Apparatus and methods for treating spinal discs

• US 20030045937A1
• Filed: 09/06/2001
• Published: 03/06/2003
• Est. Priority Date: 09/06/2001
• Status: Active Grant

• Current Assignee: Gateway Edi (Cognizant Technology Solutions Corp.)
• Original Assignee: Integrated Vascular Systems, Inc. (Abbott Laboratories)
• Inventors: Ginn, Richard S.
• Granted Patent: US 6,736,815 B2
• Time in Patent Office: Days
• US Class Current: 623/17.11
• CPC Class Codes: A61F 2/4611 of spinal prostheses
• CPC Class Codes: A61F 2002/30062 (bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
• 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 2210/0004 bioabsorbable
• CPC Class Codes: Y10S 606/907 Composed of particular material or coated
• CPC Class Codes: Y10S 606/908 Bioabsorbable material

Abstract

A band of biocompatible and/or bioabsorbable material is provided including threads on one or both of its ends. An area adjacent a spinal disc is accessed, and the band of material is wrapped around the disc to stabilize the disc and/or to facilitate healing. An elongate member is inserted around a posterior region of the disc, e.g., through tubular guide members. An end of the band is connected to a distal end of the elongate member, and the elongate member is pulled back around the disc to direct the band around the disc. The band is secured around the disc overlapping vertebrae adjacent the disc. Optionally, a relative location of the vertebrae is adjusted relative to the disc before wrapping the band around the disc, for example, using a fork member or traction. Energy may also be applied to the disc to enhance healing.

Claims

21. A method for treating a ruptured or degenerated spinal disc of a patient, comprising:

accessing an area adjacent an exterior of a spinal disc disposed between adjacent vertebrae; and

wrapping a band of material around the disc to stabilize the disc in a desired position relative to surrounding anatomy.

1. An apparatus for treating a ruptured or degenerated spinal disc, comprising:

an elongate member comprising a proximal end including a handle thereon, and a curved distal end including a connector element thereon; and

a band of biocompatible material having a first end releasably connectable to the connector element on the elongate member, the band having a length sufficient to wrap around an exterior of a spinal disc.

2. The apparatus of claim 1, wherein the connector element comprises a hook on the distal end of the elongate member.

3. The apparatus of claim 2, wherein the first end of the band comprises an opening for receiving the hook therein.

4. The apparatus of claim 1, wherein the band has a width sufficient to cover a spinal disc and at least partially cover at least one vertebra adjacent the spinal disc.

5. The apparatus of claim 1, wherein the band comprises healing-promoting material.

6. The apparatus of claim 1, further comprising an extra-cellular matrix material on at least one side of the band.

7. The apparatus of claim 1, wherein the band comprises a nonporous material.

8. The apparatus of claim 1, wherein the band comprises a porous webbing.

9. The apparatus of claim 1, wherein the band comprises bioabsorbable material.

10. The apparatus of claim 1, wherein the band comprises a second end, the second end comprising a connector for securing the second end to another portion of the band for securing the band around a spinal disc.

11. The apparatus of claim 10, wherein the connector comprises one or more threads extending from the second end.

12. The apparatus of claim 1, wherein at least a portion of the band is electrically conductive.

13. The apparatus of claim 12, further comprising a source of electrical energy coupled to the electrically conductive portion of the band.

14. The apparatus of claim 1, further comprising a fork member comprising proximal and distal ends defining an axis therebetween, the distal end comprising a pair of tines, each tine comprising a transverse portion extending generally parallel to one another transversely with respect to the axis.

15. The apparatus of claim 14, wherein the transverse portion of each tine comprises a tip and a heel disposed proximal to the tip, a length between the tip and the heel being sufficient for engaging a first vertebra with the tip and pivotally engaging a second vertebra with the heel to adjust a distance between the first and second vertebrae.

16. The apparatus of claim 1, further comprising a guide member including a proximal end and a curved distal end having a radius of curvature corresponding substantially to an exterior perimeter of a spinal disc, the guide member comprising a lumen extending between the proximal and distal ends, the lumen having a size for receiving at least a portion of the band therethrough.

17. The apparatus of claim 16, wherein the lumen through the guide member comprises a slot including a height greater than a width of the band.

18. The apparatus of claim 17, wherein the proximal end of the guide member defines an axis, and wherein the distal end of the guide member terminates in a distal tip extending transversely with respect to the axis.

19. The apparatus of claim 17, wherein the height of the lumen extends substantially perpendicular to the radius of curvature of the distal end.

20. The apparatus of claim 1, further comprising a pair of opposite-hand guide members, each guide member comprising a proximal end and a curved distal end having a radius of curvature corresponding substantially to an exterior perimeter of a spinal disc, each guide member comprising a lumen extending between the proximal and distal ends, the lumen having a size for receiving at least a portion of the band therethrough.

22. The method of claim 21, wherein the band engages at least one of the vertebrae when the band is wrapped around the disc to substantially secure the disc relative to the at least one of the vertebrae.

23. The method of claim 21, further comprising adjusting a location of at least one of the vertebrae relative to the disc.

24. The method of claim 23, wherein the adjusting step comprises:

engaging at least one of the vertebrae between tines of a fork member; and

manipulating the tines between the vertebrae to increase a space between the vertebrae.

25. The method of claim 23, wherein the adjusting step comprises subjecting the patient to traction.

26. The method of claim 21, further comprising placing an extra-cellular matrix material between the band and the disc.

27. The method of claim 26, wherein the band comprises the extra-cellular matrix material on an interior surface thereof, and wherein the extra-cellular matrix material is placed when the band is wrapped around the disc.

28. The method of claim 21, wherein the band comprises healing-promoting material for enhancing healing of damage to an annulus fibrosis of the disc.

29. The method of claim 21, wherein the band comprises nonporous material, and wherein the band substantially seals any leaks in the disc when the band is wrapped around the disc.

30. The method of claim 21, wherein the band comprises bioabsorbable material that remains around the disc until absorbed by the patient'"'"'s body.

31. The method claim 21, further comprising applying energy to the disc to enhance healing of the disc.

32. The method of claim 31, wherein at least a portion of the band is electrically conductive, wherein the method further comprises coupling a source of electrical energy to the electrically conductive portion of the band, and wherein the applying energy step comprises applying electrical energy to the disc via the electrically conductive portion of the band.

33. The method of claim 31, wherein the applying energy step comprises applying electrical energy directly to one or more desired regions of the disc.

34. The method of claim 21, further comprising inserting a tubular guide member around a portion of the exterior of the disc, and wherein the wrapping step comprises directing the band through the guide member to facilitate wrapping the band around a posterior region of the disc.

35. The method of claim 21, further comprising inserting a pair of opposite-hand tubular guide members around opposing lateral regions of the exterior of the disc.

36. The method of claim 35, wherein the guide members are inserted around the disc until distal ends of the guide members are disposed adjacent a posterior region of the disc.

37. The method of claim 35, wherein the wrapping step comprises:

directing a distal end of an elongate member through lumens of the guide members;

connecting a first end of the band to the distal end of the elongate member; and

directing the distal end of the elongate member back through the lumens of the guide members to direct the band around the posterior region of the disc.

22-1. The method of claim 21, wherein the accessing step comprises accessing an anterior region of the disc, and wherein the wrapping step comprises:

extending a distal end of an elongate member along a first lateral region of the disc around a posterior region of the disc to an opposite second lateral region of the disc;

connecting a first end of the band to the distal end of the elongate member;

pulling the elongate member back around the posterior region of the disc, thereby directing the first end of the band around the posterior region of the disc; and

securing at least one of the first end and a second end of the band to another portion of the band, thereby securing the band around the disc.

38. A method for treating a spinal region of a patient, the method comprising:

accessing an area adjacent an anterior region of a spinal disc, the disc being disposed between adjacent vertebrae and being surrounded by a ligament;

inserting an instrument between the ligament and an exterior of the disc in order to access a posterior region of the disc; and

performing a diagnostic or therapeutic procedure at a location accessed from the posterior region of the disc.

39. The method of claim 38, wherein the step of inserting an instrument comprises inserting a tubular guide member around a portion of the exterior of the disc until a distal portion of the tubular guide member is disposed adjacent the posterior region of the disc.

40. The method of claim 39, wherein the step of inserting an instrument further comprises inserting one or more instruments through the tubular guide member in order to access the posterior region.

41. The method of claim 38, wherein the step of inserting an instrument comprises inserting a pair of opposite-hand tubular guide members around opposing lateral regions of the exterior of the disc until distal ends of are disposed adjacent the posterior region.

42. The method of claim 41, wherein the step of performing a diagnostic or therapeutic procedure comprises:

directing a distal end of an elongate member through lumens of the guide members;

connecting a first end of the band to the distal end of the elongate member; and

directing the distal end of the elongate member back through the lumens of the guide members to wrap the band around the posterior region of the disc.

43. The method of claim 42, wherein the band is wrapped around the disc to stabilize the disc in a desired position relative to surrounding anatomy.

44. The method of claim 38, wherein the accessing step comprises creating an incision in the ligament to access the exterior of the disc, and wherein the inserting step comprises inserting the one or more instruments through the incision.

45. The method of claim 38, wherein the step of performing a diagnostic or therapeutic procedure comprises removing at least a portion of the disc.

46. The method of claim 38, wherein the step of performing a diagnostic or therapeutic procedure comprises imaging the posterior region of the disc.

47. The method of claim 38, further comprising adjusting a location of at least one of the vertebrae relative to the disc.

48. The method of claim 38, wherein the step of performing a diagnostic or therapeutic procedure comprises accessing a tissue structure adjacent the posterior region of the disc.