Percutaneous spinal implants and methods

• US 20070049934A1
• Filed: 02/17/2006
• Published: 03/01/2007
• Est. Priority Date: 02/17/2005
• Status: Active Grant

• Current Assignee: Medtronic Europe SARL (Medtronic Plc)
• Original Assignee: Kyphon SARL (Medtronic Plc)
• Inventors: Malandain, Hugues, Kohm, Andrew, Edidin, Avram
• Granted Patent: US 8,029,567 B2
• Time in Patent Office: Days
• US Class Current: 623/17.110
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/7065 Devices with changeable shape, e.g. collapsible or having retractable arms to aid implantation; Tools therefor
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/0256 for the spine

Abstract

Apparatuses and methods for performing minimally-invasive medical procedures are described. In one embodiment, for example, an apparatus includes an elongate member having a proximal portion configured to move repeatedly between a first configuration and a second configuration. At least a section of the proximal portion is collapsed in the first configuration and is expanded in the second configuration. The elongate member has a distal portion configured to move repeatedly between a first configuration and a second configuration. At least a section of the proximal portion is collapsed in the first configuration and is expanded in the second configuration. A non-expanding central portion is positioned between the proximal portion and the distal portion. The non-expanding central portion is configured to engage adjacent spinous processes.

Claims

1. An apparatus, comprising:

an elongate member having

a proximal portion configured to move from a first configuration to a second configuration and from the second configuration to the first configuration, at least a section of the proximal portion being collapsed in the first configuration and expanded in the second configuration;

a distal portion configured to move from a first configuration to a second configuration and from the second configuration to the first configuration, at least a section of the distal portion being collapsed in the first configuration and expanded in the second configuration; and

a non-expanding central portion between the proximal portion and the distal portion, the non-expanding central portion configured to be disposed between adjacent spinous processes upon spinal extension.

2. The apparatus of claim 1, further comprising:

a proximal end defining a threaded opening; and

a distal end defining a threaded opening, the threaded opening at the proximal end and the threaded opening at the distal end each being configured to receive a portion of an actuator to cause the elongate member to move between the first configuration and the second configuration.

3. The apparatus of claim 1, further comprising:

a proximal actuator-engaging portion; and

a distal actuator-engaging portion, the proximal actuator-engaging portion and the distal actuator-engaging portion each being configured to receive a portion of an actuator to cause the elongate member to move between the first configuration and the second configuration under an axial load.

4. The apparatus of claim 1, further comprising:

a proximal actuator-engaging portion;

a distal actuator-engaging portion; and

a central actuator-engaging portion defined by the non-expanding central portion, the proximal actuator-engaging portion, the central actuator-engaging portion and the distal actuator-engaging portion each being configured to receive a portion of an actuator to cause the elongate member to move between the first configuration and the second configuration.

5. The apparatus of claim 1, further comprising:

a proximal actuator-engaging portion;

a distal actuator-engaging portion; and

a central actuator-engaging portion defined by the non-expanding central portion, the proximal actuator-engaging portion, the central actuator-engaging portion and the distal actuator-engaging portion each being configured to receive a portion of an actuator to cause the proximal portion to move between the first configuration and the second configuration under an applied load between the proximal actuator-engaging portion and the central actuator-engaging portion, and to cause the distal portion to move between the first configuration and the second configuration under an applied load between the distal actuator-engaging portion and the central actuator-engaging portion.

6. The apparatus of claim 1, wherein the elongate member is configured to be inserted between adjacent spinous processes when the proximal portion and the distal portion are each in the first configuration.

7. The apparatus of claim 1, wherein the proximal portion and the distal portion are configured to be moved from the second configuration to the first configuration under an axial load.

8. The apparatus of claim 1, further comprising:

an actuator having a first portion and a second portion;

a proximal actuator-engaging portion configured to receive the first portion of the actuator; and

a distal actuator-engaging portion configured to receive the second portion of the actuator, the first portion of the actuator and the second portion of the actuator configured to move relative to one another in a first direction to cause the elongate member to move to the second configuration and move relative to one another in a second direction to cause the elongate member to move to the first configuration from the second configuration.

9. The apparatus of claim 1, wherein the proximal portion and the distal portion are formed from a first material and the non-expanding central portion is formed from a second material different from the first material.

10. The apparatus of claim 1, wherein the proximal portion is configured to deform to its second configuration before the distal portion deforms to its second configuration.

11. The apparatus of claim 1, wherein the proximal portion has a plurality of projections configured to extend outwardly from the elongate member in the second configuration.

12. The apparatus of claim 1, wherein the proximal portion and the distal portion are configured to deform from the first configuration to the second configuration under a first axial load applied in a first direction, and the proximal portion and the distal portion are configured to move from the second configuration to the first configuration under a second axial load applied in a second direction, the second direction being substantially opposite the first direction.

13. The apparatus of claim 1, wherein the proximal portion and the distal portion are configured to deform from the second configuration to the first configuration by an axially applied load imparted using a low-compliant balloon.

14. A method of placing an implant in a patient'"'"'s body, comprising inserting the apparatus according to claim 1 between two adjacent spinous processes in the patient'"'"'s body.

15. A method, comprising:

inserting percutaneously into a body an elongate member including a proximal end portion and a distal end portion;

moving a section of the proximal end portion from a first configuration to a second configuration;

moving a section of the distal end portion from a first configuration to a second configuration;

moving the section of the proximal end portion from its second configuration to a third configuration; and

moving the section of the distal end portion from its second configuration to a third configuration.

16. The method of claim 15, wherein the moving the section of the proximal end portion to its second configuration occurs substantially simultaneously as the moving the section of the distal end portion to its second configuration.

17. The method of claim 15, wherein the first configuration of the proximal end portion substantially corresponds to the third configuration of the proximal end portion, and the first configuration of the distal end portion substantially corresponds to the third configuration of the distal end portion.

18. The method of claim 15, wherein the first configuration of the proximal end portion differs from the third configuration of the proximal end portion, and the first configuration of the distal end portion differs from the third configuration of the distal end portion.

19. The method of claim 15, wherein the moving the section of the proximal end portion to its third configuration and the moving the section of the distal end portion to its third configuration includes imparting an axial load to the elongate member.

20. The method of claim 15, further comprising:

coupling an actuator to the elongate member at a first location and a second location before the inserting;

separating the actuator from the elongate member after the moving the section of the proximal end portion from its first configuration to its second configuration and the moving the section of the distal end portion from its first configuration to its second configuration; and

coupling the actuator to the elongate member before the moving the section of the proximal end portion from its second configuration to its third configuration and the moving the section of the distal end portion from its second configuration to its third configuration.

21. The method of claim 15, further comprising:

after moving the section of the proximal end to its third configuration and moving the section of the distal end portion to its third configuration, removing the elongate member from the body.

22. The method of claim 15, further comprising after the moving the section of the proximal end portion to its third configuration and the moving the distal end portion to its third configuration, removing the elongate member.

23. An apparatus, comprising:

an elongate member having

a proximal portion defining a first actuator-engaging portion, the proximal portion configured to move from a first configuration to a second configuration and from the second configuration to the first configuration,

a non-expanding central portion defining a second actuator-engaging portion, and

a distal portion defining a third actuator-engaging portion, the distal portion configured to move from a first configuration to a second configuration and from the second configuration to the first configuration, the elongate member configured to be disposed in tissue.

24. The apparatus of claim 23, the first actuator-engaging portion being a first threaded opening, the second actuator portion being a second threaded opening and the third actuator-engaging portion being a third threaded opening, wherein a diameter of the first threaded opening is different from a diameter of the third threaded opening.

25. The apparatus of claim 23, the first actuator-engaging portion being a first threaded opening, the second actuator portion being a second threaded opening and the third actuator-engaging portion being a third threaded opening, wherein the first threaded opening, the second threaded opening and the third threaded opening are each configured to receive at least a portion of an actuator.

26. An apparatus, comprising:

an elongate member configured to be disposed in tissue having

a proximal portion configured to move from a first configuration to a second configuration under a first axial load applied in a first direction and to move from the second configuration to the first configuration under a second axial load applied in a second direction substantially opposite the first direction,

a central portion, and

a distal portion configured to move from a first configuration to a second configuration under a third axial load applied in the first direction and to move from the second configuration to the first configuration under a fourth axial load applied in the second direction.

27. The apparatus of claim 26, wherein the first axial load and the third axial load are the same axial load.

28. The apparatus of claim 26, wherein the second axial load and the fourth axial load are the same axial load.

29. A device, comprising:

a center portion configured for placement between two adjacent spinous processes;

an expandable distal portion configured to prevent the distal portion from moving through an opening between the two adjacent spinous processes when the center portion is positioned between the two adjacent spinous processes;

an expandable proximal portion configured to prevent the proximal portion from moving through the opening between the two adjacent spinous processes when the center portion is positioned between the two adjacent spinous processes.

30. The device of claim 29, wherein the expandable distal portion is further configured to be collapsible after expansion, such that once collapsed the distal portion can move through the opening between the two spinous processes.

31. The device of claim 29, wherein the expandable distal portion is further configured to be collapsible after expansion by applying an axial load, such that once collapsed the distal portion can move through the opening between the two spinous processes.

32. The device of claim 29, wherein the expandable distal portion is further configured to be collapsible after expansion by applying an axial load using a rod slidably disposed in an opening defined by the device, such that once collapsed the distal portion can move through the opening between the two spinous processes.

33. The device of claim 29, wherein the expandable distal portion is further configured to be collapsible after expansion by applying an axial load using a rod threadedly coupled to the device, such that once collapsed the distal portion can move through the opening between the two spinous processes.

34. The device of claim 29, wherein the expandable distal portion is further configured to be collapsible after expansion by applying an axial load using an expandable body disposed in an opening defined by the device, such that once collapsed the distal portion can move through the opening between the two spinous processes.

35. The device of claim 29, wherein the expandable distal portion is further configured to be collapsible after expansion by applying an axial load using a balloon disposed in an opening defined by the device, such that once collapsed the distal portion can move through the opening between the two spinous processes.