Methods and apparatus for dynamically stable spinal implant

• US 6,883,520 B2
• Filed: 09/05/2002
• Issued: 04/26/2005
• Est. Priority Date: 08/18/1999
• Status: Expired due to Term

• Current Assignee: Intrinsic Therapeutics, Inc.
• Original Assignee: Intrinsic Therapeutics, Inc.
• Inventors: Moore, Robert Kevin, Banks, Thomas, Vidal, Claude A., Lambrecht, Gregory H., Redmond, Russel J.
• Primary Examiner(s): McDermott, Corrine
• Assistant Examiner(s): BARRETT, THOMAS C
• Application Number:
  US10/237,332
• Publication Number:
  US 20030014117A1
• Time in Patent Office: 964 Days
• Field of Search: 623 1711- 1716, 128/898
• US Class Current: 128/898
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• 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 17/320708 Curettes, e.g. hollow scraping instruments
• CPC Class Codes: A61B 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 17/7095 the filler comprising unlinked macroscopic particles
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/00637 for sealing trocar wounds through abdominal wall
• CPC Class Codes: A61B 2017/00654 entirely comprised between the two sides of the opening
• CPC Class Codes: A61B 2017/00659 located only on one side of the opening
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0488 Instruments for applying suture clamps, clips or locks for applying suture anchors A61B2017/0409; for applying wound clamps A61B17/10; for applying ligaturing clamps or clips A61B17/128
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/0647 : having one single leg, e.g. tacks
• CPC Class Codes: A61B 2017/22077 : with a part piercing the tissue A61B2017/22044 takes precedence
• CPC Class Codes: A61B 2017/320044 : Blunt dissectors blunt suture needles A61B2017/06085
• CPC Class Codes: A61B 2017/3445 : used as instrument channel for multiple instruments catheters A61B2017/22072
• CPC Class Codes: A61B 2090/061 : for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/062 : penetration depth
• 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 2002/2817 : Bone stimulation by chemical reactions or by osteogenic or biological products for enhancing ossification, e.g. by bone morphogenetic or morphogenic proteins [BMP] or by transforming growth factors [TGF]
• 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 2002/30583 : filled with hardenable fluid, e.g. curable in-situ
• 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 2210/0085 : hardenable in situ, e.g. epoxy resins
• 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 2310/00029 : Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
• CPC Class Codes: A61F 2310/00293 : containing a phosphorus-containing compound, e.g. apatite
• CPC Class Codes: A61F 2310/00365 : Proteins; Polypeptides; Degradation products thereof
• CPC Class Codes: A61F 2310/0097 : Coating or prosthesis-covering structure made of pharmaceutical products, e.g. antibiotics
• 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

Apparatus and methods are directed at stabilizing somatic implants. A site within a body is selected that has a first region having a tight and/or changing curvature bordered by a second region or regions having minimal or constant curvature. An apparatus that has a flexible portion and one or more relatively rigid portions may then be implanted such that the flexible portion is situated in the first region and the rigid portion lies in the second region whereby the implant will remain dynamically stable and resist migration.

Claims

1. A method of positioning an implant within an implantation site, said implantation site comprising a first region having a tight and/or changing curvature bordered by a second region or regions having minimal or constant curvature, said method comprising:

placing a relatively flexible region of said implant within said first region;

placing a relatively stiff or rigid region of said implant within said second region;

wherein said implantation site is the interior of an intervertebral disc and said implant comprises a barrier for preventing the migration of materials from within the disc toward the periphery of the disc;

affixing the barrier to tissue in or surrounding the intervertebral disc; and

deploying the barrier between the nucleus pulposus and the annulus fibrosis of the intervertebral disc.

2. The method of claim 1, wherein said first implantation region is the annulus fibrosis and said second implantation region is a vertebral endplate or endplate cartilage.

3. The method of claim 1, wherein said first implantation region is the posterior lateral corner of the annulus fibrosis and said second region is the posterior or lateral annulus fibrosis.

4. The method of claim 1, further comprising expanding the barrier to an expanded state.

5. The method of claim 1, wherein the barrier further comprises a frame operable to enlarge or expand at least one dimension of the barrier.

6. The method of claim 5, wherein the frame comprises an alloy of nickel and titanium.

7. The method of claim 5, wherein the frame comprises a longitudinal strut and a plurality of radial elements.

8. The method of claim 5, comprising providing a frame with a first end and a second end that extend at oblique angles relative to a longitudinal axis of the frame.

9. A method of positioning an implant within an implantation site, said implantation site comprising a first region having a tight and/or changing curvature bordered by a second region or regions having minimal or constant curvature, said method comprising:

placing a relatively flexible region of said implant within said first region;

placing a relatively stiff or rigid region of said implant within said second region;

wherein said implantation site is the interior of an intervertebral disc and said implant comprises a barrier for preventing the migration of materials from within the disc toward the periphery of the disc; and

inserting an insertion device into the intervertebral disc at a point located a distance away from a defect in the annular fibrosis of the intervertebral disc and advancing the barrier across the defect.

10. The method of claim 9, wherein said first implantation region is the annulus fibrosis and said second implantation region is a vertebral endplate or endplate cartilage.

11. The method of claim 9, wherein said first implantation region is the posterior lateral corner of the annulus fibrosis and said second region is the posterior or lateral annulus fibrosis.

12. The method of claim 9, further comprising expanding the barrier to an expanded state.

13. The method of claim 9, wherein the implant further comprises a frame operable to mount the barrier.

14. The method of claim 13, wherein the frame comprises an alloy of nickel and titanium.

15. The method of claim 13, wherein the frame comprises a longitudinal strut and a plurality of radial elements.

16. The method of claim 9, further comprising providing a frame with a first end and a second end that extend at oblique angles relative to a longitudinal axis of the frame.

17. The method of claim 9, further comprising affixing at least a portion of the barrier to tissue in or surrounding the intervertebral disc.

18. The method of claim 9, further comprising resisting or promoting tissue ingrowth.

19. A method of positioning an implant within an implantation site, said implantation site comprising a first region having a tight and/or changing curvature bordered by a second region or regions having minimal or constant curvature, said method comprising:

placing a relatively flexible region of said implant within said first region;

placing a relatively stiff or rigid region of said implant within said second region;

wherein said implantation site is the interior of an intervertebral disc and said implant comprises a barrier for preventing the migration of materials from within the disc toward the periphery of the disc; and

deploying the barrier between the nucleus pulposus and the annulus fibrosis of the intervertebral disc.

20. The method of claim 19, further comprising affixing at least a portion of the implant to tissue in or surrounding the intervertebral disc.