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EP-3991675-B1 - SURGICAL TENSIONING INSTRUMENTS

EP3991675B1EP 3991675 B1EP3991675 B1EP 3991675B1EP-3991675-B1

Inventors

  • MURRAY, PATRICK

Dates

Publication Date
20260513
Application Date
20211004

Claims (4)

  1. A surgical tensioner instrument (10) for tensioning a band (12), the instrument (10) comprising: - first and second pivoting arms (20, 22) extending from a proximal end (28, 32) to a distal end (26, 30), the first and second pivoting arms (20, 22) having handles (60, 62) near the proximal ends (28, 32), a base (24) having a generally L-shaped body coupled to the first and second pivoting arms (20, 22), - wherein when the handles (60, 62) are compressed together, the band (12) is pinched in the slot (40) between the distal end (26) of the first pivoting arm (20) and the base (24), and a distance between the distal ends (26, 30) of the first and second pivoting arms (20, 22) is increased, thereby applying a tension to the band (12); - wherein the base (24) includes a first elongate portion (34) and a second elongate portion (36) angled relative to the first elongate portion (34) at a corner (42), wherein the corner (42) of the first and second elongate portions (34, 36) couples with the first pivoting arm (20) at a first hinge (46) and characterized in that the second elongate portion (36) of the base (24) terminates at a free end (44), which couples with the second pivoting arm (22) at a second hinge (48) and the distal portion (38) of the first elongate portion (34) of the base (24) defines a slot (40) to retain the band (12) and guide the distal end (26, 30) of the first pivoting arm (20) and the second pivoting arm (22) defines an opening (50) located beneath the slot (40) and sized and dimensioned to receive the band (12), characterized in that - a ratchet (52) positioned between the proximal ends (28, 32) of the first and second pivoting arms (20, 22), and in that - the first and second pivoting arms (20, 22) each defines a handle (60, 62) configured to be gripped and squeezed by the user, the inner facing portions of the handles (60, 62) including curved leaf springs (64, 66) configured to apply an opposing force to the handles (60, 62) when squeezed.
  2. The surgical tensioner instrument (10) of claim 1, wherein the first hinge (46) moves the first pivoting arm (20) towards the base (24) and the second hinge (48) moves the base (24) away from the second pivoting arm (22).
  3. The surgical tensioner instrument (10) of claim 1, wherein a first end of the ratchet (52) is coupled to one of the first and second pivoting arms (20, 22) via a pivot pin (56) and the opposite end of the ratchet (52) is positionable through a slot (58) in the other of the first and second pivoting arms (20, 22).
  4. The surgical tensioner instrument (10) of claim 3, wherein the ratchet is a linear ratchet (52) and includes a plurality of teeth (54) along an interior of the ratchet (52), and wherein a pawl in the slot engages the teeth (54) to thereby incrementally maintain the position of the first and second pivoting arms (20, 22) and the amount of tension applied to the band (12).

Description

FIELD OF THE INVENTION The present application relates generally to surgical instruments, and more particularly, tensioning instruments, for example, for spine surgery. BACKGROUND OF THE INVENTION Many types of spinal irregularities cause pain, limit range of motion, or injure the nervous system within the spinal column. These irregularities may result from, without limitations, trauma, tumor, disc degeneration, and disease. Often, these irregularities are treated by immobilizing a portion of the spine. This treatment typically involves affixing screws, hooks and/or clamps to one or more vertebrae and connecting the screws, hooks and/or clamps to an elongate spinal rod that stabilizes members of the spine. Flexible bands may be used to achieve correction and provide fixation as an alternative and/or supplement to pedicle screws during spinal deformity surgery. The bands may be wrapped around bony anatomy and then a force may be applied to secure the spine to the spinal rod. Correction of the spinal deformity may be achieved and held by application of tension to the flexible band. There exists a need for improved tensioning instruments configured to apply tension to the bands. US6,616,667 describes an instrument known in the art. SUMMARY OF THE INVENTION To meet this and other needs, instruments, systems, of tensioning flexible bands in-situ are provided. After a flexible band is wrapped around bony anatomy, such as a lamina or transverse process, the instruments may be configured to apply and maintain tension to the flexible bands, thereby providing the desired correction to the spine. The present invention relates to a tensioner instrument for tensioning a band as claimed hereafter. Preferred embodiments of the invention are set forth in the dependent claims. The tensioner instrument may include one or more of the following features. The base may include a first elongate portion and a second elongate portion angled relative to the first elongate portion at a corner. The corner of the first and second elongate portions may couple with the first pivoting arm at a first hinge. The second elongate portion of the base may terminate at a free end, which couples with the second pivoting arm at a second hinge. The first hinge may move the first pivoting arm towards the base and the second hinge may move the base away from the second pivoting arm. The first end of the ratchet may be coupled to one of the first and second pivoting arms via a pivot pin and the opposite end of the ratchet may be positionable through a slot in the other of the first and second pivoting arms. The ratchet may be a linear ratchet having a plurality of teeth along an interior of the ratchet. A pawl in the slot may be configured to engage the teeth to thereby incrementally maintain the position of the first and second pivoting arms and the amount of tension applied to the band. It is further described but does not fall within the invention a tensioner instrument may include a clip inserter and a ratcheting tensioner. The clip inserter may include a cannulated main body extending from a proximal end to a distal tip, a collar configured to translate along the main body, and a threaded shaft configured to move the collar. The ratcheting tensioner may include a fixed handle coupled to the clip inserter, a pivoting handle coupled to the fixed handle, a ratchet assembly including a pair of rotary ratchets and a spool keyed to the ratchets and positioned between the ratchets, and an actuator assembly including an actuator configured to engage the first and second rotary ratchets. When the pivoting handle is squeezed toward the fixed handle, the actuator may contact the ratchets and forces the ratchets and spool to rotate. The tensioner instrument may include one or more of the following features. The collar may be a ring with two arms extending toward the distal tip of the main body. Each of the arms may define a notch configured to secure a spinal rod when the collar moves distally. The threaded shaft may define a hollow body such that a driver shaft is passable through the threaded shaft. The main body of the clip inserter may include a wire cut and one or more grooves on opposite sides of the wire cut configured to engage with pins on the collar. The actuator assembly may be positioned in the pivoting handle and include an actuator button for engaging and disengaging the actuator, an actuator pin for securing the actuator, and an actuator spring causing the actuator to contact the ratchets. The ratcheting tensioner may include a release assembly including a release arm pivotably coupled to the fixed handle with a pin and a release spring forcing the release arm into contact with the ratchets at rest. The release arm may include a body with a thumb press and a pair of spaced apart tongues for engaging the ratchets. The ratcheting tensioner may include a button assembly for securing the clip inserter to the ratcheting tensioner, the button assemb