Minimally invasive apparatus to manipulate and revitalize spinal column disc

• US 20060276902A1
• Filed: 02/10/2006
• Published: 12/07/2006
• Est. Priority Date: 06/03/2005
• Status: Abandoned Application

• Current Assignee: Arthrodisc LLC
• Original Assignee: Arthrodisc LLC
• Inventors: Zipnick, Richard I., Stultz, Randall W.
• Application Number:
  US11/351,665
• Publication Number:
  US 20060276902A1
• Time in Patent Office: Days
• US Class Current: 623/17.160
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 17/3476 Powered trocars, e.g. electrosurgical cutting, lasers, powered knives
• CPC Class Codes: A61B 17/7062 Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs rib fixation devices A61B17/8076; Tools for such devices
• CPC Class Codes: A61B 17/7064 Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor
• CPC Class Codes: A61B 17/8875 Screwdrivers, spanners or wrenches
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2017/320044 Blunt dissectors blunt suture needles A61B2017/06085
• CPC Class Codes: A61B 2017/32113 with extendable or retractable guard or blade
• CPC Class Codes: A61B 2090/0801 Prevention of accidental cutting or pricking
• CPC Class Codes: A61F 2/30771 applied in original prostheses, e.g. holes or grooves
• CPC Class Codes: A61F 2/3094 Designing or manufacturing processes
• 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 2/4425 made of articulated components
• 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 2/446 having a circular or elliptical cross-section substantially parallel to the axis of the spine, e.g. cylinders or frustocones
• CPC Class Codes: A61F 2/447 substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section
• CPC Class Codes: A61F 2/4611 : of spinal prostheses
• CPC Class Codes: A61F 2002/30112 : Rounded shapes, e.g. with rounded corners
• CPC Class Codes: A61F 2002/30131 : horseshoe- or crescent- or C-shaped or U-shaped
• CPC Class Codes: A61F 2002/30136 : undulated or wavy, e.g. serpentine-shaped or zigzag-shaped
• CPC Class Codes: A61F 2002/30153 : rectangular
• CPC Class Codes: A61F 2002/30172 : T-shaped
• CPC Class Codes: A61F 2002/30205 : conical
• CPC Class Codes: A61F 2002/30224 : cylindrical
• CPC Class Codes: A61F 2002/30233 : Stepped cylinders, i.e. having discrete diameter changes
• CPC Class Codes: A61F 2002/30253 : ellipsoidal or ovoid
• CPC Class Codes: A61F 2002/30261 : parallelepipedal
• CPC Class Codes: A61F 2002/30285 : rugby-ball-shaped
• CPC Class Codes: A61F 2002/30286 : barrel-shaped
• CPC Class Codes: A61F 2002/30293 : Cylindrical body made by spirally rolling up a sheet or a strip around itself
• CPC Class Codes: A61F 2002/30294 : Conical or frustoconical body made by spirally rolling up a sheet or a strip around itself
• CPC Class Codes: A61F 2002/30331 : made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
• CPC Class Codes: A61F 2002/30393 : with additional means for limiting said rotation
• CPC Class Codes: A61F 2002/30398 : Sliding
• CPC Class Codes: A61F 2002/30401 : with additional means for preventing or locking said sliding
• CPC Class Codes: A61F 2002/30428 : made by inserting a protrusion into a slot
• 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 2002/30517 : using a locking plate
• CPC Class Codes: A61F 2002/30528 : Means for limiting said movement
• CPC Class Codes: A61F 2002/30545 : for adjusting a diameter
• CPC Class Codes: A61F 2002/3055 : for adjusting length
• CPC Class Codes: A61F 2002/30553 : for adjusting a position by translation along an axis
• CPC Class Codes: A61F 2002/30566 : Helical springs
• CPC Class Codes: A61F 2002/30571 : Leaf springs
• CPC Class Codes: A61F 2002/30573 : 2-D spiral springs
• CPC Class Codes: A61F 2002/30579 : with mechanically expandable devices, e.g. fixation devices
• CPC Class Codes: A61F 2002/30593 : hollow
• CPC Class Codes: A61F 2002/30594 : slotted, e.g. radial or meridian slot ending in a polar aperture, non-polar slots, horizontal or arcuate slots
• CPC Class Codes: A61F 2002/30601 : telescopic
• CPC Class Codes: A61F 2002/30604 : modular
• CPC Class Codes: A61F 2002/30624 : Hinged joint, e.g. with transverse axle restricting the movement
• CPC Class Codes: A61F 2002/30634 : biaxial
• CPC Class Codes: A61F 2002/30649 : Ball-and-socket joints
• CPC Class Codes: A61F 2002/30662 : with rotation-limiting means
• CPC Class Codes: A61F 2002/30772 : Apertures or holes, e.g. of circular cross section
• CPC Class Codes: A61F 2002/30818 : castellated or crenellated
• CPC Class Codes: A61F 2002/30822 : Circumferential grooves
• CPC Class Codes: A61F 2002/30823 : having the shape of a reverse dovetail
• CPC Class Codes: A61F 2002/30831 : perpendicular with respect to each other
• CPC Class Codes: A61F 2002/30841 : Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
• CPC Class Codes: A61F 2002/30881 : Circumferential ribs, flanges or fins
• CPC Class Codes: A61F 2002/30883 : dovetail-shaped
• CPC Class Codes: A61F 2002/30884 : Fins or wings, e.g. longitudinal wings for preventing rotation within the bone cavity
• CPC Class Codes: A61F 2002/4415 : elements of the prosthesis being arranged in a chain like manner
• CPC Class Codes: A61F 2002/443 : having two transversal endplates and at least one intermediate component
• CPC Class Codes: A61F 2002/444 : for replacing the nucleus pulposus
• CPC Class Codes: A61F 2002/4627 : with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument
• CPC Class Codes: A61F 2002/4629 : connected to the endoprosthesis or implant via a threaded connection
• CPC Class Codes: A61F 2002/4677 : using a guide wire
• CPC Class Codes: A61F 2220/0025 : Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2220/0033 : made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
• CPC Class Codes: A61F 2220/0091 : connected by a hinged linkage mechanism, e.g. of the single-bar or multi-bar linkage type
• CPC Class Codes: A61F 2230/0004 : Rounded shapes, e.g. with rounded corners
• CPC Class Codes: A61F 2230/0013 : Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped
• CPC Class Codes: A61F 2230/0019 : rectangular
• CPC Class Codes: A61F 2230/0052 : T-shaped
• CPC Class Codes: A61F 2230/0063 : Three-dimensional shapes
• CPC Class Codes: A61F 2230/0067 : conical
• CPC Class Codes: A61F 2230/0069 : cylindrical
• CPC Class Codes: A61F 2230/0071 : spherical
• CPC Class Codes: A61F 2230/0076 : ellipsoidal or ovoid
• CPC Class Codes: A61F 2230/0082 : parallelepipedal
• CPC Class Codes: A61F 2230/0091 : helically-coiled or spirally-coiled, i.e. having a 2-D spiral cross-section
• CPC Class Codes: A61F 2250/0008 : for adjusting a position by translation along an axis or two perpendicular axes
• CPC Class Codes: A61F 2250/001 : for adjusting a diameter
• CPC Class Codes: A61F 2310/00011 : Metals or alloys
• CPC Class Codes: A61F 2310/00179 : Ceramics or ceramic-like structures

Abstract

A method and apparatus are provided to manipulate and revitalize a spinal column disc while minimizing or preventing the removal of material comprising the disc. The method allows a device to be inserted in the disc either through a pre-existing rupture or through an opening formed in the front, back, or sides of the disc. Increasing the space between the vertebra bounding the disc or removing disc material often is not necessary to insert the device in the disc. The device generates internal traction or other forces acting on the disc to alter the shape of the disc. The shape of the disc is altered to relieve pressure on nerves adjacent the disc. The shape of the disc is also altered to draw nuclear hernias back into the interior of the disc and to produce a disc shape that improves functioning of the disc.

Claims

1. A method to treat a misaligned spine comprising the steps of

(a) providing an implant shaped and dimensioned to slide down a guide wire to a selected position intermediate a pair of vertebra to contact and alter the alignment of said vertebra;

(b) sliding said implant down a guide wire to said selected position.

2. A method to treat a misaligned spine comprising the steps of

(a) providing a guide member;

(B) providing an articulated implant shaped and dimensioned to slide down and off said guide member in a first orientation to a first selected position intermediate a pair of vertebra, to articulate to a second orientation and pushed along a path of travel to a second selected position intermediate said pair of vertebra;

(c) sliding said implant down said guide member to said first selected position; and

,

(d) pushing said implant in said second orientation along said path of travel to said second selected position.

3. A method to insert an implant intermediate a pair of vertebra, comprising the steps of

(a) providing an articulated implant shaped and dimensioned to be pushed along an arcuate path of travel to a selected position intermediate the pair of vertebra;

(b) inserting said implant intermediate the pair of vertebra;

(c) pushing said implant along said arcuate path of travel to said second selected position.

4. A method to insert an implant intermediate a pair of vertebra, comprising the steps of

(a) providing a guide wire having a distal end;

(b) providing a spinal implant shaped and dimensioned to slide along said guide wire to a selected position intermediate the pair of vertebra;

(c) inserting said guide wire to position said distal end adjacent the pair of vertebra;

(d) sliding said spinal implant along said guide wire to said selected position; and

,

(e) removing said guide wire.

5. A method to treat a misaligned spine, comprising the steps of

(a) determining the apex of the misaligned spine;

(b) selecting an adjacent pair of vertebra, at least one of said pair of vertebra being located at said apex;

(c) determining at least one direction in which to move at least one of said pair of vertebra to correct at least partially the misalignment of the spine;

(d) determining a spinal implant shape and dimension to achieve movement of said at least one of said pair of vertebra to correct at least partially misalignment of the spine;

(e) providing a selected spinal implant having said shape and dimension;

(f) determining a location intermediate said adjacent pair of vertebra at which to position said selected spinal implant to achieve said movement of said at least one of said pair of vertebra; and

(g) inserting said selected spinal implant at said location.

6. A method to alter the alignment of a vertebra, comprising the steps of

(a) identifying a disc space location adjacent the vertebra;

(b) identifying a spinal implant shape and dimension to generate a force acting from said disc space to alter alignment of the vertebra;

(c) providing a selected spinal implant having said shape and dimension; and

,

(d) inserting said selected spinal implant in said disc space.

7. A method for inserting an implant comprising the steps of

(a) providing an implant;

(b) providing a guide member shaped and dimensioned to permit said implant to move along said guide member without rotating on said guide member;

(c) moving said implant along said guide member to a selected location in a patient'"'"'s body.

8. A method for fixing an implant adjacent tissue in the body of a patient, comprising the steps of

(a) forming an implant with an outer surface having at least one opening that expands in size as the distance from said outer surface into said opening increases;

and,

(b) inserting the implant adjacent viscoelastic tissue in the body to permit the tissue to move into said opening and expand inside said opening.

9. A method to align vertebrae including the steps of

(a) providing an implant that aligns a pair of adjacent vertebra and permits movement of said pair of adjacent vertebra while, to protect the facets of said vertebrae, minimizing rotation of one of said vertebra with respect to the other of said vertebra;

and,

(b) inserting said implant between said pair of vertebra to engage each of said pair of vertebra, alter the alignment of said vertebrae, permit movement of said vertebrae, and minimize rotation of one of said vertebrae with respect to the other of said vertebrae.

10. A method to insert an implant having at least one moving component, comprising the steps of

(a) providing a guide member to

(i) engage and insert said implant while immobilizing said moving component, and

(ii) once said implant is inserted, to disengage from said implant and permit said moving component to move;

(b) engaging said implant with said guide member to immobilize said moving component;

(c) inserting said implant with said guide member; and

,

(d) disengaging said guide member from said implant to permit movement of said moving component.

11. A method to alter the alignment of the spine, comprising the steps of

(a) providing an implant shaped and dimensioned to engage each one of an adjacent pair of adjacent vertebra and including at least one displaceable member to translate at least laterally at least one of said pair with respect to the other of said pair;

(b) inserting said implant intermediate said pair of vertebra to engage each of said pair; and

,

(c) displacing said member to translate laterally at least one of said pair.