WO2008051802A2 - Methods and systems for constraint of multiple spine segments - Google Patents
Methods and systems for constraint of multiple spine segments Download PDFInfo
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- WO2008051802A2 WO2008051802A2 PCT/US2007/081822 US2007081822W WO2008051802A2 WO 2008051802 A2 WO2008051802 A2 WO 2008051802A2 US 2007081822 W US2007081822 W US 2007081822W WO 2008051802 A2 WO2008051802 A2 WO 2008051802A2
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- 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
- A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
-
- 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
- A61B17/7053—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant with parts attached to bones or to each other by flexible wires, straps, sutures or cables
-
- 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
- A61B17/7055—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant connected to sacrum, pelvis or skull
-
- 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
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/842—Flexible wires, bands or straps
Definitions
- the present invention relates generally to medical methods and apparatus. More particularly, the present invention relates to methods and devices for restricting spinal flexion in patients having back pain or other spinal conditions.
- discogenic pain also known as internal disc disruption.
- Patients suffering from discogenic pain tend to be young, otherwise healthy individuals who present with pain localized to the back.
- Discogenic pain usually occurs at the discs located at the L4-L5 or L5-S1 junctions of the spine (Fig. 1). Pain tends to be exacerbated when patients put their lumbar spines into flexion (i.e. by sitting or bending forward) and relieved when they put their lumbar spines into extension (i.e. arching backwards).
- Discogenic pain can be quite disabling, and for some patients, can dramatically affect their ability to work and otherwise enjoy their lives.
- a spinal implant has been designed which inhibits spinal flexion while allowing substantially unrestricted spinal extension.
- the implant is placed over one or more adjacent pairs of spinal processes and provides an elastic restraint to the spreading apart of the spinal processes which occurs during flexion.
- Such devices and methods for their use are described in U.S. Patent Application 2005/02161017A1, published on September 29, 2005, and having common inventors with the present application.
- an implant 10 typically comprises an upper strap component 12 and a lower strap component 14 joined by a pair of compliance members 16.
- the upper strap 12 is shown disposed over the top of the spinous process SP4 of L4 while the lower strap 14 is shown extending over the bottom of the spinous process SP5 of L5.
- the compliance member 16 will typically include an internal element, such as a spring of rubber block, which is attached to the straps 12 and 14 in such a way that the straps may be "elastically" or “compliantly” pulled apart as the spinous processes SP4 and SP5 move apart during flexion.
- the implant provides an elastic tension on the spinal processes which provides a force that resists flexion. The force increases as the processes move further apart.
- the straps themselves will be essentially non-compliant so that the degree of elasticity or compliance may be controlled and provided solely by the compliance members 16.
- Fig. 2 Although providing significant benefits, the system illustrated in Fig. 2 is intended to treat only a single spinal segment between a pair of adjacent vertebral bodies. In some patients, it would be desirable to treat two or more successive spinal segments.
- the present invention provides spinal implants, implant systems, and methods for constraining spinous processes to elastically limit flexion of two or more adjacent spinal segments.
- spinal segment is synonymous with the phrase “functional spinal unit (FSU)” and intended to mean the smallest physiological motion unit of the spine that exhibits biomechanical characteristics similar to those of the entire spine.
- FSU functional spinal unit
- a spinal segment or FSU consists of two adjacent vertebrae, the intervertebral disc and all adjoining ligaments between them and excludes other connecting tissues such as muscles.
- the three-joint complex that results is sometimes referred to as the "articular triad.”
- Another term for the FSU is spinal motion segment. These definitions are taken from White AA, Panjabi MM. (1990), Clinical Biomechanics of the Spine, Philadelphia, JB Lippincott.
- the methods comprise placing a tether structure over the spinous processes of at least three adjacent vertebral bodies, or over the spinous processes of two adjacent vertebral bodies and a sacrum, wherein the structure elastically couples the at least two non-adjacent spinous processes or one spinous process and a non-adjacent sacrum.
- the spinous processes and optionally a sacrum can be interconnected and elastically coupled in a variety of ways.
- the tether structure elastically couples an upper spinous process to a lower spinous process, or to the sacrum, with at least one intermediate spinous process being free from coupling.
- the tether structure elastically couples an upper spinous process and a lower spinous process or sacrum, as well as the at least one intermediate spinous process.
- the spinous processes and optionally the sacrum may be elastically coupled by a single contiguous tether structure, or in other embodiments may be elastically connected by two or more contiguous tether structures. In the case of two or more contiguous tether structures, the tether structures may further be interconnected, coupled, or linked in order to provide desired elastic restraint characteristics.
- the spinous processes being connected will typically be in the lumbar region, most typically being at the lower levels of the lumbar, and even more particularly being at L3, L4, L5 and the sacrum.
- the spinous processes, and optionally the sacrum are elastically coupled to inhibit flexion with the spaces between the adjacent vertebral bodies being free from structure which would inhibit extension of the spinal segments being treated.
- a spinal implant comprises a contiguous tether structure adapted to circumscribe at least two non-adjacent spinous processes, or in other instances, to an anchor location on the sacrum and one non-adjacent spinous process. At least a portion of the tether structure will provide an elastic resistance to elongation in response to an elongation force which results from flexion of the spinal segments between the adjacent spinous processes and/or the sacrum.
- the implant will include at least two compliance members positioned as part of the tether structure such that they will lie symmetrically on opposite sides of the spinous processes when implanted.
- the contiguous tether structures will include at least four such compliance members.
- the compliance members will typically be coupled to non-compliant and/or cable components of the tether structure so that it is the compliance members which provide most or all of the compliance or elasticity in the implants.
- Exemplary compliance structures are illustrated in copending U.S. Patent Application 2005/02161017 Al.
- the contiguous tether structure will be continuous so that the structure forms a loop which may be placed over the non-adjacent spinous processes. Such continuous "loop" tether structures will usually be maintained on the spinous processes by friction and interference fit, but in some cases could be modified to permit further attachment by stapling, welding, gluing, suturing, or the like.
- the contiguous tether structure will be discontinuous and will have two ends which are adapted for anchoring for direct attachment to the bone. Such discontinuous tether structures will be suitable for anchoring in the sacrum.
- systems comprising a spinal implant as generally described above further include at least one additional contiguous tether structure.
- the additional tether structure will usually be adapted to circumscribe two adjacent or non- adjacent spinous processes or a sacrum.
- the additional contiguous tether structures may be continuous so that they can be looped over the spinous processes, or in other instances may be discontinuous and have two ends adapted for anchoring directly in the bone.
- the additional contiguous tether structure may be interconnected with the primary tether structure but will frequently be formed separately.
- Fig. 1 is a schematic diagram illustrating the lumbar region of the spine including the spinous processes (SP), facet joints (FJ), lamina (L), transverse processes (TP), and sacrum (S).
- SP spinous processes
- FJ facet joints
- L lamina
- TP transverse processes
- S sacrum
- Fig. 2 illustrates a spinal implant of the type described in US 2005/0216017Al.
- Fig. 3 illustrates a contiguous tether structure constructed in accordance with the principles of the present invention and adapted for placement over three adjacent spinous processes.
- Fig. 4 illustrates a contiguous tether structure similar to that shown in Fig. 3 which further includes four symmetrically placed compliance structures.
- Fig. 5 illustrates a contiguous tether structure constructed in accordance with the principles of the present invention which is adapted for placement over three adjacent spinous processes and which further includes an intermediate loop segment for engaging the intermediate spinous process.
- Fig. 6 illustrates a contiguous tether structure similar to that shown in Fig. 5, where the intermediate loop structure is adjustably attached to the main tether structure.
- Fig. 7 illustrates a contiguous tether structure constructed in accordance with the principles of the present invention and adapted for placement over four adjacent spinous processes including two intermediate loop structures and six symmetrically placed compliance members.
- Fig. 8 illustrates yet another contiguous tether structure constructed in accordance with the principles of the present invention comprising two loop segments joined together by connectors adjacent an intermediate spinous process.
- Fig. 9 illustrates a contiguous tether structure constructed in accordance with the principles of the present invention and having a discontinuous structure with two ends adapted for anchoring in the sacrum.
- Fig. 10 illustrates a system constructed in accordance with the principles of the present invention and including two contiguous tether structures which may be used simultaneously.
- the present invention provides methods, devices, and systems for constraining the flexion of two or more adjacent spinal segments by elastically restraining two or more spinous processes or at least one spinous process and an anchor region on a sacrum.
- Such restraint is achieved using a tether structure which spans at least three spinous processes or a pair of spinous processes and the sacrum (more specifically, the spinous processes on L4 and L5 as well as an anchor region on the sacrum).
- the tethers used will typically be in the form of a contiguous tether structure.
- the tether may comprise one or more elongate component(s), such as strap(s), cable(s), ribbon(s), or the like, which may be constructed or modified to provide for a desired elastic coupling of one or more spinous processes and optionally an anchor location on the sacrum.
- the "contiguous" tether structures may comprise a plurality of components, such as the straps, bands, cables, or the like, as mentioned above, together with compliance structures which provide for the desired elastic coupling.
- the straps, etc. will typically be non-compliant, effecting little or no elongation in response to tension, while the compliance members will provide the desired level of elastically coupling. Combinations of compliant elongate components and separate compliance members will also be possible.
- the contiguous tether structures may be continuous or discontinuous.
- the "continuous" contiguous tether structures will typically be formed into a loop so that the loop may be placed over a pair of spinous processes, typically non- adjacent spinous processes separated by at least one intermediate spinous process.
- the "discontinuous" contiguous tether structures in contrast, will have at least two free ends adapted with anchor structures for anchoring to bone, typically to anchor regions on a sacrum.
- a first exemplary continuous tether structure 20 is shown circumscribing the spinous processes SP1-SP3 on the L1-L3 vertebral bodies.
- the tether structure 20 may be a simple band, strap, or cable which is formed into a continuous loop, where at least a portion of the structure provides a desired elasticity to inhibit flexion of the spinal segments between Ll and L2 and L2 and L3 in a controlled manner.
- Elasticity may be provided through use of an elastomeric material, inclusion of spring-like or elastic regions in an otherwise inelastic or non-compliant structure, or the like.
- a second exemplary continuous tether structure 24 is similar to tether 20, except that it is provided with separate compliance structures 26a-26d arranged symmetrically on opposite sides of the "ridge" of spinous processes.
- the tether structure 24 is shown placed on the spinous processes SP2-SP4 on vertebral bodies L2-L4, it will be appreciated that tether structures 20 and 24 could be placed on any three contiguous spinous processes, typically in the lumbar region.
- the continuous tether structures of the present invention may be formed in multiple interconnected loops, as shown, for example, in Figs. 5-8.
- the multiple loops will usually include an outer or peripheral loop which encircles or otherwise engages at least three or more adjacent spinous processes.
- One or more inner loops may also be provided to engage or encircle one, two, or possibly more of "intermediate" spinous processes within the group which is being restrained.
- a continuous tether structure 30 includes an outer loop 32 which encircles three adjacent spinous processes, shown as SP3-SP5 on vertebral bodies L3- L5.
- An inner loop 34 is provided which encircles only SP4 and SP5.
- the upper portions of the two loops 32 and 34 are both connected in compliance members 36a and 36b.
- the compliance members may be configured to apply a generally equal elastic tensioning to the upper loop portions as the spinal segments undergo flexion.
- the compliance members 36a and 36b could be configured to provide different elastic tensioning forces to the upper segments of loops 32 and 34, respectively.
- Continuous tether structure 40 also comprises an outer loop 42 (shown to encircle SP3-SP5) and an inner loop 44 (shown to encircle SP4 and SP5 only), similar to the tether structure 30 of Fig. 5.
- An upper loop portion 46 is shown attached to sliding attachment members 48a and 48b, which attachment members allow the upper loop structure 46 to be tightened or "cinched" over the top of SP4.
- the tether structure 40 is also shown with four symmetrically placed compliance members 50a-50d, but it will be appreciated that the tether structure could include only two or even no compliance members, while retaining the adjustably placed upper loop structure 46.
- a more complex continuous tether structure 60 including one external loop and two internal loops is illustrated in Fig. 7.
- the external loop is configured to circumscribe four adjacent spinous processes (SP2-SP4) while the first internal loop defined by loop segment 64 extends over SP3 and a second internal loop segment 66 extends over SP4.
- Six compliance members 68a-68f are provided symmetrically on opposite sides of the spinous processes, and the ends of the first upper loop segment 64 are connected to compliance members 68c and 68d, respectively, while the ends of the second loop segment 66 are connected to compliance members 68e and 68f, respectively.
- the overall compliance and elastic force applied to the spinal segments will depend on the cumulative value of the elastic forces provided by all of the compliance members.
- a multiple loop tether structure 70 having a more simple configuration is shown in Fig. 8.
- An upper loop 72 is adapted to circumscribe a pair of adjacent spinous processes (shown as SP2 and SP3) while a lower loop is adapted to circumscribe an overlapping pair of spinous processes (shown as SP3 and SP4).
- the two loops are joined by connector components 76a and 76b which may be simple clips or crimps to hold the loops 64 and 66 together (in which case the loops would likely be elastic or partially elastic to allow for controlled flexion of the spinal segments) or could be compliance members which provide for controlled, elastic movement of the upper loop 72 relative to the lower loop 74. In the latter case, the loops would likely be non-compliant.
- the contiguous tether structures of the present invention will not always have a continuous structure.
- the tether structures may also have a discontinuous geometry including at least two ends adapted to anchor to bone, typically to a surface of the sacrum which generally lacks structure for attaching the lower end of a loop.
- an exemplary discontinuous tether structure 80 comprises a U-shaped tether or band structure including compliance members 82a and 82b.
- a pair of anchor structures 84a and 84b are provided on two ends of the tether structure 80 and are adapted to be anchored into the face of the sacrum S, as illustrated. In this way, the tether structure 80 can provide for controlled elastic restraint of the spinal segments between SP4 and SP5 and between SP5 and the sacrum.
- FIG. 10 illustrates a system including a tether structure 24, generally as described with reference to Fig. 4 above, and a second tether structure 90 which is similar to tether structure 80, except that it is adapted only to extend around a single spinous process (SP5) and to be anchored into the sacrum S. Attachment may be provided in a variety of ways as described in copending application no. 11/827,980, filed July 13, 2007, the full disclosure of which is incorporated herein by reference.
- the second tether structure may be attached using a dowel implanted in the sacrum, using alar screws, using superior articular facet screws, using toggle anchors (T-tags) placed in holes formed in a superior articular facet of Sl, using hooks attached to the dorsal Sl foramen, or the like.
- the tether structure 24 and tether structure 90 could be deployed without any interconnection, as generally shown in Fig. 10. Often, however, it might be desirable to interconnect the tether structures at their crossover points 92a, 92b, generally adjacent to the two sides of SP5.
- the attachment could be accomplished using a crimp structure (not shown) or by otherwise tying, welding, or fusing the tether structures together.
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Abstract
Methods, apparatus and systems for constraining spinous processes to elastically limit flexion of two or more adjacent spinal segments rely on placing a tether structure over at least three adjacent vertebral bodies or two adjacent vertebral bodies and the sacrum. The tether structures may be continuous, for example in the form of a continuous loop, or may be discontinuous, for example in the form of a loop or elongate element having at least two anchor structures for securing in bone.
Description
METHODS AND SYSTEMS FOR CONSTRAINT OF MULTIPLE SPINE SEGMENTS
BACKGROUND OF THE INVENTION [0001] 1. Field of the Invention. The present invention relates generally to medical methods and apparatus. More particularly, the present invention relates to methods and devices for restricting spinal flexion in patients having back pain or other spinal conditions.
[0002] A major source of chronic low back pain is discogenic pain, also known as internal disc disruption. Patients suffering from discogenic pain tend to be young, otherwise healthy individuals who present with pain localized to the back. Discogenic pain usually occurs at the discs located at the L4-L5 or L5-S1 junctions of the spine (Fig. 1). Pain tends to be exacerbated when patients put their lumbar spines into flexion (i.e. by sitting or bending forward) and relieved when they put their lumbar spines into extension (i.e. arching backwards). Discogenic pain can be quite disabling, and for some patients, can dramatically affect their ability to work and otherwise enjoy their lives.
[0003] This pain experienced by patients with discogenic low back pain can be thought of as flexion instability, and is related to flexion instability that is manifested in other conditions. The most prevalent of these is spondylolisthesis, a spinal condition in which abnormal segmental translation is exacerbated by segmental flexion. The device described here should as such also be useful for these other spinal disorders associated with segmental flexion, for which the prevention or control of spinal segmental flexion is desired.
[0004] Current treatment alternatives for patients diagnosed with chronic discogenic pain are quite limited. Many patients follow a conservative treatment path, such as physical therapy, massage, anti-inflammatory and analgesic medications, muscle relaxants, and epidural steroid injections, but typically continue to suffer with a significant degree of pain. Other patients elect to undergo spinal fusion surgery, which commonly requires discectomy (removal of the disk) together with fusion of adjacent vertebra. Fusion is not usually recommended for discogenic pain because it is irreversible, costly, associated with high morbidity, and of questionable effectiveness. Despite its drawbacks, however, spinal fusion for discogenic pain remains common due to the lack of viable alternatives.
[0005] Recently, a less invasive and potentially more effective treatment for discogenic pain has been proposed. A spinal implant has been designed which inhibits spinal flexion while allowing substantially unrestricted spinal extension. The implant is placed over one or more adjacent pairs of spinal processes and provides an elastic restraint to the spreading apart of the spinal processes which occurs during flexion. Such devices and methods for their use are described in U.S. Patent Application 2005/02161017A1, published on September 29, 2005, and having common inventors with the present application.
[0006] As illustrated in Fig. 2, an implant 10 as described in the '017 application, typically comprises an upper strap component 12 and a lower strap component 14 joined by a pair of compliance members 16. The upper strap 12 is shown disposed over the top of the spinous process SP4 of L4 while the lower strap 14 is shown extending over the bottom of the spinous process SP5 of L5. The compliance member 16 will typically include an internal element, such as a spring of rubber block, which is attached to the straps 12 and 14 in such a way that the straps may be "elastically" or "compliantly" pulled apart as the spinous processes SP4 and SP5 move apart during flexion. In this way, the implant provides an elastic tension on the spinal processes which provides a force that resists flexion. The force increases as the processes move further apart. Usually, the straps themselves will be essentially non-compliant so that the degree of elasticity or compliance may be controlled and provided solely by the compliance members 16.
[0007] Although providing significant benefits, the system illustrated in Fig. 2 is intended to treat only a single spinal segment between a pair of adjacent vertebral bodies. In some patients, it would be desirable to treat two or more successive spinal segments.
[0008] For these reasons, it would be desirable to provide improved spinal implants, implant systems, and methods for their use for limiting flexion in two or more successive spinal segments. It would be particularly desirable if the implants, systems, and methods permitted the spinous processes of three or more adjacent vertebral bodies, or two adjacent vertebral bodies and the sacrum, to be elastically coupled using a single implant structure which can constrain multiple adjacent spinal features. At least some of these objectives will be met by the inventions described hereinbelow.
[0009] 2. Description of the Background Art. US 2005/0216017Al has been described above. Other patents and published applications of interest include: U.S. Patent Nos. 4,966,600; 5,011,494; 5,092,866; 5,116,340; 5,282,863; 5,395,374; 5,415,658;
5,415,661; 5,449,361 ; 5,456,722; 5,462,542; 5,496,318; 5,540,698; 5,609,634; 5,645,599; 5,725,582; 5,902,305; Re. 36,221; 5,928,232; 5,935,133; 5,964,769; 5,989,256; 6,053,921 ; 6,312,431; 6,364,883; 6,378,289; 6,391,030; 6,468,309; 6,436,099; 6,451,019; 6,582,433; 6,605,091; 6,626,944; 6,629,975; 6,652,527; 6,652,585; 6,656,185; 6,669,729; 6,682,533; 6,689,140; 6,712,819; 6,689,168; 6,695,852; 6,716,245; 6,761,720; 6,835,205; Published U.S. Patent Application Nos. US 2002/0151978; US 2004/0024458; US 2004/0106995; US 2004/0116927; US 2004/0117017; US 2004/0127989; US 2004/0172132; US 2005/0033435; US 2005/0049708; US 2006/0069447; Published PCT Application Nos. WO 01/28442 Al ; WO 02/03882 A2; WO 02/051326 Al; WO 02/071960 Al; WO 03/045262 Al; WO 2004/052246 Al ; WO 2004/073532 Al ; and Published Foreign Application Nos. EP 0322334 Al; and FR 2 681 525 Al.
BRIEF SUMMARY OF THE INVENTION [0010] The present invention provides spinal implants, implant systems, and methods for constraining spinous processes to elastically limit flexion of two or more adjacent spinal segments. As used herein, the phrase "spinal segment" is synonymous with the phrase "functional spinal unit (FSU)" and intended to mean the smallest physiological motion unit of the spine that exhibits biomechanical characteristics similar to those of the entire spine. A spinal segment or FSU consists of two adjacent vertebrae, the intervertebral disc and all adjoining ligaments between them and excludes other connecting tissues such as muscles.
The three-joint complex that results is sometimes referred to as the "articular triad." Another term for the FSU is spinal motion segment. These definitions are taken from White AA, Panjabi MM. (1990), Clinical Biomechanics of the Spine, Philadelphia, JB Lippincott. The methods comprise placing a tether structure over the spinous processes of at least three adjacent vertebral bodies, or over the spinous processes of two adjacent vertebral bodies and a sacrum, wherein the structure elastically couples the at least two non-adjacent spinous processes or one spinous process and a non-adjacent sacrum. The spinous processes and optionally a sacrum can be interconnected and elastically coupled in a variety of ways.
[0011] In a first exemplary pattern, the tether structure elastically couples an upper spinous process to a lower spinous process, or to the sacrum, with at least one intermediate spinous process being free from coupling. In an alternative pattern, the tether structure elastically couples an upper spinous process and a lower spinous process or sacrum, as well as the at
least one intermediate spinous process. The spinous processes and optionally the sacrum may be elastically coupled by a single contiguous tether structure, or in other embodiments may be elastically connected by two or more contiguous tether structures. In the case of two or more contiguous tether structures, the tether structures may further be interconnected, coupled, or linked in order to provide desired elastic restraint characteristics. The spinous processes being connected will typically be in the lumbar region, most typically being at the lower levels of the lumbar, and even more particularly being at L3, L4, L5 and the sacrum. In most instances, the spinous processes, and optionally the sacrum, are elastically coupled to inhibit flexion with the spaces between the adjacent vertebral bodies being free from structure which would inhibit extension of the spinal segments being treated.
[0012] In another aspect of the present invention, a spinal implant comprises a contiguous tether structure adapted to circumscribe at least two non-adjacent spinous processes, or in other instances, to an anchor location on the sacrum and one non-adjacent spinous process. At least a portion of the tether structure will provide an elastic resistance to elongation in response to an elongation force which results from flexion of the spinal segments between the adjacent spinous processes and/or the sacrum. Often, the implant will include at least two compliance members positioned as part of the tether structure such that they will lie symmetrically on opposite sides of the spinous processes when implanted. In still other embodiments, the contiguous tether structures will include at least four such compliance members. The compliance members will typically be coupled to non-compliant and/or cable components of the tether structure so that it is the compliance members which provide most or all of the compliance or elasticity in the implants. Exemplary compliance structures are illustrated in copending U.S. Patent Application 2005/02161017 Al.
[0013] In some embodiments, the contiguous tether structure will be continuous so that the structure forms a loop which may be placed over the non-adjacent spinous processes. Such continuous "loop" tether structures will usually be maintained on the spinous processes by friction and interference fit, but in some cases could be modified to permit further attachment by stapling, welding, gluing, suturing, or the like. In other embodiments, the contiguous tether structure will be discontinuous and will have two ends which are adapted for anchoring for direct attachment to the bone. Such discontinuous tether structures will be suitable for anchoring in the sacrum.
[0014] In a third aspect of the present invention, systems comprising a spinal implant as generally described above further include at least one additional contiguous tether structure. The additional tether structure will usually be adapted to circumscribe two adjacent or non- adjacent spinous processes or a sacrum. The additional contiguous tether structures may be continuous so that they can be looped over the spinous processes, or in other instances may be discontinuous and have two ends adapted for anchoring directly in the bone. The additional contiguous tether structure may be interconnected with the primary tether structure but will frequently be formed separately.
BRIEF DESCRIPTION OF THE DRAWINGS [0015] Fig. 1 is a schematic diagram illustrating the lumbar region of the spine including the spinous processes (SP), facet joints (FJ), lamina (L), transverse processes (TP), and sacrum (S).
[0016] Fig. 2 illustrates a spinal implant of the type described in US 2005/0216017Al.
[0017] Fig. 3 illustrates a contiguous tether structure constructed in accordance with the principles of the present invention and adapted for placement over three adjacent spinous processes.
[0018] Fig. 4 illustrates a contiguous tether structure similar to that shown in Fig. 3 which further includes four symmetrically placed compliance structures.
[0019] Fig. 5 illustrates a contiguous tether structure constructed in accordance with the principles of the present invention which is adapted for placement over three adjacent spinous processes and which further includes an intermediate loop segment for engaging the intermediate spinous process.
[0020] Fig. 6 illustrates a contiguous tether structure similar to that shown in Fig. 5, where the intermediate loop structure is adjustably attached to the main tether structure.
[0021] Fig. 7 illustrates a contiguous tether structure constructed in accordance with the principles of the present invention and adapted for placement over four adjacent spinous processes including two intermediate loop structures and six symmetrically placed compliance members.
[0022] Fig. 8 illustrates yet another contiguous tether structure constructed in accordance with the principles of the present invention comprising two loop segments joined together by connectors adjacent an intermediate spinous process.
[0023] Fig. 9 illustrates a contiguous tether structure constructed in accordance with the principles of the present invention and having a discontinuous structure with two ends adapted for anchoring in the sacrum.
[0024] Fig. 10 illustrates a system constructed in accordance with the principles of the present invention and including two contiguous tether structures which may be used simultaneously.
DETAILED DESCRIPTION OF THE INVENTION
[0025] The present invention provides methods, devices, and systems for constraining the flexion of two or more adjacent spinal segments by elastically restraining two or more spinous processes or at least one spinous process and an anchor region on a sacrum. Such restraint is achieved using a tether structure which spans at least three spinous processes or a pair of spinous processes and the sacrum (more specifically, the spinous processes on L4 and L5 as well as an anchor region on the sacrum). The tethers used will typically be in the form of a contiguous tether structure. By "contiguous" it means that the tether may comprise one or more elongate component(s), such as strap(s), cable(s), ribbon(s), or the like, which may be constructed or modified to provide for a desired elastic coupling of one or more spinous processes and optionally an anchor location on the sacrum. Alternatively, the "contiguous" tether structures may comprise a plurality of components, such as the straps, bands, cables, or the like, as mentioned above, together with compliance structures which provide for the desired elastic coupling. In the latter case, the straps, etc., will typically be non-compliant, effecting little or no elongation in response to tension, while the compliance members will provide the desired level of elastically coupling. Combinations of compliant elongate components and separate compliance members will also be possible.
[0026] The contiguous tether structures may be continuous or discontinuous. The "continuous" contiguous tether structures will typically be formed into a loop so that the loop may be placed over a pair of spinous processes, typically non- adjacent spinous processes separated by at least one intermediate spinous process. The "discontinuous" contiguous
tether structures, in contrast, will have at least two free ends adapted with anchor structures for anchoring to bone, typically to anchor regions on a sacrum.
[0027] Referring now to Fig. 3, a first exemplary continuous tether structure 20 is shown circumscribing the spinous processes SP1-SP3 on the L1-L3 vertebral bodies. The tether structure 20 may be a simple band, strap, or cable which is formed into a continuous loop, where at least a portion of the structure provides a desired elasticity to inhibit flexion of the spinal segments between Ll and L2 and L2 and L3 in a controlled manner. Elasticity may be provided through use of an elastomeric material, inclusion of spring-like or elastic regions in an otherwise inelastic or non-compliant structure, or the like.
[0028] Referring now to Fig. 4, a second exemplary continuous tether structure 24 is similar to tether 20, except that it is provided with separate compliance structures 26a-26d arranged symmetrically on opposite sides of the "ridge" of spinous processes. The tether structure 24 is shown placed on the spinous processes SP2-SP4 on vertebral bodies L2-L4, it will be appreciated that tether structures 20 and 24 could be placed on any three contiguous spinous processes, typically in the lumbar region.
[0029] The continuous tether structures of the present invention may be formed in multiple interconnected loops, as shown, for example, in Figs. 5-8. The multiple loops will usually include an outer or peripheral loop which encircles or otherwise engages at least three or more adjacent spinous processes. One or more inner loops may also be provided to engage or encircle one, two, or possibly more of "intermediate" spinous processes within the group which is being restrained.
[0030] For example, in Fig. 5, a continuous tether structure 30 includes an outer loop 32 which encircles three adjacent spinous processes, shown as SP3-SP5 on vertebral bodies L3- L5. An inner loop 34 is provided which encircles only SP4 and SP5. The upper portions of the two loops 32 and 34 are both connected in compliance members 36a and 36b. The compliance members may be configured to apply a generally equal elastic tensioning to the upper loop portions as the spinal segments undergo flexion. Alternatively, the compliance members 36a and 36b could be configured to provide different elastic tensioning forces to the upper segments of loops 32 and 34, respectively.
[0031] Continuous tether structure 40, as shown in Fig. 6, also comprises an outer loop 42 (shown to encircle SP3-SP5) and an inner loop 44 (shown to encircle SP4 and SP5 only), similar to the tether structure 30 of Fig. 5. An upper loop portion 46, however, is shown
attached to sliding attachment members 48a and 48b, which attachment members allow the upper loop structure 46 to be tightened or "cinched" over the top of SP4. The tether structure 40 is also shown with four symmetrically placed compliance members 50a-50d, but it will be appreciated that the tether structure could include only two or even no compliance members, while retaining the adjustably placed upper loop structure 46.
[0032] A more complex continuous tether structure 60 including one external loop and two internal loops is illustrated in Fig. 7. The external loop is configured to circumscribe four adjacent spinous processes (SP2-SP4) while the first internal loop defined by loop segment 64 extends over SP3 and a second internal loop segment 66 extends over SP4. Six compliance members 68a-68f are provided symmetrically on opposite sides of the spinous processes, and the ends of the first upper loop segment 64 are connected to compliance members 68c and 68d, respectively, while the ends of the second loop segment 66 are connected to compliance members 68e and 68f, respectively. It will be appreciated that the use of six compliance members and the two intermediate loop segments allows the tension on each of the spinous processes to be independently adjusted to some extent. The overall compliance and elastic force applied to the spinal segments, however, will depend on the cumulative value of the elastic forces provided by all of the compliance members.
[0033] A multiple loop tether structure 70 having a more simple configuration is shown in Fig. 8. An upper loop 72 is adapted to circumscribe a pair of adjacent spinous processes (shown as SP2 and SP3) while a lower loop is adapted to circumscribe an overlapping pair of spinous processes (shown as SP3 and SP4). The two loops are joined by connector components 76a and 76b which may be simple clips or crimps to hold the loops 64 and 66 together (in which case the loops would likely be elastic or partially elastic to allow for controlled flexion of the spinal segments) or could be compliance members which provide for controlled, elastic movement of the upper loop 72 relative to the lower loop 74. In the latter case, the loops would likely be non-compliant.
[0034] The contiguous tether structures of the present invention will not always have a continuous structure. As shown in Figs. 9 and 10, the tether structures may also have a discontinuous geometry including at least two ends adapted to anchor to bone, typically to a surface of the sacrum which generally lacks structure for attaching the lower end of a loop. As shown in Fig. 9, an exemplary discontinuous tether structure 80 comprises a U-shaped tether or band structure including compliance members 82a and 82b. A pair of anchor
structures 84a and 84b are provided on two ends of the tether structure 80 and are adapted to be anchored into the face of the sacrum S, as illustrated. In this way, the tether structure 80 can provide for controlled elastic restraint of the spinal segments between SP4 and SP5 and between SP5 and the sacrum.
[0035] Fig. 10 illustrates a system including a tether structure 24, generally as described with reference to Fig. 4 above, and a second tether structure 90 which is similar to tether structure 80, except that it is adapted only to extend around a single spinous process (SP5) and to be anchored into the sacrum S. Attachment may be provided in a variety of ways as described in copending application no. 11/827,980, filed July 13, 2007, the full disclosure of which is incorporated herein by reference. The second tether structure may be attached using a dowel implanted in the sacrum, using alar screws, using superior articular facet screws, using toggle anchors (T-tags) placed in holes formed in a superior articular facet of Sl, using hooks attached to the dorsal Sl foramen, or the like. The tether structure 24 and tether structure 90 could be deployed without any interconnection, as generally shown in Fig. 10. Often, however, it might be desirable to interconnect the tether structures at their crossover points 92a, 92b, generally adjacent to the two sides of SP5. The attachment could be accomplished using a crimp structure (not shown) or by otherwise tying, welding, or fusing the tether structures together.
[0036] It will be appreciated that numerous other combinations of continuous tether structures and discontinuous tether structures could be provided in order to effect the controlled application of elastic restraint on adjacent spinal segments in the lumbar region of the spine. Thus, the examples set forth above are not meant to be limiting on the breadth of the invention as set forth in the following claims.
Claims
WHAT IS CLAIMED IS:
L A method for constraining spinous processes to elastically limit flexion of two or more adjacent spinal segments, said method comprising: placing a tether structure over spinous processes of at least three adjacent vertebral bodies, or of two adjacent vertebral bodies and a sacrum, wherein the structure elastically couples an upper spinous process and a lower spinous process or sacrum.
2. A method as in claim 1, wherein the tether structure elastically couples an upper spinous process and a lower spinous process or sacrum with at least one intermediate spinous process free from coupling.
3. A method as in claim 1, wherein the tether structure elastically couples an upper spinous process, a lower spinous process or sacrum, and at least one intermediate spinous process.
4. A method as in claim 3, wherein upper spinous process, intermediate spinous process, and lower spinous process or sacrum are coupled by a single contiguous tether structure.
5. A method as in claim 3, wherein the upper spinous process, intermediate spinous process, and lower spinous process or sacrum are coupled by at least two contiguous tether structures.
6. A method as in claim 1, wherein a lower one of the vertebral bodies is selected from the group consisting of L4, L5, and the sacrum.
7. A method as in claim 1, wherein spaces between the adjacent vertebral bodies are free from structure which would inhibit extension.
8. A method as in claim 1 , wherein the tether structure comprises one or more band elements in series with one or more compliance members.
9. A method as in claim 1 , wherein the tether structure comprises at least two compliance members, further comprising positioning the compliance members symmetrically to lie on opposite sides of the spinous processes.
10. A method as in claim 1, wherein the tether structure comprises at least four compliance members, further comprising positioning pairs of the compliance members symmetrically on opposite sides of the spinous processes.
11. A spinal implant comprising a contiguous tether structure adapted to circumscribe at least two non- adjacent spinous processes or an anchor location on a sacrum and one non-adjacent spinous process, wherein at least a portion of the tether structure provides an elastic resistance to elongation in response to an elongation force which results from flexion of the spinal segments between the adjacent spinous processes or a spinous process and a non-adjacent sacrum.
12. A spinal implant as in claim 11, further comprising at least two compliance members positioned symmetrically to lie on opposite sides of the spinous processes.
13. A spinal implant as in claim 11, further comprising at least four compliance members positioned symmetrically to lie on opposite sides of the spinous process.
14. A spinal implant as in claim 11, wherein the contiguous tether structure is continuous to loop over said non-adjacent spinous processes.
15. A spinal implant as in claim 11, wherein the contiguous tether structure is discontinuous and has two ends, each end having an anchor for attachment to bone.
16. A system comprising a spinal implant as in claim 11, and at least one additional contiguous tether structure adapted to circumscribe two adjacent or non-adjacent spinous processes or a sacrum.
17. A system as in claim 16, wherein the additional contiguous tether structure is continuous to loop over said non-adjacent spinous processes.
18. A system as in claim 16, wherein the additional contiguous tether structure is discontinuous and has two ends, each end having an anchor for attachment to bone.
Priority Applications (9)
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JP2009533535A JP2010506694A (en) | 2006-10-19 | 2007-10-18 | Method and system for multiple spinal segment constraint |
EP07854186.9A EP2083701A4 (en) | 2006-10-19 | 2007-10-18 | Methods and systems for constraint of multiple spine segments |
US12/426,119 US8162982B2 (en) | 2006-10-19 | 2009-04-17 | Methods and systems for constraint of multiple spine segments |
US13/427,551 US8790372B2 (en) | 2006-10-19 | 2012-03-22 | Methods and systems for constraint of multiple spine segments |
US13/889,581 US9295499B2 (en) | 2006-10-19 | 2013-05-08 | Methods and systems for laterally stabilized constraint of spinous processes |
US15/442,503 US20170231667A1 (en) | 2006-10-19 | 2017-02-24 | Methods and systems for laterally stabilized constraint of spinous processes |
US15/805,554 US20180064472A1 (en) | 2006-10-19 | 2017-11-07 | Methods and systems for laterally stabilized constraint of spinous processes |
US16/200,312 US20190357947A1 (en) | 2006-10-19 | 2018-11-26 | Methods and systems for laterally stabilized constraint of spinous processes |
US17/519,626 US20220323118A1 (en) | 2006-10-19 | 2021-11-05 | Methods and systems for laterally stabilized constraint of spinous processes |
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WO2010104935A1 (en) | 2009-03-10 | 2010-09-16 | Simpirica Spine, Inc. | Surgical tether apparatus and methods of use |
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US10744000B1 (en) | 2016-10-25 | 2020-08-18 | Samy Abdou | Devices and methods for vertebral bone realignment |
US10973648B1 (en) | 2016-10-25 | 2021-04-13 | Samy Abdou | Devices and methods for vertebral bone realignment |
US11179248B2 (en) | 2018-10-02 | 2021-11-23 | Samy Abdou | Devices and methods for spinal implantation |
US11883243B2 (en) | 2019-10-31 | 2024-01-30 | Orthopediatrics Corp. | Assessment of tension between bone anchors |
Citations (51)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP0322334A1 (en) | 1987-12-23 | 1989-06-28 | Cremascoli France | Prosthesis implanted between vertebral spinous processes |
FR2681525A1 (en) | 1991-09-19 | 1993-03-26 | Medical Op | Device for flexible or semi-rigid stabilisation of the spine, in particular of the human spine, by a posterior route |
US5415661A (en) | 1993-03-24 | 1995-05-16 | University Of Miami | Implantable spinal assist device |
US5449361A (en) | 1993-04-21 | 1995-09-12 | Amei Technologies Inc. | Orthopedic cable tensioner |
US5456722A (en) | 1993-01-06 | 1995-10-10 | Smith & Nephew Richards Inc. | Load bearing polymeric cable |
US5462542A (en) | 1994-01-24 | 1995-10-31 | United States Surgical Corporation | Sternum buckle with serrated strap |
US5496318A (en) | 1993-01-08 | 1996-03-05 | Advanced Spine Fixation Systems, Inc. | Interspinous segmental spine fixation device |
US5540698A (en) | 1993-04-21 | 1996-07-30 | Amei Technologies Inc. | System and method for securing a medical cable |
US5609634A (en) | 1992-07-07 | 1997-03-11 | Voydeville; Gilles | Intervertebral prosthesis making possible rotatory stabilization and flexion/extension stabilization |
US5645599A (en) | 1994-07-26 | 1997-07-08 | Fixano | Interspinal vertebral implant |
US5725582A (en) | 1992-08-19 | 1998-03-10 | Surgicraft Limited | Surgical implants |
US5902305A (en) | 1996-07-11 | 1999-05-11 | Aesculap Ag & Co. Kg | Surgical tensioning device |
USRE36221E (en) | 1989-02-03 | 1999-06-01 | Breard; Francis Henri | Flexible inter-vertebral stabilizer as well as process and apparatus for determining or verifying its tension before installation on the spinal column |
US5928232A (en) | 1994-11-16 | 1999-07-27 | Advanced Spine Fixation Systems, Incorporated | Spinal fixation system |
US5935133A (en) | 1997-08-26 | 1999-08-10 | Spinal Concepts, Inc. | Surgical cable system and method |
US5989256A (en) | 1999-01-19 | 1999-11-23 | Spineology, Inc. | Bone fixation cable ferrule |
US6053921A (en) | 1997-08-26 | 2000-04-25 | Spinal Concepts, Inc. | Surgical cable system and method |
WO2001028442A1 (en) | 1999-10-15 | 2001-04-26 | Spine Next | Intervertebral implant |
US6312431B1 (en) | 2000-04-24 | 2001-11-06 | Wilson T. Asfora | Vertebrae linking system |
WO2002003882A2 (en) | 2000-07-12 | 2002-01-17 | Spine Next | Shock-absorbing intervertebral implant |
US6364883B1 (en) | 2001-02-23 | 2002-04-02 | Albert N. Santilli | Spinous process clamp for spinal fusion and method of operation |
US6378289B1 (en) | 1999-11-19 | 2002-04-30 | Pioneer Surgical Technology | Methods and apparatus for clamping surgical wires or cables |
WO2002051326A1 (en) | 2000-12-22 | 2002-07-04 | Spine Next | Intervertebral implant with deformable wedge |
US6436099B1 (en) | 1999-04-23 | 2002-08-20 | Sdgi Holdings, Inc. | Adjustable spinal tether |
US6451019B1 (en) | 1998-10-20 | 2002-09-17 | St. Francis Medical Technologies, Inc. | Supplemental spine fixation device and method |
WO2002071960A1 (en) | 2001-03-13 | 2002-09-19 | Spine Next | Self locking fixable intervertebral implant |
US20020151978A1 (en) | 1996-07-22 | 2002-10-17 | Fred Zacouto | Skeletal implant |
US6468309B1 (en) | 2000-10-05 | 2002-10-22 | Cleveland Clinic Foundation | Method and apparatus for stabilizing adjacent bones |
WO2003045262A2 (en) | 2001-11-30 | 2003-06-05 | Spine Next | Intervertebral implant with elastically deformable wedge |
US6582433B2 (en) | 2001-04-09 | 2003-06-24 | St. Francis Medical Technologies, Inc. | Spine fixation device and method |
US6605091B1 (en) | 2000-06-30 | 2003-08-12 | Pioneer Laboratories, Inc. | Surgical cable assembly and method |
US6626944B1 (en) | 1998-02-20 | 2003-09-30 | Jean Taylor | Interspinous prosthesis |
US6629975B1 (en) | 1999-12-20 | 2003-10-07 | Pioneer Laboratories, Icn. | Multiple lumen crimp |
US6652585B2 (en) | 2001-02-28 | 2003-11-25 | Sdgi Holdings, Inc. | Flexible spine stabilization system |
US6652527B2 (en) | 1998-10-20 | 2003-11-25 | St. Francis Medical Technologies, Inc. | Supplemental spine fixation device and method |
US6656185B2 (en) | 2000-10-24 | 2003-12-02 | Spineology Inc. | Tension band clip |
US6669729B2 (en) | 2002-03-08 | 2003-12-30 | Kingsley Richard Chin | Apparatus and method for the replacement of posterior vertebral elements |
US6689140B2 (en) | 2000-10-02 | 2004-02-10 | Howmedica Osteonics Corp. | System and method for spinal reconstruction |
US6695852B2 (en) | 2001-10-31 | 2004-02-24 | Spineology, Inc. | Tension tools for tension band clip |
US6712819B2 (en) | 1998-10-20 | 2004-03-30 | St. Francis Medical Technologies, Inc. | Mating insertion instruments for spinal implants and methods of use |
US6716245B2 (en) | 2000-07-12 | 2004-04-06 | Spine Next | Intersomatic implant |
US20040116927A1 (en) | 2000-12-01 | 2004-06-17 | Henry Graf | Intervertebral stabilizing device |
WO2004052246A1 (en) | 2002-12-10 | 2004-06-24 | Sdgi Holdings, Inc. | System and method for blocking and/or retaining a prosthetic spinal implant |
US20040127989A1 (en) | 2002-12-31 | 2004-07-01 | Andrew Dooris | Prosthetic facet joint ligament |
WO2004073532A1 (en) | 2003-01-20 | 2004-09-02 | Abbott Spine | Unit for treatment of the degeneration of an intervertebral disc |
US20040172132A1 (en) | 2001-09-06 | 2004-09-02 | Ginn Richard S. | Apparatus and methods for treating spinal discs |
US6835205B2 (en) | 2000-04-04 | 2004-12-28 | Spinalabs, Llc | Devices and methods for the treatment of spinal disorders |
US20050033435A1 (en) | 2003-08-04 | 2005-02-10 | Spine Next | Intervertebral disk prosthesis |
US20050216017A1 (en) | 2004-03-09 | 2005-09-29 | Louie Fielding | Spinal implant and method for restricting spinal flexion |
US20060069447A1 (en) | 2004-09-30 | 2006-03-30 | Disilvestro Mark R | Adjustable, remote-controllable orthopaedic prosthesis and associated method |
WO2006106246A2 (en) | 2005-04-08 | 2006-10-12 | Spinevision | Surgical intervertebral implant forming a swivel joint |
Family Cites Families (76)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3648691A (en) * | 1970-02-24 | 1972-03-14 | Univ Colorado State Res Found | Method of applying vertebral appliance |
US4246660A (en) * | 1978-12-26 | 1981-01-27 | Queen's University At Kingston | Artificial ligament |
US4643178A (en) * | 1984-04-23 | 1987-02-17 | Fabco Medical Products, Inc. | Surgical wire and method for the use thereof |
US4743260A (en) | 1985-06-10 | 1988-05-10 | Burton Charles V | Method for a flexible stabilization system for a vertebral column |
US4794916A (en) * | 1986-11-20 | 1989-01-03 | Porterfield James A | Lumbar stabilizer |
GB8718708D0 (en) * | 1987-08-07 | 1987-09-16 | Mehdian S M H | Apparatus for treatment of spinal disorders |
FR2623085B1 (en) * | 1987-11-16 | 1992-08-14 | Breard Francis | SURGICAL IMPLANT TO LIMIT THE RELATIVE MOVEMENT OF VERTEBRES |
US5011494A (en) | 1988-09-16 | 1991-04-30 | Clemson University | Soft tissue implant with micron-scale surface texture to optimize anchorage |
US5116340A (en) | 1989-01-26 | 1992-05-26 | Songer Robert J | Surgical securance apparatus |
US4966600A (en) | 1989-01-26 | 1990-10-30 | Songer Robert J | Surgical securance method |
FR2642645B1 (en) | 1989-02-03 | 1992-08-14 | Breard Francis | FLEXIBLE INTERVERTEBRAL STABILIZER AND METHOD AND APPARATUS FOR CONTROLLING ITS VOLTAGE BEFORE PLACEMENT ON THE RACHIS |
US5002574A (en) * | 1989-08-18 | 1991-03-26 | Minnesota Mining And Manufacturing Co. | Tensioning means for prosthetic devices |
US5108433A (en) * | 1989-08-18 | 1992-04-28 | Minnesota Mining And Manufacturing Company | Tensioning means for prosthetic devices |
US5030220A (en) * | 1990-03-29 | 1991-07-09 | Advanced Spine Fixation Systems Incorporated | Spine fixation system |
FR2666981B1 (en) * | 1990-09-21 | 1993-06-25 | Commarmond Jacques | SYNTHETIC LIGAMENT VERTEBRAL. |
FR2672202B1 (en) * | 1991-02-05 | 1993-07-30 | Safir | BONE SURGICAL IMPLANT, ESPECIALLY FOR INTERVERTEBRAL STABILIZER. |
GB9122753D0 (en) * | 1991-10-26 | 1991-12-11 | Reis Nicolas D | Internal ilio-lumbar fixator |
US5540703A (en) * | 1993-01-06 | 1996-07-30 | Smith & Nephew Richards Inc. | Knotted cable attachment apparatus formed of braided polymeric fibers |
US5395374A (en) | 1993-09-02 | 1995-03-07 | Danek Medical, Inc. | Orthopedic cabling method and apparatus |
US5415658A (en) | 1993-12-14 | 1995-05-16 | Pioneer Laboratories, Inc. | Surgical cable loop connector |
US6255483B1 (en) * | 1995-03-15 | 2001-07-03 | Ciba Specialty Chemicals Corporation | Biphenyl-substituted triazines |
US5645084A (en) * | 1995-06-07 | 1997-07-08 | Danek Medical, Inc. | Method for spinal fusion without decortication |
EP0743045A2 (en) * | 1995-04-28 | 1996-11-20 | Gazzani, Romolo Igino | Devices for osteosynthesis |
US5707379A (en) * | 1995-10-20 | 1998-01-13 | Coral Medical | Method and apparatus for intracorporeal suturing |
US5810815A (en) * | 1996-09-20 | 1998-09-22 | Morales; Jose A. | Surgical apparatus for use in the treatment of spinal deformities |
US5860977A (en) * | 1997-01-02 | 1999-01-19 | Saint Francis Medical Technologies, Llc | Spine distraction implant and method |
US7201751B2 (en) * | 1997-01-02 | 2007-04-10 | St. Francis Medical Technologies, Inc. | Supplemental spine fixation device |
US5836948A (en) * | 1997-01-02 | 1998-11-17 | Saint Francis Medical Technologies, Llc | Spine distraction implant and method |
ATE332669T1 (en) * | 1997-02-11 | 2006-08-15 | Sdgi Holdings Inc | PLATE FOR THE FRONT CERVICAL SPINE WITH FIXATION SYSTEM FOR ONE SCREW |
US6395018B1 (en) * | 1998-02-09 | 2002-05-28 | Wilfrido R. Castaneda | Endovascular graft and process for bridging a defect in a main vessel near one of more branch vessels |
FR2774581B1 (en) * | 1998-02-10 | 2000-08-11 | Dimso Sa | INTEREPINOUS STABILIZER TO BE ATTACHED TO SPINOUS APOPHYSIS OF TWO VERTEBRES |
US6224630B1 (en) * | 1998-05-29 | 2001-05-01 | Advanced Bio Surfaces, Inc. | Implantable tissue repair device |
US6558389B2 (en) * | 1999-11-30 | 2003-05-06 | Ron Clark | Endosteal tibial ligament fixation with adjustable tensioning |
GB9929599D0 (en) * | 1999-12-15 | 2000-02-09 | Atlantech Medical Devices Limi | A graft suspension device |
US6899716B2 (en) * | 2000-02-16 | 2005-05-31 | Trans1, Inc. | Method and apparatus for spinal augmentation |
US6248106B1 (en) * | 2000-02-25 | 2001-06-19 | Bret Ferree | Cross-coupled vertebral stabilizers |
US6427080B1 (en) * | 2000-05-16 | 2002-07-30 | Richard E. Radak | Cervical spine gauge and process |
US6964667B2 (en) * | 2000-06-23 | 2005-11-15 | Sdgi Holdings, Inc. | Formed in place fixation system with thermal acceleration |
US6752831B2 (en) * | 2000-12-08 | 2004-06-22 | Osteotech, Inc. | Biocompatible osteogenic band for repair of spinal disorders |
JP4100890B2 (en) * | 2001-09-11 | 2008-06-11 | ペンタックス株式会社 | Lingual spacer |
US7285121B2 (en) * | 2001-11-05 | 2007-10-23 | Warsaw Orthopedic, Inc. | Devices and methods for the correction and treatment of spinal deformities |
US7052497B2 (en) * | 2002-08-14 | 2006-05-30 | Sdgi Holdings, Inc. | Techniques for spinal surgery and attaching constructs to vertebral elements |
FR2844179B1 (en) * | 2002-09-10 | 2004-12-03 | Jean Taylor | POSTERIOR VERTEBRAL SUPPORT KIT |
US7608094B2 (en) * | 2002-10-10 | 2009-10-27 | U.S. Spinal Technologies, Llc | Percutaneous facet fixation system |
US7909853B2 (en) * | 2004-09-23 | 2011-03-22 | Kyphon Sarl | Interspinous process implant including a binder and method of implantation |
US8172876B2 (en) * | 2003-02-05 | 2012-05-08 | Pioneer Surgical Technology, Inc. | Spinal fixation systems |
US7335203B2 (en) * | 2003-02-12 | 2008-02-26 | Kyphon Inc. | System and method for immobilizing adjacent spinous processes |
FR2851154B1 (en) * | 2003-02-19 | 2006-07-07 | Sdgi Holding Inc | INTER-SPINOUS DEVICE FOR BRAKING THE MOVEMENTS OF TWO SUCCESSIVE VERTEBRATES, AND METHOD FOR MANUFACTURING THE SAME THEREOF |
ATE499889T1 (en) * | 2003-05-02 | 2011-03-15 | Univ Yale | DYNAMIC SPINAL STABILIZER |
EP1628563B1 (en) * | 2003-05-23 | 2009-09-23 | Globus Medical, Inc. | Spine stabilization system |
US6986771B2 (en) * | 2003-05-23 | 2006-01-17 | Globus Medical, Inc. | Spine stabilization system |
WO2005037150A1 (en) * | 2003-10-16 | 2005-04-28 | Osteotech, Inc. | System and method for flexible correction of bony motion segment |
US7862586B2 (en) * | 2003-11-25 | 2011-01-04 | Life Spine, Inc. | Spinal stabilization systems |
US8133500B2 (en) | 2003-12-04 | 2012-03-13 | Kensey Nash Bvf Technology, Llc | Compressed high density fibrous polymers suitable for implant |
US7553320B2 (en) * | 2003-12-10 | 2009-06-30 | Warsaw Orthopedic, Inc. | Method and apparatus for replacing the function of facet joints |
US8523904B2 (en) | 2004-03-09 | 2013-09-03 | The Board Of Trustees Of The Leland Stanford Junior University | Methods and systems for constraint of spinous processes with attachment |
US7524324B2 (en) * | 2004-04-28 | 2009-04-28 | Kyphon Sarl | System and method for an interspinous process implant as a supplement to a spine stabilization implant |
JP4382092B2 (en) * | 2004-05-17 | 2009-12-09 | ウリドル スパイン ヘルス インスティチュート シーオー. | Intervertebral insert |
US7658753B2 (en) * | 2004-08-03 | 2010-02-09 | K Spine, Inc. | Device and method for correcting a spinal deformity |
US20060084976A1 (en) * | 2004-09-30 | 2006-04-20 | Depuy Spine, Inc. | Posterior stabilization systems and methods |
US7918875B2 (en) * | 2004-10-25 | 2011-04-05 | Lanx, Inc. | Interspinous distraction devices and associated methods of insertion |
US20060106381A1 (en) * | 2004-11-18 | 2006-05-18 | Ferree Bret A | Methods and apparatus for treating spinal stenosis |
US20060271055A1 (en) * | 2005-05-12 | 2006-11-30 | Jeffery Thramann | Spinal stabilization |
AU2006261357A1 (en) * | 2005-06-17 | 2006-12-28 | Zimmer Spine Austin, Inc. | Improved method of treating degenerative spinal disorders |
US8273088B2 (en) * | 2005-07-08 | 2012-09-25 | Depuy Spine, Inc. | Bone removal tool |
US20070083200A1 (en) * | 2005-09-23 | 2007-04-12 | Gittings Darin C | Spinal stabilization systems and methods |
US7862569B2 (en) * | 2006-06-22 | 2011-01-04 | Kyphon Sarl | System and method for strengthening a spinous process |
US20080021466A1 (en) * | 2006-07-20 | 2008-01-24 | Shadduck John H | Spine treatment devices and methods |
US20080051784A1 (en) * | 2006-08-03 | 2008-02-28 | Sohrab Gollogly | Bone repositioning apparatus and methodology |
US20080097431A1 (en) * | 2006-09-22 | 2008-04-24 | Paul Peter Vessa | Flexible spinal stabilization |
US20080114357A1 (en) * | 2006-11-15 | 2008-05-15 | Warsaw Orthopedic, Inc. | Inter-transverse process spacer device and method for use in correcting a spinal deformity |
US8109978B2 (en) * | 2006-11-28 | 2012-02-07 | Anova Corporation | Methods of posterior fixation and stabilization of a spinal segment |
US20100036424A1 (en) * | 2007-06-22 | 2010-02-11 | Simpirica Spine, Inc. | Methods and systems for increasing the bending stiffness and constraining the spreading of a spinal segment |
US8696714B2 (en) * | 2007-11-02 | 2014-04-15 | The Board Of Trustees Of The Leland Stanford Junior University | Intervertebral stabilization devices |
JP5466229B2 (en) * | 2008-06-06 | 2014-04-09 | シンピリカ・スパイン・インコーポレーテッド | Method and apparatus for securing a band |
WO2009149399A1 (en) * | 2008-06-06 | 2009-12-10 | Simpirica Spine, Inc. | Methods and apparatus for deploying spinous process constraints |
-
2007
- 2007-10-18 EP EP07863431A patent/EP2081509B1/en not_active Not-in-force
- 2007-10-18 JP JP2009533532A patent/JP2010506693A/en active Pending
- 2007-10-18 WO PCT/US2007/081822 patent/WO2008051802A2/en active Application Filing
- 2007-10-18 JP JP2009533535A patent/JP2010506694A/en active Pending
- 2007-10-18 EP EP07854186.9A patent/EP2083701A4/en not_active Withdrawn
- 2007-10-18 WO PCT/US2007/081815 patent/WO2008051801A2/en active Application Filing
- 2007-10-18 ES ES07863431T patent/ES2400535T3/en active Active
- 2007-10-18 ES ES07852824T patent/ES2364417T3/en active Active
- 2007-10-19 US US11/875,674 patent/US20080108993A1/en not_active Abandoned
Patent Citations (60)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP0322334A1 (en) | 1987-12-23 | 1989-06-28 | Cremascoli France | Prosthesis implanted between vertebral spinous processes |
USRE36221E (en) | 1989-02-03 | 1999-06-01 | Breard; Francis Henri | Flexible inter-vertebral stabilizer as well as process and apparatus for determining or verifying its tension before installation on the spinal column |
FR2681525A1 (en) | 1991-09-19 | 1993-03-26 | Medical Op | Device for flexible or semi-rigid stabilisation of the spine, in particular of the human spine, by a posterior route |
US5609634A (en) | 1992-07-07 | 1997-03-11 | Voydeville; Gilles | Intervertebral prosthesis making possible rotatory stabilization and flexion/extension stabilization |
US5725582A (en) | 1992-08-19 | 1998-03-10 | Surgicraft Limited | Surgical implants |
US5456722A (en) | 1993-01-06 | 1995-10-10 | Smith & Nephew Richards Inc. | Load bearing polymeric cable |
US5496318A (en) | 1993-01-08 | 1996-03-05 | Advanced Spine Fixation Systems, Inc. | Interspinous segmental spine fixation device |
US5415661A (en) | 1993-03-24 | 1995-05-16 | University Of Miami | Implantable spinal assist device |
US5540698A (en) | 1993-04-21 | 1996-07-30 | Amei Technologies Inc. | System and method for securing a medical cable |
US5449361A (en) | 1993-04-21 | 1995-09-12 | Amei Technologies Inc. | Orthopedic cable tensioner |
US5462542A (en) | 1994-01-24 | 1995-10-31 | United States Surgical Corporation | Sternum buckle with serrated strap |
US5645599A (en) | 1994-07-26 | 1997-07-08 | Fixano | Interspinal vertebral implant |
US5928232A (en) | 1994-11-16 | 1999-07-27 | Advanced Spine Fixation Systems, Incorporated | Spinal fixation system |
US5902305A (en) | 1996-07-11 | 1999-05-11 | Aesculap Ag & Co. Kg | Surgical tensioning device |
US20020151978A1 (en) | 1996-07-22 | 2002-10-17 | Fred Zacouto | Skeletal implant |
US5964769A (en) | 1997-08-26 | 1999-10-12 | Spinal Concepts, Inc. | Surgical cable system and method |
US6053921A (en) | 1997-08-26 | 2000-04-25 | Spinal Concepts, Inc. | Surgical cable system and method |
US6682533B1 (en) | 1997-08-26 | 2004-01-27 | Spinal Concepts, Inc. | Surgical cable system and method |
US5935133A (en) | 1997-08-26 | 1999-08-10 | Spinal Concepts, Inc. | Surgical cable system and method |
US6391030B1 (en) | 1997-08-26 | 2002-05-21 | Spinal Concepts, Inc. | Surgical cable system and method |
US6626944B1 (en) | 1998-02-20 | 2003-09-30 | Jean Taylor | Interspinous prosthesis |
US6652527B2 (en) | 1998-10-20 | 2003-11-25 | St. Francis Medical Technologies, Inc. | Supplemental spine fixation device and method |
US6712819B2 (en) | 1998-10-20 | 2004-03-30 | St. Francis Medical Technologies, Inc. | Mating insertion instruments for spinal implants and methods of use |
US6451019B1 (en) | 1998-10-20 | 2002-09-17 | St. Francis Medical Technologies, Inc. | Supplemental spine fixation device and method |
US5989256A (en) | 1999-01-19 | 1999-11-23 | Spineology, Inc. | Bone fixation cable ferrule |
US6436099B1 (en) | 1999-04-23 | 2002-08-20 | Sdgi Holdings, Inc. | Adjustable spinal tether |
US6761720B1 (en) | 1999-10-15 | 2004-07-13 | Spine Next | Intervertebral implant |
WO2001028442A1 (en) | 1999-10-15 | 2001-04-26 | Spine Next | Intervertebral implant |
US6378289B1 (en) | 1999-11-19 | 2002-04-30 | Pioneer Surgical Technology | Methods and apparatus for clamping surgical wires or cables |
US6629975B1 (en) | 1999-12-20 | 2003-10-07 | Pioneer Laboratories, Icn. | Multiple lumen crimp |
US6835205B2 (en) | 2000-04-04 | 2004-12-28 | Spinalabs, Llc | Devices and methods for the treatment of spinal disorders |
US20050049708A1 (en) | 2000-04-04 | 2005-03-03 | Atkinson Robert E. | Devices and methods for the treatment of spinal disorders |
US6312431B1 (en) | 2000-04-24 | 2001-11-06 | Wilson T. Asfora | Vertebrae linking system |
US6605091B1 (en) | 2000-06-30 | 2003-08-12 | Pioneer Laboratories, Inc. | Surgical cable assembly and method |
US6716245B2 (en) | 2000-07-12 | 2004-04-06 | Spine Next | Intersomatic implant |
US20040106995A1 (en) | 2000-07-12 | 2004-06-03 | Regis Le Couedic | Shock-absorbing intervertebral implant |
WO2002003882A2 (en) | 2000-07-12 | 2002-01-17 | Spine Next | Shock-absorbing intervertebral implant |
US6689140B2 (en) | 2000-10-02 | 2004-02-10 | Howmedica Osteonics Corp. | System and method for spinal reconstruction |
US6689168B2 (en) | 2000-10-05 | 2004-02-10 | The Cleveland Clinic Foundation | Method and apparatus for stabilizing adjacent bones |
US6468309B1 (en) | 2000-10-05 | 2002-10-22 | Cleveland Clinic Foundation | Method and apparatus for stabilizing adjacent bones |
US6656185B2 (en) | 2000-10-24 | 2003-12-02 | Spineology Inc. | Tension band clip |
US20040116927A1 (en) | 2000-12-01 | 2004-06-17 | Henry Graf | Intervertebral stabilizing device |
WO2002051326A1 (en) | 2000-12-22 | 2002-07-04 | Spine Next | Intervertebral implant with deformable wedge |
US20040024458A1 (en) | 2000-12-22 | 2004-02-05 | Jacques Senegas | Intervertebral implant with deformable wedge |
US6364883B1 (en) | 2001-02-23 | 2002-04-02 | Albert N. Santilli | Spinous process clamp for spinal fusion and method of operation |
US6652585B2 (en) | 2001-02-28 | 2003-11-25 | Sdgi Holdings, Inc. | Flexible spine stabilization system |
US20040117017A1 (en) | 2001-03-13 | 2004-06-17 | Denis Pasquet | Self locking fixable intervertebral implant |
WO2002071960A1 (en) | 2001-03-13 | 2002-09-19 | Spine Next | Self locking fixable intervertebral implant |
US6582433B2 (en) | 2001-04-09 | 2003-06-24 | St. Francis Medical Technologies, Inc. | Spine fixation device and method |
US20040172132A1 (en) | 2001-09-06 | 2004-09-02 | Ginn Richard S. | Apparatus and methods for treating spinal discs |
US6695852B2 (en) | 2001-10-31 | 2004-02-24 | Spineology, Inc. | Tension tools for tension band clip |
WO2003045262A2 (en) | 2001-11-30 | 2003-06-05 | Spine Next | Intervertebral implant with elastically deformable wedge |
US6669729B2 (en) | 2002-03-08 | 2003-12-30 | Kingsley Richard Chin | Apparatus and method for the replacement of posterior vertebral elements |
WO2004052246A1 (en) | 2002-12-10 | 2004-06-24 | Sdgi Holdings, Inc. | System and method for blocking and/or retaining a prosthetic spinal implant |
US20040127989A1 (en) | 2002-12-31 | 2004-07-01 | Andrew Dooris | Prosthetic facet joint ligament |
WO2004073532A1 (en) | 2003-01-20 | 2004-09-02 | Abbott Spine | Unit for treatment of the degeneration of an intervertebral disc |
US20050033435A1 (en) | 2003-08-04 | 2005-02-10 | Spine Next | Intervertebral disk prosthesis |
US20050216017A1 (en) | 2004-03-09 | 2005-09-29 | Louie Fielding | Spinal implant and method for restricting spinal flexion |
US20060069447A1 (en) | 2004-09-30 | 2006-03-30 | Disilvestro Mark R | Adjustable, remote-controllable orthopaedic prosthesis and associated method |
WO2006106246A2 (en) | 2005-04-08 | 2006-10-12 | Spinevision | Surgical intervertebral implant forming a swivel joint |
Non-Patent Citations (2)
Title |
---|
See also references of EP2083701A4 |
WHITE AA; PANJABI MM: "Clinical Biomechanics of the Spine", 1990, JB LIPPINCOTT |
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Also Published As
Publication number | Publication date |
---|---|
JP2010506693A (en) | 2010-03-04 |
JP2010506694A (en) | 2010-03-04 |
WO2008051801A3 (en) | 2008-08-21 |
EP2081509A2 (en) | 2009-07-29 |
ES2364417T3 (en) | 2011-09-01 |
WO2008051802A3 (en) | 2008-07-10 |
EP2081509B1 (en) | 2013-01-23 |
EP2083701A4 (en) | 2013-06-12 |
WO2008051801A2 (en) | 2008-05-02 |
ES2400535T3 (en) | 2013-04-10 |
EP2083701A2 (en) | 2009-08-05 |
EP2081509A4 (en) | 2009-11-11 |
US20080108993A1 (en) | 2008-05-08 |
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