Rod reducer instruments and methods

Claim 2

A surgical instrument for reducing a rod toward a bone fastener, comprising: a fastener engaging member extending between a proximal end and a distal end, a distal portion of said fastener engaging member being adapted to receive a portion of the rod therein and being further adapted to engage the bone fastener; a reducing member movably disposed about said fastener engaging member, said reducing member having a distal end; and an actuator assembly pivotally coupled to said fastener engaging member and pivotally coupled to said reducing member, wherein said actuator assembly is operable to move said reducing member distally with respect to said fastener engaging member whereby said distal end of said reducing member contacts the rod to move the rod toward the bone fastener.

Claim 3

The instrument of claim 1 , wherein said actuator assembly includes a lateral offset to position a proximal portion of said actuator assembly away from a proximal end opening of a passage extending through said fastener engaging member.

Claim 4

The instrument of claim 1 , wherein said actuator assembly includes a first arm pivotally coupled to a second arm.

Claim 5

The instrument of claim 3 , wherein: said first arm includes a joint between a proximal end and a distal end of said first arm, said joint defining a proximal portion and a distal portion of said first arm; said second arm includes a joint between a proximal end and a distal end of said second arm, said joint defining a proximal portion and a distal portion of said second arm; and said proximal portion of said first arm and said proximal portion of said second arm are each pivotal about a respective one of said joints to orient said proximal portions transversely to said distal portions.

Claim 6

The instrument of claim 1 , wherein said actuator assembly includes a locking mechanism to hold said reducing member in a reduced position.

Claim 7

The instrument of claim 1 , wherein said actuator assembly is spring biased to a reducing member retracted position.

Claim 8

The instrument of claim 1 , wherein said fastener engaging member includes a pair of flex arms extending proximally from said distal end thereof.

Claim 9

The instrument of claim 7 , wherein said fastener engaging member includes a prong at the distal end of each of said flex arms, each of said prongs defining a channel for receiving the rod therein.

Claim 10

The instrument of claim 8 , wherein said reducing member is positionable over at least a portion of said prongs.

Claim 11

The instrument of claim 7 , wherein said fastener engaging member includes a pair of elongated slots extending between said flex arms opening at said distal end.

Claim 12

The instrument of claim 10 , wherein said reducing member includes at least one slot through a sidewall thereof in communication with one of said elongated slots of said fastener engaging member.

Claim 13

The instrument of claim 1 , wherein said fastener engaging member and said reducing member are reciprocally slidably coupled.

Claim 14

The instrument of claim 1 , wherein said reducing member and said fastener engaging member each include a generally circular cross-section.

Claim 15

The instrument of claim 1 , wherein: said fastener engaging member has a longitudinal axis extending proximally and distally therethrough; and said reducing member has a longitudinal axis extending proximally and distally therethrough, said longitudinal axis of said reducing member being generally positioned along said longitudinal axis of said fastener engaging member.

Claim 16

The instrument of claim 1 , wherein said actuator assembly includes: a first link having a distal end pivotally coupled to a first side of said reducing member; a first pivot arm having a distal end pivotally coupled to a proximal end of said first link, said first pivot arm having a medially extending connector pivotally coupled to said fastener engaging member; a first arm having a distal end pivotally coupled to a proximal end of said first pivot arm, said first arm having a proximal portion extending proximally from a medially extending connector; a second link having a distal end pivotally coupled to a second side of said reducing member opposite said first side; a second pivot arm having a distal end pivotally coupled to a proximal end of said second link, said second pivot arm having a medially extending connector pivotally coupled to said medially extending connector of said first pivot arm and also pivotally coupled to said fastener engaging member; and a second arm having a medially extending connector pivotally coupled to said medially extending connector of said first arm, said second arm having a distal end pivotally coupled to a proximal end of said second pivot arm, said second arm further having a proximal portion extending proximally of said medially extending connector of said second arm.

Claim 17

The instrument of claim 1 , wherein said actuator assembly includes: a first link having a distal end pivotally coupled to said reducing member; a first arm having a distal end pivotally coupled to said fastener engaging member, said first arm extending to a proximal end, said first arm further being pivotally coupled between said proximal and distal ends to a proximal end of said first link; a second link having a distal end pivotally coupled to said reducing member opposite said first link; and a second arm having a distal end pivotally coupled to said fastener engaging member opposite said first arm, said second arm extending to a proximal end and being pivotally coupled between said proximal and distal ends to a proximal end of said second link.

Claim 18

The instrument of claim 16 , further comprising a stop member at said proximal end of said fastener engaging member to limit proximal movement of said reducing member.

Claim 19

A surgical instrument for reducing a rod toward a bone fastener, comprising: a fastener engaging member having a passage extending between a proximal end and a distal end, a distal portion of said fastener engaging member being adapted to receive a portion of the rod therein and being further adapted to engage the bone fastener; a reducing member movably disposed with respect to said fastener engaging member, said reducing member having a distal end; an actuator assembly coupled between said fastener engaging member and said reducing member and including a proximal portion extending proximally of said reducing member and said fastener engaging member, wherein: said actuator assembly includes a lateral offset portion to locate said proximal portion of said actuator assembly away from a proximal end opening of said passage of said fastener engaging member; and said actuator assembly is operable to move said reducing member distally with respect to said fastener engaging member whereby said distal end of said reducing member contacts the rod to move the rod toward the bone fastener.

Claim 20

A surgical instrument for reducing a rod toward a bone fastener, comprising: a fastener engaging member having a passage extending between a proximal end and a distal end, a distal portion of said fastener engaging member being adapted to receive a portion of the rod therein and being further adapted to engage the bone fastener; a reducing member movably disposed with respect to said fastener engaging member, said reducing member having a distal end; an actuator assembly coupled between said fastener engaging member and said reducing member and including a proximal portion extending proximally of said reducing member and said fastener engaging member, wherein: said actuator assembly includes a lateral offset portion to locate said proximal portion of said actuator assembly away from a proximal end opening of said passage of said fastener engaging member; and said actuator assembly is operable to move said reducing member distally with respect to said fastener engaging member whereby said distal end of said reducing member contacts the rod to move the rod toward the bone fastener.

Claim 21

The instrument of claim 18 , wherein said reducing member is positioned about said fastener engaging member and slidable with respect thereto in response to operation of said actuator assembly.

Claim 22

The instrument of claim 19 , wherein said distal end of said fastener engaging member includes a pair of prongs forming a rod passage.

Claim 23

The instrument of claim 20 , wherein said reducing member and said distal end of said fastener engaging member are configured such that said reducing member exerts inward pressure on at least one of said prongs when said reducing member is positioned over said prongs.

Claim 24

The instrument of claim 18 , wherein: said fastener engaging member has a longitudinal axis extending proximally and distally therethrough; and said reducing member has a longitudinal axis extending proximally and distally therethrough, said longitudinal axis of said reducing member being generally positioned along said longitudinal axis of said fastener engaging member.

Claim 25

The instrument of claim 18 , wherein said actuator assembly includes: a first link having a distal end pivotally coupled to a first side of said reducing member; a first pivot arm having a distal end pivotally coupled to a proximal end of said first link, said first pivot arm having a medially extending connector pivotally coupled to said fastener engaging member; a first arm having a distal end pivotally coupled to a proximal end of said first pivot arm, said first arm having a medially extending connector; a second link having a distal end pivotally coupled to a second side of said reducing member opposite said first side; a second pivot arm having a distal end pivotally coupled to a proximal end of said second link, said second pivot arm having a medially extending connector pivotally coupled to said medially extending connector of said first pivot arm and also pivotally coupled to said fastener engaging member; and a second arm having a medially extending connector pivotally coupled to said medially extending connector of said first arm, said second arm having a distal end pivotally coupled to a proximal end of said second pivot arm.

Claim 26

The instrument of claim 18 , wherein said actuator assembly includes: a first link having a distal end pivotally coupled to said reducing member; a first arm having a distal end pivotally coupled to said fastener engaging member, said first arm extending to a proximal end, said first arm further being pivotally coupled between said proximal and distal ends to a proximal end of said first link; a second link having a distal end pivotally coupled to said reducing member opposite said first link; and a second arm having a distal end pivotally coupled to said fastener engaging member opposite said first arm, said second arm extending to a proximal end and being pivotally coupled between said proximal and distal ends to a proximal end of said second link.

Claim 27

The instrument of claim 18 , wherein said actuator assembly includes a first arm pivotally coupled to a second arm.

Claim 28

The instrument of claim 25 , wherein: said first arm includes a joint between a proximal end and a distal end of said first arm, said joint defining a proximal portion and a distal portion of said first arm; said second arm includes a joint between a proximal end and a distal end of said second arm, said joint defining a proximal portion and a distal portion of said second arm; and said proximal portion of said first arm and said proximal portion of said second arm are each pivotal about a respective one of said joints to orient said proximal portions transversely to said distal portions.

Claim 29

The instrument of claim 25 , wherein said first arm and said second arm are spring biased away from one another.

Claim 30

The instrument of claim 18 , wherein said actuator assembly includes a locking mechanism to hold said reducing member in a reduced position.

Claim 31

The instrument of claim 18 , wherein said fastener engaging member includes a pair of flex arms extending proximally from said distal end thereof.

Claim 32

The instrument of claim 29 , wherein each of said flex arms includes a prong at a distal end thereof, each of said prongs defining a channel for receiving the rod therein.

Claim 33

The instrument of claim 30 , wherein said fastener engaging member includes a pair of elongated slots extending between said flex arms to said distal end.

Claim 34

A surgical instrument for reducing a rod toward a bone fastener, comprising: a fastener engaging member extending between a proximal end and a distal end, a distal portion of said fastener engaging member being adapted to engage the bone fastener; a reducing member disposed about said fastener engaging member; an actuator assembly coupled between said fastener engaging member and said reducing member and operable to move said reducing member about said fastener engaging member between a reduced position and a retracted position, wherein said actuator assembly includes: a first link having a distal end pivotally coupled to a first side of said reducing member; a first pivot arm having a distal end pivotally coupled to a proximal end of said first link, said first pivot arm having a medially extending connector pivotally coupled to said fastener engaging member; a first arm having a distal end pivotally coupled to a proximal end of said first pivot arm, said first arm having a medially extending connector; a second link having a distal end pivotally coupled to a second side of said reducing member opposite said first side; a second pivot arm having a distal end pivotally coupled to a proximal end of said second link, said second pivot arm having a medially extending connector pivotally coupled to said medially extending connector of said first pivot arm and also pivotally coupled to said fastener engaging member; and a second arm having a medially extending connector pivotally coupled to said medially extending connector of said first arm, said second arm having a distal end pivotally coupled to a proximal end of said second pivot arm.

Claim 35

A surgical instrument for reducing a rod toward a bone fastener, comprising: a fastener engaging member extending between a proximal end and a distal end, a distal portion of said fastener engaging member being adapted to engage the bone fastener; a reducing member disposed about said fastener engaging member; an actuator assembly coupled between said fastener engaging member and said reducing member and operable to move said reducing member about said fastener engaging member between a reduced position and a retracted position, wherein said actuator assembly includes: a first link having a distal end pivotally coupled to a first side of said reducing member; a first pivot arm having a distal end pivotally coupled to a proximal end of said first link, said first pivot arm having a medially extending connector pivotally coupled to said fastener engaging member; a first arm having a distal end pivotally coupled to a proximal end of said first pivot arm, said first arm having a medially extending connector; a second link having a distal end pivotally coupled to a second side of said reducing member opposite said first side; a second pivot arm having a distal end pivotally coupled to a proximal end of said second link, said second pivot arm having a medially extending connector pivotally coupled to said medially extending connector of said first pivot arm and also pivotally coupled to said fastener engaging member; and a second arm having a medially extending connector pivotally coupled to said medially extending connector of said first arm, said second arm having a distal end pivotally coupled to a proximal end of said second pivot arm.

Claim 36

The instrument of claim 32 , wherein: said first arm includes a joint between a proximal end and a distal end of said first arm, said joint defining a proximal portion and a distal portion of said first arm; said second arm includes a joint between a proximal end and a distal end of said second arm, said joint defining a proximal portion and a distal portion of said second arm; and said proximal portion of said first arm and said proximal portion of said second arm are each pivotal about a respective one of said joints to orient said proximal portions transversely to said distal portions.

Claim 37

The instrument of claim 32 , wherein said first arm and said second arm are spring biased away from one another.

Claim 38

The instrument of claim 32 , wherein said actuator assembly includes a locking mechanism at the proximal ends of said first and second arms to hold said reducing member in a reduced position.

Claim 39

The instrument of claim 32 , wherein said first pivot arm and said second pivot arm each include a lateral offset to locate a proximal portion of the actuator assembly away from a proximal end opening of said fastener engaging member.

Claim 40

A surgical instrument for reducing a rod toward a bone fastener, comprising: a fastener engaging member extending between a proximal end and a distal end, a distal portion of said fastener engaging member being adapted to engage the bone fastener; a reducing member disposed about said fastener engaging member; an actuator assembly coupled between said fastener engaging member and said reducing member and operable to move said reducing member about said fastener engaging member between a reduced position and a retracted position, wherein said actuator assembly includes: a first link having a distal end pivotally coupled to said reducing member; a first arm having a distal end pivotally coupled to said fastener engaging member, said first arm extending to a proximal end, said first arm further being pivotally coupled between said proximal and distal ends to a proximal end of said first link; a second link having a distal end pivotally coupled to said reducing member opposite said first link; and a second arm having a distal end pivotally coupled to said fastener engaging member opposite said first arm, said second arm extending to a proximal end, said second arm further being pivotally coupled between said proximal and distal ends to a proximal end of said second link.

Claim 41

A surgical instrument for reducing a rod toward a bone fastener, comprising: a fastener engaging member extending between a proximal end and a distal end, a distal portion of said fastener engaging member being adapted to engage the bone fastener; a reducing member disposed about said fastener engaging member; an actuator assembly coupled between said fastener engaging member and said reducing member and operable to move said reducing member about said fastener engaging member between a reduced position and a retracted position, wherein said actuator assembly includes: a first link having a distal end pivotally coupled to said reducing member; a first arm having a distal end pivotally coupled to said fastener engaging member, said first arm extending to a proximal end, said first arm further being pivotally coupled between said proximal and distal ends to a proximal end of said first link; a second link having a distal end pivotally coupled to said reducing member opposite said first link; and a second arm having a distal end pivotally coupled to said fastener engaging member opposite said first arm, said second arm extending to a proximal end, said second arm further being pivotally coupled between said proximal and distal ends to a proximal end of said second link.

Claim 42

The instrument of claim 37 , wherein said actuator assembly, said reducing member, and said fastener engaging member have a common central axis.

Claim 43

The instrument of claim 37 , wherein said first arm and said second arm each include a laterally extending blocking arm for contacting a proximal end of an access tube and limiting the insertion depth of the surgical instrument therein.

Claim 44

A surgical instrument for reducing a rod toward a bone fastener, comprising: a fastener engaging member extending between a proximal end and a distal end, a distal portion of said fastener engaging member being adapted to receive a portion of the rod therein and being further adapted to engage the bone fastener; a reducing member having a body movably disposed about said fastener engaging member, said body having an extension portion extending proximally from a distal end of said reducing member; and an actuator assembly operable to move said reducing member distally with respect to said fastener engaging member whereby said distal end of said reducing member contacts the rod to move the rod toward the bone fastener, wherein said reducing member can be moved distally so that said extension portion is positioned distally of said distal end of said fastener engaging member.

Claim 45

A surgical instrument for reducing a rod toward a bone fastener, comprising: a fastener engaging member extending between a proximal end and a distal end, a distal portion of said fastener engaging member being adapted to receive a portion of the rod therein and being further adapted to engage the bone fastener; a reducing member having a body movably disposed about said fastener engaging member, said body having an extension portion extending proximally from a distal end of said reducing member; and an actuator assembly operable to move said reducing member distally with respect to said fastener engaging member whereby said distal end of said reducing member contacts the rod to move the rod toward the bone fastener, wherein said reducing member can be moved distally so that said extension portion is positioned distally of said distal end of said fastener engaging member.

Claim 46

The instrument of claim 40 , wherein said reducing member defines a passage extending between a proximal end and a distal end thereof.

Claim 47

The instrument of claim 41 , wherein said passage has a distal portion defined by said extension portion and proximal portion extending from said distal portion to said proximal end of said reducing member, said reducing member defining a lip between said proximal and distal portions of said passage.

Claim 48

The instrument of claim 42 , wherein said fastener engaging member has an enlarged rim about its distal end, said rim contacting said lip to establish a predetermined reduction distance for said extension portion with respect to said fastener engaging member.

Claim 51

The method of claim 44 , further comprising: moving said reducing member to position said elongated implant member at a first location in the yoke of the fastener; and engaging said elongated implant member in said yoke with a set screw inserted through a passage defined by said fastener engaging member.

Claim 54

The method of claim 46 , wherein securing said elongated implant member includes engaging said elongated implant member in a yoke of said first and second fasteners with a set screw inserted through a passage defined by said fastener engaging member of each of said rod reducer instrument and said modified rod reducer instrument.