Methods and devices for spinal correction

• US 10,271,832 B2
• Filed: 09/08/2016
• Issued: 04/30/2019
• Est. Priority Date: 04/08/2014
• Status: Active Grant

• Current Assignee: Depuy Synthes Products Incorporated (Johnson & Johnson)
• Original Assignee: Depuy Synthes Products Incorporated (Johnson & Johnson)
• Inventors: O'Neil, Michael J., Lomeli, Roman, Hawkins, John Riley, Ramsay, Christopher, Bootwala, Zoher, DiPietro, Jennifer, Griffin, John
• Primary Examiner(s): Hammond, Ellen C
• Application Number:
  US15/259,157
• Publication Number:
  US 20160374660A1
• Time in Patent Office: 964 Days
• CPC Class Codes: A61B 1/00087 Tools A61B17/00234 takes precedence
• CPC Class Codes: A61B 1/3135 for examination of the epidural or the spinal space
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2017/00106 ultrasonic
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/065 for measuring contact or contact pressure
• CPC Class Codes: A61B 2090/066 for measuring torque
• CPC Class Codes: A61B 2505/05 Surgical care
• CPC Class Codes: A61B 2562/04 Arrangements of multiple sensors of the same type
• CPC Class Codes: A61B 5/0071 by measuring fluorescence emission
• CPC Class Codes: A61B 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 5/1076 for measuring dimensions inside body cavities, e.g. using catheters A61B3/1005 takes precedence
• CPC Class Codes: A61B 5/4566 Evaluating the spine A61B5/4561 takes precedence
• CPC Class Codes: A61B 5/6853 with a balloon
• CPC Class Codes: A61B 8/0858 involving measuring tissue layers, e.g. skin, interfaces
• CPC Class Codes: A61B 8/0875 for diagnosis of bone A61B5/4504 takes precedence
• CPC Class Codes: A61B 8/12 : in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61B 90/06 : Measuring instruments not otherwise provided for
• CPC Class Codes: A61F 2/44 : for the spine, e.g. vertebrae, spinal discs
• 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 2/4455 : for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages intervertebral discs A61F2/442
• CPC Class Codes: A61F 2/4611 : of spinal prostheses
• CPC Class Codes: A61F 2/4657 : Measuring instruments used for implanting artificial joints for surgical instruments A61B90/06
• CPC Class Codes: A61F 2/4684 : Trial or dummy prostheses
• CPC Class Codes: A61F 2002/30405 : made by screwing complementary threads machined on the parts themselves
• CPC Class Codes: A61F 2002/30471 : connected by a hinged linkage mechanism, e.g. of the single-bar or multi-bar linkage type
• CPC Class Codes: A61F 2002/30507 : using a threaded locking member, e.g. a locking screw or a set screw
• CPC Class Codes: A61F 2002/30515 : using a locking wedge or block
• CPC Class Codes: A61F 2002/30537 : adjustable
• CPC Class Codes: A61F 2002/30538 : for adjusting angular orientation
• CPC Class Codes: A61F 2002/30556 : for adjusting thickness
• CPC Class Codes: A61F 2002/30579 : with mechanically expandable devices, e.g. fixation devices
• CPC Class Codes: A61F 2002/4633 : for selection of endoprosthetic joints or for pre-operative planning
• CPC Class Codes: A61F 2002/4658 : for measuring dimensions, e.g. length
• CPC Class Codes: A61F 2002/4666 : for measuring force, pressure or mechanical tension

Abstract

An expandable trial can include an inferior portion, a superior portion, and a middle expanding portion as well as load cells for monitoring the load on the trial. The trial may also include recesses on its lateral sides to provide spacing to accommodate a disc removal tool so tissue can be cleared monitoring load. In addition, neural foramen spacing can be monitoring to provide information about how much neural release has been achieved as the disc is cleaned and the spine is positioned and repositioned.

Claims

1. A method for spinal correction, comprising:

inserting an expandable trial implant in an intervertebral disc space;

receiving load information from the expandable trial implant disposed in the intervertebral disc space, the implant being in a first expanded position after removal of a portion of the disc tissue;

comparing the load information to a load threshold;

indicating when the load information exceeds the load threshold;

receiving information representative of a neural foramen spacing from a neural spacing monitoring system, the neural foramen being located proximate the intervertebral disc space;

comparing the information representative of a neural foramen spacing to a predefined foramen spacing parameter; and

determining whether to remove more of the disc based on comparison of the information representative of a neural foramen spacing and the predefined foramen spacing parameter.

2. The method of claim 1 wherein the receiving information representative of the neural foramen spacing comprises receiving information from an image guided surgery system.

3. The method of claim 1 wherein the receiving information representative of the neural foramen spacing comprises receiving information from a spinal pressure monitoring system.

4. The method of claim 1 wherein the receiving information representative of the neural foramen spacing comprises receiving information from a visualization system.

5. The method of claim 1 wherein the receiving information representative of the neural foramen spacing comprises receiving information from an ultrasonic detection system.

6. The method of claim 1 wherein the receiving information representative of the neural foramen spacing comprises receiving information from a balloon measurement system.

7. The method of claim 1 wherein the receiving load information from the expandable trial implant comprises receiving information from a plurality of load cells disposed on inferior and superior surfaces of the trial implant and mapping the load cell information from the load cells disposed on the inferior surface into at least two regions and mapping the load cell information from the load cells disposed on the superior surface into at least two regions.

8. The method of claim 1 wherein determining whether to remove more of the disc comprises determining where to remove more of the disc tissue based on at least one of the mapped regions of load information.

9. The method of claim 1 wherein determining whether to remove more of the disc comprises determining whether to remove more of the disc based on historical information of patient surgeries.

10. The method of claim 1 wherein determining whether to remove more of the disc comprises determining whether to remove more of the disc based on information representative of the neural foramen spacing received from a visualization system.

11. The method of claim 1 wherein determining whether to remove more of the disc comprises determining whether to remove more of the disc based on information received from a spinal pressure monitoring system.

12. The method of claim 1 wherein determining whether to remove more of the disc comprises determining whether to remove more of the disc based on information received from a balloon measurement system.

13. The method of claim 1 wherein determining whether to remove more of the disc comprises determining whether to remove more of the disc based on information received from an ultrasonic detection system.

14. The method of claim 1 wherein determining whether to remove more of the disc comprises determining whether to remove more of the disc based on information received from an image guided surgery system.