Open surgical technique for vertebral fixation with subcutaneous fixators positioned between the skin and the lumbar fascia of a patient

Claim 1

A method for fixation of vertebrae of a patient, said patient having a back covered with skin under which is fascia, said patient also having vertebrae with spinous processes and pedicles, said pedicles having medullary canals, said method comprising the steps of: a) posterolaterally entering the back of a patient by means of forming an incision with an open surgical technique wherein tissue is retracted and vertebrae are exposed; b) introducing a plurality of pedicle screws having proximal ends through a plurality of small incisions into the medullary canal of the pedicles of adjacent vertebrae, to a position where the proximal ends of said pedicle screws lie adjacent the fascia of the patient beneath the skin; c) inserting first and second pedicle screw linkage means between the skin of the patient and the fascia of the patient; d) detachably securing said linkage means to said proximal ends of said screws on a same side of the spinous process of said vertebrae to restrict relative movement between said vertebrae; and e) closing the incisions after the linkage means is secured to the screws.

Claim 2

A method for fixation of vertebrae of a patient, said patient having a back covered with skin under which is fascia, said patient also having vertebrae with spinous processes and pedicles, said pedicles having medullary canals, said method comprising the steps of: a) posterolaterally entering the back of a patient by means of forming an incision with an open surgical technique wherein tissue is retracted and vertebrae are exposed; b) introducing a plurality of pedicle screws having proximal ends through a plurality of small incisions into the medullary canal of the pedicles of adjacent vertebrae, to a position where the proximal ends of said pedicle screws lie adjacent the fascia of the patient beneath the skin; c) inserting first and second pedicle screw linkage means between the skin of the patient and the fascia of the patient; d) detachably securing said linkage means to said proximal ends of said screws on a same side of the spinous process of said vertebrae to restrict relative movement between said vertebrae; and e) closing the incisions after the linkage means is secured to the screws.

Claim 11

A method for fixation of a pair of lumbar vertebrae of a patient, said patient having a back covered with skin under which is fascia, said patient also having lumbar vertebrae with cortical bone, transverse processes, proximal particular processes and pedicles, said pedicles having medullary canals, said method comprising the steps of: a) posterolaterally entering the back of a patient by means of forming a first incision with an open surgical technique and performing a laminectomy procedure at the site of the first incision; b) forming a second small incision into the fascia of a patient adjacent to the first incision; c) forming an opening in the cortical bone of each said pair of lumbar vertebrae at a juncture of a base of the transverse process and the proximal articular process of said vertebrae, said openings in each pair of vertebrae providing entrances into the respective medullary canals of the pedicles supporting said vertebral processes; d) subcutaneously screwing into each of said medullary canals a pedicle screw having a proximal end to a position where the proximal end thereof lies adjacent the fascia of the lumbar vertebrae of the patient, providing for each pedicle screw an adapter having a slotted cap and a tubular body extending therefrom; said slotted cap lying in a plane perpendicular to said tubular body; e) fastening the tubular body onto the proximal end of each said pedicle screws such that the slotted cap of the adapter lies between the lumbar fascia and skin of the patient; f) closing the second incision; g) positioning at least one beam member under the skin and onto the slotted caps and detachably locking said beam member into said caps; and h) closing the first incision after the beam member is locked into the caps.

Claim 12

A method for fixation of a pair of lumbar vertebrae of a patient, said patient having a back covered with skin under which is fascia, said patient also having lumbar vertebrae with cortical bone, transverse processes, proximal particular processes and pedicles, said pedicles having medullary canals, said method comprising the steps of: a) posterolaterally entering the back of a patient by means of forming a first incision with an open surgical technique and performing a laminectomy procedure at the site of the first incision; b) forming a second small incision into the fascia of a patient adjacent to the first incision; c) forming an opening in the cortical bone of each said pair of lumbar vertebrae at a juncture of a base of the transverse process and the proximal articular process of said vertebrae, said openings in each pair of vertebrae providing entrances into the respective medullary canals of the pedicles supporting said vertebral processes; d) subcutaneously screwing into each of said medullary canals a pedicle screw having a proximal end to a position where the proximal end thereof lies adjacent the fascia of the lumbar vertebrae of the patient, providing for each pedicle screw an adapter having a slotted cap and a tubular body extending therefrom; said slotted cap lying in a plane perpendicular to said tubular body; e) fastening the tubular body onto the proximal end of each said pedicle screws such that the slotted cap of the adapter lies between the lumbar fascia and skin of the patient; f) closing the second incision; g) positioning at least one beam member under the skin and onto the slotted caps and detachably locking said beam member into said caps; and h) closing the first incision after the beam member is locked into the caps.

Claim 29

A method for fixation of a pair of lumbar vertebrae of a patient, said patient having a back covered with skin under which is fascia, said patient also having lumbar vertebrae with cortical bone, transverse processes, proximal articular processes and pedicles, said pedicles having medullary canals, said method, comprising the steps of: a) posterolaterally entering the back of a patient by means of forming a first mid-line incision with an open surgical technique and performing a laminectomy procedure at the site of the first incision; b) forming a second paramedial incision through the fascia of a patient adjacent to the first incision; c) forming an opening in the cortical bone of each said pair of lumbar vertebrae at a juncture of a base of the transverse process and the proximal articular process of said vertebrae, said openings in each pair of vertebrae providing entrances into the respective medullary canals of the pedicles supporting said vertebral processes; d) screwing into each of said medullary canals a pedicle screw having a proximal end to a position where the proximal end thereof lies adjacent the fascia of the lumbar vertebrae of the patient, providing for each pedicle screw an adaptor having a slotted cap and a tubular body extending therefrom, said slotted cap lying in a plane perpendicular to said tubular body; e) fastening the tubular body onto the proximal end of each said pedicle screws such that the slotted cap of the adaptor lies between the lumbar fascia and skin of the patient; f) closing the second incision; g) positioning at least one beam member under the skin and onto the slotted caps and detachably locking said beam member into said caps; and h) closing the first incision after the beam member is locked into the caps.

Claim 30

A method for fixation of a pair of lumbar vertebrae of a patient, said patient having a back covered with skin under which is fascia, said patient also having lumbar vertebrae with cortical bone, transverse processes, proximal articular processes and pedicles, said pedicles having medullary canals, said method, comprising the steps of: a) posterolaterally entering the back of a patient by means of forming a first mid-line incision with an open surgical technique and performing a laminectomy procedure at the site of the first incision; b) forming a second paramedial incision through the fascia of a patient adjacent to the first incision; c) forming an opening in the cortical bone of each said pair of lumbar vertebrae at a juncture of a base of the transverse process and the proximal articular process of said vertebrae, said openings in each pair of vertebrae providing entrances into the respective medullary canals of the pedicles supporting said vertebral processes; d) screwing into each of said medullary canals a pedicle screw having a proximal end to a position where the proximal end thereof lies adjacent the fascia of the lumbar vertebrae of the patient, providing for each pedicle screw an adaptor having a slotted cap and a tubular body extending therefrom, said slotted cap lying in a plane perpendicular to said tubular body; e) fastening the tubular body onto the proximal end of each said pedicle screws such that the slotted cap of the adaptor lies between the lumbar fascia and skin of the patient; f) closing the second incision; g) positioning at least one beam member under the skin and onto the slotted caps and detachably locking said beam member into said caps; and h) closing the first incision after the beam member is locked into the caps.