Method for implanting a rod implant along a spine of a patient

Abstract

A tool set for implanting a rod in a human spine in conjunction with bone screws. The tool set includes a pair of end guide tools that receive opposite ends of the rod in channels and under manipulation by a surgeon facilitate transport of the rod toward the bone screws attached to the guide tools. Intermediate guide tools having guiding pass through slots are utilized to guide intermediate locations along the rod toward associated bone screws. An attachment structure operably connects the guide tools to the bone screws. The guide tools each include a lower guide and advancement structure to allow a closure top with mating structure to be rotated and driven downward against the rod and to cooperate with similar structure in the bone screw to seat and lock the rod therein. A method utilizing the tool set allows a surgeon to percutaneously implant the rod in the patient.

What is claimed is: 
     
         1 . A guide tool for guiding a spinal rod in a bone anchor assembly inserted in a subject, the guide tool comprising:
 an elongate body sized and shaped to extend from the bone anchor assembly positioned in the subject to an exterior of the subject's skin; and   a radially outward facing channel extending longitudinally from near a distal end of the elongate body to near or at a proximal end thereof, the radially outward facing channel sized and shaped to receive and guide a first end of the spinal rod to the bone anchor assembly;   an attachment structure on an inner surface of the elongate body, the attachment structure configured to releasably mate with a matching attachment structure on an outer surface of the bone anchor assembly thereby securing the guide tool to the bone anchor assembly.   
     
     
         2 . The guide tool of  claim 1 , wherein the elongate body further comprises a back wall joining a pair of side walls, the radially outward facing channel at least partly defined by the pair of side walls. 
     
     
         3 . The guide tool of  claim 2 , wherein at least one of the pair of side walls comprises a rod abutment recess at a distal end thereof, and wherein the rod abutment recess is configured to allow the pair of side walls to straddle the spinal rod when the elongate body is rotated away from a secured position with the bone anchor assembly. 
     
     
         4 . The guide tool of  claim 3 , wherein the rod abutment recess is configured to allow the pair of side walls to straddle the spinal rod after the spinal rod is positioned in the bone anchor assembly. 
     
     
         5 . The guide tool of  claim 3 , wherein the rod abutment recess is at a distal end of the at least one of the pair of side walls. 
     
     
         6 . The guide tool of  claim 3 , wherein the rod abutment recess is configured for uncoupling of the guide tool from the bone anchor assembly. 
     
     
         7 . The guide tool of  claim 1 , wherein the elongate body comprises a non-uniform cross-section from the proximal end to the distal end. 
     
     
         8 . The guide tool of  claim 1 , wherein the channel comprises a non-uniform cross-section radius from the proximal end to the distal end. 
     
     
         9 . The guide tool of  claim 1 , further comprising a guide and advancement structure on the inner surface of the elongate body at or near the distal end thereof. 
     
     
         10 . The guide tool of  claim 9 , wherein the guide and advancement structure comprises a helically wound guide and advancement structure configured to: provide a pathway that rotatably receives a closure top; and align with a second helically wound guide and advancement structure on the bone anchor assembly thereby allowing transferring of the closure top between the guide tool and a bone screw. 
     
     
         11 . A guide tool for guiding a spinal rod in a bone anchor assembly inserted in a subject, the guide tool comprising:
 an elongate body comprising a back wall joining a pair of side walls;   a longitudinal opening that connects to an interior passageway of the elongate body, the longitudinal opening and the interior passageway extending from at or near a proximal end of the guide tool to a distal end thereof, wherein the longitudinal opening and the interior passageway are sized and shaped to receive an end of the spinal rod and guide the end of the spinal rod distally to a bone screw; and   a rod abutment recess at the at least one of the pair of the side walls, the rod abutment recess configured to allow the pair of side walls to straddle the spinal rod when the elongate body is rotated away from a secured position with the bone anchor assembly.   
     
     
         12 . The guide tool of  claim 11 , wherein the rod abutment recess is configured to allow the pair of side walls to straddle the spinal rod after the spinal rod is positioned in the bone anchor assembly. 
     
     
         13 . The guide tool of  claim 11 , wherein the rod abutment recess is at a distal end of the at least one of the pair of side walls. 
     
     
         14 . The guide tool of  claim 11 , wherein the rod abutment recess is configured for uncoupling of the guide tool from the bone anchor assembly. 
     
     
         15 . The guide tool of  claim 11 , wherein the elongate body is sized and shaped to extend from the bone anchor assembly implanted in the subject to an exterior of the subject's skin. 
     
     
         16 . The guide tool of  claim 11 , wherein the elongate body comprises a non-uniform cross-section from the proximal end to the distal end. 
     
     
         17 . The guide tool of  claim 11 , wherein the interior passageway comprises a non-unifom cross-section radius from the proximal end to the distal end. 
     
     
         18 . The guide tool of  claim 11 , further comprising a guide and advancement structure located at or near the distal end of the elongate body. 
     
     
         19 . The guide tool of  claim 18 , wherein the guide and advancement structure comprises a helically wound guide and advancement structure configured to: provide a pathway that rotatably receives a closure top; and align with a second helically wound guide and advancement structure on the bone anchor assembly thereby allowing transferring of the closure top between the guide tool and the bone screw. 
     
     
         20 . The guide tool of  claim 11 , wherein the longitudinal opening has a first width that is narrower side to side at an intermediate portion than at a distal portion or a proximal portion of the elongate body.