Method and apparatus for closing fissures in the annulus fibrosus

• US 10,245,018 B2
• Filed: 01/12/2016
• Issued: 04/02/2019
• Est. Priority Date: 06/13/2006
• Status: Active Grant

• Current Assignee: Suture Concepts Inc.
• Original Assignee: Suture Concepts Inc.
• Inventors: Ferree, Bret A.
• Primary Examiner(s): Harvey, Julianna N
• Application Number:
  US14/993,391
• Publication Number:
  US 20160361053A1
• Time in Patent Office: 1,176 Days
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0485 Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/06061 Holders for needles or sutures, e.g. racks, stands hand-held holding instruments A61B17/0483; holders for articles A61B50/20; racks for syringes or for hypodermic or infusion needles A61M5/008
• CPC Class Codes: A61B 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• CPC Class Codes: A61B 17/06109 Big needles, either gripped by hand or connectable to a handle
• CPC Class Codes: A61B 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/842 Flexible wires, bands or straps A61B17/72, A61B17/82, A61B17/86 take precedence
• CPC Class Codes: A61B 2017/00849 with respect to tissue, e.g. hollow organs
• CPC Class Codes: A61B 2017/00867 shape memory effect
• CPC Class Codes: A61B 2017/0403 Dowels
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening
• CPC Class Codes: A61B 2017/0427 having anchoring barbs or pins extending outwardly from the anchor body
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/0608 J-shaped
• CPC Class Codes: A61B 2017/061 : hollow or tubular
• CPC Class Codes: A61B 2017/0619 : thermoplastic, e.g. for bonding, welding, fusing or cutting the suture by melting it
• CPC Class Codes: A61B 2017/081 : Tissue approximator A61B2017/1103, A61B17/8866 take precedence
• CPC Class Codes: A61B 2017/088 : Sliding fasteners
• CPC Class Codes: A61F 2/442 : Intervertebral or spinal discs, e.g. resilient non-disc-shaped intervertebral inflatable pockets A61F2/441; non-disc-shaped intervertebral fusion implants A61F2/4455
• CPC Class Codes: A61F 2002/30062 : (bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
• CPC Class Codes: A61F 2002/30075 : swellable, e.g. when wetted
• CPC Class Codes: A61F 2002/30092 : using shape memory or superelastic materials, e.g. nitinol
• CPC Class Codes: A61F 2002/30125 : elliptical or oval
• CPC Class Codes: A61F 2002/30166 : H-shaped or I-shaped
• CPC Class Codes: A61F 2002/30235 : tubular, e.g. sleeves
• CPC Class Codes: A61F 2002/30451 : soldered or brazed or welded
• CPC Class Codes: A61F 2002/30461 : sutured, ligatured or stitched
• CPC Class Codes: A61F 2002/30677 : Means for introducing or releasing pharmaceutical products, e.g. antibiotics, into the body
• CPC Class Codes: A61F 2002/30772 : Apertures or holes, e.g. of circular cross section
• CPC Class Codes: A61F 2002/30841 : Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
• CPC Class Codes: A61F 2002/3085 : with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface
• CPC Class Codes: A61F 2002/30932 : for retarding or preventing ingrowth of bone tissue
• CPC Class Codes: A61F 2002/4435 : Support means or repair of the natural disc wall, i.e. annulus, e.g. using plates, membranes or meshes
• CPC Class Codes: A61F 2210/0014 : using shape memory or superelastic materials, e.g. nitinol
• CPC Class Codes: A61F 2210/0061 : swellable
• CPC Class Codes: A61F 2220/005 : using adhesives
• CPC Class Codes: A61F 2220/0058 : soldered or brazed or welded
• CPC Class Codes: A61F 2220/0075 : sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2230/0008 : elliptical or oval
• CPC Class Codes: A61F 2230/0023 : triangular
• CPC Class Codes: A61F 2230/0069 : cylindrical
• CPC Class Codes: A61F 2310/00365 : Proteins; Polypeptides; Degradation products thereof

Abstract

A method for closing a fissure in a region of tissue having an inner surface and an outer surface, the method comprising:

• • providing at least a pair of transverse anchor components, each transverse anchor component being coupled to at least one flexible longitudinal fixation component having a longitudinal axis;
  • placing the transverse anchor components relative to the inner surface of the tissue on both sides of the fissure such that an exposed end of a flexible longitudinal fixation component extends through the tissue and past the outer surface of the tissue on both sides of the fissure;
  • applying axial tension to the exposed ends; and
  • anchoring the exposed ends.

Claims

1. A method for closing a fissure in a region of tissue having an inner surface and an outer surface, the method comprising:

providing a first transverse anchor having a first surface, a second surface and a hole extending from the first surface to the second surface, and a first flexible longitudinal fixation component having a first end and a second end, wherein the first flexible longitudinal fixation component is passed through the hole in the first transverse anchor and secured to the first transverse anchor with a first knot tied on the second surface of the first transverse anchor;

providing a second transverse anchor having a first surface, a second surface and a hole extending from the first surface to the second surface, and a second flexible longitudinal fixation component having a first end and a second end, wherein the second flexible longitudinal fixation component is passed through the hole in the second transverse anchor and secured to the second transverse anchor with a second knot tied on the second surface of the second transverse anchor;

positioning the first surface of the first transverse anchor on one side of the fissure and against the inner surface of the tissue, with the second end of the first flexible longitudinal fixation component extending to the outer surface of the tissue on the first side of the fissure;

positioning the first surface of the second transverse anchor on the second side of the fissure and against the inner surface of the tissue, with the second end of the second flexible longitudinal fixation component extending to the outer surface of the tissue on the second side of the fissure;

tensioning the first flexible longitudinal fixation component and second flexible longitudinal fixation component so as to reduce the size of the fissure; and

securing the first flexible longitudinal fixation component to the second flexible longitudinal fixation component.

2. A method for closing a fissure in the annulus of an intervertebral disc, comprising:

providing a first transverse anchor having a first surface, a second surface and a hole extending from the first surface to the second surface, and having a first filament extending therefrom, wherein the first filament comprises a first end and a second end, and further wherein the first filament is passed through the hole in the first transverse anchor and secured to the first transverse anchor with a first knot tied on the second surface of the first transverse anchor;

providing a second transverse anchor having a first surface, a second surface and a hole extending from the first surface to the second surface, and having a second filament extending therefrom, wherein the second filament comprises a first end and a second end, and further wherein the second filament is passed through the hole in the first transverse anchor and secured to the first transverse anchor with a second knot tied on the second surface of the second transverse anchor;

advancing said first transverse anchor through the annulus of the intervertebral disc on one side of the fissure so that the first transverse anchor is disposed against an inner surface of the annulus and the first filament extends through the wall of the annulus on one side of the fissure, and advancing said second transverse anchor through the annulus of the intervertebral disc on a second side of the fissure so that the second transverse anchor is disposed against an inner surface of the annulus and the second filament extends through the wall of the annulus on the second side of the fissure;

applying tension to the first and second filaments so as to close the fissure; and

welding the first filament to the second filament.