US20130123849A1 - Devices and methods for the minimally invasive treatment of spinal stenosis - Google Patents
Devices and methods for the minimally invasive treatment of spinal stenosis Download PDFInfo
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- US20130123849A1 US20130123849A1 US13/669,294 US201213669294A US2013123849A1 US 20130123849 A1 US20130123849 A1 US 20130123849A1 US 201213669294 A US201213669294 A US 201213669294A US 2013123849 A1 US2013123849 A1 US 2013123849A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- 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
- A61B17/7067—Devices bearing against one or more spinous processes and also attached to another part of the spine; Tools therefor
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- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
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Definitions
- the present disclosure is related to orthopedic devices implanted between skeletal segments.
- the implanted devices are used to adjust and maintain the spatial relationship(s) of adjacent bones.
- the motion between the skeletal segments may be returned to normal, increased, modified, limited or completely immobilized.
- lumbar stenosis Constriction of the canal within the lumbar spine is termed lumbar stenosis. This condition is very common in the elderly and causes a significant proportion of the low back pain, lower extremity pain, lower extremity weakness, limitation of mobility and the high disability rates that afflict this age group.
- laminectomy is the surgical removal of the lamina portion of bone and the adjacent ligamentous structures that constrict the spinal canal.
- spinal decompression surgery can be an extensive operation with risks of complication from the actual surgical procedure and the general anesthetic that is required to perform it. Since many of these elderly patients are in frail health, the risk of developing significant peri-operative medical problems remains high.
- the surgical resection of spinal structures may relieve the neural compression but lead to spinal instability in a substantial minority of patients. That is, removal of the spinal elements that compress the nerves may weaken the vertebral column and lead to spinal instability and vertebral mal-alignment.
- lumbar stenosis has been treated by the distraction—instead of resection—of those tissues that compress the spinal canal.
- an implantable device is placed between the spinous processes of the vertebral bodies at the stenotic level in order to limit the extent of bone contact during spinal extension. Since encroachment upon the nerve elements occurs most commonly and severely in extension, this treatment strategy produces an effective increase in the size of the spinal canal by limiting the amount of spinal extension.
- the distraction of the spinous processes changes the local bony anatomy and decompress the nerves at the distracted level by placing the spinal segment into slight flexion.
- distraction members are percutaneously placed into the space between two adjacent spinous processes.
- the distraction members are attached to a distraction platform and the platform is configured to adjustably distract and set the distance between the distraction members.
- the inner surface of at least one distraction members forms a guide channel that is adapted to guide and position an orthopedic implant into the distracted interspinous space.
- the implant is adapted to maintain the increased distance between the spinous processes after removal of the distraction members and distraction platform.
- distraction members are percutaneously placed into the tissues adjacent to the spinous processes and used to introduce an implant delivery device.
- the implant is attached to and contained within the delivery device. With actuation, the implant is rotated into the inter-spinous space and used to forcibly separate the spinous processes.
- a pin or similar anchor is placed at least partially through a first spinous process and positioned so that the distal end abuts a surface of an adjacent spinous process.
- the pin is used to separate the two adjacent spinous processes and maintain the increased distance between them.
- a pin is placed into the base of the superior facet of the lower vertebra and used to limit vertebral extension by preventing the downward travel of the inferior facet of the superior vertebra.
- the pin has a hollow central cavity that accommodates a bone graft or a bone graft substitute and is adapted to fuse with the surrounding bone at the insertion site of the inferior vertebra. Additional embodiments are disclosed that modify the facet joint anatomy and provide direct nerve decompression and/or a limit of vertebral extension.
- an implant is attached onto at least one vertebral bone and adapted to limit the motion of the attached bone relative to an adjacent vertebra.
- the motion pathway permitted by the implanted is substantially curvilinear and has at least one center of rotation near the natural Instantaneous Axis of Rotation between adjacent vertebrae. Further, the implant permits greater relative motion between the adjacent vertebrae in flexion than it does in extension.
- an orthopedic device comprising a first member adapted to be attached onto at least one vertebra arid adapted to limit the motion of the attached vertebra relative to an adjacent vertebra, wherein the first member defines a motion pathway of the attached vertebra, wherein the motion pathway is substantially curvilinear and has at least one center of rotation near a natural instantaneous axis of rotation between the attached vertebra and the adjacent vertebrae and, wherein the first member provides limited relative motion between two vertebrae such that the relative motion is greater in flexion than it is in extension.
- a method for the treatment of spinal stenosis in which an orthopedic implant is introduced into a space between the spinous processes of two adjacent vertebras using a minimally invasive surgical technique, comprising: placing two extension members into the space between two adjacent spinous processes of adjacent vertebrae, wherein the extension members are coupled to a distraction platform device capable of adjusting a distance between the extension members; using the distraction platform to separate the extension members, wherein the outer surface of each extension member is adapted to abut a spinous process of each adjacent vertebra so that separation of the extension members by the platform produces an increase in the distance between the adjacent spinous processes, wherein an inner surface of at least one extension members forms a guide channel that is adapted to guide and position an orthopedic implant into the distracted inter-spinous space; placing an orthopedic implant into the space between the two adjacent spinous processes, wherein the implant is adapted to maintain the increase in distance between the adjacent spinous processes after removal of the extension members; and removing the extension members and the distraction platform.
- a method for the treatment of spinal stenosis in which an orthopedic implant is introduced into the space between the spinous processes of two adjacent vertebrae using a minimally invasive surgical technique, comprising: positioning two extension members adjacent to, but not into, an inter-spinous space between two adjacent spinous processes, wherein the extension members are coupled to a distraction platform device capable of setting a distance between the extension members; using the distraction platform to separate the extension members, wherein the outer surface of each extension member is adapted to separate tissue adjacent to the inter-spinous space, wherein an inner surface of at least one of the extension members forms a guide channel that is adapted to guide and position an implant delivery device into the tissue adjacent to the inter-spinous space, wherein the implant is adapted to be attached onto the delivery device and be at least partially contained therein, wherein the implant delivery device is adapted to rotate the attached implant about a center point that is substantially contained within the delivery device and through an angle range of 45 to 135 degrees; deploying the implant delivery device onto the extension members, wherein the implant
- a method for the treatment of spinal stenosis comprising: placing a body of a pin at least partially through a first spinous process such that one end of the pin is positioned to abut a surface of a second, adjacent spinous process that faces the first spinous process; and using the pin to set and maintain a distracted space between the spinous processes.
- an orthopedic device comprising a first member configured to attach onto at least one first vertebra and limit motion of the first vertebra relative to a second, adjacent vertebra.
- the first member defines a substantially curvilinear motion pathway of the first vertebra having at least one center of rotation near a natural instantaneous axis of rotation between the first vertebra and the second vertebra.
- the first member is configured to provide limited relative motion between the first vertebra and the second vertebra such that the relative motion is greater in flexion than it is in extension.
- an assembly for placement or an orthopedic implant within a target inter-spinous space of a spinal column comprises: (i) an implant placement device comprising: at least a first extension member and a second extension member each of the first and second extension members comprising an elongated segment configured to extend from a proximal aspect to a distal aspect and each of the first and second extension members configured to be positioned within the target inter-spinous space at the distal aspect thereof, and a distraction mechanism configured to connect to the proximal aspect of each of the first and the second extension members, and to forcibly move the first extension member relative to the second extension member the movement configured to produce at least some expansion of the target inter-spinous space, (ii) a guide channel formed at least in part by a bore configured to extend from a proximal opening to distal opening in between the first and second extension members, and (ii) an orthopedic implant configured to be advanced at least partially through the guide channel and be positioned within the target inter-spinous space.
- the assembly comprises: (i) an implant placement device comprising: at least a first extension member and a second extension member each of the first and second extension members comprising an elongated segment configured to extend from a proximal aspect to a distal aspect and each of the first and second extension members configured to be positioned within the target inter-spinous space at the distal aspect thereof, and a distraction mechanism configured to connect to the proximal aspect of each of the first and the second extension members, and to forcibly move the first extension member relative to the second extension member the movement configured to produce at least some expansion of the target inter-spinous space, the first and second extension members thereby creating a guide channel therebetween, (ii) an elongated member configured to be slidably positioned within the guide channel during advancement of the first and second extension members towards the target inter-spinous space, the elongated member being shaped to separate tissues ahead of the advancing first and second extension members, and (iii) an orthopedic implant configured to be advanced at least partially through the guide channel and be
- FIG. 1 shows a perspective view of an installer device that is adapted to position an implant in the inter-spinous space between two vertebras.
- FIG. 2 shows the installer device in a distracted state.
- FIG. 3 shows the installer device with an implant at the distal region of the installer arms.
- FIG. 4 illustrates an exemplary implant placed within the inter-spinous space.
- FIGS. 5A and 5B show perspective and cross-sectional views of an implant, respectively.
- FIGS. 6A and 6B show another embodiment of an installer device without and with an exemplary imp/ant, respectively.
- FIGS. 7 A and 7 B show prospective and cross-sectional views of an exemplary implant in the un-deployed state.
- FIGS. 8A and 8B show prospective and cross-sectional views of an exemplary implant in the deployed state.
- FIG. 9A shows another embodiment of an installer device and an implant delivery instrument.
- FIG. 9B shows perspective views of an implant delivery instrument.
- FIG. 10 shows the delivery instrument after actuation such that an implant has rotated to a deployment position.
- FIG. 11 shows the linkage mechanism of the implant delivery instrument.
- FIG. 12 shows the delivery instrument coupled to the installer device prior to deployment of the implant.
- FIG. 13 shows the implant in the inter-spinous space after deployment with the delivery instrument removed.
- FIG. 14A shows another embodiment of an implant.
- FIG. 14B shows an alternative application of the implant.
- FIG. 15 shows an implant positioned in a inter-spinous space with a fixation screw anchoring the implant in place.
- FIGS. 16 and 17 show perspective views of a device that is configured for placement between the spinous processes of two adjacent vertebras.
- FIGS. 18 and 19 show exploded views of the device.
- FIG. 20 shows a side, cross-sectional view of the device mounted to a pair of vertebrae.
- FIG. 21 shows a side, cross-sectional view of the device mounted to a pair of vertebrae.
- FIG. 22 shows perspective views of another embodiment in the disassembled state.
- FIG. 23 shows additional views of the assembled implant of FIG. 22 .
- FIG. 24 shows the implant of FIG. 22 mounted on the sacrum.
- FIG. 25 illustrates an oblique view of the mounted implant of FIG. 24 .
- FIG. 26 shows an additional embodiment.
- FIGS. 27A and B show the implant of FIG. 26 placed into the spinal column.
- FIG. 28A shows an additional embodiment of an orthopedic implant.
- FIG. 28B shows an additional embodiment of an orthopedic implant.
- FIG. 29A shows a lateral view of the vertebral bodies while FIG. 29B shows the implant in place.
- FIGS. 30A and 30B show an additional embodiment of an implant.
- FIG. 31 shows perspective views of the implant.
- FIG. 32 shows the implant of FIG. 31 placed into the spinal column.
- FIG. 1 shows a perspective view of an installer device 1605 that is adapted to position an orthopedic implant in the inter-spinous space between the spinous processes of two adjacent vertebras.
- the device 1605 includes a platform 1610 having an actuator 1615 that can be used to separate a pair of distraction arms 1620 a and 1620 b.
- the platform member 1610 may include a scale for measuring the distraction distance or the distraction force.
- the scale can display the measured distance in a recognized physical unit or as an arbitrary designation (such as, for example, A, B, C, etc.) that is used for implant selection.
- Each distraction arm 1620 has a semi-circular inner surface so that, in the non-distracted state, the arms 1620 collectively form an interior circular conduit.
- a curvilinear trocar with sharpened distal end 1625 b and discoid proximal member 1625 a is positioned through the circular conduit formed by arms 1620 .
- Discoid proximal member 1625 a has locking tabs on its inferior surface that interact with complimentary tabs 1622 of arms 1620 and lock the trocar to the distraction arms.
- the sharpened end 1625 b emerges from the distal end of arms 1620 and, at the time of device insertion, end 1625 b divides the skin and soft tissue ahead of advancing arms 1620 .
- the distraction arms 1620 are positioned into the inter-spinous space at the stenotic spinal level under x-ray guidance.
- the trocar is removed and actuator 1615 is rotated to separate the distraction arms and apply a distraction force upon the spinous processes of the two adjacent vertebras.
- FIG. 2 shows the device 1605 in a distracted state.
- each distraction arm 1620 is forcibly driven into the spinous process of the adjacent vertebral bone producing distraction of the inter-spinous space.
- arms 1620 are curved, although the arms can be also straight or partially curved.
- a pathway is formed between the separated arms 1620 through which an implant can be driven into the inter-spinous space. The size of the needed implant is given by reading the scale along platform member 1610 .
- FIG. 3 shows the device 1605 with an exemplary implant 1805 positioned at the distal region of the arms 1620 .
- the implant 1805 is inserted into the proximal aspect of the pathway and advanced distally until it rests within the inter-spinous space.
- the implant is held in place by a placement handle (not shown) and the distraction arms and platform are then removed.
- the implant is distracted by actuating the placement handle.
- the implant is shown in FIG. 4 resting within the inter-spinous space.
- FIGS. 5A and 5B illustrate perspective and cross-sectional views, respectively, of the implant 1805 .
- the implant 1805 includes a first piece 1905 and a second piece 1910 that are movably attached to one another.
- a pair of wedge-shaped bearing members 1915 form a bearing surface between the two pieces 1905 and 1910 .
- the pieces 1905 have respective shoulders 1925 that abut one another to guide and limit relative movement there between.
- the bearing members 1915 and the shoulders 1925 guide movement between the two pieces 1905 and 1910 such that the pieces can move and increase the dimensions of the implant 1805 .
- the implant can be initially delivered into the inter-spinous space in a state of reduces size and then transitioned to the state of enlarged size after it is positioned within the inter-spinous space.
- FIGS. 6A and 6B show another embodiment of an installer device 2105 .
- the device 2105 includes a platform 2110 having an actuator 2115 that can be used to separate a pair of distractor arms 2120 .
- the distractor arms are straight.
- the arms 2110 can be used as a guide for positioning an implant 2205 into the inter-spinous space ( FIG. 6B )
- FIGS. 7A and 78 show perspective and cross-sectional views of an exemplary implant 2205 in the un-deployed state.
- Implant 2205 contains at least longitudinal tract 2207 that interacts with the inner aspect of arms 2210 .
- the implant 2205 includes first and second members 2210 and 2215 that are movably attached.
- one or more pivotably mounted arias 2220 are moved to a position that extends outwardly from the implant 2205 .
- the arms can be moved to the extended position after implantation in the inter-spinous space.
- FIGS. 8A and 8B show perspective and cross-sectional views of an exemplary implant 2205 in the deployed state.
- the distal arms 2220 have a bearing articulation with the deploying portion of member 2210 while the proximal arms 2220 have a deformable base that is integrally attached to member 2210 .
- Either mechanism may be employed on any of mounted arms 2220 .
- FIG. 9A illustrates an additional embodiment.
- a distraction platform with straight distraction arms is percutaneously positioned under x-ray guidance. The arms are placed lateral to the inter-spinous space.
- a delivery instrument 2303 is attached to the implant and used to place the implant into the inter-spinous space.
- FIG. 9B shows perspective views of the delivery instrument 2302 .
- the instrument 2302 includes a two-piece handle having a first arm 2310 and a second arm 2320 that is movably mounted relative to the first arm 231 b in a pivot or trigger fashion.
- the first and second arms are ergonomically arranged such that an operator can grasp the arms using a single hand.
- the first arm 2310 is sized and shaped to support an operator's palm and thumb such as on a thumb grip 2322 .
- the second arm 320 can be grasped by the operator's fingers to pull the second arm 2320 toward the first au u 2310 and actuate the instrument 2302 .
- a biasing member 2325 is interposed between the first and second arms. It should be appreciated that the instrument can be actuated with other mechanisms and need not use a two-piece handle configuration.
- a housing 2311 extends outward from the handle.
- the housing 2311 is sized and shaped to contain the implant 2205 .
- the housing 2311 has an elongated, tube-like shape and is partially hollow so as to contain the implant 2205 as well as an internal actuation mechanism that expels the implant from the housing.
- a slot 2330 is located at or near a distal end of the housing 2311 .
- the slot communicates with an internal cavity in the housing 2311 in which the implant 2205 resides.
- the slot is sufficiently long and wide such that the implant 2205 can pass through the slot during deployment of the implant.
- FIG. 10 illustrates the internal mechanism of the placement device.
- FIG. 11 shows the instrument 2302 after actuation such that the implant 2205 has rotated (as represented by the arrow R) to a deployment position.
- FIG. 12 shows the delivery instrument 2302 coupled to the installer device 2105 prior to deployment of the implant 2205 .
- the elongated housing 2311 is placed in between the distractor arms 2120 such that a distal end of the housing 2311 is lateral to the inter-spinous space between the vertebrae.
- the delivery instrument is then actuated to rotate the implant 2205 into the inter-spinous space.
- FIG. 13 shows the implant 2205 in the inter-spinous space after removal of delivery instrument 2302 .
- FIG. 14A shows another embodiment of an implant.
- the implant comprises a curved pin or screw 2805 that is sized and shaped to be passed through the spinous process of a vertebrae.
- the screw 2805 has a curved contour that permits a portion of the screw to extend through the spinous process with a distal region of the screw extending through the inter-spinous space.
- a proximal end of the screw 2805 is positioned at the exterior of the spinous process.
- the distal end of the screw 2805 abuts a surface of the spinous process of the adjacent vertebra.
- the pin may be at least partially comprised of a bone graft or bone graft substitute so as to fuse with the spinous process in which it is embedded.
- the pin maybe embedded in a first spinous process and abut a second spinous process, as shown in FIG. 14A , or it may be alternatively embedded in the second spinous process and abut the first spinous process, as shown in FIG. 14B .
- FIG. 15 shows an implant positioned in an inter-spinous space and affixed to the spine with a fixation screw 3010 .
- the implant 3005 is positioned within the disc space such that outer surface of the implant abuts adjacent vertebrae.
- a fixation screw 3010 extends through the spinous process and into the implant 3005 .
- the screw may be at least partially comprised of a bone graft or bone graft substitute so as to fuse with the spinous process in which it is embedded. If the interior aspect of implant 3005 is also at least partially comprised of a bone graft or bone graft substitute, then screw 3010 can fuse with both the spinous process and implant 3005 . This provides a bone bridge between the implant 3005 and the spinous process without direct fusion of the implant onto the spinous process.
- FIGS. 16 and 17 show perspective views of a device 105 that is configured for placement between the spinous processes of two adjacent vertebral bodies.
- the device 105 includes a spacer region or central region 110 that is sized and shaped to fit between the spinous processes of the two adjacent vertebral bodies.
- the device 105 further includes a pair of attachment members 115 that are adapted to attach and anchor onto the spinous process of at least one of the vertebral bodies.
- the central region 110 can have a variety of shapes and sizes for placement between the spinous processes.
- the attachment members 115 can also have various sizes and shapes for attachment to the spinous processes.
- FIGS. 18 and 19 show exploded views of the device 105 .
- the device 105 includes attachment members 115 that are adapted to attach and anchor onto the spinous process of at least one of the vertebral bodies.
- Each attachment member 115 has a pair of downwardly-extending aims 305 that are sized to receive a spinous process therebetween.
- An upper portion of the attachment member 115 is sized and shaped to sit over the spinous process.
- the upper portion has a borehole that is sized to receive a threaded screw 410 during implantation:
- a locking mechanism 415 can be within the attachment, member 115 to serves to prevent unwanted movement and/or back out of the screw 410 . While illustrated as a locking cam, the locking mechanism 415 may include any locking mechanism known in the art.
- a first bearing member 425 has a rounded articulating surface that is adapted to interact with a complimentary articulating surface on a second bearing member 430 .
- the member 425 is sized and shaped to be received in a cavity inside the member 430 so as to permit at least some rotational movement therebetween.
- a third bearing member 440 is at least partially dome-shaped and is adapted to couple to the members 425 and 430 . In particular, the member 440 mates with the member 430 such as through a threaded engagement.
- member 430 includes a protrusion 445 that is sized and shaped to mate with an indentation 450 in the member 425 .
- the interaction of protrusion 445 and indentation 450 serves to limit the amount of rotation and lateral flexion between the members 425 and 430 .
- FIG. 20 shows a side, cross-sectional views of the device mounted to a pair of vertebrae.
- the members 115 can be coupled to one another by mating the member 425 beneath the member 430 such that articulating surfaces abut one another and permit rotational movement therebetween.
- the member 440 is positioned below the member 430 and secured thereto such as in a threaded relationship. This retains the device in the assembled state.
- FIG. 21 shows an enlarged, cross-sectional view of the device in the assembled state and mounted between vertebrae.
- the member 425 has a rounded surface 605 .
- the surface 605 interacts with a complimentary rounded surface 610 on the member 430 .
- a space 630 is formed when the member 440 is secured onto the member 430 .
- the member 425 resides within the space 630 in the assembled device.
- the space 630 permits a certain amount of “play” between the articulation of members 430 and 425 .
- the space 630 contains a malleable member that keeps members 425 and 430 in a preferred, neutral position and acts to return these members to the neutral position when they move away from it.
- the curvilinear surfaces 605 and 610 define a spherical path of motion that is centered at Point A (shown in FIG. 20 ). That is, the surfaces 605 and 610 can move relative to one another along a pathway that is curvilinear or spherical. Alternative motion paths that are non-spherical may be alternatively made. In specific, a configuration that is similar, but not identical, to a hyperbolic paraboloid may be incorporated within the articulating surface. Moreover, the interaction of the protrusion 445 and indentation 450 allows a variable degree of rotational movements of one vertebral body relative to the other. The extent of rotation and lateral flexion permitted is dependant on the degree of flexion of the vertebral bodies.
- the extent of rotation and lateral flexion permitted by the device is greater that amount of 14 rotation and lateral flexion that is permitted when the vertebral bodies are in extension. This feature reproduces the natural motion characteristics between the vertebral bodies.
- FIG. 22 illustrates perspective views of device 3305 in the disassembled state.
- FIG. 23 shows sectional views of the assembled device 3305 .
- Threaded wall 3320 surrounds central cavity 3315 and contains multiple full thickness bore holes 3325 .
- the distal aspect of wall 3320 contains interior threads 3340 that couple with complimentary threads 3520 of distal member 3510 .
- the central cavity 3315 is adapted to house a bone graft or bone graft substitute and permit fusion between the bone graft within cavity 3315 and the vertebral bone surrounding the outer aspect of device 3305 .
- distal member 3510 is screwed onto device 3305 .
- the fusion forms across bore holes 3325 .
- the proximal aspect of device 3305 contains hexagonal cut out 3360 . Cut out 3360 is adapted to accept a hex screw driver and the latter is used to drive device 3305 into bone.
- the proximal aspect of device 3305 contains at least one flap 3605 that is movably attached to device 3305 . When a force is applied to the proximal aspect of device 3305 , flap 3605 transiently and reversibly moves towards the center line of the device. In this way, flap 3605 functions as a malleable member and imparts a spring-like quality to the proximal aspect of device 3305 .
- the central cavity 3315 is filed with a bone graft and distal member 3510 is threaded onto device 3305 .
- distal member 3510 is rigidly attached to 3305 .
- the device is percutaneously driven into the base of the superior articulating surface of the lower vertebral body and abuts the inferior surface of the inferior articulating surface of the superior vertebra.
- a single device is used on each side of the vertebral midline, so that two devices 3305 are used at each stenotic level.
- the devices are shown attached to bone in FIGS. 24 and 25 .
- each device 3305 limits the downward travel of the inferior articulating surface of the superior vertebra and limits the degree of extension at that spinal level.
- the bone contained within cavity 3315 will fuse with the adjacent bone and rigidly anchor the device to the vertebra. Because of the fusion the device does not to be anchored into the pedicle portion of the vertebra and it can be short in length.
- FIG. 26 illustrates device 3705 .
- the device is intended to reside within the facet joint and be anchored onto one, but not both, of the adjacent vertebras.
- the device may be affixed onto the vertebral bone using pins and a bone screw or the device may be at least partially comprised of a bone graft or bone graft substitute so as to fuse onto the adjacent bone.
- the device may be coated/made with osteo-conductive (such as deminerized bone matrix, hydroxyapatite, and the like) and/or osteo-inductive (such as Transforming Growth Factor “TGF-B,” Platelet-Derived Growth Factor “PDGF,” BoneMorphogenic Protein “BMP,” and the like) bio-active materials that promote bone formation.
- osteo-conductive such as deminerized bone matrix, hydroxyapatite, and the like
- osteo-inductive such as Transforming Growth Factor “TGF-B,” Platelet-Derived Growth Factor “PDGF,” BoneMorphogenic Protein “B
- one or more surfaces may be made with a porous ingrowth surface (such as titanium wire mesh, plasma-sprayed titanium, tantalum, Porous CoCr, and the like), provided with a bioactive coating, made using tantalum, and/or helical rosette carbon nanotubes (or other carbon nanotube-based coating) in order to promote bone in-growth or establish a mineralized connection between the bone and the implant.
- a porous ingrowth surface such as titanium wire mesh, plasma-sprayed titanium, tantalum, Porous CoCr, and the like
- a bioactive coating made using tantalum, and/or helical rosette carbon nanotubes (or other carbon nanotube-based coating) in order to promote bone in-growth or establish a mineralized connection between the bone and the implant.
- FIG. 28A shows an additional embodiment of an orthopedic implant 705 positioned on two vertebral bodies of the lumbar spine.
- the implant 705 is attached onto the superior articulating surface and lamina of the lower vertebra and functions to stop the downward movement of the inferior articulating surface of the upper vertebral body. In this way, the device stops the extension of the two vertebral bodies and keeps them in relative flexion.
- the device can include contains one or more bore holes through which one or more screws are passed and anchored onto the underlying bone. As shown, the inferior aspect of the lamia of the upper vertebra is preferably removed (laminotomy) to decompress the nerve elements prior to device placement.
- FIG. 28B shows an additional embodiment of an orthopedic implant 805 positioned on two vertebral bodies of the lumbar spine.
- the implant 805 is attached onto the superior articulating surface and lamina of the lower vertebra and transverses the facet joint between the two vertebral bodies.
- the superior surface of the device abuts the inferior aspect of the pedicle of the upper vertebral body.
- the implant functions to stop the extension of the two vertebral bodies and keeps them in relative flexion.
- the implant 805 can contain one or more bore holes through which screws are passed and anchored onto the underlying bone.
- FIG. 29A shows a lateral view of the vertebral bodies and FIG. 29B shows the implant 805 in place. Note that implant placement will necessarily place the lower articulating surface of the upper vertebral body more posteriorly and at least partially realign an anterior spondylolisthesis.
- FIGS. 30A and 30B show an additional embodiment of an implant 1305 .
- the implant 1305 is a “c” shaped implant.
- FIG. 31 shows perspective views of the implant 1305 .
- the implant 1305 functions to separate the top of the superior articular surface of the inferior body from the inferior aspect of the pedicle of the upper vertebral body.
- the implant 1305 has a size and shape such that the opening of the “C” can be positioned over at least a portion of the vertebral body.
- a separate attachment device is not used to attach the implant 1305 to bone.
- the implant 1305 contain one or more bore holes through which screws are passed and anchored onto the underlying bone.
- FIG. 32 shows the implant 1305 positioned on the bone.
- the disclosed devices or any of their components can be made of any biologically adaptable or compatible materials.
- Materials considered acceptable for biological implantation are well known and include, but are not limited to, stainless steel, titanium, tantalum, combination metallic alloys, various plastics, resins, ceramics, biologically absorbable materials and the like.
- Any components may be also coated/made with osteo-conductive (such as deminerized bone matrix, hydroxyapatite, and the like) and/or osteo-inductive (such as Transforming Growth Factor “TGF-B,” Platelet-Derived Growth Factor “PDGF,” Bone-Morphogenic Protein “BMP,” and the like) bio-active materials that promote bone formation.
- osteo-conductive such as deminerized bone matrix, hydroxyapatite, and the like
- osteo-inductive such as Transforming Growth Factor “TGF-B,” Platelet-Derived Growth Factor “PDGF,” Bone-Morphogenic Protein “BMP,” and the like
- any surface may be made with a porous ingrowth surface (such as titanium wire mesh, plasma-sprayed titanium, tantalum, porous CoCr, and the like), provided with a bioactive coating, made using tantalum, and/or helical rosette carbon nanotubes (or other carbon nanotube-based coating) in order to promote bone in-growth or establish a mineralized connection between the bone and the implant, and reduce the likelihood of implant loosening.
- a porous ingrowth surface such as titanium wire mesh, plasma-sprayed titanium, tantalum, porous CoCr, and the like
- a bioactive coating made using tantalum, and/or helical rosette carbon nanotubes (or other carbon nanotube-based coating) in order to promote bone in-growth or establish a mineralized connection between the bone and the implant, and reduce the likelihood of implant loosening.
- the system or any of its components can also be entirely or partially made of a shape memory material or other deformable material.
Abstract
Multiple implants and methods for the minimally invasive treatment of spinal stenosis are disclosed. A spinal implant device includes a spacer region and an attachment region. The spacer region is adapted to be positioned between first and second spinous processes of first and second vertebral bodies to limit movement of the first spinous process and the second spinous process toward one another. The attachment region attaches to the first spinous process via a fastener that extends substantially along a long axis of the spinous process.
Description
- This application is a continuation of and claims priority to co-pending U.S. patent application Ser. No. 11/881,584 issuing as U.S. Pat. No. 8,303,630 on Nov. 6, 2012, which is incorporated herein by reference in its entirety, and which claims priority of the following co-pending U.S. Provisional Patent Applications: (1) U.S. Provisional Patent Application Ser. No. 60/834,209, filed Jul. 27, 2006; (2) U.S. Provisional Patent Application Ser. No. 60/834,003, filed Jul. 28, 2006; (3) U.S. Provisional Patent Application Ser. No. 60/860,942, filed Nov. 24, 2006. Priority of the aforementioned filing dates is hereby claimed. The disclosures of the Non-provisional and Provisional Patent Applications are hereby incorporated by reference in their entirety.
- The present disclosure is related to orthopedic devices implanted between skeletal segments. The implanted devices are used to adjust and maintain the spatial relationship(s) of adjacent bones. Depending on the implant design, the motion between the skeletal segments may be returned to normal, increased, modified, limited or completely immobilized.
- Progressive constriction of the central canal within the spinal column is a predictable consequence of aging. As the spinal canal narrows, the nerve elements that reside within it become progressively more crowded. Eventually, the canal dimensions become sufficiently small so as to significantly compress the nerve elements and produce pain, weakness, sensory changes, clumsiness and other manifestation of nervous system dysfunction.
- Constriction of the canal within the lumbar spine is termed lumbar stenosis. This condition is very common in the elderly and causes a significant proportion of the low back pain, lower extremity pain, lower extremity weakness, limitation of mobility and the high disability rates that afflict this age group.
- The traditional treatment for this condition has been laminectomy, which is the surgical removal of the lamina portion of bone and the adjacent ligamentous structures that constrict the spinal canal. Despite advances in surgical technique, spinal decompression surgery can be an extensive operation with risks of complication from the actual surgical procedure and the general anesthetic that is required to perform it. Since many of these elderly patients are in frail health, the risk of developing significant peri-operative medical problems remains high. In addition, the surgical resection of spinal structures may relieve the neural compression but lead to spinal instability in a substantial minority of patients. That is, removal of the spinal elements that compress the nerves may weaken the vertebral column and lead to spinal instability and vertebral mal-alignment. With instability, the vertebrae will move in an abnormal fashion relative to one another and produce pain, nerve re-impingement, weakness and disability. Further, re-stabilization of the spinal column requires additional and even more extensive surgery. Because of these issues, elderly patients with lumbar stenosis must often choose between living the remaining years in significant pain or enduring the potential life-threatening complications of open spinal decompression surgery.
- Recently, lumbar stenosis has been treated by the distraction—instead of resection—of those tissues that compress the spinal canal. In this approach, an implantable device is placed between the spinous processes of the vertebral bodies at the stenotic level in order to limit the extent of bone contact during spinal extension. Since encroachment upon the nerve elements occurs most commonly and severely in extension, this treatment strategy produces an effective increase in the size of the spinal canal by limiting the amount of spinal extension. In effect, the distraction of the spinous processes changes the local bony anatomy and decompress the nerves at the distracted level by placing the spinal segment into slight flexion.
- Unfortunately, the placement of a conventional inter-spinous implant requires surgical exposure of the posterior and lateral aspects of the spinous processes as well as the posterior aspect of the spinal column. Since these operations still carry a significant risk of peri-operative complications in the elderly, there remains a need in the field for devices and methods that reduce the scope of the surgical procedure and its inherent risks.
- This application discloses a series of novel devices and methods for the minimally invasive treatment of spinal stenosis. In an embodiment, distraction members are percutaneously placed into the space between two adjacent spinous processes. The distraction members are attached to a distraction platform and the platform is configured to adjustably distract and set the distance between the distraction members. With actuation of the distraction platform, the outer surfaces of the distraction members forcibly abut the spinous processes and distract the adjacent spinous processes away from one another. The inner surface of at least one distraction members forms a guide channel that is adapted to guide and position an orthopedic implant into the distracted interspinous space. The implant is adapted to maintain the increased distance between the spinous processes after removal of the distraction members and distraction platform.
- In an alternative embodiment, distraction members are percutaneously placed into the tissues adjacent to the spinous processes and used to introduce an implant delivery device. The implant is attached to and contained within the delivery device. With actuation, the implant is rotated into the inter-spinous space and used to forcibly separate the spinous processes.
- In another embodiment, a pin or similar anchor is placed at least partially through a first spinous process and positioned so that the distal end abuts a surface of an adjacent spinous process. The pin is used to separate the two adjacent spinous processes and maintain the increased distance between them. In another embodiment, a pin is placed into the base of the superior facet of the lower vertebra and used to limit vertebral extension by preventing the downward travel of the inferior facet of the superior vertebra. Preferably, the pin has a hollow central cavity that accommodates a bone graft or a bone graft substitute and is adapted to fuse with the surrounding bone at the insertion site of the inferior vertebra. Additional embodiments are disclosed that modify the facet joint anatomy and provide direct nerve decompression and/or a limit of vertebral extension.
- In another embodiment, an implant is attached onto at least one vertebral bone and adapted to limit the motion of the attached bone relative to an adjacent vertebra. The motion pathway permitted by the implanted is substantially curvilinear and has at least one center of rotation near the natural Instantaneous Axis of Rotation between adjacent vertebrae. Further, the implant permits greater relative motion between the adjacent vertebrae in flexion than it does in extension.
- In one aspect, there is disclosed an orthopedic device, comprising a first member adapted to be attached onto at least one vertebra arid adapted to limit the motion of the attached vertebra relative to an adjacent vertebra, wherein the first member defines a motion pathway of the attached vertebra, wherein the motion pathway is substantially curvilinear and has at least one center of rotation near a natural instantaneous axis of rotation between the attached vertebra and the adjacent vertebrae and, wherein the first member provides limited relative motion between two vertebrae such that the relative motion is greater in flexion than it is in extension.
- In another aspect, there is disclosed a method for the treatment of spinal stenosis in which an orthopedic implant is introduced into a space between the spinous processes of two adjacent vertebras using a minimally invasive surgical technique, comprising: placing two extension members into the space between two adjacent spinous processes of adjacent vertebrae, wherein the extension members are coupled to a distraction platform device capable of adjusting a distance between the extension members; using the distraction platform to separate the extension members, wherein the outer surface of each extension member is adapted to abut a spinous process of each adjacent vertebra so that separation of the extension members by the platform produces an increase in the distance between the adjacent spinous processes, wherein an inner surface of at least one extension members forms a guide channel that is adapted to guide and position an orthopedic implant into the distracted inter-spinous space; placing an orthopedic implant into the space between the two adjacent spinous processes, wherein the implant is adapted to maintain the increase in distance between the adjacent spinous processes after removal of the extension members; and removing the extension members and the distraction platform.
- In another aspect, there is disclosed a method for the treatment of spinal stenosis in which an orthopedic implant is introduced into the space between the spinous processes of two adjacent vertebrae using a minimally invasive surgical technique, comprising: positioning two extension members adjacent to, but not into, an inter-spinous space between two adjacent spinous processes, wherein the extension members are coupled to a distraction platform device capable of setting a distance between the extension members; using the distraction platform to separate the extension members, wherein the outer surface of each extension member is adapted to separate tissue adjacent to the inter-spinous space, wherein an inner surface of at least one of the extension members forms a guide channel that is adapted to guide and position an implant delivery device into the tissue adjacent to the inter-spinous space, wherein the implant is adapted to be attached onto the delivery device and be at least partially contained therein, wherein the implant delivery device is adapted to rotate the attached implant about a center point that is substantially contained within the delivery device and through an angle range of 45 to 135 degrees; deploying the implant delivery device onto the extension members, wherein the implant delivery device has an attached orthopedic implant; placing the attached orthopedic implant into the space between the two adjacent spinous processes, wherein the implant is adapted to maintain a distance between the spinous processes after removal of the extension members; and removing the delivery device, extension members and the distraction platform.
- In another aspect, there is disclosed a method for the treatment of spinal stenosis, comprising: placing a body of a pin at least partially through a first spinous process such that one end of the pin is positioned to abut a surface of a second, adjacent spinous process that faces the first spinous process; and using the pin to set and maintain a distracted space between the spinous processes.
- In yet another aspect, an orthopedic device is disclosed. In one embodiment, the device comprises a first member configured to attach onto at least one first vertebra and limit motion of the first vertebra relative to a second, adjacent vertebra. The first member defines a substantially curvilinear motion pathway of the first vertebra having at least one center of rotation near a natural instantaneous axis of rotation between the first vertebra and the second vertebra. The first member is configured to provide limited relative motion between the first vertebra and the second vertebra such that the relative motion is greater in flexion than it is in extension.
- In another aspect, an assembly for placement or an orthopedic implant within a target inter-spinous space of a spinal column is disclosed. In one embodiment, the assembly comprises: (i) an implant placement device comprising: at least a first extension member and a second extension member each of the first and second extension members comprising an elongated segment configured to extend from a proximal aspect to a distal aspect and each of the first and second extension members configured to be positioned within the target inter-spinous space at the distal aspect thereof, and a distraction mechanism configured to connect to the proximal aspect of each of the first and the second extension members, and to forcibly move the first extension member relative to the second extension member the movement configured to produce at least some expansion of the target inter-spinous space, (ii) a guide channel formed at least in part by a bore configured to extend from a proximal opening to distal opening in between the first and second extension members, and (ii) an orthopedic implant configured to be advanced at least partially through the guide channel and be positioned within the target inter-spinous space. The first and second extension members are removed from the target inter-spinous space, yet the orthopedic implant remains positioned within the inter-spinous space to maintain first and second vertebral bones of the spinal column separated by a desired distance.
- In another embodiment, the assembly comprises: (i) an implant placement device comprising: at least a first extension member and a second extension member each of the first and second extension members comprising an elongated segment configured to extend from a proximal aspect to a distal aspect and each of the first and second extension members configured to be positioned within the target inter-spinous space at the distal aspect thereof, and a distraction mechanism configured to connect to the proximal aspect of each of the first and the second extension members, and to forcibly move the first extension member relative to the second extension member the movement configured to produce at least some expansion of the target inter-spinous space, the first and second extension members thereby creating a guide channel therebetween, (ii) an elongated member configured to be slidably positioned within the guide channel during advancement of the first and second extension members towards the target inter-spinous space, the elongated member being shaped to separate tissues ahead of the advancing first and second extension members, and (iii) an orthopedic implant configured to be advanced at least partially through the guide channel and be positioned within the target inter-spinous space. The elongated member is removed prior to advancement of the orthopedic implant through the guide channel. The first and second extension members are removed from the target inter-spinous space after the advancement of the orthopedic implant.
- The implants and methods described permit treatment of spinal stenosis through a minimally invasive surgical procedure. Other features and advantages will be apparent from the following description of various embodiments, which illustrate, by way of example, the principles of the disclosed devices and methods.
-
FIG. 1 shows a perspective view of an installer device that is adapted to position an implant in the inter-spinous space between two vertebras. -
FIG. 2 shows the installer device in a distracted state. -
FIG. 3 shows the installer device with an implant at the distal region of the installer arms. -
FIG. 4 illustrates an exemplary implant placed within the inter-spinous space. -
FIGS. 5A and 5B show perspective and cross-sectional views of an implant, respectively. -
FIGS. 6A and 6B show another embodiment of an installer device without and with an exemplary imp/ant, respectively. -
FIGS. 7 A and 7B show prospective and cross-sectional views of an exemplary implant in the un-deployed state. -
FIGS. 8A and 8B show prospective and cross-sectional views of an exemplary implant in the deployed state. -
FIG. 9A shows another embodiment of an installer device and an implant delivery instrument. -
FIG. 9B shows perspective views of an implant delivery instrument. -
FIG. 10 shows the delivery instrument after actuation such that an implant has rotated to a deployment position. -
FIG. 11 shows the linkage mechanism of the implant delivery instrument. -
FIG. 12 shows the delivery instrument coupled to the installer device prior to deployment of the implant. -
FIG. 13 shows the implant in the inter-spinous space after deployment with the delivery instrument removed. -
FIG. 14A shows another embodiment of an implant. -
FIG. 14B shows an alternative application of the implant. -
FIG. 15 shows an implant positioned in a inter-spinous space with a fixation screw anchoring the implant in place. -
FIGS. 16 and 17 show perspective views of a device that is configured for placement between the spinous processes of two adjacent vertebras. -
FIGS. 18 and 19 show exploded views of the device. -
FIG. 20 shows a side, cross-sectional view of the device mounted to a pair of vertebrae. -
FIG. 21 shows a side, cross-sectional view of the device mounted to a pair of vertebrae. -
FIG. 22 shows perspective views of another embodiment in the disassembled state. -
FIG. 23 shows additional views of the assembled implant ofFIG. 22 . -
FIG. 24 shows the implant ofFIG. 22 mounted on the sacrum. -
FIG. 25 illustrates an oblique view of the mounted implant ofFIG. 24 . -
FIG. 26 shows an additional embodiment. -
FIGS. 27A and B show the implant ofFIG. 26 placed into the spinal column. -
FIG. 28A shows an additional embodiment of an orthopedic implant. -
FIG. 28B shows an additional embodiment of an orthopedic implant. -
FIG. 29A shows a lateral view of the vertebral bodies whileFIG. 29B shows the implant in place. -
FIGS. 30A and 30B show an additional embodiment of an implant. -
FIG. 31 shows perspective views of the implant. -
FIG. 32 shows the implant ofFIG. 31 placed into the spinal column. -
FIG. 1 shows a perspective view of aninstaller device 1605 that is adapted to position an orthopedic implant in the inter-spinous space between the spinous processes of two adjacent vertebras. For clarity of illustration, the vertebral bodies are represented schematically and those skilled in the art will appreciate that actual vertebral bodies include anatomical details not shown inFIG. 1 . Thedevice 1605 includes aplatform 1610 having anactuator 1615 that can be used to separate a pair ofdistraction arms platform member 1610 may include a scale for measuring the distraction distance or the distraction force. The scale can display the measured distance in a recognized physical unit or as an arbitrary designation (such as, for example, A, B, C, etc.) that is used for implant selection. - Each
distraction arm 1620 has a semi-circular inner surface so that, in the non-distracted state, thearms 1620 collectively form an interior circular conduit. A curvilinear trocar with sharpeneddistal end 1625 b and discoidproximal member 1625 a is positioned through the circular conduit formed byarms 1620. Discoidproximal member 1625 a has locking tabs on its inferior surface that interact withcomplimentary tabs 1622 ofarms 1620 and lock the trocar to the distraction arms. The sharpenedend 1625 b emerges from the distal end ofarms 1620 and, at the time of device insertion,end 1625 b divides the skin and soft tissue ahead of advancingarms 1620. Preferably, thedistraction arms 1620 are positioned into the inter-spinous space at the stenotic spinal level under x-ray guidance. The trocar is removed andactuator 1615 is rotated to separate the distraction arms and apply a distraction force upon the spinous processes of the two adjacent vertebras. -
FIG. 2 shows thedevice 1605 in a distracted state. With rotation ofactuator 1615, eachdistraction arm 1620 is forcibly driven into the spinous process of the adjacent vertebral bone producing distraction of the inter-spinous space. In an embodiment,arms 1620 are curved, although the arms can be also straight or partially curved. A pathway is formed between the separatedarms 1620 through which an implant can be driven into the inter-spinous space. The size of the needed implant is given by reading the scale alongplatform member 1610.FIG. 3 shows thedevice 1605 with anexemplary implant 1805 positioned at the distal region of thearms 1620. Theimplant 1805 is inserted into the proximal aspect of the pathway and advanced distally until it rests within the inter-spinous space. The implant is held in place by a placement handle (not shown) and the distraction arms and platform are then removed. Finally, the implant is distracted by actuating the placement handle. The implant is shown inFIG. 4 resting within the inter-spinous space. -
FIGS. 5A and 5B illustrate perspective and cross-sectional views, respectively, of theimplant 1805. Theimplant 1805 includes afirst piece 1905 and asecond piece 1910 that are movably attached to one another. A pair of wedge-shapedbearing members 1915 form a bearing surface between the twopieces pieces 1905 haverespective shoulders 1925 that abut one another to guide and limit relative movement there between. The bearingmembers 1915 and theshoulders 1925 guide movement between the twopieces implant 1805. The implant can be initially delivered into the inter-spinous space in a state of reduces size and then transitioned to the state of enlarged size after it is positioned within the inter-spinous space. -
FIGS. 6A and 6B show another embodiment of aninstaller device 2105. Thedevice 2105 includes aplatform 2110 having anactuator 2115 that can be used to separate a pair ofdistractor arms 2120. In this embodiment, the distractor arms are straight. As discussed below, thearms 2110 can be used as a guide for positioning animplant 2205 into the inter-spinous space (FIG. 6B )FIGS. 7A and 78 show perspective and cross-sectional views of anexemplary implant 2205 in the un-deployed state.Implant 2205 contains at least longitudinal tract 2207 that interacts with the inner aspect ofarms 2210. Theimplant 2205 includes first andsecond members members arias 2220 are moved to a position that extends outwardly from theimplant 2205. The arms can be moved to the extended position after implantation in the inter-spinous space. -
FIGS. 8A and 8B show perspective and cross-sectional views of anexemplary implant 2205 in the deployed state. Note that thedistal arms 2220 have a bearing articulation with the deploying portion ofmember 2210 while theproximal arms 2220 have a deformable base that is integrally attached tomember 2210. Either mechanism may be employed on any of mountedarms 2220. -
FIG. 9A illustrates an additional embodiment. A distraction platform with straight distraction arms is percutaneously positioned under x-ray guidance. The arms are placed lateral to the inter-spinous space. A delivery instrument 2303 is attached to the implant and used to place the implant into the inter-spinous space.FIG. 9B shows perspective views of thedelivery instrument 2302. In the illustrated embodiment, theinstrument 2302 includes a two-piece handle having afirst arm 2310 and asecond arm 2320 that is movably mounted relative to the first arm 231 b in a pivot or trigger fashion. The first and second arms are ergonomically arranged such that an operator can grasp the arms using a single hand. For example, thefirst arm 2310 is sized and shaped to support an operator's palm and thumb such as on athumb grip 2322. Likewise, the second arm 320 can be grasped by the operator's fingers to pull thesecond arm 2320 toward thefirst au u 2310 and actuate theinstrument 2302. A biasingmember 2325 is interposed between the first and second arms. It should be appreciated that the instrument can be actuated with other mechanisms and need not use a two-piece handle configuration. - With reference still to
FIG. 9B , ahousing 2311 extends outward from the handle. Thehousing 2311 is sized and shaped to contain theimplant 2205. In the illustrated embodiment, thehousing 2311 has an elongated, tube-like shape and is partially hollow so as to contain theimplant 2205 as well as an internal actuation mechanism that expels the implant from the housing. Aslot 2330 is located at or near a distal end of thehousing 2311. The slot communicates with an internal cavity in thehousing 2311 in which theimplant 2205 resides. The slot is sufficiently long and wide such that theimplant 2205 can pass through the slot during deployment of the implant.FIG. 10 illustrates the internal mechanism of the placement device.FIG. 11 shows theinstrument 2302 after actuation such that theimplant 2205 has rotated (as represented by the arrow R) to a deployment position. -
FIG. 12 shows thedelivery instrument 2302 coupled to theinstaller device 2105 prior to deployment of theimplant 2205. Theelongated housing 2311 is placed in between thedistractor arms 2120 such that a distal end of thehousing 2311 is lateral to the inter-spinous space between the vertebrae. The delivery instrument is then actuated to rotate theimplant 2205 into the inter-spinous space.FIG. 13 shows theimplant 2205 in the inter-spinous space after removal ofdelivery instrument 2302. -
FIG. 14A shows another embodiment of an implant. In this embodiment, the implant comprises a curved pin orscrew 2805 that is sized and shaped to be passed through the spinous process of a vertebrae. Thescrew 2805 has a curved contour that permits a portion of the screw to extend through the spinous process with a distal region of the screw extending through the inter-spinous space. A proximal end of thescrew 2805 is positioned at the exterior of the spinous process. The distal end of thescrew 2805 abuts a surface of the spinous process of the adjacent vertebra. The pin may be at least partially comprised of a bone graft or bone graft substitute so as to fuse with the spinous process in which it is embedded. The pin maybe embedded in a first spinous process and abut a second spinous process, as shown inFIG. 14A , or it may be alternatively embedded in the second spinous process and abut the first spinous process, as shown inFIG. 14B . -
FIG. 15 shows an implant positioned in an inter-spinous space and affixed to the spine with afixation screw 3010. Theimplant 3005 is positioned within the disc space such that outer surface of the implant abuts adjacent vertebrae. Afixation screw 3010 extends through the spinous process and into theimplant 3005. The screw may be at least partially comprised of a bone graft or bone graft substitute so as to fuse with the spinous process in which it is embedded. If the interior aspect ofimplant 3005 is also at least partially comprised of a bone graft or bone graft substitute, then screw 3010 can fuse with both the spinous process andimplant 3005. This provides a bone bridge between theimplant 3005 and the spinous process without direct fusion of the implant onto the spinous process. -
FIGS. 16 and 17 show perspective views of a device 105 that is configured for placement between the spinous processes of two adjacent vertebral bodies. The device 105 includes a spacer region or central region 110 that is sized and shaped to fit between the spinous processes of the two adjacent vertebral bodies. The device 105 further includes a pair ofattachment members 115 that are adapted to attach and anchor onto the spinous process of at least one of the vertebral bodies. The central region 110 can have a variety of shapes and sizes for placement between the spinous processes. Theattachment members 115 can also have various sizes and shapes for attachment to the spinous processes. -
FIGS. 18 and 19 show exploded views of the device 105. The device 105 includesattachment members 115 that are adapted to attach and anchor onto the spinous process of at least one of the vertebral bodies. Eachattachment member 115 has a pair of downwardly-extendingaims 305 that are sized to receive a spinous process therebetween. An upper portion of theattachment member 115 is sized and shaped to sit over the spinous process. The upper portion has a borehole that is sized to receive a threadedscrew 410 during implantation: A lockingmechanism 415 can be within the attachment,member 115 to serves to prevent unwanted movement and/or back out of thescrew 410. While illustrated as a locking cam, thelocking mechanism 415 may include any locking mechanism known in the art. - A
first bearing member 425 has a rounded articulating surface that is adapted to interact with a complimentary articulating surface on asecond bearing member 430. Themember 425 is sized and shaped to be received in a cavity inside themember 430 so as to permit at least some rotational movement therebetween. Athird bearing member 440 is at least partially dome-shaped and is adapted to couple to themembers member 440 mates with themember 430 such as through a threaded engagement. - With reference still to
FIGS. 18 and 19 ,member 430 includes aprotrusion 445 that is sized and shaped to mate with anindentation 450 in themember 425. In the assembled device, the interaction ofprotrusion 445 andindentation 450 serves to limit the amount of rotation and lateral flexion between themembers -
FIG. 20 shows a side, cross-sectional views of the device mounted to a pair of vertebrae. Themembers 115 can be coupled to one another by mating themember 425 beneath themember 430 such that articulating surfaces abut one another and permit rotational movement therebetween. Themember 440 is positioned below themember 430 and secured thereto such as in a threaded relationship. This retains the device in the assembled state. -
FIG. 21 shows an enlarged, cross-sectional view of the device in the assembled state and mounted between vertebrae. Themember 425 has a roundedsurface 605. Thesurface 605 interacts with a complimentaryrounded surface 610 on themember 430. Aspace 630 is formed when themember 440 is secured onto themember 430. Themember 425 resides within thespace 630 in the assembled device. Thespace 630 permits a certain amount of “play” between the articulation ofmembers space 630 contains a malleable member that keepsmembers - In addition, the
curvilinear surfaces FIG. 20 ). That is, thesurfaces protrusion 445 andindentation 450 allows a variable degree of rotational movements of one vertebral body relative to the other. The extent of rotation and lateral flexion permitted is dependant on the degree of flexion of the vertebral bodies. That is, with the vertebral bodies in flexion, the extent of rotation and lateral flexion permitted by the device is greater that amount of 14 rotation and lateral flexion that is permitted when the vertebral bodies are in extension. This feature reproduces the natural motion characteristics between the vertebral bodies. -
FIG. 22 illustrates perspective views ofdevice 3305 in the disassembled state.FIG. 23 shows sectional views of the assembleddevice 3305. Threadedwall 3320 surroundscentral cavity 3315 and contains multiple full thickness bore holes 3325. The distal aspect ofwall 3320 containsinterior threads 3340 that couple withcomplimentary threads 3520 ofdistal member 3510. Thecentral cavity 3315 is adapted to house a bone graft or bone graft substitute and permit fusion between the bone graft withincavity 3315 and the vertebral bone surrounding the outer aspect ofdevice 3305. After placement of bone graft material withincavity 3315,distal member 3510 is screwed ontodevice 3305. The fusion forms across bore holes 3325. - The proximal aspect of
device 3305 contains hexagonal cut out 3360. Cut out 3360 is adapted to accept a hex screw driver and the latter is used to drivedevice 3305 into bone. The proximal aspect ofdevice 3305 contains at least oneflap 3605 that is movably attached todevice 3305. When a force is applied to the proximal aspect ofdevice 3305,flap 3605 transiently and reversibly moves towards the center line of the device. In this way,flap 3605 functions as a malleable member and imparts a spring-like quality to the proximal aspect ofdevice 3305. - In use, the
central cavity 3315 is filed with a bone graft anddistal member 3510 is threaded ontodevice 3305. Once assembled,distal member 3510 is rigidly attached to 3305. Under x-ray guidance, the device is percutaneously driven into the base of the superior articulating surface of the lower vertebral body and abuts the inferior surface of the inferior articulating surface of the superior vertebra. Preferably, a single device is used on each side of the vertebral midline, so that twodevices 3305 are used at each stenotic level. The devices are shown attached to bone inFIGS. 24 and 25 . As illustrated, eachdevice 3305 limits the downward travel of the inferior articulating surface of the superior vertebra and limits the degree of extension at that spinal level. With time the bone contained withincavity 3315 will fuse with the adjacent bone and rigidly anchor the device to the vertebra. Because of the fusion the device does not to be anchored into the pedicle portion of the vertebra and it can be short in length. -
FIG. 26 illustratesdevice 3705. The device is intended to reside within the facet joint and be anchored onto one, but not both, of the adjacent vertebras. The device may be affixed onto the vertebral bone using pins and a bone screw or the device may be at least partially comprised of a bone graft or bone graft substitute so as to fuse onto the adjacent bone. The device may be coated/made with osteo-conductive (such as deminerized bone matrix, hydroxyapatite, and the like) and/or osteo-inductive (such as Transforming Growth Factor “TGF-B,” Platelet-Derived Growth Factor “PDGF,” BoneMorphogenic Protein “BMP,” and the like) bio-active materials that promote bone formation. Further, one or more surfaces may be made with a porous ingrowth surface (such as titanium wire mesh, plasma-sprayed titanium, tantalum, Porous CoCr, and the like), provided with a bioactive coating, made using tantalum, and/or helical rosette carbon nanotubes (or other carbon nanotube-based coating) in order to promote bone in-growth or establish a mineralized connection between the bone and the implant. - The device is shown anchored to bone in
FIGS. 27A and 27B . It is intended to at least partially replace the function of a natural facet joint that been at least partially removed at surgery. It may alternatively be used within an intact but degenerated facet joint to reestablish a functional articulation.FIG. 28A shows an additional embodiment of anorthopedic implant 705 positioned on two vertebral bodies of the lumbar spine. Theimplant 705 is attached onto the superior articulating surface and lamina of the lower vertebra and functions to stop the downward movement of the inferior articulating surface of the upper vertebral body. In this way, the device stops the extension of the two vertebral bodies and keeps them in relative flexion. The device can include contains one or more bore holes through which one or more screws are passed and anchored onto the underlying bone. As shown, the inferior aspect of the lamia of the upper vertebra is preferably removed (laminotomy) to decompress the nerve elements prior to device placement. -
FIG. 28B shows an additional embodiment of anorthopedic implant 805 positioned on two vertebral bodies of the lumbar spine. Theimplant 805 is attached onto the superior articulating surface and lamina of the lower vertebra and transverses the facet joint between the two vertebral bodies. The superior surface of the device abuts the inferior aspect of the pedicle of the upper vertebral body. The implant functions to stop the extension of the two vertebral bodies and keeps them in relative flexion. Theimplant 805 can contain one or more bore holes through which screws are passed and anchored onto the underlying bone.FIG. 29A shows a lateral view of the vertebral bodies andFIG. 29B shows theimplant 805 in place. Note that implant placement will necessarily place the lower articulating surface of the upper vertebral body more posteriorly and at least partially realign an anterior spondylolisthesis. -
FIGS. 30A and 30B show an additional embodiment of animplant 1305. In an embodiment, theimplant 1305 is a “c” shaped implant.FIG. 31 shows perspective views of theimplant 1305. Theimplant 1305 functions to separate the top of the superior articular surface of the inferior body from the inferior aspect of the pedicle of the upper vertebral body. Theimplant 1305 has a size and shape such that the opening of the “C” can be positioned over at least a portion of the vertebral body. In an embodiment, a separate attachment device is not used to attach theimplant 1305 to bone. In another embodiment, theimplant 1305 contain one or more bore holes through which screws are passed and anchored onto the underlying bone.FIG. 32 shows theimplant 1305 positioned on the bone. - The disclosed devices or any of their components can be made of any biologically adaptable or compatible materials. Materials considered acceptable for biological implantation are well known and include, but are not limited to, stainless steel, titanium, tantalum, combination metallic alloys, various plastics, resins, ceramics, biologically absorbable materials and the like. Any components may be also coated/made with osteo-conductive (such as deminerized bone matrix, hydroxyapatite, and the like) and/or osteo-inductive (such as Transforming Growth Factor “TGF-B,” Platelet-Derived Growth Factor “PDGF,” Bone-Morphogenic Protein “BMP,” and the like) bio-active materials that promote bone formation. Further, any surface may be made with a porous ingrowth surface (such as titanium wire mesh, plasma-sprayed titanium, tantalum, porous CoCr, and the like), provided with a bioactive coating, made using tantalum, and/or helical rosette carbon nanotubes (or other carbon nanotube-based coating) in order to promote bone in-growth or establish a mineralized connection between the bone and the implant, and reduce the likelihood of implant loosening. Lastly, the system or any of its components can also be entirely or partially made of a shape memory material or other deformable material.
- Although embodiments of various methods and devices are described herein in detail with reference to certain versions, it should be appreciated that other versions, embodiments, methods of use, and combinations thereof are also possible. Therefore the spirit and scope of the appended claims should not be limited to the description of the embodiments contained herein.
Claims (22)
1.-10. (canceled)
11. An orthopedic device, comprising:
a first member configured to attach onto at least one first vertebra and limit motion of said first vertebra relative to a second, adjacent vertebra;
wherein said first member defines a substantially curvilinear motion pathway of said first vertebra having at least one center of rotation near a natural instantaneous axis of rotation between said first vertebra and said second vertebra; and
wherein said first member is configured to provide limited relative motion between said first vertebra and said second vertebra such that said relative motion is greater in flexion than in extension.
12. The device of claim 11 , wherein said first member is configured to attach onto at least one spinous process of said first vertebra.
13. An assembly for placement of an orthopedic implant within a target inter-spinous space of a spinal column, said assembly comprising:
an implant placement device comprising:
at least a first extension member and a second extension member, each of said first and second extension members comprising an elongated segment configured to extend from a proximal aspect to a distal aspect, and each of said first and second extension members configured to be positioned within said target inter-spinous space at said distal aspect thereof; and
a distraction mechanism configured to connect to said proximal aspect of each of said first and said second extension members, and to forcibly move said first extension member relative to said second extension member, said movement configured to produce at least some expansion of said target inter-spinous space;
a guide channel formed at least in part by a bore configured to extend from a proximal opening to distal opening in between said first and second extension members; and
an orthopedic implant configured to be advanced at least partially through said guide channel and be positioned within said target inter-spinous space;
wherein said first and second extension members are removed from said target inter-spinous space, yet said orthopedic implant remains positioned within said inter-spinous space to maintain first and second vertebral bones of said spinal column separated by a desired distance.
14. The assembly of claim 13 , wherein a surface of said first extension member is configured to form at least a portion of said guide channel used for orthopedic implant placement.
15. The assembly of claim 13 , wherein a surface of said second extension member is configured to form at least a portion of said guide channel used for orthopedic implant placement.
16. The assembly of claim 13 , wherein said first extension member extends away from said distraction mechanism along a curvilinear trajectory.
17. The assembly of claim 13 , wherein said second extension member extends away from said distraction mechanism along a curvilinear trajectory.
18. The assembly of claim 13 , wherein said guide channel extends from a proximal end to a distal end along a curvilinear trajectory.
19. The assembly of claim 13 , further comprising an elongated member configured to be slidably positioned within said guide channel during advancement of said first and second extension members towards said target inter-spinous space, said elongated member being shaped to separate tissues ahead of said advancing first and second extension members.
20. The assembly of claim 19 , wherein said elongated member is configured to be removed from between said first and second extension members prior to advancement of said orthopedic implant through said guide channel.
21. The assembly of claim 13 , wherein said orthopedic implant comprises at least two segments configured to be movable relative to one another.
22. The assembly of claim 13 , wherein said orthopedic implant is adapted to transition from a first size to a second, larger size after advancement into said target inter-spinous space.
23. An assembly for placement or an orthopedic implant within a target inter-spinous space of a spinal column, said assembly comprising:
an implant placement device comprising:
at least a first extension member and a second extension member each of said first and second extension members comprising an elongated segment configured to extend from a proximal aspect to a distal aspect and each of said first and second extension members configured to be positioned within said target inter-spinous space at said distal aspect thereof; and
a distraction mechanism configured to connect to said proximal aspect of each of said first and said second extension members, and to forcibly move said first extension member relative to said second extension member said movement configured to produce at least some expansion of said target inter-spinous space, said first and second extension members thereby creating a guide channel therebetween;
an elongated member configured to be slidably positioned within said guide channel during advancement of said first and second extension members towards said target inter-spinous space, said elongated member being shaped to separate tissues ahead of said advancing first and second extension members; and
an orthopedic implant configured to be advanced at least partially through said guide channel and be positioned within said target inter-spinous space;
wherein said elongated member is configured to be removed prior to advancement of said orthopedic implant through said guide channel; and
wherein said first and second extension members are configured to be removed from said target inter-spinous space after said advancement of said orthopedic implant.
24. The assembly of claim 23 , wherein said implant placement device further comprises an actuatable mechanism configured to couple to a proximal segment of each of said first and second extension members, and to reversibly change a distance between said first and second extension members and thus a size of said guide channel.
25. The assembly of claim 24 , wherein actuation of said actuatable mechanism produces at least some movement of a spinous process of a first vertebral bone relative to a spinous process of a second vertebral bone, said target inter-spinous space being located between said first and second vertebral bones.
26. The assembly of claim 24 , wherein said implant placement device further comprises an indicia of a value of a distraction force delivered to said first and second extension members by said actuatable mechanism.
27. The assembly of claim 24 , wherein said implant placement device further comprises an indicia of a distance between said first and second extension members.
28. The assembly of claim 24 , wherein said implant placement device further comprises an indicia of a size of an implant appropriate for placement into said target inter-spinous space.
29. The assembly of claim 23 , wherein said guide channel is formed at least in part by a surface of said first extension member or a surface of said second extension member.
30. The assembly of claim 23 , wherein said orthopedic implant further comprises at least two segments configured to move relative to one another.
31. The assembly of claim 23 , wherein said orthopedic implant is configured to expand in size after advancement into said target inter-spinous space.
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US13/669,294 US20130123849A1 (en) | 2006-07-27 | 2012-11-05 | Devices and methods for the minimally invasive treatment of spinal stenosis |
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US83420906P | 2006-07-27 | 2006-07-27 | |
US83400306P | 2006-07-28 | 2006-07-28 | |
US86094206P | 2006-11-24 | 2006-11-24 | |
US11/881,584 US8303630B2 (en) | 2006-07-27 | 2007-07-27 | Devices and methods for the minimally invasive treatment of spinal stenosis |
US13/669,294 US20130123849A1 (en) | 2006-07-27 | 2012-11-05 | Devices and methods for the minimally invasive treatment of spinal stenosis |
Related Parent Applications (1)
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Cited By (11)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
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US10543107B2 (en) | 2009-12-07 | 2020-01-28 | Samy Abdou | Devices and methods for minimally invasive spinal stabilization and instrumentation |
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Families Citing this family (76)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US7578834B2 (en) * | 2004-05-03 | 2009-08-25 | Abdou M S | Devices and methods for the preservation of spinal prosthesis function |
WO2005122922A2 (en) * | 2004-06-14 | 2005-12-29 | Abdou M S | Occipital fixation system and method of use |
US7641690B2 (en) | 2004-08-23 | 2010-01-05 | Abdou M Samy | Bone fixation and fusion device |
WO2006041963A2 (en) * | 2004-10-05 | 2006-04-20 | Abdou M S | Devices and methods for inter-vertebral orthopedic device placement |
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US8105382B2 (en) | 2006-12-07 | 2012-01-31 | Interventional Spine, Inc. | Intervertebral implant |
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US9265532B2 (en) | 2007-01-11 | 2016-02-23 | Lanx, Inc. | Interspinous implants and methods |
US9247968B2 (en) | 2007-01-11 | 2016-02-02 | Lanx, Inc. | Spinous process implants and associated methods |
US7842074B2 (en) * | 2007-02-26 | 2010-11-30 | Abdou M Samy | Spinal stabilization systems and methods of use |
US7799058B2 (en) * | 2007-04-19 | 2010-09-21 | Zimmer Gmbh | Interspinous spacer |
US8075593B2 (en) * | 2007-05-01 | 2011-12-13 | Spinal Simplicity Llc | Interspinous implants and methods for implanting same |
US8142479B2 (en) * | 2007-05-01 | 2012-03-27 | Spinal Simplicity Llc | Interspinous process implants having deployable engagement arms |
US8900307B2 (en) | 2007-06-26 | 2014-12-02 | DePuy Synthes Products, LLC | Highly lordosed fusion cage |
US9561060B2 (en) * | 2007-11-02 | 2017-02-07 | Zimmer Biomet Spine, Inc. | Interspinous implants with adjustable height spacer |
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US8252029B2 (en) * | 2008-02-21 | 2012-08-28 | Zimmer Gmbh | Expandable interspinous process spacer with lateral support and method for implantation |
US8343190B1 (en) | 2008-03-26 | 2013-01-01 | Nuvasive, Inc. | Systems and methods for spinous process fixation |
CA2720580A1 (en) | 2008-04-05 | 2009-10-08 | Synthes Usa, Llc | Expandable intervertebral implant |
DE102008032685B4 (en) * | 2008-07-04 | 2016-06-23 | Aesculap Ag | Implant for mutual support of spinous processes of vertebral bodies |
US20100016906A1 (en) * | 2008-07-21 | 2010-01-21 | Abdou M Samy | Device and method to access the anterior column of the spine |
ES2574302T3 (en) * | 2008-08-08 | 2016-06-16 | Alphatec Spine, Inc. | Device for spinous process |
US20100087923A1 (en) * | 2008-08-23 | 2010-04-08 | Abdou M Samy | Implants for facet joint repair and methods use |
US8172878B2 (en) * | 2008-08-27 | 2012-05-08 | Yue James J | Conical interspinous apparatus and a method of performing interspinous distraction |
WO2010025408A2 (en) * | 2008-08-28 | 2010-03-04 | Synthes Usa, Llc | Bone-derived interspinous spacer |
US20100087858A1 (en) * | 2008-09-18 | 2010-04-08 | Abdou M Samy | Dynamic connector for spinal stabilization and method of use |
US8292923B1 (en) | 2008-10-13 | 2012-10-23 | Nuvasive, Inc. | Systems and methods for treating spinal stenosis |
US8021393B2 (en) * | 2008-12-12 | 2011-09-20 | Globus Medical, Inc. | Lateral spinous process spacer with deployable wings |
US9757164B2 (en) | 2013-01-07 | 2017-09-12 | Spinal Simplicity Llc | Interspinous process implant having deployable anchor blades |
US9861399B2 (en) | 2009-03-13 | 2018-01-09 | Spinal Simplicity, Llc | Interspinous process implant having a body with a removable end portion |
US9526620B2 (en) | 2009-03-30 | 2016-12-27 | DePuy Synthes Products, Inc. | Zero profile spinal fusion cage |
CA2751288A1 (en) | 2009-04-13 | 2010-10-21 | Rlt Healthcare, Llc | Interspinous spacer and facet joint fixation device |
US9149305B2 (en) * | 2009-10-14 | 2015-10-06 | Latitude Holdings, Llc | Spinous process fixation plate and minimally invasive method for placement |
US8795335B1 (en) * | 2009-11-06 | 2014-08-05 | Samy Abdou | Spinal fixation devices and methods of use |
US9393129B2 (en) | 2009-12-10 | 2016-07-19 | DePuy Synthes Products, Inc. | Bellows-like expandable interbody fusion cage |
US20110160772A1 (en) * | 2009-12-28 | 2011-06-30 | Arcenio Gregory B | Systems and methods for performing spinal fusion |
DE102010000231A1 (en) | 2010-01-27 | 2011-07-28 | Aesculap AG, 78532 | Implant for the mutual support of spinous processes of adjacent vertebral bodies and surgical system |
DE102010000230A1 (en) | 2010-01-27 | 2011-07-28 | Aesculap AG, 78532 | Surgical instruments |
US9101409B2 (en) * | 2010-03-09 | 2015-08-11 | National University Corporation Kobe University | Inter-spinous process implant |
US8409287B2 (en) * | 2010-05-21 | 2013-04-02 | Warsaw Orthopedic, Inc. | Intervertebral prosthetic systems, devices, and associated methods |
USD643115S1 (en) | 2010-06-04 | 2011-08-09 | Entrigue Surgical, Inc. | Insertion device |
US9907560B2 (en) | 2010-06-24 | 2018-03-06 | DePuy Synthes Products, Inc. | Flexible vertebral body shavers |
US8979860B2 (en) | 2010-06-24 | 2015-03-17 | DePuy Synthes Products. LLC | Enhanced cage insertion device |
AU2011271465B2 (en) | 2010-06-29 | 2015-03-19 | Synthes Gmbh | Distractible intervertebral implant |
US8758412B2 (en) | 2010-09-20 | 2014-06-24 | Pachyderm Medical, L.L.C. | Integrated IPD devices, methods, and systems |
US9402732B2 (en) * | 2010-10-11 | 2016-08-02 | DePuy Synthes Products, Inc. | Expandable interspinous process spacer implant |
US8496689B2 (en) | 2011-02-23 | 2013-07-30 | Farzad Massoudi | Spinal implant device with fusion cage and fixation plates and method of implanting |
US8425560B2 (en) | 2011-03-09 | 2013-04-23 | Farzad Massoudi | Spinal implant device with fixation plates and lag screws and method of implanting |
BR112013024167A2 (en) * | 2011-03-23 | 2016-12-06 | Alphatec Spine Inc | expandable intercorporate spacer |
US8926661B2 (en) | 2011-06-02 | 2015-01-06 | Smith & Nephew, Inc. | Surgical fastening |
USD757943S1 (en) | 2011-07-14 | 2016-05-31 | Nuvasive, Inc. | Spinous process plate |
US8882805B1 (en) | 2011-08-02 | 2014-11-11 | Lawrence Maccree | Spinal fixation system |
US8685096B2 (en) * | 2011-08-23 | 2014-04-01 | Amendia, Inc. | Lumbar fusion device |
US11812923B2 (en) | 2011-10-07 | 2023-11-14 | Alan Villavicencio | Spinal fixation device |
US9693876B1 (en) | 2012-03-30 | 2017-07-04 | Ali H. MESIWALA | Spinal fusion implant and related methods |
US10448977B1 (en) | 2012-03-31 | 2019-10-22 | Ali H. MESIWALA | Interspinous device and related methods |
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US9198697B2 (en) | 2013-03-13 | 2015-12-01 | Globus Medical, Inc. | Spinous process fixation system and methods thereof |
US9522070B2 (en) | 2013-03-07 | 2016-12-20 | Interventional Spine, Inc. | Intervertebral implant |
WO2015073397A1 (en) | 2013-11-13 | 2015-05-21 | Thixos Llc | Devices, kits and methods relating to treatment of facet joints |
US10123813B2 (en) | 2014-02-17 | 2018-11-13 | Smith & Nephew, Inc. | Drill guide |
US11426290B2 (en) | 2015-03-06 | 2022-08-30 | DePuy Synthes Products, Inc. | Expandable intervertebral implant, system, kit and method |
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US11596523B2 (en) | 2016-06-28 | 2023-03-07 | Eit Emerging Implant Technologies Gmbh | Expandable and angularly adjustable articulating intervertebral cages |
US10398563B2 (en) | 2017-05-08 | 2019-09-03 | Medos International Sarl | Expandable cage |
US11344424B2 (en) | 2017-06-14 | 2022-05-31 | Medos International Sarl | Expandable intervertebral implant and related methods |
US11931269B2 (en) * | 2017-07-10 | 2024-03-19 | Xtant Medical, Inc. | Delivery systems for interspinous, interlaminar stabilization devices and methods of use |
US11446156B2 (en) | 2018-10-25 | 2022-09-20 | Medos International Sarl | Expandable intervertebral implant, inserter instrument, and related methods |
US10722380B1 (en) * | 2019-02-04 | 2020-07-28 | Bret Michael Berry | Laterally expandable spinal implant |
US11426286B2 (en) | 2020-03-06 | 2022-08-30 | Eit Emerging Implant Technologies Gmbh | Expandable intervertebral implant |
US11850160B2 (en) | 2021-03-26 | 2023-12-26 | Medos International Sarl | Expandable lordotic intervertebral fusion cage |
US11752009B2 (en) | 2021-04-06 | 2023-09-12 | Medos International Sarl | Expandable intervertebral fusion cage |
Citations (11)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4899761A (en) * | 1988-03-31 | 1990-02-13 | Brown Mark D | Apparatus and method for measuring spinal instability |
US20010021850A1 (en) * | 1997-01-02 | 2001-09-13 | St. Francis Medical Technologies, Inc. | Spine distraction implant |
US20020165550A1 (en) * | 1999-10-21 | 2002-11-07 | George Frey | Devices and techniques for a posterior lateral disc space approach |
US6599294B2 (en) * | 1999-01-30 | 2003-07-29 | Aesculap Ag & Co. Kg | Surgical instrument for introducing intervertebral implants |
US20040030346A1 (en) * | 1999-10-21 | 2004-02-12 | George Frey | Devices and techniques for a posterior lateral disc space approach |
US20050021040A1 (en) * | 2003-07-21 | 2005-01-27 | Rudolf Bertagnoli | Vertebral retainer-distracter and method of using same |
US20050283245A1 (en) * | 2003-08-05 | 2005-12-22 | Gordon Charles R | Method of insertion of an expandable intervertebral implant using a tool |
US20060195102A1 (en) * | 2005-02-17 | 2006-08-31 | Malandain Hugues F | Apparatus and method for treatment of spinal conditions |
US20080177312A1 (en) * | 2006-12-28 | 2008-07-24 | Mi4Spine, Llc | Interspinous Process Spacer Device |
US20090216234A1 (en) * | 2006-11-03 | 2009-08-27 | Innovative Spine | Spinal Access Systems and Methods |
US7922750B2 (en) * | 2006-11-30 | 2011-04-12 | Paradigm Spine, Llc | Interlaminar-interspinous vertebral stabilization system |
Family Cites Families (206)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US2248054A (en) * | 1939-06-07 | 1941-07-08 | Becker Joseph | Screw driver |
US2774350A (en) | 1952-09-08 | 1956-12-18 | Jr Carl S Cleveland | Spinal clamp or splint |
US3090386A (en) * | 1961-07-20 | 1963-05-21 | Curtis Scott Company | Surgical suturing instrument |
US3659595A (en) * | 1969-10-22 | 1972-05-02 | Edward J Haboush | Compensating plates for bone fractures |
NL7306853A (en) * | 1973-05-16 | 1974-11-19 | ||
US4037592A (en) * | 1976-05-04 | 1977-07-26 | Kronner Richard F | Guide pin locating tool and method |
US4289123A (en) | 1980-03-31 | 1981-09-15 | Dunn Harold K | Orthopedic appliance |
US4569662A (en) * | 1981-10-26 | 1986-02-11 | Dragan William B | Bulk cartridge for packaging and dispensing a dental material |
US4580563A (en) * | 1983-10-24 | 1986-04-08 | Gross R Michael | Arthroscopic surgical instrument and method |
US4722331A (en) * | 1985-09-03 | 1988-02-02 | Fox James M | Orthopaedic tool guide |
US4790303A (en) | 1987-03-11 | 1988-12-13 | Acromed Corporation | Apparatus and method for securing bone graft |
US5484437A (en) * | 1988-06-13 | 1996-01-16 | Michelson; Gary K. | Apparatus and method of inserting spinal implants |
US4903692A (en) * | 1989-05-08 | 1990-02-27 | Reese Hewitt W | Bone clamp installation tool |
FR2657774B1 (en) * | 1990-02-08 | 1992-05-22 | Sofamor | SACRED TAKING SHOE FOR A SPINAL OSTEOSYNTHESIS DEVICE. |
WO1993000868A1 (en) | 1991-07-04 | 1993-01-21 | Earl Ronald Owen | Tubular surgical implant |
US5545228A (en) | 1991-08-15 | 1996-08-13 | Smith & Nephew Richards Inc. | Offset bone bolt |
US5275601A (en) * | 1991-09-03 | 1994-01-04 | Synthes (U.S.A) | Self-locking resorbable screws and plates for internal fixation of bone fractures and tendon-to-bone attachment |
US5254118A (en) | 1991-12-04 | 1993-10-19 | Srdjian Mirkovic | Three dimensional spine fixation system |
US5360429A (en) | 1992-02-20 | 1994-11-01 | Jbs Societe Anonyme | Device for straightening, fixing, compressing, and elongating cervical vertebrae |
US5171279A (en) | 1992-03-17 | 1992-12-15 | Danek Medical | Method for subcutaneous suprafascial pedicular internal fixation |
FR2693364B1 (en) * | 1992-07-07 | 1995-06-30 | Erpios Snc | INTERVERTEBRAL PROSTHESIS FOR STABILIZING ROTATORY AND FLEXIBLE-EXTENSION CONSTRAINTS. |
US5484440A (en) * | 1992-11-03 | 1996-01-16 | Zimmer, Inc. | Bone screw and screwdriver |
US5545164A (en) | 1992-12-28 | 1996-08-13 | Advanced Spine Fixation Systems, Incorporated | Occipital clamp assembly for cervical spine rod fixation |
US5413576A (en) * | 1993-02-10 | 1995-05-09 | Rivard; Charles-Hilaire | Apparatus for treating spinal disorder |
US5354292A (en) | 1993-03-02 | 1994-10-11 | Braeuer Harry L | Surgical mesh introduce with bone screw applicator for the repair of an inguinal hernia |
US5531745A (en) * | 1993-03-11 | 1996-07-02 | Danek Medical, Inc. | System for stabilizing the spine and reducing spondylolisthesis |
US5334205A (en) | 1993-06-30 | 1994-08-02 | The United States Of America As Represented By The Secretary Of The Air Force | Sacroiliac joint fixation guide |
FR2709246B1 (en) | 1993-08-27 | 1995-09-29 | Martin Jean Raymond | Dynamic implanted spinal orthosis. |
US5330468A (en) * | 1993-10-12 | 1994-07-19 | Burkhart Stephen S | Drill guide device for arthroscopic surgery |
US5558674A (en) | 1993-12-17 | 1996-09-24 | Smith & Nephew Richards, Inc. | Devices and methods for posterior spinal fixation |
US5616142A (en) * | 1994-07-20 | 1997-04-01 | Yuan; Hansen A. | Vertebral auxiliary fixation device |
FR2722980B1 (en) * | 1994-07-26 | 1996-09-27 | Samani Jacques | INTERTEPINOUS VERTEBRAL IMPLANT |
DE19509332C1 (en) | 1995-03-15 | 1996-08-14 | Harms Juergen | Anchoring element |
JP3718233B2 (en) | 1995-11-30 | 2005-11-24 | ジンテーズ アクチエンゲゼルシャフト クール | Bone fixation device |
AU1352097A (en) * | 1995-12-22 | 1997-07-17 | Ohio Medical Instrument Company, Inc. | Spinal fixation device with laterally attachable connectors |
DE29606468U1 (en) | 1996-04-09 | 1997-08-07 | Link Waldemar Gmbh Co | Spinal fixator |
US5681312A (en) | 1996-05-31 | 1997-10-28 | Acromed Corporation | Spine construct with band clamp |
US6117135A (en) | 1996-07-09 | 2000-09-12 | Synthes (U.S.A.) | Device for bone surgery |
FR2757761B1 (en) * | 1996-12-27 | 1999-08-20 | Stryker France Sa | SPINE OTEOSYNTHESIS SYSTEM WITH POSITION ADJUSTMENT |
US7101375B2 (en) | 1997-01-02 | 2006-09-05 | St. Francis Medical Technologies, Inc. | Spine distraction implant |
US6156038A (en) * | 1997-01-02 | 2000-12-05 | St. Francis Medical Technologies, Inc. | Spine distraction implant and method |
US5836948A (en) | 1997-01-02 | 1998-11-17 | Saint Francis Medical Technologies, Llc | Spine distraction implant and method |
US6695842B2 (en) * | 1997-10-27 | 2004-02-24 | St. Francis Medical Technologies, Inc. | Interspinous process distraction system and method with positionable wing and method |
US6451019B1 (en) | 1998-10-20 | 2002-09-17 | St. Francis Medical Technologies, Inc. | Supplemental spine fixation device and method |
US6039761A (en) * | 1997-02-12 | 2000-03-21 | Li Medical Technologies, Inc. | Intervertebral spacer and tool and method for emplacement thereof |
IL128261A0 (en) | 1999-01-27 | 1999-11-30 | Disc O Tech Medical Tech Ltd | Expandable element |
US5976146A (en) * | 1997-07-11 | 1999-11-02 | Olympus Optical Co., Ltd. | Surgical operation system and method of securing working space for surgical operation in body |
FR2766353B1 (en) | 1997-07-28 | 1999-11-26 | Dimso Sa | IMPLANT, ESPECIALLY ANTERIOR CERVICAL PLATE |
US6226548B1 (en) * | 1997-09-24 | 2001-05-01 | Surgical Navigation Technologies, Inc. | Percutaneous registration apparatus and method for use in computer-assisted surgical navigation |
FR2777443B1 (en) * | 1998-04-21 | 2000-06-30 | Tornier Sa | ANCILLARY FOR THE PLACEMENT AND REMOVAL OF AN IMPLANT AND MORE PARTICULARLY A SUTURE ANCHOR |
US5928139A (en) * | 1998-04-24 | 1999-07-27 | Koros; Tibor B. | Retractor with adjustable length blades and light pipe guides |
FR2781359B1 (en) | 1998-07-21 | 2001-01-26 | Pierre Boccara | SPINAL OSTEOSYNTHESIS MATERIAL |
US5971987A (en) | 1998-09-18 | 1999-10-26 | Ethicon, Inc. | Biocompatible absorbable polymer fastener and driver for use in surgical procedures |
US6355038B1 (en) * | 1998-09-25 | 2002-03-12 | Perumala Corporation | Multi-axis internal spinal fixation |
US6059786A (en) * | 1998-10-22 | 2000-05-09 | Jackson; Roger P. | Set screw for medical implants |
US6193757B1 (en) * | 1998-10-29 | 2001-02-27 | Sdgi Holdings, Inc. | Expandable intervertebral spacers |
US6159244A (en) | 1999-07-30 | 2000-12-12 | Suddaby; Loubert | Expandable variable angle intervertebral fusion implant |
US6123707A (en) | 1999-01-13 | 2000-09-26 | Spinal Concepts, Inc. | Reduction instrument |
US6086589A (en) * | 1999-02-02 | 2000-07-11 | Spineology, Inc. | Method and device for fixing spondylolisthesis posteriorly |
US6423069B1 (en) * | 1999-03-23 | 2002-07-23 | Synthes (Usa) | Orthopedic system having detachable bone anchors |
DE60032225T2 (en) * | 1999-03-30 | 2007-09-13 | Howmedica Osteonics Corp. | APPARATUS FOR STABILIZING THE SPINE |
US6332887B1 (en) * | 1999-04-06 | 2001-12-25 | Benjamin D. Knox | Spinal fusion instrumentation system |
EP1164979B1 (en) * | 1999-04-07 | 2005-12-21 | Howmedica Osteonics Corp. | Low profile fusion cage and insertion set |
US6428576B1 (en) | 1999-04-16 | 2002-08-06 | Endospine, Ltd. | System for repairing inter-vertebral discs |
US7094239B1 (en) * | 1999-05-05 | 2006-08-22 | Sdgi Holdings, Inc. | Screws of cortical bone and method of manufacture thereof |
US6805697B1 (en) | 1999-05-07 | 2004-10-19 | University Of Virginia Patent Foundation | Method and system for fusing a spinal region |
AU761199B2 (en) * | 1999-05-14 | 2003-05-29 | Synthes Gmbh | Bone fixation device with a rotation joint |
US6770096B2 (en) | 1999-07-01 | 2004-08-03 | Spinevision S.A. | Interbody spinal stabilization cage and spinal stabilization method |
US6508839B1 (en) * | 1999-08-18 | 2003-01-21 | Intrinsic Orthopedics, Inc. | Devices and methods of vertebral disc augmentation |
US20040044412A1 (en) * | 1999-08-18 | 2004-03-04 | Gregory Lambrecht | Devices and method for augmenting a vertebral disc |
EP1779815A3 (en) * | 1999-09-14 | 2007-06-27 | Spine Solutions Inc. | Insert instrument for an implant between vertebrae |
FR2799640B1 (en) | 1999-10-15 | 2002-01-25 | Spine Next Sa | IMPLANT INTERVETEBRAL |
US6530929B1 (en) | 1999-10-20 | 2003-03-11 | Sdgi Holdings, Inc. | Instruments for stabilization of bony structures |
TW447286U (en) | 1999-12-10 | 2001-07-21 | Lin Jr Yi | Intervertebral restorer |
US6319257B1 (en) | 1999-12-20 | 2001-11-20 | Kinamed, Inc. | Inserter assembly |
US6331179B1 (en) | 2000-01-06 | 2001-12-18 | Spinal Concepts, Inc. | System and method for stabilizing the human spine with a bone plate |
DE10005385A1 (en) * | 2000-02-07 | 2001-08-09 | Ulrich Gmbh & Co Kg | Pedicle screw |
US6899716B2 (en) | 2000-02-16 | 2005-05-31 | Trans1, Inc. | Method and apparatus for spinal augmentation |
US6558390B2 (en) * | 2000-02-16 | 2003-05-06 | Axiamed, Inc. | Methods and apparatus for performing therapeutic procedures in the spine |
US7014633B2 (en) * | 2000-02-16 | 2006-03-21 | Trans1, Inc. | Methods of performing procedures in the spine |
US6558386B1 (en) * | 2000-02-16 | 2003-05-06 | Trans1 Inc. | Axial spinal implant and method and apparatus for implanting an axial spinal implant within the vertebrae of the spine |
US6575979B1 (en) | 2000-02-16 | 2003-06-10 | Axiamed, Inc. | Method and apparatus for providing posterior or anterior trans-sacral access to spinal vertebrae |
US6790210B1 (en) | 2000-02-16 | 2004-09-14 | Trans1, Inc. | Methods and apparatus for forming curved axial bores through spinal vertebrae |
US6309391B1 (en) | 2000-03-15 | 2001-10-30 | Sdgi Holding, Inc. | Multidirectional pivoting bone screw and fixation system |
US6402750B1 (en) * | 2000-04-04 | 2002-06-11 | Spinlabs, Llc | Devices and methods for the treatment of spinal disorders |
US6665555B2 (en) | 2000-04-05 | 2003-12-16 | Georgetown University School Of Medicine | Radiosurgery methods that utilize stereotactic methods to precisely deliver high dosages of radiation especially to the spine |
US6312431B1 (en) | 2000-04-24 | 2001-11-06 | Wilson T. Asfora | Vertebrae linking system |
US6645207B2 (en) | 2000-05-08 | 2003-11-11 | Robert A. Dixon | Method and apparatus for dynamized spinal stabilization |
US6478800B1 (en) * | 2000-05-08 | 2002-11-12 | Depuy Acromed, Inc. | Medical installation tool |
US6749614B2 (en) * | 2000-06-23 | 2004-06-15 | Vertelink Corporation | Formable orthopedic fixation system with cross linking |
US6821277B2 (en) | 2000-06-23 | 2004-11-23 | University Of Southern California Patent And Copyright Administration | Percutaneous vertebral fusion system |
FR2811540B1 (en) * | 2000-07-12 | 2003-04-25 | Spine Next Sa | IMPORTING INTERVERTEBRAL IMPLANT |
DE20012549U1 (en) | 2000-07-20 | 2000-10-12 | Aesculap Ag & Co Kg | Insertion tool for an intervertebral implant |
US6533787B1 (en) | 2000-07-31 | 2003-03-18 | Sdgi Holdings, Inc. | Contourable spinal staple with centralized and unilateral prongs |
US6524315B1 (en) * | 2000-08-08 | 2003-02-25 | Depuy Acromed, Inc. | Orthopaedic rod/plate locking mechanism |
CA2354747A1 (en) | 2000-08-08 | 2002-02-08 | Depuy Acromed, Inc. | Spinal rod/plate locking mechanisms and surgical methods |
US6319002B1 (en) | 2000-08-24 | 2001-11-20 | Gary J. Pond | Handheld device for applying dental materials |
US20040073216A1 (en) * | 2000-10-05 | 2004-04-15 | The Cleveland Clinic Foundation | Apparatus and method for attaching adjacent bones |
US20040018228A1 (en) * | 2000-11-06 | 2004-01-29 | Afmedica, Inc. | Compositions and methods for reducing scar tissue formation |
US6666891B2 (en) * | 2000-11-13 | 2003-12-23 | Frank H. Boehm, Jr. | Device and method for lumbar interbody fusion |
US20050010227A1 (en) * | 2000-11-28 | 2005-01-13 | Paul Kamaljit S. | Bone support plate assembly |
US6663631B2 (en) | 2000-12-01 | 2003-12-16 | Charles A. Kuntz | Method and device to correct instability of hinge joints |
US6702817B2 (en) * | 2001-01-19 | 2004-03-09 | Aesculap Ag & Co. Kg | Locking mechanism for a bone screw |
ATE384500T1 (en) | 2001-02-04 | 2008-02-15 | Warsaw Orthopedic Inc | INSTRUMENTS FOR INSERTING AND POSITIONING AN EXPANDABLE INTERVERBEL FUSION IMPLANT |
US20020120335A1 (en) * | 2001-02-28 | 2002-08-29 | Angelucci Christopher M. | Laminoplasty implants and methods of use |
US6641583B2 (en) | 2001-03-29 | 2003-11-04 | Endius Incorporated | Apparatus for retaining bone portions in a desired spatial relationship |
US6582433B2 (en) | 2001-04-09 | 2003-06-24 | St. Francis Medical Technologies, Inc. | Spine fixation device and method |
US6719795B1 (en) * | 2001-04-25 | 2004-04-13 | Macropore Biosurgery, Inc. | Resorbable posterior spinal fusion system |
WO2002098276A2 (en) | 2001-06-04 | 2002-12-12 | Michelson Gary K | Dynamic anterior cervical plate system having moveable segments, instrumentation, and method for installation thereof |
US7041105B2 (en) | 2001-06-06 | 2006-05-09 | Sdgi Holdings, Inc. | Dynamic, modular, multilock anterior cervical plate system having detachably fastened assembleable and moveable segments |
US6440133B1 (en) | 2001-07-03 | 2002-08-27 | Sdgi Holdings, Inc. | Rod reducer instruments and methods |
CA2457686A1 (en) | 2001-07-12 | 2003-01-23 | Osteotech, Inc. | Intervertebral impant with movement resistant structure |
US20030040746A1 (en) * | 2001-07-20 | 2003-02-27 | Mitchell Margaret E. | Spinal stabilization system and method |
US6746449B2 (en) * | 2001-09-12 | 2004-06-08 | Spinal Concepts, Inc. | Spinal rod translation instrument |
US7175633B2 (en) * | 2001-10-17 | 2007-02-13 | Synthes (Usa) | Orthopedic implant insertion instruments |
DE10152094C2 (en) * | 2001-10-23 | 2003-11-27 | Biedermann Motech Gmbh | Bone fixation device |
US6716212B1 (en) * | 2002-01-25 | 2004-04-06 | Tyrone Sam Pickens | Universal modular external fixation system |
US6733534B2 (en) * | 2002-01-29 | 2004-05-11 | Sdgi Holdings, Inc. | System and method for spine spacing |
US7232441B2 (en) | 2002-02-13 | 2007-06-19 | Cross Medicalproducts, Inc. | Occipital plate and rod system |
FR2836373B1 (en) * | 2002-02-26 | 2005-03-25 | Materiel Orthopedique En Abreg | CONNECTING INTERSOMATIC IMPLANTS FOR INSERTING BONE GRAFT FOR REALIZING INTERVERTEBRAL FUSION, INSTRUMENTS FOR CONNECTING THESE IMPLANTS |
US7011658B2 (en) * | 2002-03-04 | 2006-03-14 | Sdgi Holdings, Inc. | Devices and methods for spinal compression and distraction |
US6783547B2 (en) | 2002-04-05 | 2004-08-31 | Howmedica Corp. | Apparatus for fusing adjacent bone structures |
US7572276B2 (en) | 2002-05-06 | 2009-08-11 | Warsaw Orthopedic, Inc. | Minimally invasive instruments and methods for inserting implants |
US20030236472A1 (en) | 2002-06-19 | 2003-12-25 | James Van Hoeck | Systems and methods for moving anatomical elements |
US7060066B2 (en) * | 2002-06-28 | 2006-06-13 | Mayo Foundation For Medical Education And Research | Spinal fixation support device and methods of using |
AU2003253866B2 (en) | 2002-07-10 | 2008-05-01 | Zimmer Spine, Inc. | Spinal support coupling device |
US7107091B2 (en) * | 2002-07-25 | 2006-09-12 | Orthosoft Inc. | Multiple bone tracking |
US7476228B2 (en) * | 2002-10-11 | 2009-01-13 | Abdou M Samy | Distraction screw for skeletal surgery and method of use |
US7232463B2 (en) | 2002-10-23 | 2007-06-19 | U.S. Spinal Technologies, Llc | Intervertebral cage designs |
US20080021468A1 (en) * | 2002-10-29 | 2008-01-24 | Zucherman James F | Interspinous process implants and methods of use |
US7153281B2 (en) | 2002-10-30 | 2006-12-26 | Mekanika, Inc | Apparatus and method for measuring instability of a motion segment unit of a spine |
EP3222231A1 (en) | 2002-10-30 | 2017-09-27 | Zimmer Spine, Inc. | Spinal stabilization system insertion |
DE20216857U1 (en) | 2002-11-02 | 2003-02-20 | Stryker Trauma Gmbh | Aiming device for a locking nail |
US6739068B1 (en) * | 2003-01-06 | 2004-05-25 | Pilling Weck Incorporated | Pliers with jaw spacing and load measuring readings |
US7331961B2 (en) | 2003-01-10 | 2008-02-19 | Abdou M Samy | Plating system for bone fixation and subsidence and method of implantation |
US7660623B2 (en) | 2003-01-30 | 2010-02-09 | Medtronic Navigation, Inc. | Six degree of freedom alignment display for medical procedures |
US7575588B2 (en) | 2003-02-03 | 2009-08-18 | Warsaw Orthopedic Inc. | Midline occipital vertebral fixation system |
US7335203B2 (en) | 2003-02-12 | 2008-02-26 | Kyphon Inc. | System and method for immobilizing adjacent spinous processes |
US20040204712A1 (en) | 2003-04-09 | 2004-10-14 | Eric Kolb | Bone fixation plates |
US7291152B2 (en) * | 2003-04-18 | 2007-11-06 | Abdou M Samy | Bone fixation system and method of implantation |
FR2856271B1 (en) | 2003-06-23 | 2005-12-30 | Charles Khalife | SPINAL OSTEOSYNTHESIS PLATE WITH ADAPTABLE HEAD |
US6945975B2 (en) | 2003-07-07 | 2005-09-20 | Aesculap, Inc. | Bone fixation assembly and method of securement |
US7326200B2 (en) | 2003-07-25 | 2008-02-05 | Warsaw Orthopedic, Inc. | Annulus repair systems, instruments and techniques |
US7377942B2 (en) * | 2003-08-06 | 2008-05-27 | Warsaw Orthopedic, Inc. | Posterior elements motion restoring device |
US7252673B2 (en) * | 2003-09-10 | 2007-08-07 | Warsaw Orthopedic, Inc. | Devices and methods for inserting spinal implants |
US7455685B2 (en) | 2003-09-29 | 2008-11-25 | Warsaw Orthopedic, Inc. | Instruments and methods for securing a connecting element along a bony segment |
US7588588B2 (en) | 2003-10-21 | 2009-09-15 | Innovative Spinal Technologies | System and method for stabilizing of internal structures |
US20050126576A1 (en) * | 2003-11-04 | 2005-06-16 | Ferree Bret A. | Protecting biological structures, including the great vessels, particularly during spinal surgery |
US20050131406A1 (en) * | 2003-12-15 | 2005-06-16 | Archus Orthopedics, Inc. | Polyaxial adjustment of facet joint prostheses |
US7527638B2 (en) | 2003-12-16 | 2009-05-05 | Depuy Spine, Inc. | Methods and devices for minimally invasive spinal fixation element placement |
US7635366B2 (en) | 2003-12-29 | 2009-12-22 | Abdou M Samy | Plating system for bone fixation and method of implantation |
US7621938B2 (en) | 2004-01-15 | 2009-11-24 | Warsaw Orthopedic, Inc. | Spinal implant construct and method for implantation |
US7597694B2 (en) | 2004-01-30 | 2009-10-06 | Warsaw Orthopedic, Inc. | Instruments and methods for minimally invasive spinal stabilization |
US7815664B2 (en) | 2005-01-04 | 2010-10-19 | Warsaw Orthopedic, Inc. | Systems and methods for spinal stabilization with flexible elements |
WO2005076868A2 (en) | 2004-02-06 | 2005-08-25 | Depuy Spine, Inc. | Devices and methods for inserting a spinal fixation element |
CA2555876C (en) * | 2004-02-09 | 2012-12-11 | Depuy Spine, Inc. | Systems and methods for spinal surgery |
US7160300B2 (en) | 2004-02-27 | 2007-01-09 | Jackson Roger P | Orthopedic implant rod reduction tool set and method |
US8636802B2 (en) | 2004-03-06 | 2014-01-28 | DePuy Synthes Products, LLC | Dynamized interspinal implant |
US7799053B2 (en) | 2004-03-08 | 2010-09-21 | Warsaw Orthopedic, Inc. | Occipital and cervical stabilization systems and methods |
US7763073B2 (en) | 2004-03-09 | 2010-07-27 | Depuy Spine, Inc. | Posterior process dynamic spacer |
US20050209694A1 (en) | 2004-03-12 | 2005-09-22 | Loeb Marvin P | Artificial spinal joints and method of use |
US20050203533A1 (en) | 2004-03-12 | 2005-09-15 | Sdgi Holdings, Inc. | Technique and instrumentation for intervertebral prosthesis implantation |
US7547318B2 (en) | 2004-03-19 | 2009-06-16 | Depuy Spine, Inc. | Spinal fixation element and methods |
US7648520B2 (en) | 2004-04-16 | 2010-01-19 | Kyphon Sarl | Pedicle screw assembly |
US7578834B2 (en) | 2004-05-03 | 2009-08-25 | Abdou M S | Devices and methods for the preservation of spinal prosthesis function |
US7776051B2 (en) | 2004-05-03 | 2010-08-17 | Theken Spine, Llc | System and method for displacement of bony structures |
US7338527B2 (en) * | 2004-05-11 | 2008-03-04 | Geoffrey Blatt | Artificial spinal disc, insertion tool, and method of insertion |
US7585316B2 (en) | 2004-05-21 | 2009-09-08 | Warsaw Orthopedic, Inc. | Interspinous spacer |
WO2005122922A2 (en) | 2004-06-14 | 2005-12-29 | Abdou M S | Occipital fixation system and method of use |
US7303563B2 (en) | 2004-06-17 | 2007-12-04 | Sdgi Holdings, Inc. | Orthopedic fixation system and method of use |
US7854752B2 (en) * | 2004-08-09 | 2010-12-21 | Theken Spine, Llc | System and method for dynamic skeletal stabilization |
US7641690B2 (en) * | 2004-08-23 | 2010-01-05 | Abdou M Samy | Bone fixation and fusion device |
US20060052870A1 (en) | 2004-09-09 | 2006-03-09 | Ferree Bret A | Methods and apparatus to prevent movement through artificial disc replacements |
US7396360B2 (en) * | 2004-09-29 | 2008-07-08 | The Cleveland Clinic Foundation | Minimally invasive method and apparatus for fusing adjacent vertebrae |
US8298235B2 (en) * | 2004-09-30 | 2012-10-30 | Depuy Spine, Inc. | Instrument and method for the insertion and alignment of an intervertebral implant |
WO2006041963A2 (en) * | 2004-10-05 | 2006-04-20 | Abdou M S | Devices and methods for inter-vertebral orthopedic device placement |
US8012207B2 (en) * | 2004-10-20 | 2011-09-06 | Vertiflex, Inc. | Systems and methods for posterior dynamic stabilization of the spine |
US8241330B2 (en) | 2007-01-11 | 2012-08-14 | Lanx, Inc. | Spinous process implants and associated methods |
US8075591B2 (en) | 2004-11-09 | 2011-12-13 | Depuy Spine, Inc. | Minimally invasive spinal fixation guide systems and methods |
EP1814474B1 (en) | 2004-11-24 | 2011-09-14 | Samy Abdou | Devices for inter-vertebral orthopedic device placement |
US8038698B2 (en) | 2005-02-17 | 2011-10-18 | Kphon Sarl | Percutaneous spinal implants and methods |
US8096994B2 (en) | 2005-02-17 | 2012-01-17 | Kyphon Sarl | Percutaneous spinal implants and methods |
BRPI0607139A2 (en) | 2005-02-18 | 2009-08-11 | M S Abdou | bone fixation set |
US20060217710A1 (en) | 2005-03-07 | 2006-09-28 | Abdou M S | Occipital fixation system and method of use |
US20060235409A1 (en) | 2005-03-17 | 2006-10-19 | Jason Blain | Flanged interbody fusion device |
US7758617B2 (en) | 2005-04-27 | 2010-07-20 | Globus Medical, Inc. | Percutaneous vertebral stabilization system |
US7749232B2 (en) | 2005-05-24 | 2010-07-06 | Anthony Salerni | Electromagnetically guided spinal rod system and related methods |
US7837688B2 (en) | 2005-06-13 | 2010-11-23 | Globus Medical | Spinous process spacer |
US7383639B2 (en) | 2005-07-12 | 2008-06-10 | Medtronic Spine Llc | Measurement instrument for percutaneous surgery |
US7753938B2 (en) * | 2005-08-05 | 2010-07-13 | Synthes Usa, Llc | Apparatus for treating spinal stenosis |
US20070093823A1 (en) * | 2005-09-29 | 2007-04-26 | Nuvasive, Inc. | Spinal distraction device and methods of manufacture and use |
EP1942838A4 (en) * | 2005-10-03 | 2012-01-04 | Samy M Abdou | Devices and methods for inter-vertebral orthopedic device placement |
US7857833B2 (en) * | 2005-10-06 | 2010-12-28 | Abdou M Samy | Devices and methods for inter-vertebral orthopedic device placement |
WO2007044705A2 (en) * | 2005-10-07 | 2007-04-19 | Abdou Samy M | Devices and methods for inter-verterbral orthopedic device placement |
WO2007056516A2 (en) * | 2005-11-09 | 2007-05-18 | Abdou M S | Bone fixation systems and methods of implantation |
US20070173831A1 (en) | 2005-11-14 | 2007-07-26 | Abdou M S | Device and method for the placement of spinal fixators |
US7998173B2 (en) | 2005-11-22 | 2011-08-16 | Richard Perkins | Adjustable spinous process spacer device and method of treating spinal stenosis |
WO2007064695A2 (en) | 2005-11-29 | 2007-06-07 | Abdou M S | Device and method for the placement of spinal fixators |
US7862592B2 (en) | 2005-12-06 | 2011-01-04 | Nuvasive, Inc. | Methods and apparatus for treating spinal stenosis |
US8430911B2 (en) | 2005-12-14 | 2013-04-30 | Spinefrontier Inc | Spinous process fixation implant |
US7704271B2 (en) | 2005-12-19 | 2010-04-27 | Abdou M Samy | Devices and methods for inter-vertebral orthopedic device placement |
US20070233084A1 (en) | 2006-01-25 | 2007-10-04 | Spinemedica Corporation | Implantable spinous process prosthetic devices, including cuffs, and methods of fabricating same |
US7871426B2 (en) | 2006-03-21 | 2011-01-18 | Spinefrontier, LLS | Spinous process fixation device |
US20070233077A1 (en) | 2006-03-31 | 2007-10-04 | Khalili Farid B | Dynamic intervertebral spacer assembly |
US20080183218A1 (en) | 2007-01-31 | 2008-07-31 | Nuvasive, Inc. | System and Methods for Spinous Process Fusion |
US20100016906A1 (en) | 2008-07-21 | 2010-01-21 | Abdou M Samy | Device and method to access the anterior column of the spine |
-
2007
- 2007-07-27 WO PCT/US2007/016949 patent/WO2008013960A2/en active Application Filing
- 2007-07-27 US US11/881,584 patent/US8303630B2/en active Active
-
2012
- 2012-11-05 US US13/669,294 patent/US20130123849A1/en not_active Abandoned
Patent Citations (11)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4899761A (en) * | 1988-03-31 | 1990-02-13 | Brown Mark D | Apparatus and method for measuring spinal instability |
US20010021850A1 (en) * | 1997-01-02 | 2001-09-13 | St. Francis Medical Technologies, Inc. | Spine distraction implant |
US6599294B2 (en) * | 1999-01-30 | 2003-07-29 | Aesculap Ag & Co. Kg | Surgical instrument for introducing intervertebral implants |
US20020165550A1 (en) * | 1999-10-21 | 2002-11-07 | George Frey | Devices and techniques for a posterior lateral disc space approach |
US20040030346A1 (en) * | 1999-10-21 | 2004-02-12 | George Frey | Devices and techniques for a posterior lateral disc space approach |
US20050021040A1 (en) * | 2003-07-21 | 2005-01-27 | Rudolf Bertagnoli | Vertebral retainer-distracter and method of using same |
US20050283245A1 (en) * | 2003-08-05 | 2005-12-22 | Gordon Charles R | Method of insertion of an expandable intervertebral implant using a tool |
US20060195102A1 (en) * | 2005-02-17 | 2006-08-31 | Malandain Hugues F | Apparatus and method for treatment of spinal conditions |
US20090216234A1 (en) * | 2006-11-03 | 2009-08-27 | Innovative Spine | Spinal Access Systems and Methods |
US7922750B2 (en) * | 2006-11-30 | 2011-04-12 | Paradigm Spine, Llc | Interlaminar-interspinous vertebral stabilization system |
US20080177312A1 (en) * | 2006-12-28 | 2008-07-24 | Mi4Spine, Llc | Interspinous Process Spacer Device |
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US20080027438A1 (en) | 2008-01-31 |
WO2008013960A3 (en) | 2008-12-04 |
WO2008013960A2 (en) | 2008-01-31 |
US8303630B2 (en) | 2012-11-06 |
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