Orthopedic support system and method of installation

• US 6,645,211 B2
• Filed: 02/07/2001
• Issued: 11/11/2003
• Est. Priority Date: 02/07/2001
• Status: Expired due to Term

• Current Assignee: Howmedica Osteonics Corp. (Stryker Corporation)
• Original Assignee: Howmedica Osteonics Corp. (Stryker Corporation)
• Inventors: Magana, Ignacio
• Primary Examiner(s): Robert, Eduardo C.
• Application Number:
  US09/778,179
• Publication Number:
  US 20020107524A1
• Time in Patent Office: 1,007 Days
• Field of Search: 606/60, 606/61, 606/72, 606/74, 606/103, 606/228, 606/233, 623/17.11, 623/17.15, 623/17.16
• US Class Current: 606/247
• CPC Class Codes: A61B 17/7022 Tethers, i.e. longitudinal elements capable of transmitting tension only, e.g. straps, sutures or cables A61B17/702 takes precedence
• CPC Class Codes: A61B 17/7059 Cortical plates A61B17/7007, A61B17/7058 take precedence
• CPC Class Codes: A61B 17/8085 with pliable or malleable elements or having a mesh-like structure, e.g. small strips A61B17/8071, A61B17/8076 take precedence
• CPC Class Codes: A61B 17/842 Flexible wires, bands or straps A61B17/72, A61B17/82, A61B17/86 take precedence

Abstract

A tensioned cord (208) formed into a closed loop is secured to adjacent bone structures (201, 203), and a flexible patch (236) is secured to the cord in tension so that the combined, predetermined tension is applied between the adjacent bones structures (201, 203). The tensioned cord (203) and patch (236) may be used with or without a fusion implant device (206) in order to, in the former instance, contribute to compressive forces applied to the fusion device by the surrounding bone structures. The patch (236) may also be used as a delivery medium for a substance such as bone graft (241).

Claims

1. A method of securing adjacent bone structures to each other while permitting a predetermined amount of relative movement therebetween, said method comprising:

forming at least one hole on a first bone structure;

forming at least one hole on a second bone structure;

passing a folded cord through each of said holes, said cord having a first end comprising two free ends of the cord and second end comprising a folded end; and

fixing two sections of the cord to each other to form a closed loop.

2. A method according to claim 1, wherein

said two sections are fixed by forming a first loop on the second end, passing the first end through the first loop and drawing the first end until a desired tension in the cord is achieved, and forming a first half-hitch with the two free ends.

3. A method according to claim 2, further comprising

forming a second half-hitch with the two free ends.

4. A method of securing adjacent vertebrae to each other while permitting a predetermined amount of relative movement therebetween, said method comprising:

forming a pair of holes on a first vertebra;

forming a pair of holes on a second vertebra;

passing a cord through each pair of said holes; and

fixing two sections of the cord located near the ends of the cord to each other to form a closed loop.

5. A method according to claim 4, further comprising

drawing the ends of said cord relative to each other in order to achieve a desired tension in the loop to be formed prior to the step of fixing the ends of the cord to each other.

6. A method according to claim 4, wherein

said sections of the cord are fixed by tying them together.

7. A method according to claim 6, wherein

said cord is crossed over itself at least between said first and second vertebrae.

8. A method according to claim 4, wherein

prior to passing said cord through each of said holes, said cord is folded in half forming a first end comprising two free ends, and a second end comprising a folded end.

9. A method according to claim 8, wherein

said two sections are fixed by forming a first loop on the second end, passing the first end through the first loop and drawing the first end until a desired tension in the cord is achieved, and forming a first half-hitch with the two free ends.

10. A method according to claim 9, further comprising

forming a second half-hitch with the two free ends.

11. A method according to claim 4, wherein

said cord is crossed over itself between said first and second vertebrae.

12. A method of securing adjacent bone structures to each other while permitting a predetermined amount of relative movement therebetween, said method comprising:

forming at least one hole on a first bone structure;

forming at least one hole on a second bone structure;

passing a cord through each of said holes and through securing means attached to a flexible patch; and

fixing two sections of the cord located near the ends of the cord to each other to form a closed loop.

13. A method according to claim 12, further comprising

drawing the ends of said cord relative to each other in order to achieve a desired tension in the loop to be formed by the cord and a desired tension in the flexible patch prior to the step of fixing the ends of the cord to each other.

14. A method according to claim 12, wherein

said sections of the cord are fixed by tying them together.

15. A method according to claim 12, wherein

prior to passing said cord through each of said holes, said cord is folded in half forming a first end comprising two free ends, and a second end comprising a folded end.

16. A method according to claim 15, wherein

said two sections are fixed by forming a first loop on the second end, passing the first end through the first loop and drawing the first end until a desired tension in the cord is achieved, and forming a first half-hitch with the two free ends.

17. A method according to claim 16, further comprising

forming a second half-hitch with the two free ends.

18. A method according to claim 12, wherein

said securing means comprise a section of said flexible patch that is folded over to form a passage for said cord to pass therethrough.

19. A method according to claim 12, wherein

said flexible patch is formed by a tube of flexible material and said securing means comprise the inside of said tube through which said cord is passed.

20. A system for securing adjacent bone structures to each other while permitting a predetermined amount of relative movement therebetween, said system comprising:

a cord forming a closed loop and being adapted to be secured to the adjacent bone structures such that said cord is tensioned; and

a flexible patch secured to said cord at a plurality of points on said cord such that said patch is adapted to be tensioned between the bone structures.

21. A system according to claim 20, wherein

said cord is securable to the bone structures by passing said cord through holes formed in the bone structures.

22. A system as in claim 20 wherein the adjacent bone structures are adjacent vertebral bodies.

23. A method of fusing adjacent bone structures, said method comprising

positioning a bone fusion implant device between said adjacent bone structures;

forming at least one hole on a first bone structure;

forming at least one hole on a second bone structure;

passing a cord through each of said holes; and

fixing two sections of the cord located near the ends of the cord to each other to form a closed loop.

24. A method according to claim 23, further comprising

drawing the ends of said cord relative to each other in order to achieve a desired tension in the loop to be formed prior to the step of fixing the ends of the cord to each other, such that said tension in said loop contributes to compressive force applied to said implant device by said adjacent bone structures.

25. A method according to claim 23, wherein

said sections of the cord are fixed by tying them together.

26. A method according to claim 23, wherein

prior to passing said cord through each of said holes, said cord is folded in half forming a first end comprising two free ends, and a second end comprising a folded end.

27. A method according to claim 26, wherein

said two sections are fixed by forming a first loop on the second end, passing the first end through the first loop and drawing the first end until a desired tension in the cord is achieved, and forming a first half-hitch with the two free ends.

28. A method according to claim 27, further comprising

forming a second half-hitch with the two free ends.

29. A method of fusing adjacent vertebrae, said method comprising

positioning a bone fusion implant device between said adjacent vertebrae;

forming at least one hole on a first vertebra;

forming at least one hole on a second vertebra;

passing a cord through each of said holes; and

fixing two sections of the cord located near the ends of the cord to each other to form a closed loop.

30. A method according to claim 29, further comprising

drawing the ends of said cord relative to each other in order to achieve a desired tension in the loop to be formed prior to the step of fixing the ends of the cord to each other, such that the tension in said loop contributes to compressive force applied to said implant device by said adjacent vertebrae.

31. A method according to claim 29, wherein

said sections of the cord are fixed by tying them together.

32. A method according to claim 29, wherein

prior to passing said cord through each of said holes, said cord is folded in half forming a first end comprising two free ends, and a second end comprising a folded end.

33. A method according to claim 32, wherein

said two sections are fixed by forming a first loop on the second end, passing the first end through the first loop and drawing the first end until a desired tension in the cord is achieved, and forming a first half-hitch with the two free ends.

34. A method according to claim 33, further comprising

forming a second half-hitch with the two free ends.

35. A method of fusing adjacent vertebrae, said method comprising:

positioning a bone fusion implant device between said vertebrae;

forming at least one hole on a first vertebra;

forming at least one hole on a second vertebra;

passing a cord through each of said holes and through securing means attached to a flexible patch; and

fixing two sections of the cord located near the ends of the cord to each other to form a closed loop.

36. A method according to claim 35, further comprising

drawing the ends of said cord relative to each other in order to achieve a desired tension in the loop to be formed by the cord and a desired tension in the flexible patch prior to the step of fixing the ends of the cord to each other, such that the tension in said loop and said patch contributes to compressive force applied to said implant device by said adjacent vertebrae.

37. A method according to claim 35, wherein

said sections of the cord are fixed by tying them together.

38. A method according to claim 35, wherein

prior to passing said cord through each of said holes, said cord is folded in half forming a first end comprising two free ends, and a second end comprising a folded end.

39. A method according to claim 38, wherein

said two sections are fixed by forming a first loop on the second end, passing the first end through the first loop and drawing the first end until a desired tension in the cord is achieved, and forming a first half-hitch with the two free ends.

40. A method according to claim 39, further comprising

forming a second half-hitch with the two free ends.

41. A system for fusing adjacent bone structures, said system comprising:

a fusion implant device adapted to be positioned between the adjacent bone structures;

a cord securable to the adjacent bone structures such that said cord is tensioned; and

a flexible patch secured to said cord at a plurality of points on said cord such that said patch is adapted to be tensioned between the bone structures in a manner in which compressive force is applied to said implant device by the adjacent bone structures.

42. A system according to claim 41, wherein

said cord forms a closed loop and is securable to the bone structures by passing said cord through holes formed in the bone structures.

43. A system as in claim 41 wherein the adjacent bone structures are adjacent vertebral bodies.

44. A method of fusing adjacent bone structures, said method comprising

placing a fusion implant device between said adjacent bone structures;

and

securing a flexible patch to at least two points on each of said adjacent bone structures in a manner in which said patch is tensioned therebetween, contributing to compressive force applied to said implant device by said flexible patch.

45. A method according to claim 44, further comprising

securing bone graft material to said patch such that said patch holds said bone graft material in a location between said adjacent bone structures.

46. A method of securing a plurality of adjacent vertebrae to each other in a manner permitting a predetermined amount of relative movement therebetween, said method comprising

forming at least one hole on a first vertebra;

forming at least one hole on a second vertebra;

forming at least one hole on a third vertebra;

passing a cord through each of said holes;

drawing the ends of the cord to each other to create tension in said cord; and

securing said cord ends in order to form a closed loop while maintaining tension therein.

47. A method of securing a plurality of adjacent vertebrae to each other in a manner permitting a predetermined amount of relative movement therebetween, said method comprising

forming at least a pair of holes on a first vertebra;

forming at least a pair of holes on a second vertebra;

forming at least a pair of holes on a third vertebra;

passing a cord through each of said holes;

drawing the ends of the cord to each other to create tension in said cord; and

securing said cord ends in order to form a closed loop while maintaining tension therein.

48. A method according to claim 47, wherein

prior to passing said cord through each of said holes, said cord is folded in half forming a first end comprising two free ends, and a second end comprising a folded end.

49. A method according to claim 48, wherein

said two sections are fixed by forming a first loop on the second end, passing the first end through the first loop and drawing the first end until a desired tension in the cord is achieved, and forming a first half-hitch with the two free ends.

50. A method according to claim 49, further comprising

forming a second half-hitch with the two free ends.

51. A method of securing a plurality of adjacent vertebrae to each other in a manner permitting a predetermined amount of relative movement therebetween, said method comprising

securing a first flexible patch to at least two points on each of a first vertebra and a second vertabra in a manner in which said first patch is tensioned therebetween;

and

securing a second flexible patch to at least two points on each of said second vertebra and a third vertebra in a manner in which said second patch is tensioned therebetween.

52. A system for securing adjacent bone structures to each other while permitting a movement therebetween, said system comprising

a cord capable of being secured to the adjacent bone structures;

a flexible patch secured to said cord at a plurality of points on said cord, said cord and said patch capable of applying a force tending to bring the adjacent bone structures toward each other when said cord is secured to the bone structures.

53. A system according to claim 52, wherein

said cord is securable to said bone structures by passing said cord through pre-drilled holes in the adjacent bone structures.

54. A system according to claim 52 further comprising

a fusion implant device for insertion between said adjacent bone structures.

55. A system according to claim 52 wherein said adjacent bone structures are adjacent vertebral bodies.