Bone screw extender reattachment system and methods

Abstract

A bone screw extender reattachment system including an elongated reattachment rod having a proximal and a distal end. The distal end of the elongated reattachment rod includes a tip configured to attach to a head of a bone screw. The elongated reattachment rod is configured so that a screw extender assembly having an inner sleeve, an outer housing and an extender head can slide over the reattachment rod. The bone screw extender reattachment system also includes a tension plunger having a plunger-type head and an elongated shaft configured to slide over the reattachment rod so as to communicate with the screw extender assembly.

1 - 20 . (canceled) 
     
     
         21 . A method for reattaching a screw extender to a screw head, the method comprising:
 advancing a screw extender assembly having an extender and a housing positioned within the extender, wherein the extender comprises an extender head having locking tabs into position with a screw;   inserting a solid tension plunger having a head attached to a solid shaft into a top portion of the extender head;   applying pressure on the solid tension plunger so as to apply tension to the housing positioned within the extender while the locking tabs on the extender head are in an open position so as to advance the screw extender assembly over the screw head such that the screw extension assembly engages the screw head;   manipulating the locking tabs of the extender into a locked position so as to lock the screw extender assembly onto the screw head; and   removing the solid tension plunger thereby leaving the screw extender assembly attached to the screw head.   
     
     
         22 . The method of  claim 21 , wherein the screw head has a rod already in place when the screw extender is reattached to the screw head. 
     
     
         23 . The method of  claim 21 , wherein the screw head is attached to a spine before the screw extender is reattached to the screw head. 
     
     
         24 . The method of  claim 21 , further comprising aligning the proximal end of the extender assembly with a mark on the reattachment rod so as to provide visual confirmation that the extender head has engaged the head of the screw. 
     
     
         25 . The method of  claim 21 , wherein the locking tabs of the extender are in the closed position when the screw extender assembly is advanced into the skin towards the spine. 
     
     
         26 . The method of  claim 21 , wherein the screw extender assembly is manipulated through skin of a patient towards a spine so as to tactilely feel for when a distal end of the screw extender assembly is seated within the head of the screw. 
     
     
         27 . The method of  claim 21 , further comprising pulling up on the extender while applying tension on the solid tension plunger so as to move the locking tabs from the locked position to the unlocked position. 
     
     
         28 . The method of  claim 27 , further comprising releasing the tension of the solid tension plunger while releasing the extender so as to manipulate the locking tabs from the unlocked position to the locked position. 
     
     
         29 . A method for reattaching a screw extender to a screw head with a rod already in place comprising:
 advancing a screw extender assembly having an extender and a housing positioned within the extender, wherein the extender comprises an extender head having locking tabs into position with a spine having a screw with a rod positioned therein;   inserting a solid tension plunger having a head attached to a solid shaft into a top portion of the extender head;   applying pressure on the solid tension plunger so as to apply tension to the housing positioned within the extender while the locking tabs on the extender head are in an open position so as to advance the screw extender assembly over the screw head such that the screw extension assembly engages the screw head;   manipulating the locking tabs of the extender into a locked position so as to lock the screw extender assembly onto the screw head; and   removing the solid tension plunger thereby leaving the screw extender assembly attached to the screw head.   
     
     
         30 . The method of  claim 29 , further comprising aligning the proximal end of the extender assembly with a mark on the reattachment rod so as to provide visual confirmation that the extender head has engaged the head of the screw. 
     
     
         31 . The method of  claim 29 , wherein the locking tabs of the extender are in the closed position when the screw extender assembly is advanced into the skin towards the spine. 
     
     
         32 . The method of  claim 29 , wherein the screw extender assembly is manipulated through the skin of a patient towards the spine so as to tactilely feel for when a distal end of the screw extender assembly is seated within the head of the screw. 
     
     
         33 . The method of  claim 29 , further comprising pulling up on the extender while applying tension on the solid tension plunger so as to move the locking tabs from the locked position to the unlocked position. 
     
     
         34 . The method of  claim 33 , further comprising releasing the tension of the solid tension plunger while releasing the extender so as to manipulate the locking tabs from the unlocked position to the locked position. 
     
     
         35 . A method for reattaching a screw extender to a screw head in situ comprising:
 inserting a tip of a reattachment rod through a receiver of a screw in a spine and into a recess in a proximal end of a threaded shank of the screw;   advancing a screw extender assembly having an inner sleeve, and outer housing and an extender head and locking tabs, over the reattachment rod until arms of the outer housing engage the receiver and threads on a distal end of the inner sleeve engage threads on internal surfaces of the receiver;   inserting a tension plunger over the reattachment rod and sliding the tension plunger down to contact a ledge of the inner sleeve and a proximal end of the outer housing;   applying pressure on the tension plunger while locking tabs on the extender head are in an open position so that the outer housing engages the receiver;   manipulating the locking tabs to a locked position so as to lock the screw extender assembly to the receiver; and   removing the plunger and the reattachment rod leaving the screw extender assembly attached to the receiver.   
     
     
         36 . The method of  claim 35 , wherein the receiver is pivotable relative to the threaded shank when the locking tabs are in the open position and the receiver is fixed relative to the threaded shank when the locking tabs are in the locked position. 
     
     
         37 . The method of  claim 35 , wherein engaging the arms of the outer housing with the receiver comprises engaging bosses on inner surfaces of the arms with angled surfaces on the receiver. 
     
     
         38 . The method of  claim 35 , wherein advancing the screw extender assembly over the reattachment rod comprises rotating the inner sleeve relative to the receiver such that the threads on the distal end of the inner sleeve mate with the threads on the internal surfaces of the receiver. 
     
     
         39 . The method of  claim 35 , further comprising inserting a guide wire through a bore in the reattachment rod to align the reattachment rod with the screw. 
     
     
         40 . The method of  claim 35 , wherein the receiver comprises a U-shaped channel and inserting the tip of the reattachment rod into the recess in the proximal end of the threaded shank comprises engaging distal faces of the reattachment rod with a portion of the U-shaped channel to form an interface to prevent the receiver from pivoting relative to the threaded shank, the distal faces being defined by reliefs of the reattachment rod.