WO2006090380A2 - Dispositif et methode pour une distraction et pour une oscillation de colonne vertebrale - Google Patents

Dispositif et methode pour une distraction et pour une oscillation de colonne vertebrale Download PDF

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Publication number
WO2006090380A2
WO2006090380A2 PCT/IL2006/000240 IL2006000240W WO2006090380A2 WO 2006090380 A2 WO2006090380 A2 WO 2006090380A2 IL 2006000240 W IL2006000240 W IL 2006000240W WO 2006090380 A2 WO2006090380 A2 WO 2006090380A2
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WO
WIPO (PCT)
Prior art keywords
activator
vertebrae
magnetic
affixed
spinal
Prior art date
Application number
PCT/IL2006/000240
Other languages
English (en)
Other versions
WO2006090380A3 (fr
Inventor
Mordechay Ilovich
Yona Kosashvili
Elik Chen
Original Assignee
Orthogon Technologies 2003 Ltd.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Orthogon Technologies 2003 Ltd. filed Critical Orthogon Technologies 2003 Ltd.
Priority to US11/989,795 priority Critical patent/US20100228167A1/en
Priority to AU2006274537A priority patent/AU2006274537A1/en
Priority to PCT/IL2006/000888 priority patent/WO2007015239A2/fr
Priority to CA002617664A priority patent/CA2617664A1/fr
Priority to JP2008524673A priority patent/JP2009502412A/ja
Priority to EP06766202A priority patent/EP1915099A2/fr
Publication of WO2006090380A2 publication Critical patent/WO2006090380A2/fr
Publication of WO2006090380A3 publication Critical patent/WO2006090380A3/fr
Priority to IL188981A priority patent/IL188981A0/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7014—Longitudinal elements, e.g. rods with means for adjusting the distance between two screws or hooks
    • A61B17/7016—Longitudinal elements, e.g. rods with means for adjusting the distance between two screws or hooks electric or electromagnetic means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72—Intramedullary pins, nails or other devices
    • A61B17/7216—Intramedullary pins, nails or other devices for bone lengthening or compression
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8004—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with means for distracting or compressing the bone or bones
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/025—Joint distractors
    • A61B2017/0256—Joint distractors for the spine
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B2017/7073—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant with intervertebral connecting element crossing an imaginary spinal median surface

Definitions

  • the present invention relates to methods and devices for manipulating spinal vertebrae. More particularly, the invention relates to methods and devices for distracting, compressing, and/or oscillating, spinal vertebrae.
  • Some orthopedic treatments involve the straightening and/or lengthening of the spinal cord, and/or enhancing spinal fusion.
  • spinal deformities such as scoliosis are prone to loss of height following spinal fixation.
  • the expected lost height for each vertebra is 0.07 cm per year of growth remaining until skeletal maturity.
  • Patien-ts suffering with pain resulting from spinal instability often find relief following spinal fusion of the affected region.
  • spinal fusion is performed by using pedicular screws and rods in addition to bone graft in the form of bone chips between the corresponding transverse processes of the vertebrae.
  • the prior art procedures that utilize the implantation of bone chips along with rigid spinal fixation are unsuccessful due to lack of fusion of said chips resulting in a failure rate of the above said fusion of 10-30%, especially when more than one segment is fused and in case the patient is a smoker.
  • the technique of bone grafting is a cornerstone of many spinal fusion operations, including but not limited to scoliosis.
  • patients need to wear cumbersome braces for long periods of up to one year in order to allow the fusion process to take place without risking hardware failure of the instrumentation. These patients would be highly satisfied if this period could be considerably shortened.
  • U.S. Patent application serial No. 2005/261682 (to Bret A. Ferree) describes a vertebral shock absorber constructed from telescopic members.
  • a compressible resilient component such as a spring, elastomeric material, liquid, gel, or hydrogel, is disposed in the cavity of the telescopic members.
  • the ends of the shock absorber are fastened to an upper vertebra and a lower vertebra by pedicle screws or by way of ball-and-socket joints for enhanced range of motion.
  • the primary aim of the present invention is to provide a device that may be implanted in close relation to the desired region of the vertebral column and which may be used for either controlled vertebral distraction or for stimulating bone union by means of causing mechanical oscillation, compression, and/or tension.
  • Another aim of the present invention is to provide a surgical procedure for causing controlled distraction that may be followed, if required, by mechanical vibrations (oscillations), of the spinal column, said procedure being suitable for use in the management of spinal deformities such as scoliosis and stenosis.
  • a further aim of the present invention is to provide a surgical method for causing stimulating bone union in clinical situations by compression and/or vibration (oscillation) in which it is desirable to initiate and/or enhance spinal fusion-.
  • the present invention describes a device for manipulating spinal vertebrae of a subject, wherein said device may be implanted by means of screws onto at least two vertebrae of said subject.
  • the device generally comprises at least one activator comprising a moveable element which is capable of being displaced in response to externally induced energizing signals, wherein said activator is affixed to at least one vertebra, and coupled to at least one other vertebra, such that said activator is capable of moving the vertebra (e) to which it is coupled in an axial direction, wherein said movement can be unidirectional, resulting in either distraction or compression of the vertebrae, or bidirectional, resulting in an oscillatory movement of the vertebrae.
  • manipulating spinal vertebrae and phrases related thereto refer to manipulations whereby the vertebrae are caused to move axially, in any desired direction (i.e. distractive, compressive and/or oscillatory movements) .
  • encodergizing signals in the context of the present disclosure refers to signals (e.g. a magnetic field) capable of remotely and wirelessly actuating mechanical displacement means attached to the spinal column, which react in the presen-ce of said signal. These “energizing signals” may be applied according to a predetermined pattern of signals, or they may be determined according to a feedback signal received from the device that monitors the obtained movements.
  • the device preferably comprises one or more elongated platforms, each of which is horizontally affixed to one of the vertebrae of said subject, wherein said elongated platforms are used for affixing said at least one activator, and/or for attaching coupling means, to the respective vertebra.
  • the device may further comprise linear guidance means slidably attached to the sides of said two or more vertebrae.
  • the device may comprise stabilizing and synchronizing arms rotatably attached to the sides of some of said at least two vertebrae and/or to elongated platforms horizontally affixed thereto.
  • the coupling means may be implemented by lever arms and/or ramp surfaces attached to one or more of said elongated platforms.
  • the activator may be configured to be energized by an externally induced magnetic field.
  • the activator comprises at least one pair of ferromagnetic/magnetic elements, wherein each pair of ferromagnetic/magnetic elements comprises a stationary ferromagnetic/magnetic element affixed to the internal wall of said activator and a movable ferromagnetic/magnetic element affixed in proximity to said stationary ferromagnetic/magnetic element to a shaft coaxially and slidably supported therein, such that magnetic attraction forces are evolved between said ferromagnetic/magnetic elements in the presence of a magnetic field, and wherein said magnetic attraction forces may affect axial movements of said shaft.
  • the activator may further comprise a gear unit coupled to said shaft by means of a clutch and motion conversion units.
  • the activator may further comprise a feedback monitoring assembly for indicating obtained movements and outputting the same to the user, to an external device, or to a controlled feedback system.
  • the device comprises at least one parallel pair of activators affixed to the lateral sides of at least one vertebra and coupled to another vertebra.
  • the at least one pair of activators, and/or coupling means coupled thereto, may be affixed to at least one vertebra by means of elongated platforms horizontally affixed to said vertebra.
  • the present invention is directed to a method for regaining lost height in a subject having already undergone a spinal fixation procedure comprising the steps of: a) Removing one of the fixation rods previously implanted for the purpose of reducing a spinal deformity; b) Connecting a first device of the present invention as disclosed hereinabove to the same side of the spinal column from which the previously implanted fixation rod was removed in step (a) ; c) Removing the second fixation rod; d) Connecting a second device of the present invention as disclosed hereinabove to the same side of the spinal column from which the second fixation rod was removed in step (c) ; e) Optionally interconnecting the two devices by means of one or more interconnecting elements (as described hereinabove) ; f) Applying a magnetic field induced by an externally placed coil to the region of the spinal column in which the devices were implanted, such that the activators of said devices respond by applying distracting forces to the vertebrae to
  • the subject is a patient being treated for scoliosis.
  • the magnetic field is applied at least once per day between 1 second to 30 minutes for a total period of between 1 and 30 days, preferably for a period of one week.
  • the magnetic field may be applied in several sessions per day where in each session the obtained distraction length may range between few micro-millimeters and up to few tenths of a millimeter.
  • the magnetic field may be applied within time intervals of 0.5 to 30 seconds, where in each of said time intervals the magnetic field is applied for a period of time ranging between 0.1 to 1.5 sec.
  • the magnetic field may be applied in pulses, wherein, the width of said magnetic pulse is in the range of 0.001 second to 10 seconds and the frequency of said pulses is in the range of 0.01 Hz to 500 Hz.
  • the present invention also provides a method for causing spinal fusion comprising the steps of:
  • the compressive force is applied between once and fifty times per day, each time for a period of between 1 milisecond and 120 minutes.
  • the compressive force is applied once per day for a period of 20 minutes.
  • the present invention also provides a method for causing spinal fusion comprising the steps of: a) connecting a first device of the present invention as disclosed hereinabove to one side of the spinal column and a second said device to the other side of the spinal column; b) optionally interconnecting the two devices by means of one or more interconnecting elements (as described hereinabove) ; c) applying a magnetic field induced by an externally placed coil to the region of the spinal column in which the devices were implanted, such that the activators of said devices respond by applying axially-directed oscillatory forces to the vertebrae to which they are coupled thereby causing axial oscillation of said vertebrae.
  • the frequency of the axial oscillation is between 0.01 and 50 Hz, preferably 0.5 Hz:
  • This oscillatory motion may be induced between 1 and 8 times per day, preferably once a day for a period of 20 minutes .
  • the first and second devices are preferably connected to the vertebral column using pedicular screws.
  • Fig. IA is a block diagram generally demonstrating an axial activator of the invention
  • Fig. IB schematically illustrates a preferred embodiment of an axial activator of the invention based on a magnetic driving source
  • Fig. 1C schematically illustrates another implementation of the magnetic activator of the invention wherein the driving force is delivered to the activator by an arm- lever transferring means/
  • Fig. ID is a block diagram generally demonstrating a rotary output activator of the invention
  • Fig. IE schematically illustrates a preferred embodiment of a rotary output activator of the invention based on a magnetic driving source
  • Fig. IF schematically illustrates a preferred embodiment of an axial magnetic activator of the invention in which the axis of rotations is perpendicular to the activator;
  • Fig. IG schematically illustrates a preferred embodiment of a rotary output magnetic activator of the invention based on a linear ratchet mechanism;
  • Fig. 2A schematically illustrates a magnetic activation scheme wherein the windings of an electromagnet enclose an axial/rotary magnetic activator
  • Fig. 2B schematically illustrates a magnetic activation scheme wherein the windings of an electromagnet are positioned in the proximity of an axial/rotary magnetic activator;
  • FIG. 3A schematically illustrates a device of the invention operating with a pair of parallel axial activators
  • Fig. 3B schematically illustrates a device of the invention operating with a single axial activator and linear guidance means
  • FIG. 3C schematically illustrates a device of the invention operating with a single axial activator and with stabilizing and synchronizing arms;
  • Fig . 3D is a variation of the device illustrated in Fig.
  • Fig. 3E schematically illustrates a device of the invention operating with a single axial activator and with two pairs of stabilizing and synchronizing arms;
  • Fig. 3F schematically illustrates a device of the invention operating with a single axial activator and a lever arm
  • Fig. 3G schematically illustrates a device of the invention operating with a pair of axial activators and respective lever arms linked thereto;
  • Fig. 3H schematically illustrates a device of the invention operating with a pair of horizontally disposed axial activators and respective ramp surfaces;
  • Fig. 4A schematically illustrates a device of the invention operating with a single rotary activator and ramped surfaces
  • Fig. 4B schematically illustrates a device of the invention operating with a single horizontally disposed rotary activator and an eccenter;
  • Fig. 4C is a variation of the device illustrated in Fig.
  • Fig. 4D is a variation of the device illustrated in Fig.
  • Fig. 4E is a variation of the device illustrated in Fig.
  • Fig. 5A illustrates a portion of a typical vertebral column
  • Fig. 5B shows a top view of a typical spinal vertebra
  • Fig. 6A schematically illustrates a device of the invention comprising a pair of rotary activators and designed to concurrently operate on a number of vertebrae;
  • Fig. 6B schematically illustrates a device of the invention comprising a pair of axial activators and designed to concurrently operate on a number of vertebrae;
  • Fig. 6C schematically illustrates a device of the invention comprising a pair of axial activators and designed to concurrently push a number of vertebrae throughout a pin to pin coupling;
  • Fig. 6D schematically illustrates a device of the invention comprising a number of rotary activator and designed to concurrently operate on a number of vertebrae with linear guidance means;
  • Fig. 6E schematically illustrates a device of the invention comprising a number of axial activators and designed to concurrently operate on a number of vertebrae with linear guidance means.
  • the present invention aims to provide devices and methods for treating spinal deformities. More particularly, the present invention aims to provide devices and methods for straightening and/or lengthening the spinal cord, and/or enhancing spinal fusion.
  • Fig. 5A schematically illustrates a portion of a typical vertebral column comprising series of vertebrae 50a, 50b, and 50c.
  • each vertebrae 50 is composed of a disk (anterior body) 100 and a (posterior) neural arch 107.
  • the neural arch 107 comprises two transverse processes 101 protruding transversely, a spinous process 104 protruding posteriorly, and superior articular facets 103 protruding upwardly.
  • the device of the present invention comprises an activator configured to generate axial or rotary motion which may be used to cause increased or decreased separation between pairs of adjacent vertebrae.
  • a typical axial activator is composed of at least one pair of mutually-contacting elongate members which are arranged such that the overall end-to-end length thereof may be altered by causing each member of the at least one pair to move axially in relation to each other.
  • the cross section of said members can be circular, elliptic, rectangular, square or any other shape.
  • the members may be solid, hollow or a combination of the two, and are manufactured by the use of the standard machining processes that are well known in the art.
  • Said members may be constructed from any suitable biocompatible material including (but not limited to) titanium alloys and a biocompatible stainless steel alloy such as 316LVM.
  • the overall end-to-end length of a device activator of the invention i.e. comprising one or more pairs of elongate members
  • the overall end-to-end length of a device activator of the invention is usually in the range of 2 cm to 40 cm. The precise length will, of course, be determined by the length of the vertebral column that requires to be treated.
  • Each elongate member will typically have, but not be limited to, an external diameter of between 1 and 25 mm.
  • each of said members Connected to each of said members is at least one connecting element, the purpose of which is to connect said member with a pedicular screw inserted into a vertebra 50.
  • the pedicular screws will generally have a diameter of between 1 mm and 16 mm, preferably 3.5 mm, and can be fully or half threaded, the screws may be uncoated or coated either with hydroxyapatite or with other materials improving their lasting purchase of bone.
  • the pedicular screws are typically screwed into the transverse processes 101 and/or the into disk 100 section of the vertebra .
  • each activator is linked with two connecting elements.
  • any suitable larger number of connecting elements in accordance with the overall length of the elongate member in question may be used, as required, without exceeding the bounds of the present invention.
  • one or more of said members may also have connected thereto a longer interconnecting element, the purpose of which is to provide a connection with the corresponding member of a similar device located on the contralateral side of the vertebral column.
  • Standard connectors for use in spinal surgery may be used to construct both the aforementioned connecting elements and the aforementioned optional interconnecting elements.
  • each pair of members may be arranged in one of the two following ways:
  • Each pair of members may consist of two mutually-telescoping members, such that the overall change in end-to-end length of said member pair is caused by the axial telescopic movement of one member within the other member.
  • One of the pair of members is hollow, that is, it comprises an internal cavity in which the second member may engage in its axial movement.
  • Each pair of members i.e., activator
  • Each pair of members may consist of two members arranged so that they may be caused to slide axially in relation to each other, such that the overall change in end-to-end length of said member pair is caused by the axial sliding of one member over the other member.
  • one or both of said members may comprise guide means (e.g., linear guidance) for ensuring the accurate, controlled axial movement of the other member along its length.
  • the guide means may consist of a guide-track having lateral lips that prevent sideways slipping of the second member or guiding pin(s) (e.g., guided pin comprising rollers to minimize friction) that is inserted therein, without impeding the desired axial movement.
  • the guide means comprises a semi-circular channel into which the second member (having a circular or semicircular cross-section) is able to move in an axial (but not lateral or rotary) direction.
  • the guide means may be provided in the form of a "tongue-and- groove" structure, whereby an axially-directed tongue (or ridge)- located on one member may move freely in an axial direction within a complementarily-shaped groove or slot in the second member.
  • a "tongue-and- groove” structure whereby an axially-directed tongue (or ridge)- located on one member may move freely in an axial direction within a complementarily-shaped groove or slot in the second member.
  • Both members of the activator are constructed of a nonmagnetic material.
  • one of said members comprises a ferromagnetic and/or magnetic material (present either in the form of one unit or in the form of several discrete units) that are capable of being actuated by an external magnetic field, such that the member with the ferromagnetic/magnetic unit(s) and/or the member without the ferromagnetic/magnetic parts move axially in relation to each other.
  • the aforementioned magnetic material may be provided in the form of a series of pairs of cylindrical (or other shape, such as square) ferromagnets (and/or magnets) , each ferromagnet (or magnet) having, for example, a diameter of 3- 12 mm and a length of up to 2-40mm (or any other suitable length according to the device dimensions), with a spacing of up to 6 mm between each pair to minimize attraction forces between moveable Ferromagnets and stationary Ferromagnets of adjacent pairs.
  • the gap between the moving and the stationary Ferromagnets/magnets in each pair is preferably up to 1.5mm.
  • this arrangement would consist of a series of up to 8 pairs of ferromagnets. It should be emphasized that this configuration is given by way of example only, and is not intended to be limiting in any way.
  • the axial movement in one direction is caused by the magnetic forces induced by the external magnetic field acting on the member comprising the ferromagnetic/magnetic material, as described hereinabove.
  • this axial returning movement in the other direction is caused either by said magnetic forces or by means of a spring and/or other return mechanism, for example a ratchet together with appropriate screws or bolts and nuts (e.g., lead screw).
  • a spring and/or other return mechanism for example a ratchet together with appropriate screws or bolts and nuts (e.g., lead screw).
  • said spring and/or other return mechanism is located in the internal space of the hollow section.
  • the above-described axial movements of the elongate members may be used to cause the two sections of the activator to distract from each other in one embodiment (thereby increasing the total end-to-end length of the device) , or cause compression in a second embodiment (thereby reducing the total end-to-end length of the device) , or to oscillate in a third embodiment .
  • Progressive spinal distraction (which is most typically used in cases in which height restoration is required) can be achieved by uni-directional magnetically-induced distraction (as described hereinabove) combined with a ratchet or/and unidirectional clutch mechanism or a transmission mechanism pushing an internal and/or external screw or a slider in order to prevent backward motion.
  • the device of the present invention may comprise a single pair of mutually-contacting elongate members, as described hereinabove. In other embodiments, however, the device may comprise a plurality of pairs of elongate members, such that upon application of the external magnetic field, the members comprising the magnetic/ferromagnetic material will move in an axial or rotatronal direction, thereby altering the end-to-end length of the entire device.
  • the plurality of pairs may take.
  • each member is a hollow member, capable of accommodating the telescope-like axial movement of another hollow member within its internal cavity.
  • the device will comprise an assembly of three or more hollow members, each of said members having a larger outer diameter than its neighbor (on one side) , in order to accommodate said neighbor within its internal cavity.
  • the device of the invention comprises an assembly of three or more members, arranged such that a hollow member alternates with a piston-like member that is capable of moving axially within the internal space of said hollow member.
  • the middle (i.e. non-terminal) hollow members have either an internal space running through their entire length or two separate internal spaces extending inwards from each end of the member, in order to allow telescopic interaction of piston-like members on both sides of said hollow member.
  • each of the hollow members will be the same.
  • the device comprises a plurality of pairs of members, each having the same diameter, said members being connected in series, the end-to-end distance of each pair being elongated by the magnetic field
  • the spinal vertebra manipulator of the invention may utilize a multi vertebral linear guiding mechanism such as bushings and guide rods or linkage mechanism. As will be described and exemplified herein below, in such implementations a single activator may be effectively used to manipulate a relevant spinal section.
  • Fig. IA is a block diagram generally demonstrating an axial activator 18 of the invention.
  • the activator 18 comprises a driving source 1 that is preferably adapted for generating axial movements to a movement transformation unit 2 capable of transforming said axial movements into angular movements,, i.e., rotary motion.
  • Said angular movements are received by a gear and unidirectional clutch unit 4 via a ratchet mechanism 3, wherein said gear is configured to allow the actuation of the vertebra manipulation device of the invention with reduced moments.
  • the rotary movements outputted by gear device 4 are then transformed into axial movements by the transformation unit 5.
  • Fig. IB schematically illustrates an implementation of an axial activator 18a, constructed according to the scheme described above with reference to Fig.
  • Axial activator 18a comprises an elongated hollow body 9 used for housing the units and devices (1, 2, 3, 4 and 5) utilized in axial activator 18a.
  • the driving source (1) is implemented by one or more pairs of stationary magnetic (or ferromagnetic) elements 11 and movable magnetic elements 10, wherein magnetic elements 11a, lib,..., Hn, are affixed to the inner wall of body 9, and movable magnetic elements 10a, 10b,..., 1On, are affixed to shaft 122 slidably centered thereinside.
  • Stationary magnetic elements 11 are configured to provide a concentric passage suitable to slidably comprise shaft 122.
  • Each stationary magnetic element 11 preferably occupies a circumferential cross-sectional area of hollow body 9 while providing a passage thereinside, where the passage of the adjacent stationary magnetic elements 11 are centered about the longitudinal axis of elongated body 9.
  • Stationary magnetic elements 11 are preferably distributed over a longitudinal section of body 9 in equal distances therebetween, and movable magnetic elements 10 are preferably distributed along shaft 122 in corresponding distances therebetween, such that corresponding pairs of stationary and movable magnetic elements ( ⁇ 10a, Ha ⁇ , ⁇ 10b, lib ⁇ ,...) are obtained.
  • shaft 122 may be moved horizontally, as exemplified by arrow 7, by applying a magnetic field along the longitudinal axis of elongated body 9, which in turn cause attraction forces to develop between each pair of stationary and movable magnetic elements 11 and 10.
  • Elongated body 9 is preferably a hollow cylindrical body manufactured from a non-magnetic material such as S.S316LVM or Titanium alloy.
  • Stationary magnetic elements 11 are preferably toroid shape elements manufactured form ferromagnetic or magnetic material, such as carbon steel or industial Ferromagnetic alloy, preferably from VACCOFLUX 50, SAElOlO, SAE1018, or SAE1020, Carbon steel.
  • the diameter of stationary magnetic elements 11 is determined to allow fitting thereof in the hollow interior of elongated body 9.
  • Stationary magnetic elements 11 preferably comprise a hollow bore, aligned with the longitudinal axis of elongated body 9, wherein said bore is configured to allow shaft 122 to move therethrough, for example, said bore may be in the range of 1.5 mm to 3.5 mm, preferably about 2.4 mm.
  • Shaft 122 may be manufactured from Stainless steel or Titanium alloy, preferably from S . S316LVM.
  • the length of shaft 122 is generally in range of 20 mm to 80 mm, preferably about 30 mm, and its diameter is generally in range of 1 mm to 3 mm, preferably about 2 mm.
  • the distance between pairs of magnetic elements (e.g., the distance between magnetic element 10a and 10b) along the longitudinal axis of elongated hollow body 9 is generally in range of 6 mm to 20 mm, preferably about 11 mm.
  • the gap between a stationary magnetic elements 11 and a movable magnetic elements 10 is generally in range of 0.4 mm to 2 mm, preferably about 1.2 mm, and the magnetic force applied during operation of the activator may bring said elements to come into contact.
  • one end tip of shaft 122 contacts the base 12a of plunger 12.
  • Plunger 12 is slidably centered in elongated body 9 by means of collar 17 and bearing (or roller) 14 which are affixed to the inner wall of elongated body 9.
  • Collar 17 is engaged with the body section 12c of plunger 12, wherein said body section 12c comprises a returning spring 13 disposed thereover and between said collar 17 and said base 12a.
  • body section 12c is attached to base 12a of plunger 12 while its other end is slidably engaged in the hollow interior of base section 18a of motion converter 18.
  • One or more rollers 16 provided on body section 12c are engaged in corresponding helical grooves 18d provided on the inside wall of the hollow interior of base section 18a.
  • grooves 18d may be implemented as helical slits passing from the outer surface of base section 18a into its hollow interior.
  • Hollow interior of base section 18a of motion converter 18 should be respectively configured to allow body section 12c of plunger 12 perform the entire axial movements forwarded thereto by shaft 122.
  • An annular groove 18b is provided over the outer surface of motion converter 18 for rotatably centering it in the internal space of elongated hollow body 9 by means of bearings (or rollers) 8 affixed to the inner side wall of elongated hollow body 9. This linkage between plunger
  • bearing 8 may be implemented without a corresponding groove 18b, but with one or more concentric ball bearings arranged in tandem, wherein the axes of said bearings coincides with the axis of converter 18.
  • Plunger 12 may be manufactured by lathing or mold casting in a cylindrical shape from a stainless steel or Titanium alloy, preferably from S.S316LVM.
  • the diameter of the base 12a of plunger 12 is generally in the range of 4 mm to 8 mm, preferably about 7.5 mm, and the diameter of its body section 12c is generally in the range of 2.5 mm to 6.5 mm, preferably about 6 mm.
  • Converter 18 is coupled to gear and unidirectional clutch unit (4) via ratchet mechanism (3) implemented by the coupling of a driving ratchet element 18c, attached to (or formed on) a cross—sectional surface of motion converter 18, and a driven ratchet element 19a attached to (or formed on) the base of ratchet 19.
  • said ratchet elements, 18c and 19a may be implemented by a circular saw tooth arrangement (not shown) provided on opposing faces of said elements, and configured such that rotations of converter 18 resulting from movements forwarded by shaft 122 establish coupling therebetween, while the rotations in the opposite direction, caused by the return of plunger 12 due to spring 20, breaks said coupling due to the sliding of the saw tooth ramps.
  • Motion converter 18 may be manufactured by lathing, milling, EDM (Electro Erosion) , or mold casting, in a cylindrical shape, from stainless steel or Titanium alloy, preferably from S.S316LVM.
  • the length of motion converter 18 is generally in the range of 6 mm to 8mm, preferably about 7 mm, its diameter is generally in the range of 6 mm to 8 mm, preferably about 7.5 mm, and the angular motions it performs are generally in the range of 4° to 12° , preferably about 6.4°.
  • the cross section of body section 19b of ratchet 19 is smaller than the cross section area of the driven ratchet element 19a, which defines an annular recess between driven ratchet . element 19a and coupling element 20, wherein returning spring 27 resides.
  • the hollow base 20a of coupling element 20 is configured to receive an end portion of body section 19b of ratchet 19 thereinto and any axial movements thereof during the sliding of the saw tooth ramps. Returning spring 27 retract portion of said body section 19b from the interior of hollow base of coupling element 20, thereby restoring the coupling between ratchet elements, 18c and 19a.
  • ratchet 19 Backwards angular motion of ratchet 19 is prevented by means of friction like O-ring seal , the shape of the interacted teeth's profile angle (moderate) and the unidirectional clutch.
  • a sliding pin 19c, provided on body section 19b of ratchet 19, transfers the angular displacements of driven ratchet element 19a to coupling element 20.
  • the hollow interior of coupling element 20 receives body section 19b of ratchet 19 and sliding pin 19 ⁇ provided thereon is received in horizontal groove 20b, thus allowing ratchet 19 to move back and forth, linearly guided, while the ratchet teeth of ratchet elements, 18c and 19a, are being engaged/disengaged during their rotation.
  • Ratchet 19 may be manufactured by lathing, milling, EDM (Electro Erosion) , or mold casting, in a cylindrical shape from stainless steel or Titanium alloy, preferably from S.S316LVM.
  • the diameter of driven ratchet element 19a of ratchet 19 is generally in the range of 6 mm to 8 mm, preferably about 7.5 mm, and its length is preferably about 2 mm.
  • the diameter of body section 19b of ratchet 19 is generally in the range of 4.5 mm to 6.5 mm, preferably about 5.5 mm, and its length if preferably about 5 mm.
  • Linear guidance means 20 may be manufactured by lathing or mold casing in a cylindrical shape from stainless steel or Titanium alloy, preferably from S.S316LVM.
  • the outer diameter of hollow base 20a is generally in the range of 6 mm to 8 mm, preferably about 7.5 mm, and its length is preferably about 6 mm.
  • the inner diameter of hollow base 20a is generally in the range of 5 mm to 7 mm, preferably about 6 mm, and its length is preferably about 6 mm.
  • the diameter of coupling portion 20c of linear guidance means 20 is generally in the range of 2 mm to 8 mm, preferably about 5 to 7.5 mm, and its length is preferably about 7 mm.
  • the rotations transferred by linear guidance means 20 are received via coupling portion 20c thereof in gear 21.
  • the chassis 21a of gear and unidirectional clutch 21 is affixed to inner wall of elongated hollow body 9, and a stationary part 22a of thrust bearing element 22 is affixed on its cross section surface.
  • the rotating part 22b of said thrust bearing element 22 is affixed to the base 23a of rotating shaft 23.
  • Thrust bearing element is designed to absorb external shocks and payload axial force which may be delivered via rotating shaft 23.
  • a cross sectional portion area of said base 23a is coupled to the output shaft 21b of gear 21, where said output shaft 21b outputs rotational movements received via coupling portion 20 ⁇ and which are transformed by transmission elements (not shown) of gear 21.
  • An annular groove may be formed on the circumference of said base 23a in which O-ring 23b may be mounted for sealing elongated hollow body 9.
  • O-ring 23a may be implemented by a single, or a pair of, silicone 0-rings mounted in grooves provided in base 23a of rotating shaft 23.
  • Gear and unidirectional clutch 21 may be a type of planetary gear head (e.g., 16/1 of Faulhaber group), its diameter is generally in the range of 6 mm to 8 mm, preferably about 7.5 mm, and its length is preferably about 6 mm.
  • the unidirectional clutch is preferably an "of the shelve" unidirectional clutch, such as manufactured by INA integrated in a gear and unidirectional clutch 21.
  • Thrust bearing element 22 may be implemented by F3-8M manufactured by SAPPORO PRECISION INC.
  • Rotating pivot 23 comprises a threaded section 23c for transl-ating the rotational motions received via gear 21 into linear movements outputted via moving arm 24 slidably centered inside elongated hollow body 9.
  • Moving arm 24 is made hollow and its internal space can be accessed via an opening provided by the bore of nut 24a mounted at the base of moving arm 24.
  • Moving arm 24 may further comprise horizontal grooves for receiving linear guiding means such as rollers, keys, pins, and the like. Affixed to respective locations on the inner wall of elongated hollow body 9.
  • Rotating pivot 23 may be manufactured from stainless steel or Ti alloy, preferably from S.S316LVM, its diameter is generally in the range of 5 mm to 7.5 mm, preferably about 7 mm, and its length is preferably about 50 mm.
  • Moving arm 24 may be manufactured by lathing and milling from stainless steel or Titanium alloy, preferably from S.S316LVM, its diameter is generally in the range of 8 mm to 7 mm, preferably about 7.5 mm, and its length is preferably about 90 mm.
  • the diameter of the hollow interior of moving arm 24 is generally in the range of 2.4 mm to 4.4 mm, preferably about 3.4 mm, and its length is preferably about 50 mm.
  • the axial motion output of magnetic activator 18a is provided by axial movements of moving arm 24 which protrudes outwardly via opening 28 of elongated hollow body 9. Said axial motion is obtained from the angular motion outputted by gear 21 which is translated by the threaded section 23c of rotating pivot 23 and the nut 24a affixed to the opening to the hollow interior of moving arm 24 into corresponding axial movements.
  • the magnetic actuation scheme described hereinabove may be used to implement a reciprocating motion device (e.g., for oscillation purposes) operating with lower force magnitudes (e.g., up to 10Kg pushing/pulling force).
  • a reciprocating motion * device may be implemented using pairs of Ferromagnets and/or magnetic elements ( ⁇ 10a, lla ⁇ , ⁇ 10b, lib ⁇ ... ⁇ 10n, lln ⁇ ) and a shaft (122) and returning spring (13) , as described above.
  • the motion converters, ratchet mechanism and gear and clutch devices are not needed in such implementation.
  • the magnetic actuation may be implemented in various Ferromagnetic and/or magnetic elements arrangement using 3 such element in tandem, for instance 2 moving ferromagnetic/magnetic elements and one stationary. Such reciprocating motion implementation may be useful in cases wherein pushing two bone's fracture to each other stimulates and improves fusion at the fracture zone.
  • the activator may also comprise a monitoring feedback device for measuring directly or indirectly the axial/rotary movements of the activator and output corresponding indications.
  • the monitoring feedback device may be implemented by one of the following options:
  • a standard miniature RF transmitter may be located inside the activator. Said RF transmitter may be energized via a small battery and transmit system displacement (rotary or linear) to an external monitor. A RF antenna can be located external to the activator.
  • the rotary or linear displacement measuring may be carried out using a rotary chopper disc (disc with many slots) passing through an opto-coupler device (Infra red solid state diode illuminating a receiver) capable of counting the received pulses.
  • an opto-coupler device Infra red solid state diode illuminating a receiver
  • a capacitance proximitter, a Hall Effect proximitter, a mechanical switch, or a rotary or linear encoder may be used in such implementation to provide a readout of the measured movements.
  • An internal Buzzer alert may be used to provide indication relating to the measured movements.
  • the buzzer may be located inside the activator, such that whenever it is indicated that the required elongation was accomplished the buzzer is energized and generates an audible signal that may be sensed by an external microphone located outside the body of the treated subject.
  • a mechanical internal feedback scheme may utilized to lock the Ferromagnets/magnets actuation system whenever a complete elongation cycle (e.g., 0.25mm) is accomplished. In this way, an external microphone may be used to sense that no internal impact noise is created and stop the elongation.
  • An additional electro-magnetic field or internal mechanism may be used to actuate the locking index into a disable position in which it is ready for the next elongation treatment.
  • Fig. 1C schematically illustrates another possible embodiment of a magnetically-actuated linear activator 18b of the invention wherein the driving force is delivered from a driving source (1) by an arm-lever transferring means 33.
  • the driving source (1) is produced by a driving unit comprising a single pair (or several pairs) of ferromagnetic/magnetic elements, movable ferromagnetic/magnetic element 31 attached to shaft 122b which passes through stationary ferromagnetic/magnetic element 32 affixed to the inner wall of the driving unit.
  • the axial movements produced by this driving unit in the presence of an alternating magnetic field are transferred by an arm-lever transferring means 33 to a parallel unit comprising axial to rotary motion transformation means (2) , ratchet mechanism (3) , gear and unidirectional clutch unit (4) , and rotary to axial motion transformation means (5) , similar to those which were previously described hereinabove.
  • a driving unit comprising a single pair (or several pairs) of ferromagnetic/magnetic elements, movable ferromagnetic/magnetic element 31 attached to shaft 122b which passes through stationary ferromagnetic/magnetic element 32 affixed to the inner wall of the driving unit.
  • such implementation can effectively provide a magnetic activator having a shorter longitudinal length.
  • the arm-lever means 33 may be encapsulated inside the activator hollow body, for example where the plunger (12 in Fig. IB) and return spring (13 in Fig. IB) to prevent backlash.
  • the rotary arm of arm-lever means 33 may be implemented by a pivoted rod rotatably supported at the center of its length to assure pure rotational displacement.
  • Fig. ID is a block diagram demonstrating construction of an activator 30 of the invention which outputs rotary movements.
  • Activator 30 is substantially similar to activator 18, which was described hereinabove with reference to Fig. IA.
  • Activator 30 comprises driving source 1, axial to rotary motion transformer 2, a ratchet mechanism 3, and a gear and unidirectional clutch device 4.
  • a rotary motion magnetic activator 30a may be constructed with similar components as in the axial magnetic activator which was described hereinabove with reference to Fig. IB.
  • rotary magnetic activator 30a outputs rotary motion directly via rotating pivot 23, the end tip of which may protrude outwardly via opening 28a of elongated hollow body 9a.
  • Fig. IF schematically illustrates a magnetic rotary activator 30b of the invention in which the axis 36 of the outputted rotary motions is perpendicular to the axis of the elongated hollow body of the activator 30b.
  • Activator 30b may comprise a driving source (1), axial to rotary motion transformer (2), ratchet mechanism (3), and gear and unidirectional device (4), similar to those described herein above with reference to Fig. IB.
  • the rotary motions outputted by gear device 21 are transferred to rotating shaft 35 via bevel gear 34 comprised of conical transmission wheels 34a and 34b.
  • elongated hollow body 9b is preferably formed in a "L" shape having an opening 28b perpendicular to the axis of elongated hollow housing 30b.
  • the base of transmission wheel 34a is * coupled to output shaft 21b of gear 21, and its tapered end is coupled to the tapering end of transmission wheel 34b.
  • Rotating shaft is concentrically affixed in transmission wheel 34b and is rotatably affixed to the inner wall of elongated hollow body 9b via supports 26a and 26b.
  • Bevel gear 34 may be a type of straight, spiral or hypoid shape gear, manufactured by milling from stainless steel or Titanium alloy, preferably from S.S316LVM. Of course, the rotary motion may be transferred perpendicularly using other gear means, such as a worm gear.
  • Fig. IG schematically illustrates a rotary magnetic activator
  • elongated hollow body 9c comprises a pair of actuating magnetic elements, movable magnetic element 41 attached to shaft 122c which passes through stationary magnetic element 42 affixed to the inner wall of elongated hollow body 9c via supports 43.
  • the axial movements produced by this driving unit in the presence of an alternating magnetic field are transferred via shaft 122c to a linear ratchet 45 coupled to driven rotary ratchet 47.
  • Return spring 44 which returns shaft 122c to its initial position, after each magnetic activation, is mounted between inner end wall of elongated hollow body 9c and linear ratchet 45.
  • Pawl mechanism 46 may be used to prevent angular backward motion of driven rotary ratchet 47 during the return cycles of shaft 122c.
  • Gear head 48, outputting angular motions via output shaft affixed thereto, may be concentrically affixed to driven rotary ratchet 47.
  • Linear ratchet 45 is guided linearly via rolling or friction means to maintain consistent coupling with the rotary driven ratchet 47.
  • Linear ratchet 45 may be manufactured by milling or mold casting from stainless steel or titanium alloy, preferably from S.S316LVM.
  • Driven rotary ratchet 47 is designed to output a desired angular motion, it may be manufactured by milling, EDM, or mold casting from a stainless steel or Titanium alloy, preferably from S.S316LVM.
  • Gear head 48 is preferably a type of planetary gear head, manufactured by milling or mold casting from a stainless steel or Ti alloy, preferably from S.S316LVM.
  • Figs. 2A and 2B demonstrates magnetic activation schemes which may be possibly used in actuating the spinal column manipulator of the invention.
  • the windings of electromagnet 112 may enclose the magnetic activator 18/30 (18 - axial activator; 30 - rotary activator) of the invention.
  • the magnetic activator can be actuated by magnetic flux 111 emanating from electromagnet 112 and passing therethrough, when connected to an electrical current source 113.
  • electromagnet 112 may be located adjacent to activator 18/30 such that magnetic flux 111 surrounding it can actuate it.
  • other magnetic field sources may be similarly used, such as a permanent magnet.
  • the magnetic field induced by the electromagnet 112 is in the range of 0.01 Tesla to 2 Tesla.
  • the magnetic forces induced by electromagnet 112 are generally in the range of 0.1Kg to 20Kg.
  • Electromagnet 112 may be helmholtz type such as manufactured by TESLA.
  • the electrical currents driven by current source 113 are sinusoidal alternating currents or DC currents, generally in the range of 1 to 500 Amper, preferably about 50 Amper, and their frequency is generally in the range of 0.01 to 50 Hz, preferably about 1 Hz.
  • Electromagnet 112 may comprise 1 or 2 serially connected coils, wherein said coils are encapsulated, or partially encapsulated, in a suitable Ferromagnetic shielding such as carbon steel to minimize environmental electro magnetic field interferences, and to concentrate the electro magnetic flux within an active area.
  • one device is situated on each side of the vertebral column.
  • the two devices are of equal end-to-end length. Coordination of the end-to-end length changes between the two devices is achieved, in part, by the use of the interconnecting elements described hereinabove.
  • the devices used in these examples are comprised of the following elements:
  • Tightening screws (51) - the screw heads may be circular or rectangular or any other suitable shape.
  • Using rectangular shapes heads accompanied by two respective open slots at the platform front side enables easy insertion of the platform onto the two rectangular screw heads and then clamping or securing the platform to the screws.
  • the magnetic activator (18/30) may activate a linearly bushing guided telescopic arm (Figs. 3B, 3G, 4C), or a mechanical cantilever leverage mechanism (Figs. 3F, 3G) or a rotational axial cam shaft (Fig. 4A) (Figs. 4B-4E) , or a cam shaft mechanism (Figs. 4B, 4C, 4D, 4E) or arms kinematics mechanism with 3-10 arms etc (Fig. 3C, 3D, 3E, 4D, 4E) .
  • Fig. 3A schematically illustrates a device of the invention operating with a pair of parallel axial activators 18.
  • Two platforms, 53a and 53b are attached to the manipulated vertebrae 50a (lower) and 50b (upper) , respectively, by means of screws 51a and 51b, respectively.
  • the screws 51 may be threaded into the disc (100, Figs. 5A and 5B), and/or the transverse processes (101, Figs. 5A and 5B) bony portions of the vertebrae 50.
  • the body part of axial activators 18 may be affixed (e.g., by screws 51a) to the lower platform 53a, and the moving arm thereof may be similarly affixed to the upper platform 53b, or the other way around.
  • Platforms 53a and 53b may be manufactured form a S.S316LVM or Ti alloy type of material, preferably from S.S316LVM, and their geometrical dimensions should be determined according to the dimensions of the manipulated vertebrae.
  • the horizontal length of the platforms may be in general in range of 30 mm to 60 mm, preferably about 40 mm, their width in range of 10 mm to 30 mm, preferably about 15 mm, and their thickness in the range of 4 mm to 10 mm.
  • Screws 51a and 51b may be any type of suitable screws, such as pedicular screws.
  • FIG. 3B schematically illustrates a device of the invention operating with a single axial activator 18 and with linear guidance means, 85 and 86.
  • Axial activator is preferably attached to the centers of platforms 53a and 53b by means of clamping or tightening screws on one side where in the other floating/rigid coupling such as surface to surface contact, ball ' and socket mechanism, clevis mechanism, round edge against conical shape slot or cavity.
  • Linear guidance means may be constructed from shafts 85b and 86b, affixed (e.g., by screws 51a) to the lower platform 53a and telescopically engaged in respective bushings and 85b, which are affixed (e.g., by screws 51b) to the upper platform 53b.
  • Shafts 85b and 86b may be manufactured by lathing from a stainless steel or Titanium alloy type of material, preferably from S.S316LVM, their diameter is generally in range of 2 mm to 6 mm, preferably about 3 mm.
  • Bushings 85a and 86a may be manufactured by lathing from stainless steel or Titanium alloy, preferably from S.S316LVM, their outer diameter is generally in range of 5 mm to 10 mm, their inner diameter is generally in range of 3 mm to 8.
  • the length of said shafts and bushings should be determined in each specific case according the distance between the vertebrae.
  • a bio-compatible low friction polymeric bushing may be implemented into the metallic bushing inner diameter spacing to be in-contact with the shaft in order to reduce friction.
  • Fig. 3C schematically illustrates a device of the invention operating with a single axial activator and with stabilizing and synchronizing arms 56a and 56b.
  • activator 18 is affixed to the centers of platforms 53a and 53b.
  • Arms 56a and 56b are rotatably attached to respective supporting means, 55b and 55a, which are welded or machined at one lateral side to the lower side of platform 53b and to the upper side of platform 53a, respectively.
  • Mutual rotational axis 59 attached the centers of arms 56a and 56b, and their other end is rotatably attached to wheels 52a and 52b, respectively.
  • Wheels 52a and 52b are slidably enclosed in compartments 58a and 58b, respectively, wherein said wheels are free to horizontally slide in said compartments thereby permitting the vertical manipulation of vertebrae 53a and 53b by the device.
  • Arms 56a and 56b are preferably made from stainless steel or Titanium alloy, preferably from S.S316LVM, their width may be in the range of 3 mm to 8 mm, their thickness in the range 0.5 mm to 4 mm, and their length should be determined in each specific case according to the distance between the vertebrae.
  • Compartments 58a and 58b are attached to the upper side of the lower platform 53a and to the lower side of the upper platform 53b, at the lateral side opposing supports 55a and 55b. Compartments 58a and 58b may be manufactured from the same material of platforms 53b and 53a, and their geometrical dimensions are determined according to the wheels 52a and 52b which are used.
  • Wheels 52a and 52b may be manufactured from a stainless steel, Titanium alloy or Bio-compatible polymer, preferably from S.S316LVM, and their diameter is generally in the range of 3 mm to 8 mm.
  • Fig. 3D is a variation of the device illustrated in Fig. 3C, wherein axial activator 18 mounted near one of the lateral sides of the device (off center positioning) .
  • axial activator 18 is mounted at the same side with compartments 58a and 58b, and its moving arm 24 is attached to the lower part of compartment 58b (or to arm 56b) .
  • Fig. 3E schematically illustrates a device of the invention operating with a single axial activator 18 and with two pairs of stabilizing and synchronizing arms 63 and 64.
  • Two lateral supports with rotational axes 55c and 55d are welded or machined with to the upper side of the lower platform 53a.
  • First arms, 63c and 63d, are rotatably attached at one end thereof to respective supports 55c and 55d, and second arms 64c and 64d, are rotatably attached at one end thereof to the other end of said first arms.
  • Gear wheels 62c and 62d are rotatably attached to the other end of said second arms 64c and 64d, where said gear wheels are slidably enclosed in respective compartments 58c and 58d, which are attached to the lower side of upper platform 53b.
  • a rack and pinion mechanism may be provided to couple wheels 62c and 62d to respective racks 65c and 65d attached to the lower side of upper platform 53b. Said rack and pinion mechanism synchronizes the movements applied to platforms 53a and 53b by activator 18.
  • Arms 63a, 63b, 64a, and 64b are preferably made from a stainless steel or Ti alloy, preferably from S.S316LVM, their width may be in the range of 3 mm to 8 mm, their thickness is in the range 0.5 mm to 4 mm, and their length should be determined in each specific case according to the distance between the vertebrae.
  • Fig. 3F schematically illustrates a device of the invention operating with a single axial 18 activator and a lever arm 68.
  • Lever arm 68 may be rotatably attached to supporting means 66 affixed to the upper side of lower platform 53a.
  • the body of activator 18 is affixed to the upper platform 53b and its moving arm is linked to the actuated part 68b of arm 68.
  • Wheel 67 may be rotatably attached to the manipulating part 68a of arm 68, where said wheel 67 is slidably engaged with the lower side of platform 53b, such that it may slide horizontally thereon according to the movements of arm 68.
  • the ratio between the lengths of the manipulating part 68a and the actuated part 68b of arm 68 may be utilized to amplify the applied movements or applied pushing force.
  • Arm 68 is preferably made from stainless steel or Titanium alloy, preferably from S.S316LVM, its width may be in the range of 3 mm to 8 mm, and its thickness in the range 0.5 mm to 6 mm.
  • Fig. 3G schematically illustrates a device of the invention operating with a pair of axial activators 18 and respective lever arms 68 and 70 linked thereto.
  • Fig. 3H schematically illustrates a device of the invention operating with a pair of horizontally disposed axial activators 18 and respective ramp surfaces 74a and 74b.
  • Axial activators 18 are horizontally affixed to support members 72a and 72b, attached to the upper side of platform 53a and to the lower side of platform 53b, respectively.
  • Wheels 73a and 73b are rotatably attached to the moving arms of said activators 18, wherein each of said wheels is sandwiched between a respective ramp surface, 74a and 74b, and the horizontal surface a support member, 72b and 72a, respectively.
  • Ramps 74a and 74b are preferably made from a stainless steel or Titanium alloy, preferably from S.S316LVM, their horizontal widths may be in the range of 4 mm to 15 mm, their thickness in the range 1 mm to 6 mm, and their ramp angle may be in the range of 15° to 45°.
  • Support members 72a and 72b are preferably made from a stainless steel or Ti alloy, preferably from S.S316LVM, their horizontal widths may be in the range of 5 mm to 15 mm, their thickness in the range 1 mm to 7 mm.
  • Fig. 4 " 7A schematically illustrates a device of the invention operating with a single rotary activator 30 and ramped surfaces 76 and 77, or additional ramp surfaces used to improve stability.
  • rotary activator 30 is centrically affixed to lower platform 53a and its rotating shaft is attached to the bottom side of the ramp surfaces 76 and 77.
  • Said ramp surfaces are rotatably attached to the upper side of platform 53a via bearings (or rollers, or low friction bio-compatible polymeric material) 66.
  • the upper side of ramp surfaces 76 and 77 is coupled with the lower side of upper platform 53b via wheels 75 rotatably attached thereto.
  • Ramps 76 and 77 are preferably made from stainless steel or
  • Titanium alloy preferably from S.S316LVM
  • their horizontal widths may be in the range of 5 mm to 30 mm
  • their thickness in the range 1 mm to 6 mm
  • their ramp angle may be in the range of 15° to 45°.
  • Fig. 4B schematically illustrates a device of the invention operating with a single horizontally disposed rotary activator 30 and an eccenter 79 mounted on its rotating shaft.
  • Activator 30 is horizontally affixed to support means 78 that is attached to the upper side of lower platform 53a.
  • Eccenter 79 is mounted on the rotating arm of rotary activator 30, and it is coupled with cam follower 80 that is rotatably mounted on the lower side of upper platform 53b via a clevids affixed thereto.
  • Eccenter 79 is preferably made from stainless steel or Titanium alloy, preferably from S.S316LVM, its thickness may be in the range of 1 mm to 5 mm, and its diameter in the range 6 mm to 25 mm.
  • Cam follower 80 is preferably made from the same material exxenter 79i made from, its thickness may be in the range of 1 mm to 5 mm, and its diameter in the range 3 mm to 10 mm.
  • Figs. 4C, 4D and 4E exemplifies implementations of the device described above wherein vertical manipulations are affected by a horizontally disposed rotary activator 30 having an eccenter 79 mounted on its rotating shaft, which eccenter is coupled with a cam follower 80, and wherein the devices utilizes linear guidance means 85 and 86, stabilizing and synchronizing arms 56a and 56b, and two pairs of stabilizing and synchronizing arms 63c, 64c, 63d, and 64d.
  • the use of linear guidance means and stabilizing and synchronizing arms exemplified in Figs. 4C, 4D and 4E, is substantially as was described hereinabove with reference to figs. 3B, 3C-3D, and 3E, and for the sake of brevity will not be further discussed in detail.
  • the rotary activator 30 used in the device demonstrated in Figs. 4A to 4E may be a type of rotary activator in which the axis of rotation is aligned with axis of the elongated hollow housing (e.g., 30a in Fig. IE), or a type of rotary activator in which the axis of rotation is perpendicular to the axis of the elongated hollow housing (e.g., 30b and 30c in Figs. IF and IG), mutatis mutandis.
  • One activator is actuating all of the selected vertebra, each of which is equipped with two bushings (or other linear guidance measures) which allows them to slide linearly during distraction on mutual or/and separate linear guidance rods.
  • Each two neighbor vertebrae are equipped with guiding measures and single activator.
  • Fig. 6A schematically illustrates a device of the invention comprising several pairs of rotary output shafts 130a, 130b and 130c, and designed to concurrently manipulate a number of vertebrae.
  • said pairs of rotary output shafts activators 130a, 130b and 130c have a rotating pivot which axis is perpendicular to the axis of the body of the activators, wherein a respective eccenter 79a, 79b and 79c is mounted on the rotating pivot of each manipulator.
  • This vertebrae manipulating device comprises two elongated members 131 which may comprise, or alternatively function as, the hollow elongated body of rotary output shafts 130a, 130b and 130c.
  • the eccentiricity of the eccentric cam should be gradually increased from lower to upper manipulated vertebra respectively.
  • the elongated members of this vertebrae manipulating device are affixed (e.g., by screws) to the lowermost and upper most platforms, 531 and 53u.
  • the eccenters 79a, 79b and 79c are coupled to intermediate platforms 53a, 53b and 53c, via respective cam followers 80a, 80b and 80c, rotatably attached to lower side of said intermediate platforms.
  • This device allows manipulating the respective vertebrae to which said intermediate platforms (53a, 53b and 53c) are attached relative to the vertebrae to which said uppermost and lowermost platforms (53u and 531) are attached.
  • Fig. 6B schematically illustrates a device of the invention comprising a tandem of axial (linear) activators 18 and designed to concurrently manipulate a number of vertebrae.
  • Axial activators 18 are affixed (e.g., via screws or clamping) to the lower platform 53a, wherein the moving arms of said activators are attached to the lower side of the consecutive platform 53b via support members 136b.
  • the consecutive platforms 53c and 53d are attached to platforms 53b and 53c, respectively, via rods, 135c and 135d, and support members, 136c and 136d, assemblies, wherein rods 135c and 135d are affixed to platforms 53b and 53 ⁇ , respectively.
  • W 2
  • the vertebrae located above the vertebra to which platform 53a is attached may be manipulated by the device.
  • Fig. 6C schematically illustrates a device of the invention comprising a tandem of axial (linear) activators 18 and designed to concurrently operate on a number of vertebrae with linear guidance means.
  • axial activators 18 are affixed to lower platform 531.
  • Said activators 18 comprise elongated moving arms 131 which slidably pass through the upper platform 53u and thus provide linear guidance.
  • the vertebrae located between said upper and lower platforms (53u and 531) , 50a-50c, have respective pairs of rods 132a-132c attached at their lateral sides.
  • Respective pairs of support members 133a-133c are distributed along elongated moving arms of activators 18, and are engaged with said rods 132a-132c, such that the axial movements applied by activators 18 are transferred to vertebrae 50a-50c.
  • Fig. 6D schematically illustrates a device of the invention comprising a number of rotary activators 30b, 30c, 3Od, mounted in-between each pair of vertebrae and designed to concurrently manipulate a number of vertebrae with linear guidance means.
  • supporting shaft 138 connects the lower and the upper vertebrae platforms 53a and 53e, wherein bushings 137b, 137c and 137d, are linearly guided onto mutual linear shaft 138 on both sides.
  • each moving vertebra is being guided on the same mutual shafts 138 which are attached to the lowermost and uppermost vertebrae 53a and 53e, and thereby provide linear guidance.
  • Each vertebra platform is being attached to the linear guiding bushing via clamping, welding or screwing.
  • the rotary activator 30b is affixed to the lowermost platform 53a and eccenter 79 mounted on its rotating pivot is coupled to cam follower 80 rotatably attached to the lower side of platform 53b.
  • each pair of vertebrae may be driven by separate activator.
  • Fig. 6E schematically illustrates a device of the invention comprising a number of axial activators 18b, 18c, 18d, and designed to concurrently manipulate a number of vertebrae with linear guidance means. These examples are substantially similar to the device described with reference to Fig. 6D, respectively. As demonstrated in these figures The moving arm of activator 18 may be attached to the respective platforms via clevis means 140b, 140c, and 14Od, respectively.
  • the activator used in the device of the invention may be driven using other wirelessly energizable means, such as linear or rotary piezoelectric motors (e.g., Nanomotion linear piezo electric) , motors that may actuated by an external applied alternating magnetic or electromagnetic filed (e.g., rotary synchronized magnetic or electromagnetic field which could drive invasive permanent core) .
  • linear or rotary piezoelectric motors e.g., Nanomotion linear piezo electric
  • motors that may actuated by an external applied alternating magnetic or electromagnetic filed (e.g., rotary synchronized magnetic or electromagnetic field which could drive invasive permanent core) .
  • the patient Prior to the surgical procedure requiring the use of the device of the present invention, the patient will have already undergone a spinal fixation procedure.
  • pedicular screws will have been inserted into certain, relevant vertebrae, and a helically-twisted rod inserted and wound (in accordance with the Cotrel-Dubouset maneuver) in order to achieve unwinding of the abnormally curved vertebral column.
  • Bone chips (usually obtained by autografting from other anatomical sites) are placed between the transverse processes on both sides of adjacent vertebrae in the treated region. With time, growth of the bone chips will result in the formation of a single, unified bone bar on each side of the vertebral column, thereby resulting in spinal fixation .
  • said procedure comprises the following steps:
  • the replacement by the fixation rods by devices of the present invention can be performed either at the end of the first operation, or later on, when elongation is decided upon.
  • the two devices may be interconnected by one or more interconnecting elements (as described hereinabove) , in order to co-ordinate the distraction of one side of the vertebral column with the other, contralateral side.
  • the distraction will start between 3 to 28 days post operatively, preferably after 7 days.
  • the any bone bridges between to vertebrae should be severed and soft tissues should be released to allow elongation to take place.
  • the distraction will start between 3 to 28 days post operatively, after the bone bar and soft tissue release, preferably after 7 days.
  • a single electromagnetic coil placed over the trunk region of the patient being treated, such that it overlays the length of the vertebral column that is being treated with the device of the present invention. In this way, a homogenous magnetic field is created, such that an attractive magnetic force is applied to the magnetic or ferromagnetic elements situated within the telescopic or sliding member pair(s).
  • a pair of electromagnetic coils is placed in contact with the body surface overlaying the region of the vertebral column that is being treated with the device of the present invention, such that the current flowing through one coil runs in the opposite direction to the current flowing through the other coil.
  • the design of the two coils and the precise position of placement thereof are such that the area of the magnetic field generated by one coil is connected to the magnetic field area generated by the second coil by way of the magnetic/ferromagnetic material located in the telescopic or sliding member pair(s) of the present invention. In this way, an attractive force is exerted on one or more of the members of each pair.
  • a suitable magnetic coil would be one generating a magnetic field at total current in about 500 amps, the power consumption at that field being about 25 KW.
  • Such a coil when used together with the exemplary 8-pair ferromagnet configuration described hereinabove, has been found to exert a 2 Kg force on the telescopic or sliding member pair.
  • the application of the magnetic field is performed at least once per day for a period of between 1 and 150 days, preferably for a period of one month. This regime will normally result in elongation of the treated vertebral column by 0.05 mm to 2 mm per day, preferably lmm per day.
  • any preexisting rods are removed and replaced by the presently- disclosed devices, essentially as described in steps 1 to 5 of section 2.1, hereinabove.
  • the spinal fusion procedure either ⁇ ompj ⁇ e ⁇ si ⁇ on, that is reduction of the total -end-to-end length of the elongate member pair(s), or axial oscillation of said elongate member pairs (rather than distraction) is performed by application of an external magnetic field, as described above.
  • said procedure may also be used as a primary treatment, i.e. as a method of first choice for obtaining spinal fusion
  • the reverse-direction movement is driven by means of spring or other return mechanism as described hereinabove.
  • the amplitude of the oscillatory motion is controlled by standard means such as slot and fin mechanisms that are well known in the art.
  • the frequency of the oscillatory motion is generally between 0.01 and 50 Hz, preferably 0.5 Hz. This oscillatory motion may be induced between 1 and 50 times per day, preferably once a day for a period of 20 minutes.
  • the compressive force is applied for a period of between 1 milisecond and 120 minutes, between once per day and fifty times per day, preferably once per day for 20 minutes.
  • a constant compressive force can also be changed to other level by applying an appropriate magnetic field produced by the coil system that decrease the length of the device thus inducing compression force
  • both the oscillation and compression procedures may be used also to expedite fusion of bone chips at the end of a primary scoliosis surgery.

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Neurology (AREA)
  • Engineering & Computer Science (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Electromagnetism (AREA)
  • Physics & Mathematics (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
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  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne généralement un dispositif pour manipuler la colonne vertébrale d'un patient. Ce dispositif comprend au moins un activateur présentant un élément mobile pouvant être déplacé par rapport à des signaux de mise sous tension induite. Cet activateur est fixé sur au moins une vertèbre, et relié à au moins une autre vertèbre, de sorte que l'activateur peut déplacer la ou les vertèbres auxquelles il est relié, dans une direction axiale. Le déplacement de cette activateur peut être unilatéral, ce qui provoque soit une distraction ou une compression des vertèbres, ou bilatérale, ce qui provoque un déplacement oscillatoire des vertèbres.
PCT/IL2006/000240 2005-02-22 2006-02-22 Dispositif et methode pour une distraction et pour une oscillation de colonne vertebrale WO2006090380A2 (fr)

Priority Applications (7)

Application Number Priority Date Filing Date Title
US11/989,795 US20100228167A1 (en) 2005-08-01 2006-07-31 Implantable Magnetically Activated Actuator
AU2006274537A AU2006274537A1 (en) 2005-08-01 2006-07-31 An implantable magnetically activated actuator
PCT/IL2006/000888 WO2007015239A2 (fr) 2005-08-01 2006-07-31 Actionneur magnetique implantable
CA002617664A CA2617664A1 (fr) 2005-08-01 2006-07-31 Actionneur magnetique implantable
JP2008524673A JP2009502412A (ja) 2005-08-01 2006-07-31 移植型磁気作動式アクチュエータ
EP06766202A EP1915099A2 (fr) 2005-08-01 2006-07-31 Actionneur magnetique implantable
IL188981A IL188981A0 (en) 2005-08-01 2008-01-23 An implantable magnetically activated actuator

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US65451005P 2005-02-22 2005-02-22
US60/654,510 2005-02-22
US70388405P 2005-08-01 2005-08-01
US60/703,884 2005-08-01

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WO2011006456A1 (fr) * 2009-07-17 2011-01-20 Ulrich Gmbh & Co. Kg Élément de distraction pour colonne vertébrale
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US7981025B2 (en) 2006-10-20 2011-07-19 Ellipse Technologies, Inc. Adjustable implant and method of use
US8057472B2 (en) 2007-10-30 2011-11-15 Ellipse Technologies, Inc. Skeletal manipulation method
EP2422731A1 (fr) * 2010-08-26 2012-02-29 Wittenstein AG Actionneur pour la correction de la scoliose
US8197490B2 (en) 2009-02-23 2012-06-12 Ellipse Technologies, Inc. Non-invasive adjustable distraction system
US8382756B2 (en) 2008-11-10 2013-02-26 Ellipse Technologies, Inc. External adjustment device for distraction device
US8449543B2 (en) 2009-09-04 2013-05-28 Ellipse Technologies, Inc. Bone growth device and method
US8715282B2 (en) 2011-02-14 2014-05-06 Ellipse Technologies, Inc. System and method for altering rotational alignment of bone sections
US9078711B2 (en) 2012-06-06 2015-07-14 Ellipse Technologies, Inc. Devices and methods for detection of slippage of magnetic coupling in implantable medical devices
US9248043B2 (en) 2010-06-30 2016-02-02 Ellipse Technologies, Inc. External adjustment device for distraction device
US9622792B2 (en) 2009-04-29 2017-04-18 Nuvasive Specialized Orthopedics, Inc. Interspinous process device and method
WO2018187566A1 (fr) * 2017-04-05 2018-10-11 University Of Tennessee Research Foundation Systèmes de dispositifs d'orthèse vertébrale lombaire permettant une distraction et une mobilité, et des procédés de traitement d'une douleur lombaire mécanique
US10238427B2 (en) 2015-02-19 2019-03-26 Nuvasive Specialized Orthopedics, Inc. Systems and methods for vertebral adjustment
US10271885B2 (en) 2014-12-26 2019-04-30 Nuvasive Specialized Orthopedics, Inc. Systems and methods for distraction
US10349982B2 (en) 2011-11-01 2019-07-16 Nuvasive Specialized Orthopedics, Inc. Adjustable magnetic devices and methods of using same
US10405891B2 (en) 2010-08-09 2019-09-10 Nuvasive Specialized Orthopedics, Inc. Maintenance feature in magnetic implant
US10743794B2 (en) 2011-10-04 2020-08-18 Nuvasive Specialized Orthopedics, Inc. Devices and methods for non-invasive implant length sensing
US10751094B2 (en) 2013-10-10 2020-08-25 Nuvasive Specialized Orthopedics, Inc. Adjustable spinal implant
US10835290B2 (en) 2015-12-10 2020-11-17 Nuvasive Specialized Orthopedics, Inc. External adjustment device for distraction device
US10918425B2 (en) 2016-01-28 2021-02-16 Nuvasive Specialized Orthopedics, Inc. System and methods for bone transport
US11191579B2 (en) 2012-10-29 2021-12-07 Nuvasive Specialized Orthopedics, Inc. Adjustable devices for treating arthritis of the knee
US11241257B2 (en) 2008-10-13 2022-02-08 Nuvasive Specialized Orthopedics, Inc. Spinal distraction system
US11246694B2 (en) 2014-04-28 2022-02-15 Nuvasive Specialized Orthopedics, Inc. System for informational magnetic feedback in adjustable implants
US11504259B2 (en) 2016-12-05 2022-11-22 University Of Tennessee Research Foundation Controlled tension device fastening devices, systems, and methods
US11839410B2 (en) 2012-06-15 2023-12-12 Nuvasive Inc. Magnetic implants with improved anatomical compatibility
CN118021499A (zh) * 2024-04-12 2024-05-14 中国医学科学院北京协和医院 脊柱矫形系统

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US9011499B1 (en) 2004-07-02 2015-04-21 Ellipse Technologies, Inc Expandable rod system to treat scoliosis and method of using the same
US7955357B2 (en) 2004-07-02 2011-06-07 Ellipse Technologies, Inc. Expandable rod system to treat scoliosis and method of using the same
US9398925B2 (en) 2004-07-02 2016-07-26 Nuvasive Specialized Orthopedics, Inc. Expandable rod system to treat scoliosis and method of using the same
US8343192B2 (en) 2004-07-02 2013-01-01 Ellipse Technologies, Inc. Expandable rod system to treat scoliosis and method of using the same
US10016221B2 (en) 2004-07-02 2018-07-10 Nuvasive Specialized Orthopedics, Inc. Expandable rod system to treat scoliosis and method of using the same
US8852236B2 (en) 2004-07-02 2014-10-07 Ellipse Technologies, Inc. Expandable rod system to treat scoliosis and method of using the same
WO2008003952A1 (fr) * 2006-07-04 2008-01-10 The University Of Birmingham Dispositif de déviation
US10039661B2 (en) 2006-10-20 2018-08-07 Nuvasive Specialized Orthopedics, Inc. Adjustable implant and method of use
US7981025B2 (en) 2006-10-20 2011-07-19 Ellipse Technologies, Inc. Adjustable implant and method of use
US11234849B2 (en) 2006-10-20 2022-02-01 Nuvasive Specialized Orthopedics, Inc. Adjustable implant and method of use
US11672684B2 (en) 2006-10-20 2023-06-13 Nuvasive Specialized Orthopedics, Inc. Adjustable implant and method of use
US8715159B2 (en) 2006-10-20 2014-05-06 Ellipse Technologies, Inc. Adjustable implant and method of use
US8057472B2 (en) 2007-10-30 2011-11-15 Ellipse Technologies, Inc. Skeletal manipulation method
US8419734B2 (en) 2007-10-30 2013-04-16 Ellipse Technologies, Inc. Skeletal manipulation method
US10349995B2 (en) 2007-10-30 2019-07-16 Nuvasive Specialized Orthopedics, Inc. Skeletal manipulation method
US9693813B2 (en) 2007-10-30 2017-07-04 Nuvasive Specialized Orthopedics, Inc. Skeletal manipulation method
US11172972B2 (en) 2007-10-30 2021-11-16 Nuvasive Specialized Orthopedics, Inc. Skeletal manipulation method
US11925389B2 (en) 2008-10-13 2024-03-12 Nuvasive Specialized Orthopedics, Inc. Spinal distraction system
US11241257B2 (en) 2008-10-13 2022-02-08 Nuvasive Specialized Orthopedics, Inc. Spinal distraction system
US11974782B2 (en) 2008-11-10 2024-05-07 Nuvasive Specialized Orthopedics, Inc. External adjustment device for distraction device
US8382756B2 (en) 2008-11-10 2013-02-26 Ellipse Technologies, Inc. External adjustment device for distraction device
US10729470B2 (en) 2008-11-10 2020-08-04 Nuvasive Specialized Orthopedics, Inc. External adjustment device for distraction device
US11304729B2 (en) 2009-02-23 2022-04-19 Nuvasive Specialized Orthhopedics, Inc. Non-invasive adjustable distraction system
US9848914B2 (en) 2009-02-23 2017-12-26 Nuvasive Specialized Orthopedics, Inc. Non-invasive adjustable distraction system
US8974463B2 (en) 2009-02-23 2015-03-10 Ellipse Technologies, Inc. Non-invasive adjustable distraction system
US8197490B2 (en) 2009-02-23 2012-06-12 Ellipse Technologies, Inc. Non-invasive adjustable distraction system
US10517643B2 (en) 2009-02-23 2019-12-31 Nuvasive Specialized Orthopedics, Inc. Non-invasive adjustable distraction system
US10478232B2 (en) 2009-04-29 2019-11-19 Nuvasive Specialized Orthopedics, Inc. Interspinous process device and method
US11602380B2 (en) 2009-04-29 2023-03-14 Nuvasive Specialized Orthopedics, Inc. Interspinous process device and method
US9622792B2 (en) 2009-04-29 2017-04-18 Nuvasive Specialized Orthopedics, Inc. Interspinous process device and method
WO2011006456A1 (fr) * 2009-07-17 2011-01-20 Ulrich Gmbh & Co. Kg Élément de distraction pour colonne vertébrale
US11207110B2 (en) 2009-09-04 2021-12-28 Nuvasive Specialized Orthopedics, Inc. Bone growth device and method
US8449543B2 (en) 2009-09-04 2013-05-28 Ellipse Technologies, Inc. Bone growth device and method
US10660675B2 (en) 2010-06-30 2020-05-26 Nuvasive Specialized Orthopedics, Inc. External adjustment device for distraction device
US9248043B2 (en) 2010-06-30 2016-02-02 Ellipse Technologies, Inc. External adjustment device for distraction device
US11497530B2 (en) 2010-06-30 2022-11-15 Nuvasive Specialized Orthopedics, Inc. External adjustment device for distraction device
US10405891B2 (en) 2010-08-09 2019-09-10 Nuvasive Specialized Orthopedics, Inc. Maintenance feature in magnetic implant
EP2422731A1 (fr) * 2010-08-26 2012-02-29 Wittenstein AG Actionneur pour la correction de la scoliose
US10646262B2 (en) 2011-02-14 2020-05-12 Nuvasive Specialized Orthopedics, Inc. System and method for altering rotational alignment of bone sections
US11406432B2 (en) 2011-02-14 2022-08-09 Nuvasive Specialized Orthopedics, Inc. System and method for altering rotational alignment of bone sections
US10105167B2 (en) 2011-02-14 2018-10-23 Nuvasive Specialized Orthopedics, Inc. System and method for altering rotational alignment of bone sections
US8715282B2 (en) 2011-02-14 2014-05-06 Ellipse Technologies, Inc. System and method for altering rotational alignment of bone sections
US8852187B2 (en) 2011-02-14 2014-10-07 Ellipse Technologies, Inc. Variable length device and method
US10743794B2 (en) 2011-10-04 2020-08-18 Nuvasive Specialized Orthopedics, Inc. Devices and methods for non-invasive implant length sensing
US10349982B2 (en) 2011-11-01 2019-07-16 Nuvasive Specialized Orthopedics, Inc. Adjustable magnetic devices and methods of using same
US11123107B2 (en) 2011-11-01 2021-09-21 Nuvasive Specialized Orthopedics, Inc. Adjustable magnetic devices and methods of using same
US9078711B2 (en) 2012-06-06 2015-07-14 Ellipse Technologies, Inc. Devices and methods for detection of slippage of magnetic coupling in implantable medical devices
US9730612B2 (en) 2012-06-06 2017-08-15 Nuvasive Specialized Orthopedics, Inc. Devices and methods for detection of slippage of magnetic coupling in implantable medical devices
US11839410B2 (en) 2012-06-15 2023-12-12 Nuvasive Inc. Magnetic implants with improved anatomical compatibility
US11191579B2 (en) 2012-10-29 2021-12-07 Nuvasive Specialized Orthopedics, Inc. Adjustable devices for treating arthritis of the knee
US11213330B2 (en) 2012-10-29 2022-01-04 Nuvasive Specialized Orthopedics, Inc. Adjustable devices for treating arthritis of the knee
US10751094B2 (en) 2013-10-10 2020-08-25 Nuvasive Specialized Orthopedics, Inc. Adjustable spinal implant
US11246694B2 (en) 2014-04-28 2022-02-15 Nuvasive Specialized Orthopedics, Inc. System for informational magnetic feedback in adjustable implants
US11439449B2 (en) 2014-12-26 2022-09-13 Nuvasive Specialized Orthopedics, Inc. Systems and methods for distraction
US10271885B2 (en) 2014-12-26 2019-04-30 Nuvasive Specialized Orthopedics, Inc. Systems and methods for distraction
US11612416B2 (en) 2015-02-19 2023-03-28 Nuvasive Specialized Orthopedics, Inc. Systems and methods for vertebral adjustment
US10238427B2 (en) 2015-02-19 2019-03-26 Nuvasive Specialized Orthopedics, Inc. Systems and methods for vertebral adjustment
US10835290B2 (en) 2015-12-10 2020-11-17 Nuvasive Specialized Orthopedics, Inc. External adjustment device for distraction device
US10918425B2 (en) 2016-01-28 2021-02-16 Nuvasive Specialized Orthopedics, Inc. System and methods for bone transport
US11504259B2 (en) 2016-12-05 2022-11-22 University Of Tennessee Research Foundation Controlled tension device fastening devices, systems, and methods
WO2018187566A1 (fr) * 2017-04-05 2018-10-11 University Of Tennessee Research Foundation Systèmes de dispositifs d'orthèse vertébrale lombaire permettant une distraction et une mobilité, et des procédés de traitement d'une douleur lombaire mécanique
US11213419B2 (en) 2017-04-05 2022-01-04 University Of Tennessee Research Foundation Distractive and mobility-enabling lumbar spinal orthosis devices, systems, and methods for treating mechanical low back pain
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