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 method of installing an implant, comprising:
 inserting distal tips of a pair of opposed levers between adjacent vertebral bodies, the distal tips being movable relative to one another between a closed position and an open position; and   advancing a pusher rod disposed between the pair of opposed levers distally to advance a pusher block distally and to move an implant engaged by the pusher block from an initial proximal location to a final location adjacent to the distal tips and between the adjacent vertebral bodies, the pusher block being coupled to a distal end of the pusher rod and disposed between the pair of opposed levers, and the pusher block having projections that slide within respective tracks formed in the pair of opposed levers as the pusher block is advanced distally.   
     
     
       31. The method of claim 30, wherein advancing the pusher block causes the distal tips to move to an open position and to distract the adjacent vertebral bodies. 
     
     
       32. The method of claim 30, wherein inserting the distal tips comprises advancing the distal tips distally between the adjacent vertebral bodies until stop surfaces of the distal tips abut the adjacent vertebral bodies. 
     
     
       33. The method of claim 30, wherein inserting the distal tips effects a separation of the adjacent vertebral bodies. 
     
     
       34. A method of installing an implant, comprising:
 inserting distal tips of a pair of opposed levers between adjacent vertebral bodies, the pair of opposed levers being 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; and   advancing an implant having first and second surface features formed thereon by sliding the and first and second surface features along complementary surface features formed on inwardly facing surfaces of the opposed levers, the implant being engaged and advanced by a pusher component positioned between the pair of opposed levers such that projections of the pusher component slide in engagement with the opposed levers to maintain alignment between the pusher component and the opposed levers.   
     
     
       35. The method of claim 34, wherein the surface feature on each lever extends between the proximal and distal ends of the lever. 
     
     
       36. The method of claim 34, 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. 
     
     
       37. The method of claim 34, further comprising moving the levers from the closed position to the open position to distract the adjacent vertebral bodies by moving the pusher component distally towards the distal ends of the opposed levers. 
     
     
       38. The method of claim 34, 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. 
     
     
       39. The method of claim 34, wherein inserting the distal tips comprises advancing the distal tips distally between the adjacent vertebral bodies until stop features of the distal tips engage the adjacent vertebral bodies to stop further distal movement of the opposed levers. 
     
     
       40. The method of claim 34, wherein inserting the distal tips effects a separation of the adjacent vertebral bodies. 
     
     
       41. A method of installing an implant, comprising:
 inserting a distal tip of a first lever and a distal tip of a second lever between adjacent vertebral bodies, the first lever having proximal and distal ends and a first rail formed thereon, the second lever having proximal and distal ends and a second rail formed thereon and being coupled to the first lever at a location proximal to the distal tips of the first and second levers; and   sliding a pusher block disposed between the first and second levers and engaged with an implant towards the distal tips of the first and second levers to advance the implant distally relative to the first and second levers such that the first and second rails slide within first and second grooves formed in opposed surfaces of the implant.   
     
     
       42. The method of claim 41, wherein sliding the pusher block comprises sliding a first post of the pusher block along a first track formed in the first lever and sliding a second post of the pusher block along a second track formed in the second lever to move the pusher block with respect to the first and second levers. 
     
     
       43. The method of claim 41, wherein advancing the pusher block causes the distal tips to move to an open position and to distract the adjacent vertebral bodies. 
     
     
       44. The method of claim 41, wherein inserting the distal tips comprises advancing the distal tips distally between the adjacent vertebral bodies until stop surfaces of the distal tips abut the adjacent vertebral bodies. 
     
     
       45. The method of claim 41, wherein inserting the distal tips effects a separation of the adjacent vertebral bodies.