LAMINOPLASTY METHODS USING HINGE DEVICE

• US 20100241165A1
• Filed: 03/18/2009
• Published: 09/23/2010
• Est. Priority Date: 03/18/2009
• Status: Active Grant

• Current Assignee: Depuy Synthes Products Incorporated (Johnson & Johnson)
• Original Assignee: Depuy Spine Incorporated (Johnson & Johnson)
• Inventors: Page, Jayson S., Slivka, Michael A., Hawkins, John R., Konieczynski, David D., Jacene, Michael, Mazzuca, Michael, Zalenski, Ed
• Granted Patent: US 8,435,265 B2
• Time in Patent Office: Days
• US Class Current: 606/248
• CPC Class Codes: A61B 17/7059 Cortical plates A61B17/7007, A61B17/7058 take precedence
• CPC Class Codes: A61B 17/7071 Implants for expanding or repairing the vertebral arch or wedged between laminae or pedicles; Tools therefor
• CPC Class Codes: A61B 17/808 Instruments for holding or positioning bone plates, or for adjusting screw-to-plate locking mechanisms
• CPC Class Codes: A61B 17/863 with thread interrupted or changing its form along shank, other than constant taper
• CPC Class Codes: A61B 17/866 Material or manufacture
• CPC Class Codes: A61B 2017/8655 with special features for locking in the bone
• CPC Class Codes: A61B 2090/037 with a frangible part, e.g. by reduced diameter

Abstract

A vertebra implant is provided that includes an elongate body with a first end configured to mate the first end to a first location on a vertebra, and a second end having at least one fastener configured to mate the second end to a second location on a vertebra. The elongate body also includes a deformable portion extending between the first and second ends that has an unexpanded configuration in which the deformable portion is configured to allow a tool to cut bone extending between the first and second ends when the first and second ends are mated to first and second locations on a vertebra, and an expanded configuration in which the deformable portion is deformed to increase a distance between the first and second ends such that a gap is created in the cut bone. The deformable portion is configured to maintain the first and second ends at a fixed distance apart when the deformable portion is in the expanded configuration. A vertebral implant is also provided that includes an elongate member configured to extend into a vertebra and form a hinge therein using a breakage point located along a length of the elongate member.

Claims

1. A laminoplasty implant, comprising:

an elongate body having

a first end having at least one fastener configured to mate the first end to a first location on a vertebra,

a second end having at least one fastener configured to mate the second end to a second location on a vertebra, and

a deformable portion extending between the first and second ends, the deformable portion having an unexpanded configuration in which the deformable portion is configured to allow a tool to cut bone extending between the first and second ends when the first and second ends are mated to first and second locations on a vertebra, and an expanded configuration in which the deformable portion is deformed to increase a distance between the first and second ends such that a gap is created in the cut bone, the deformable portion being configured to maintain the first and second ends at a fixed distance apart when the deformable portion is in the expanded configuration.

2. The implant of claim 1, wherein the fastener on at least one of the first and second ends is disposed within a thru-hole formed in the elongate body.

3. The implant of claim 2, wherein the fastener comprises a bone screw.

4. The implant of claim 1, wherein the fastener on at least one of the first and second ends comprises a clamp formed on the elongate body and configured to engage bone.

5. The implant of claim 1, wherein the deformable portion extends out of an axis extending between the first and second ends of the elongate body to allow a tool to cut bone positioned between the first and second ends of the elongate body.

6. The implant of claim 1, wherein the deformable portion has at least one u-shaped region.

7. The implant of claim 1, wherein the deformable portion is in the form of an elongate coiled member.

8. The implant of claim 1, wherein the deformable portion has at least one bend formed therein in the unexpanded configuration, and wherein the deformable portion is substantially linear in the expanded configuration.

9. The implant of claim 1, wherein the deformable portion has a mesh configuration.

10. The implant of claim 1, further comprising a first feature formed between the first end and the deformable portion and a second feature formed between the second end and the deformable portion, the first and second features facing one another such that a tool having first and second jaws that pivot relative to one another can be positioned in the first and second features to apply a force to the first and second ends to move the deformable portion to the expanded configuration.

15. The method of claim 11, wherein coupling at least one of the first and second ends of the implant to the first and second locations on the vertebra comprises inserting a fastener through a thru-hole formed in the implant and inserting the fastener into the vertebra.

11. A method for increasing a size of a spinal canal, comprising:

coupling a first end of an implant to a first location on a vertebra;

coupling a second end of the implant to a second location on the vertebra;

cutting the vertebra between the first and second locations; and

deforming a deformable portion of the implant to increase and maintain a distance between the first and second locations on the vertebra thereby increasing a size of a spinal canal extending through the vertebra.

12. The method of claim 11, where the vertebra is cut after coupling at least one of the first and second ends of the implant to the first and second locations on the vertebra.

13. The method of claim 11, wherein deforming the deformable portion of the implant comprises inserting a tool between the first and second ends of the implant, and actuating the tool to apply a force to the first and second ends of the implant to increase a distance therebetween.

14. The method of claim 13, wherein deforming the deformable portion of the implant stretches out at least one bend formed in the deformable portion.

16. The method of claim 11, wherein the first and second locations are on a lamina located on a first side of a spinous process of the vertebra, and wherein cutting the vertebra comprises separating the lamina into two portions.

17. The method of claim 16, further comprising forming a hinge in a lamina located on a second side of the spinous process of the vertebra.

18. A laminoplasty implant kit, comprising:

an elongate member configured to extend into a lamina on a first lateral side of a vertebra, the elongate member having a breakage point located along a length thereof, the breakage point being configured to form a hinge in the lamina when the elongate member is disposed therein; and

an implant having first and second ends configured to mate to first and second locations on a lamina on a second lateral side of a vertebra, the first and second ends being configured to maintain the first and second locations on the lamina at a fixed distance apart from one another to thereby increase a size of a spinal canal extending through the vertebra.

19. The implant kit of claim 18, wherein the breakage point comprises a flexible region formed on the elongate member.

20. The implant kit of claim 18, wherein the breakage point comprises a hinge formed on the elongate member.

21. The implant kit of claim 18, wherein the breakage point comprises a probe disposed within the elongate member and movable between a first position in which a distal end of the probe is fully disposed within the elongate member, and a second position in which the distal end of the probe protrudes from an opening formed in a sidewall of the elongate member to penetrate bone and cause the lamina to break and form a hinge.

22. The implant kit of claim 21, wherein the elongate member is cannulated to allow for the probe to be inserted therein.

23. The implant kit of claim 18, wherein the breakage point comprises a weakened region formed on the elongate member and configured to break and form the hinge in the first lateral side of the vertebra.

24. The implant kit of claim 18, further comprising at least one fastener for mating the implant to bone.

25. The implant kit of claim 18, wherein the implant includes an expandable portion located between the first and second ends and configured to expand to maintain the first and second locations on the lamina at a fixed distance apart from one another.

26. A method for increasing a size of a spinal canal, comprising:

implanting an elongate member in a lamina on a first lateral side of a vertebra;

applying a force to the elongate member to create a hinge in the lamina;

forming a cut in a lamina on a second lateral side of the vertebra to separate the lamina into two halves; and

increasing a distance between the two halves of the lamina to expand a size of a spinal canal extending through the vertebra, the hinge pivoting as the distance between the two halves of the lamina is increased.

27. The method of claim 26, further comprising coupling an implant to opposed sides of the cut in the lamina on the second lateral side of the vertebra.

28. The method of claim 27, wherein increasing the distance between the two halves of the lamina comprises deforming a deformable portion on the implant to increase a length of the implant.

29. The method of claim 26, wherein applying a force to the elongate member comprises inserting a tool into the elongate member to push a probe out of an opening formed in the sidewall of the elongate member, the probe penetrating into the lamina to create the hinge.

30. The method of claim 26, wherein applying a force to the elongate member causes a breakage point on the elongate member to break to create the hinge in the lamina.

31. The method of claim 26, wherein applying a force to the elongate member causes a portion of the lamina adjacent to a distal tip of the elongate member to break to create the hinge in the lamina.

32. A method for increasing the size of a spinal canal, comprising:

accessing a first lateral side of the spine through an access port formed through tissue on the first lateral side of the spine;

forming a hinge on a second lateral side of the spine through the access port;

forming a cut in a lamina on the first lateral side through the access port to separate the lamina into two halves; and

increasing a distance between the two halves of the lamina to expand a size of a spinal canal extending through the spine, the hinge pivoting as the distance between the two halves of the lamina is increased.