the pusher block being slidably disposed between the levers;   a pusher rod having a proximal, handle portion and a distal portion extending through the bore in the pusher block; and   a plurality of connector elements having a proximal portion adapted to mate to a distal tip of the pusher rod and a distal portion adapted to mate to a prosthesis.   
     
     
       11. A medical device installation tool, comprising:
 a pair of opposed levers, each having a proximal, handle portion and a distal portion;   a fulcrum disposed between the two levers and including an opening extending therethrough;   a pusher block having a proximal end, a distal end, and a bore extending at least partially therethrough, the pusher block being positioned between the two levers and slidably moveable between an initial location distal of the fulcrum and a final location adjacent a distal end of the levers; and   a pusher rod having a proximal, handle end, and a distal end, the pusher rod being slidably disposed through the fulcrum and the distal end of the pusher rod extending into the bore in the pusher block.   
     
     
       12. The medical device installation tool of  claim 11 , wherein the bore is a blind bore and the distal end of the pusher rod mates with the blind bore in the pusher block. 
     
     
       13. The medical devise installation tool of  claim 11 , wherein each lever includes a surface feature disposed between the proximal and distal portions thereof, the surface feature being effective to slidably mate to a complementary surface feature formed in a prosthesis. 
     
     
       14. The medical device installation tool of  claim 11 , wherein the bore extends entirely through the pusher block and the distal end of the pusher rod has a distal tip that is adapted to extend through the bore in the pusher block and that is effective to mate to a prosthesis. 
     
     
       15. The medical device installation tool of  claim 14 , wherein the pusher block has a height effective to separate the levers from a prosthesis such that, when the pusher rod is mated to a prosthesis, the levers are spaced apart from the prosthesis. 
     
     
       16. The medical device installation tool of  claim 14 , wherein the rod includes an externally threaded first distal portion and an externally threaded second distal portion, the second distal portion having a diameter greater than a diameter of the first distal portion and being positioned proximal to the first distal portion. 
     
     
       17. The medical device installation tool of  claim 16 , wherein:
 the bore of the pusher block includes a threaded proximal opening that is threadingly matable with the second distal portion of the rod;   a distal opening of the pusher block having a diameter less than the diameter of the second distal portion of the rod; and   a chamber disposed between the proximal and distal openings, the chamber having a diameter greater than the diameter of the second distal portion of the rod.   
     
     
       18. The medical device installation tool of  claim 17 , wherein the rod is freely rotatable when the second distal portion is disposed within the chamber of the pusher block. 
     
     
       19. The medical device installation tool of  claim 17 , wherein the threaded first distal portion of the rod is threaded in a direction opposite to the direction of the threads of the threaded second distal portion. 
     
     
       20. The medical device installation tool of  claim 11 , wherein the bore extends entirely through the pusher block and a distal tip of the pusher rod is adapted to extend through the bore in the pusher block, the distal tip of the pusher rod being further adapted to mate to a grasping element effective to releasably engage a prosthesis. 
     
     
       21. The medical device installation tool of  claim 20 , further comprising a grasping element that has an elongate proximal portion with a bore formed therein and a distal portion that is effective to releasably engage a prosthesis, the proximal portion having an outer diameter that is adapted to fit within the bore of the distal end of the pusher block. 
     
     
       22. The medical device installation tool of  claim 21 , wherein the distal portion of the grasping element includes opposed first and second components that are movable between a first, open position, and a second, closed position that is effective to engage a prosthesis. 
     
     
       23. The medical device installation tool of  claim 22 , wherein the distal end of the rod threadingly engages the bore of the grasping element, and wherein rotation of the rod in a first direction is effective to cause the elongate proximal portion of the grasping element to move proximally within the bore of the pusher block and move the first and second components to the second, closed position while rotation of the rod in a second direction is effective to cause the elongate proximal portion of the grasping element to move distally out of the bore of the pusher block and move the first and second components to the first, open position. 
     
     
       24. The medical device installation tool of  claim 23 , wherein the first and second components each include at least one surface feature effective to engage a prosthesis. 
     
     
       25. The medical installation tool of  claim 11 , wherein the bore extends entirely through the pusher block and a distal tip of the pusher rod is adapted to extend through the bore in the pusher block, the distal tip of the pusher rod being further adapted to positively engage a prosthesis. 
     
     
       26. The medical device installation tool of  claim 11 , wherein the pusher block has upper and lower recesses, each adapted to seat one of the levers, each of the upper and lower recesses including opposed, substantially vertical walls separated by a substantially horizontal base wall, the vertical walls each including a rail extending between the proximal and distal ends of the pusher block and effective to retain the levers. 
     
     
       27. The medical device installation tool of  claim 11 , wherein the handle portion of each lever is substantially T-shaped. 
     
     
       28. The medical device installation tool of  claim 11 , wherein the pusher rod includes a stop member effective to limit advancement of the pusher rod through the opening in the fulcrum. 
     
     
       29. The medical device installation tool of  claim 11 , wherein the distal portion of each lever includes a curve tip. 
     
     
       30. A medical device installation tool, comprising:
 a pair of opposed levers movable at a distal end thereof relative to one another between a closed position and an open position;   a pusher block positioned between the pair of opposed levers and being movable between an initial proximal location and a final location adjacent to the distal end of the pair of opposed levers, the pusher block including projections that engage respective tracks formed in the pair of opposed levers as the projections advance distally with the pusher block; and   a pusher rod disposed between the pair of opposed levers and having a distal end that is coupled to the pusher block.   
     
     
       31. The medical device installation tool of claim 30, wherein each lever has an indented region formed therein that is received in one of a plurality of opposed recesses formed in a fulcrum, wherein the opposed recesses each have a generally rectangular shape. 
     
     
       32. The medical device installation tool of claim 30, wherein each lever includes opposed cut-outs formed therein and defining an indented region that is received in one of a plurality of opposed recesses formed in a fulcrum. 
     
     
       33. A medical device installation system, comprising:
 a pair of opposed levers coupled to one another adjacent a proximal end thereof and being movable at a distal end thereof between a closed position and an open position, each lever having a surface feature formed on an inwardly facing surface thereof for engaging an implant;   a pusher component positioned between the pair of opposed levers and configured to distally advance an implant, the pusher component including projections which are in slidable engagement with the opposed levers during distal advancement to maintain alignment between the pusher component and the opposed levers; and   an implant having first and second complementary surface features formed thereon and complementary to the surface features of the opposed levers to facilitate movement of the implant with respect to the opposed levers.   
     
     
       34. The tool of claim 33, wherein the surface feature on each lever extends between the proximal and distal ends of the lever. 
     
     
       35. The tool of claim 33, wherein the surface feature on each lever comprises a rail, and the first and second surface features on the implant comprise first and second channels formed in the implant. 
     
     
       36. The tool of claim 35, wherein the pusher component comprises:
 a pusher block movable distally towards the distal ends of the opposed levers to move the levers from the closed position to the open position; and   a pusher rod coupled to the pusher block such that the pusher rod is configured to advance the pusher block distally.   
     
     
       37. The tool of claim 36, wherein the projections comprise a plurality of posts extending from the pusher block, each post being complementary to a track formed in each lever such that the post is configured to slide along the track to facilitate movement of the pusher block with respect to the opposed levers. 
     
     
       38. The tool of claim 33, wherein at least one of the opposed levers includes a stop feature located on a distal portion thereof and configured to engage a vertebral body to stop further distal movement of the opposed levers. 
     
     
       39. The tool of claim 38, wherein the stop feature comprises a vertically oriented, distally facing surface located on the distal portion of at least one of the opposed levers. 
     
     
       40. A medical device installation system, comprising:
 a first lever having proximal and distal ends, the first lever having a first rail formed thereon;   a second lever having proximal and distal ends, the second lever being coupled to the first lever at a location proximal to the distal ends of the first and second levers, the second lever having a second rail formed thereon;   an implant having first and second grooves formed in opposed surfaces thereof for seating the first and second rails to facilitate slidable movement of the implant with respect to the first and second levers; and   a pusher block disposed between the first and second levers and slidably movable towards the distal ends of the first and second levers to distally advance the implant.   
     
     
       41. The system of claim 40, further comprising a pusher rod coupled to the pusher block and configured to advance the pusher block distally towards the distal ends of the first and second levers. 
     
     
       42. The system of claim 41, wherein the pusher block includes a bore formed therein for receiving a distal end of the pusher rod. 
     
     
       43. The system of claim 40, wherein the pusher block includes a plurality of posts extending therefrom, with a first post of the plurality of posts being configured to slide along a first track formed in the first lever and a second post of the plurality of posts being configured to slide along a second track formed in the second lever to facilitate movement of the pusher block with respect to the first and second levers. 
     
     
       44. The system of claim 40, wherein at least one of the first and second levers includes a stop feature located on a distal portion thereof and configured to engage a vertebral body to stop further distal movement of the respective lever. 
     
     
       45. The system of claim 44, wherein the stop feature further comprises a vertically oriented, distally facing surface located on the distal portion of at least one of the first and second levers.