Devices and methods of vertebral disc augmentation

• US 6,425,919 B1
• Filed: 06/30/2000
• Issued: 07/30/2002
• Est. Priority Date: 08/18/1999
• Status: Expired due to Term

• Current Assignee: Intrinsic Therapeutics, Inc.
• Original Assignee: Intrinsic Orthopedics, Inc.
• Inventors: Lambrecht, Gregory H
• Primary Examiner(s): McDermott, Corrine
• Assistant Examiner(s): BARRETT, THOMAS C
• Application Number:
  US09/608,797
• Time in Patent Office: 760 Days
• Field of Search: 623/17.16, 128/898
• US Class Current: 623/17.16
• 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 2017/00261 Discectomy
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/320044 Blunt dissectors blunt suture needles A61B2017/06085
• CPC Class Codes: A61B 2090/061 for measuring dimensions, e.g. length
• CPC Class Codes: A61B 5/1076 for measuring dimensions inside body cavities, e.g. using catheters A61B3/1005 takes precedence
• CPC Class Codes: A61B 5/4514 Cartilage
• CPC Class Codes: A61F 2/2846 Support means for bone substitute or for bone graft implants, e.g. membranes or plates for covering bone defects nets or sleeves applied to surface of endoprostheses A61F2/30907; bone plates A61B17/80; bone regeneration in dental surgery A61C8/0006
• CPC Class Codes: A61F 2/30723 Plugs or restrictors for sealing a cement-receiving space tools for inserting plugs A61F2/4614; sealing collars for use during cementing A61B17/8808
• CPC Class Codes: A61F 2/30907 Nets or sleeves applied to surface of prostheses or in cement
• CPC Class Codes: A61F 2/441 made of inflatable pockets or chambers filled with fluid, e.g. with hydrogel
• 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 2/4601 for introducing bone substitute, for implanting bone graft implants or for compacting them in the bone cavity
• CPC Class Codes: A61F 2/4611 of spinal prostheses
• CPC Class Codes: A61F 2/4657 Measuring instruments used for implanting artificial joints for surgical instruments A61B90/06
• CPC Class Codes: A61F 2002/30062 (bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
• CPC Class Codes: A61F 2002/30075 swellable, e.g. when wetted
• CPC Class Codes: A61F 2002/30131 horseshoe- or crescent- or C-shaped or U-shaped
• CPC Class Codes: A61F 2002/30224 cylindrical
• CPC Class Codes: A61F 2002/30228 Cylinders of elliptical or oval basis
• CPC Class Codes: A61F 2002/30291 : spirally-coiled, i.e. having a 2D spiral cross-section
• CPC Class Codes: A61F 2002/30462 : retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2002/30571 : Leaf springs
• CPC Class Codes: A61F 2002/30589 : Sealing means
• CPC Class Codes: A61F 2002/30677 : Means for introducing or releasing pharmaceutical products, e.g. antibiotics, into the body
• CPC Class Codes: A61F 2002/30777 : Oblong apertures
• CPC Class Codes: A61F 2002/30785 : parallel
• CPC Class Codes: A61F 2002/4435 : Support means or repair of the natural disc wall, i.e. annulus, e.g. using plates, membranes or meshes
• CPC Class Codes: A61F 2002/444 : for replacing the nucleus pulposus
• CPC Class Codes: A61F 2002/448 : comprising multiple adjacent spinal implants within the same intervertebral space or within the same vertebra, e.g. comprising two adjacent spinal implants
• CPC Class Codes: A61F 2002/4635 : using minimally invasive surgery
• CPC Class Codes: A61F 2002/4658 : for measuring dimensions, e.g. length
• CPC Class Codes: A61F 2002/4661 : for measuring thickness
• CPC Class Codes: A61F 2002/4662 : for measuring penetration depth
• CPC Class Codes: A61F 2210/0004 : bioabsorbable
• CPC Class Codes: A61F 2210/0061 : swellable
• CPC Class Codes: A61F 2220/0075 : sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2230/0013 : Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped
• CPC Class Codes: A61F 2230/0069 : cylindrical
• CPC Class Codes: A61F 2230/0091 : helically-coiled or spirally-coiled, i.e. having a 2-D spiral cross-section
• CPC Class Codes: A61F 2310/00017 : Iron- or Fe-based alloys, e.g. stainless steel
• CPC Class Codes: A61F 2310/00023 : Titanium or titanium-based alloys, e.g. Ti-Ni alloys
• CPC Class Codes: A61F 2310/00365 : Proteins; Polypeptides; Degradation products thereof
• CPC Class Codes: A61F 2310/00976 : Coating or prosthesis-covering structure made of proteins or of polypeptides, e.g. of bone morphogenic proteins BMP or of transforming growth factors TGF

Abstract

A disk herniation constraining device for implantation into a vertebral disk can include a support member for support of a herniated portion of a disk. The support member can be connected to an anchor. The constraining device can include the insertion of augmentation material within the disk. A defect in the annulus of a disk can be closed using a prosthesis such as a barrier.

The barrier can be placed between the annulus and the nucleus of the disk. The barrier can include a sealant and an enlarger. The barrier can be implanted into the disk using a delivery cannule, an advancer and at least one control filament to control the positioning of the barrier over the defect. A stiffening element can be included within the barrier to impart stiffness to the barrier.

Claims

1. An implant for implantation between a nucleus and an anulus and across a defect in the anulus in an intervertebral disc, comprising:

a barrier having a first and second surface, wherein said first surface is adapted to present a concave surface facing the nucleus in the implanted orientation and wherein said barrier is dimensioned to extend along the anulus across and beyond the periphery of the area defining a defeat.

2. The implant of claim 1, wherein said barrier is resilient.

3. The implant of claim 1, wherein said barrier is adapted to contact load bearing anulus tissue sufficient to prevent extrusion of said barrier through said defect.

4. The implant of claim 1, wherein said barrier is adapted to contact load bearing vertebral body endplate tissue sufficient to prevent extrusion of said barrier through said defect.

5. The implant of claim 1, wherein said barrier has a width of at least 1 cm.

6. The implant of claim 1, wherein said barrier has a height of at least 0.05 cm.

7. The implant of claim 1, wherein said second surface is adapted to present a convex surface in conformity with the interior surface of the anulus.

8. The implant of claim 1, wherein said second surface is adapted to present a convex surface in conformity with the endplates.

9. The implant of claim 1, wherein said barrier is adapted to fit between the nucleus and the anulus.

10. The implant of claim 1, wherein said barrier has a top and bottom edge and a first and second side edge, wherein said top and bottom edge are dimensioned to contact the endplates at maximum distraction.

11. The implant of claim 1, wherein said barrier is dimensioned such that when the barrier is centered in the posterior anulus, the first and second side edges of said barrier lie beyond the posterior anulus and along opposite lateral walls of the anulus.

12. A device for augmenting an anulus of an intervertebral disc suitable for inserting along an interior aspect of an anular lamella substantially in front of a defect in the anulus, comprising:

a thin resilient barrier having a first surface facing an interior aspect of the anular lamella and a second surface facing the interior of the intervertebral disc, wherein said barrier is adapted to be sealably positioned against the lamella via the exertion of force on the second surface sustained by a pressurized intervertebral disc environment.

13. The device of claim 12, wherein the barrier is adapted to be inserted between the anulus and the nucleus.

14. A device for partially encapsulating inter-anular material comprising resilient flexible material adapted to conform to at least a portion of the interior surface of an anulus fibrosus and of sufficient size and sufficient rigidity to not be extrudable through an anulus defect.

15. An anulus augmentation implant for insertion along the surface of an anular lamella and across a defect in an intervertebral disc, comprising:

a collapseable resilient barrier having a top and bottom edge and a first and second side edge,

wherein the top and bottom edge are sized to contact the endplates at maximum distraction;

and wherein the first and second edge extend beyond the defect.

16. The device of claim 15, wherein the barrier has a concave cross section along at least a portion of its length.

17. The implant of claim 15, wherein the first edge and the second edge are adapted to extend beyond the posterior anulus when implanted.

18. A device for transferring intervertebral disc pressure from a defect in an anulus fibrosus to load bearing tissue, comprising:

a flexible barrier having a first convex surface and a second concave surface;

wherein the first convex surface is in communication with a portion of the posterior anulus;

wherein the second concave surface is in communication with the nucleus pulposus; and

wherein said barrier is dimensioned to extend beyond the periphery of the area defining the defect such that the barrier contacts load bearing intervertebral disc tissue.

19. A dynamically stable device for shielding defects in an anulus fibrosus of an intervertebral disc, comprising:

a flexible membrane adapted to yield to interdiscal pressure and conform to at least a portion of the posterior anulus under both distraction and compression of the disc, wherein said membrane is sized to extend along the interior of The posterior anulus.

20. The device of claim 19, wherein the device has a width in a lateral direction and a height in an inferior-superior direction, wherein the height exceeds the distance between an inferior vertebral body and a superior vertebral body when filly distracted so that the device is concave inwardly along an inferior superior axis in the implanted orientation.