Apparatus and methods for vertebral augmentation

• US 20070093846A1
• Filed: 10/10/2006
• Published: 04/26/2007
• Est. Priority Date: 10/12/2005
• Status: Active Grant

• Current Assignee: Synthes USA LLC (Johnson & Johnson)
• Original Assignee: Synthes USA LLC (Johnson & Johnson)
• Inventors: Frigg, Robert, Appenzeller, Andreas, Dutoit, Christof, Stoll, Thierry, Benoit, Alfred, Fuerst, Christoph, Heini, Paul
• Granted Patent: US 8,157,806 B2
• Time in Patent Office: Days
• US Class Current: 606/90
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/7077 for moving bone anchors attached to vertebrae, thereby displacing the vertebrae
• CPC Class Codes: A61B 17/7079 Tools requiring anchors to be already mounted on an implanted longitudinal or transverse element, e.g. where said element guides the anchor motion
• CPC Class Codes: A61B 17/8805 for introducing fluid filler into bone or extracting it A61B17/7097, A61B17/8833 take precedence
• CPC Class Codes: A61B 2017/0256 for the spine

Abstract

Apparatuses and methods of treating a collapsed vertebra may include inserting cannulae into the damaged vertebral body and one or more adjacent vertebral bodies and repositioning the one or more adjacent vertebral bodies by manipulating one or more of the cannulae. Before or after repositioning the vertebral bodies, the method may further include passing through the cannula and into the damaged vertebra a disruption tool for fracturing the damaged vertebral body. Once the cortical bone is broken or otherwise disrupted, the height of the damaged vertebral body may be restored, for example by removing the disruption tool and inserting through the cannula another tool, implant, device and/or material to restore the height of the vertebral body and to restore normal spinal curvature in the affected area. Bone cement, bone chips, demineralized bone or other grafting material or filler may be added with or without an implanted device to augment the damaged vertebral body.

Claims

1. An apparatus for repositioning vertebrae, comprising:

at least one elongated member, each of said elongated members having a first end and a second end, wherein the first end of each elongated member is configured for insertion into a vertebral body;

a fixation rod having an arcuate shape; and

at least one clamp configured to adjustably secure the second end of one of the elongated members to the fixation rod,

wherein, the clamp is configured to move along the fixation rod to pivot the elongated member to reposition a vertebral body.

2. The apparatus of claim 1, further comprising a handle engaged with the second end of the elongated members.

3. The apparatus of claim 1, wherein the two or more elongated members are tubular bodies having a lumen along its length.

4. The apparatus of claim 1, wherein:

the fixation rod comprises a plurality of surface features arranged along a longitudinal axis of the fixation rod; and

the clamp has a first configuration wherein the clamp is capable of moving in a first direction along the longitudinal axis of the fixation rod, and to engage the surface features to prevent movement in a second direction along the longitudinal axis of the fixation rod.

5. The apparatus of claim 4, wherein the clamp comprises a button and has a second configuration wherein the button disengages the clamp from the surface features of the fixation rod and allows movement of the clamp in the second direction.

6. The apparatus of claim 1, further comprising a cannula having a first end, a second end, and a lumen providing a passage through the cannula from the first end to the second end, said first end configured for insertion into a fractured vertebral body.

7. The apparatus of claim 1, wherein said elongated member comprises at least one the group consisting of stainless steel, a metal, a metal alloy, a polymer, a composite, a ceramic or a combination thereof.

8. A method for treating a damaged vertebral body, comprising:

Applying a force in region to restore spinal lordosis in a region of a damaged vertebral body;

fracturing the damaged vertebral body;

restoring a height of the damaged vertebral body; and

augmenting the vertebral body.

9. The method of claim 8, wherein the step of restoring spinal lordosis comprises:

inserting a first elongated member into a first vertebral body, wherein the first vertebral body is adjacent to a first end of the damaged vertebral body;

inserting a second elongated member into a second vertebral body, wherein the second vertebral body is adjacent to a second end of the damaged vertebral body opposite the first end;

moving the first elongated member to change the position of the first vertebral body with respect to the damaged vertebral body; and

positioning first elongated member on a fixation rod.

10. The method of claim 9, wherein the elongated members are positioned on the fixation rod prior to moving the first elongated member with respect to the damaged vertebral body.

11. The method of claim 9, wherein the moving step comprises positioning the first elongated member relative to the damaged vertebral body.

12. The method of claim 9, wherein the positioning step comprises securing the first elongated member to an arcuate fixation rod with a first clamp.

13. The method of claim 12, wherein the moving step comprises:

disengaging the first clamp from the fixation rod;

pivoting the elongated member; and

reengaging the first clamp with the fixation rod to fix the position of the first vertebral body.

14. The method of claim 12, wherein the moving step comprises moving the position of the clamp connected to the elongated member along the longitudinal axis of the fixation rod.

15. The method of claim 12, wherein the step of restoring spinal lordosis further comprises inserting a cannula into the damaged vertebral body and fixing the cannula to the fixation rod.

16. The method of claim 8, wherein the step of fracturing the damaged vertebral body comprises:

inserting a cannula, via a posterior approach, into the damaged vertebral body, the cannula having a lumen dimensioned to provide a passage into the vertebral body;

inserting a disruption device through the cannula; and

fracturing the damaged vertebral body using the disruption device.

17. The method of claim 8, wherein the step of restoring the height of the damaged vertebral body comprises:

inserting a cannula into the damaged vertebral body, the cannula having a lumen dimensioned to provide a passage into the vertebral body;

inserting a tool through the cannula and into the vertebral body; and

moving an endplate of the damaged vertebral body with the tool to restore the height of the damaged vertebral body.

18. The method of claim 17, wherein:

the access tool comprises a curved rod having a longitudinal axis and a distal end configured to contact bone; and

the step of moving the endplate comprises advancing the curved rod through the cannula contacting the endplate with the distal end of the curved rod, and moving the endplate away from an opposite endplate of the vertebra to reposition the vertebra endplate by applying a force along the longitudinal axis of the curved rod.

19. The method of claim 8, further comprising, before the restoring step, inserting a cannula into the damaged vertebral body, the cannula having a lumen dimensioned to provide a passage into the vertebral body.

20. The method of claim 8, where in the fracturing step is performed before the restoring spinal lordosis step.