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 a proximal location and a location adjacent to the distal end of the pair of opposed levers, the pusher block including projections that slide within 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 tool of claim 30, 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. 
     
     
       32. The tool of claim 30, 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. 
     
     
       33. The tool of claim 32, wherein the stop feature comprises a vertically oriented, distally facing surface located on the distal portion of at least one of the opposed levers. 
     
     
       34. The tool of claim 30, wherein the pusher rod is configured to advance the pusher block distally towards the distal ends of the opposed levers. 
     
     
       35. The tool of claim 30, wherein the pusher block includes a bore formed therein for receiving a distal end of the pusher rod. 
     
     
       36. The tool of claim 30, wherein the pusher block includes a recessed region adapted to nest an implant. 
     
     
       37. The tool of claim 36, wherein the recessed region includes a concave, arcuate contact wall. 
     
     
       38. A medical device installation system, comprising:
 first and second opposed levers being movable at a distal end thereof between a closed position and an open position, each lever having an inwardly facing surface upon which an implant can ride;   a pusher block positioned between the first and second opposed levers and configured to distally advance an implant, the pusher block having vertical sidewalls that define an upper recess in which the first lever slides and a lower recess in which the second lever slides during distal advancement of the pusher block to maintain alignment between the pusher block and the first and second levers; and   an implant having a first groove formed in an upper surface of the implant that receives a portion of the first lever and a second groove formed in a lower surface of the implant that receives a portion of the second lever.   
     
     
       39. The system of claim 38, wherein the first and second levers have a T-shaped profile. 
     
     
       40. The system of claim 38, 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. 
     
     
       41. The system of claim 40, wherein the stop feature comprises a vertically oriented, distally facing surface located on the distal portion of at least one of the opposed levers. 
     
     
       42. The system of claim 38, further comprising a pusher rod extending proximally from the pusher block and configured to advance the pusher block distally towards the distal ends of the first and second levers. 
     
     
       43. The system of claim 38, wherein the pusher block includes a recessed region adapted to nest the implant. 
     
     
       44. The system of claim 38, wherein the recessed region includes a concave, arcuate contact wall. 
     
     
       45. The system of claim 38, wherein the pusher block includes a grasper having first and second wings movable towards one another to grasp the implant when the implant is disposed therebetween. 
     
     
       46. The system of claim 45, wherein the first and second wings each include a hook configured to fit within a recess formed in the implant to grasp and retain the implant.