Systems and methods for moving anatomical elements

• US 20030236472A1
• Filed: 09/30/2002
• Published: 12/25/2003
• Est. Priority Date: 06/19/2002
• Status: Abandoned Application

• Current Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Original Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Inventors: Foley, Kevin T., Coates, Bradley J., Poyner, Jeffrey W., Van Hoeck, James
• Application Number:
  US10/260,891
• Publication Number:
  US 20030236472A1
• Time in Patent Office: Days
• US Class Current: 600/587
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• CPC Class Codes: A61B 17/0206 with antagonistic arms as supports for retractor elements
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 2017/00017 Electrical control of surgical instruments
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2090/061 for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61F 2/4611 of spinal prostheses
• CPC Class Codes: A61F 2002/4658 for measuring dimensions, e.g. length

Abstract

Systems and methods for measuring a separation characteristic of separated anatomical elements include a separator contactable with first and second anatomical elements. A sensor provides an indication of the separation characteristic of the anatomical elements. The measured separation characteristic can be compared with a desired or predetermined separation characteristic, and subsequent surgical procedures can be performed based on the measured separation characteristic.

Claims

1. A method positioning a spinal construct in a patient, comprising:

providing a separation instrument having a feedback system operable to provide objective data regarding at least one separation characteristic of anatomical elements;

making an incision in the patient to provide first and second anatomical elements;

positioning the separation instrument in contact with at least one of the first and second anatomical elements;

separating the first and second anatomical elements with the separation instrument;

objectively measuring the at least one separation characteristic with the feedback system, wherein the at least one separation characteristic includes a force applied to separate the first and second anatomical elements;

comparing the measured separation characteristic with a desired separation characteristic; and

positioning a construct in the space between the separated anatomical elements when the measured separation characteristic corresponds to the desired separation characteristic.

2. The method of claim 1, further comprising:

comparing the measured separation characteristic to a threshold separation characteristic; and

moving the first and second anatomical elements relative to one another obtain a second measured separation characteristic below the threshold characteristic.

3. The method of claim 1, wherein positioning the construct in the space includes positioning the construct through the space between the separated first and second anatomical elements.

4. The method of claim 3, wherein the first and second anatomical elements include soft tissue elements.

5. The method of claim 3, wherein the first and second anatomical elements include bony tissue elements.

6. The method of claim 5, wherein the desired separation characteristic corresponds to a compressive force applied to the construct when the construct is engaged to the first and second bony tissue elements and the separation instrument is released from at least one of the first and second bony tissue elements.

7. The method of claim 6, further comprising engaging the construct to the first and second bony tissue elements when the measured separation characteristic substantially corresponds to the desired separation characteristic.

8. The method of claim 7, wherein the construct is an implant positioned in an intervertebral space between the first and second bony tissue elements.

9. The method of claim 7, further comprising engaging a plate to the first and second bony tissue elements to maintain the compressive force.

10. The method of claim 7, wherein the construct is a plate extending across an intervertebral space defined by the first and second bony tissue elements.

11. A method for separating first and second vertebral bodies, comprising:

positioning a separation instrument in contact with the first vertebral body and the second vertebral body, the separation instrument including a feedback system associated therewith to provide objective data regarding at least one separation characteristic of the first and second vertebral bodies;

separating the first and second vertebral bodies;

determining a separation characteristic associated with the separated first and second vertebral bodies, wherein the separation characteristic includes an objective indication of a force applied to separate the first and second vertebral bodies;

determining if the separation characteristic substantially corresponds to a predetermined separation characteristic; and

adjusting the separation characteristic based on the determination.

12. The method of claim 11, further comprising engaging a construct to the first and second vertebrae when the separation characteristic substantially corresponds to the predetermined separation characteristic.

13. The method of claim 12, wherein engaging the construct includes positioning an implant positioned in the intervertebral space between the first and second vertebral bodies.

14. The method of claim 13, wherein engaging the construct further includes engaging a plate to the first and second vertebral bodies.

15. The method of claim 12, wherein engaging the construct further includes engaging a plate to the first and second vertebral bodies.

16. The method of claim 11, wherein the force is indicated as a pressure.

17. The method of claim 11, wherein the force is indicated as a change in force per change in separation distance.

18. The method of claim 11, wherein the predetermined separation characteristic corresponds to a residual compressive force applied by the first and second vertebral bodies to a construct engaged between the first and second vertebral bodies when the separation instrument is released from at least one of the first and second vertebral bodies.

19. The method of claim 18, further comprising engaging the construct to the first and second vertebral bodies when the separation characteristic substantially corresponds to the desired separation characteristic.

20. The method of claim 11, wherein adjusting the separation characteristic further comprises applying a compressive load to the vertebral bodies after engaging a construct in the intervertebral space between the first and second vertebral bodies to provide a desired post-operative compressive load on the construct.

21. The method of claim 20, wherein the implant is an interbody fusion device.

22. The method of claim 20, further comprising engaging a plate to the first and second vertebral bodies to post-operatively maintain the compressive load.

23. The method of claim 20, wherein the implant is an artificial disc.

24. The method of claim 20, wherein the construct is a plate engaged to the first and second vertebral bodies.

25. The method of claim 19, wherein the compressive load is applied with the separation instrument to provide an objective indication of the compressive load.

26. The method of claim 11, wherein adjusting the separation characteristic includes reducing the force applied to separate the first and second vertebral bodies.

27. A system for moving first and second soft tissue elements relative to one another, comprising:

a connector having an engageable portion extending between opposite ends;

a first member extending from said connector contactable with a first soft tissue element;

a second member extending from said connector and contactable with a second soft tissue element spaced from the first soft tissue element, said second member being movable relative to said first member; and

a system associated with at least one of said first member and said second member operable to determine an actual separation characteristic associated with separation of the first and second soft tissue elements and provide objective feedback regarding the same, wherein said first member and said second member are movable relative to one another to adjust said actual separation characteristic in accordance with the objective feedback to obtain a desired separation characteristic.

28. The system of claim 27, wherein the objective feedback includes at least one from the group consisting of:

a separation distance between the first and second soft tissue elements;

a force applied to separate the first and second soft tissue elements; and

a change in force per change in separation distance between the first and second soft tissue elements.

29. The system of claim 27, further comprising an adjustment mechanism coupled between said connector and said second member operable to move said second member relative to said first member.

30. The system of claim 29, further comprising a locking mechanism for securing said first member and said second member in a position relative to one another.

31. The system of claim 30, wherein said locking mechanism includes a spring loaded lever selectively engageable with a ratcheting surface provided along said connecting member.

32. The system of claim 31, wherein said adjustment mechanism includes a wheel having a number of teeth thereabout engageable with said ratcheting surface.

33. The system of claim 27, wherein said system includes a sensor associated with at least one of said first member and said second member.

34. The system of claim 33, wherein said sensor includes at least one selected from the group consisting of:

a strain gauge, a spring; and

a pressure sensor.

35. The system of claim 33, wherein:

said second member includes a housing positioned about said connector;

said sensor includes a spring in said housing coupled with a tissue contacting portion of said second member, said spring being responsive to a load on said tissue contacting portion to provide an indication corresponding to said actual separation characteristic.