Method for treating tibial plateau compression fractures

• US 7,153,305 B2
• Filed: 07/21/2003
• Issued: 12/26/2006
• Est. Priority Date: 03/08/2001
• Status: Expired due to Term

• Current Assignee: Spine Wave Incorporated
• Original Assignee: Spine Wave Incorporated
• Inventors: Kieval, Robert, Wales, Larry, Johnson, Wes, Lipschultz, Tyler
• Primary Examiner(s): Lewis, Ralph A.
• Application Number:
  US10/623,791
• Publication Number:
  US 20040064144A1
• Time in Patent Office: 1,254 Days
• Field of Search: 606/90, 606/99, 606/198, 606/61, 623/17.11, 623/17.16
• US Class Current: 606/90
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/66 Alignment, compression or distraction mechanisms
• CPC Class Codes: A61B 17/7097 Stabilisers comprising fluid filler in an implant, e.g. balloon; devices for inserting or filling such implants disc prostheses made of inflatable chambers or pockets filled with fluid A61F2/441; replacing the nucleus pulposus A61F2002/444
• CPC Class Codes: A61B 17/8852 capable of being assembled or enlarged, or changing shape, inside the bone or disc
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61F 2/28 Bones joints A61F2/30
• CPC Class Codes: A61F 2/44 for the spine, e.g. vertebrae, spinal discs
• 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 2/4425 made of articulated components
• CPC Class Codes: A61F 2/4455 for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages intervertebral discs A61F2/442
• CPC Class Codes: A61F 2/447 substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section
• CPC Class Codes: A61F 2/4611 of spinal prostheses
• CPC Class Codes: A61F 2002/30075 swellable, e.g. when wetted
• CPC Class Codes: A61F 2002/3008 radio-opaque, e.g. radio-opaque markers
• CPC Class Codes: A61F 2002/30237 partial tubes
• CPC Class Codes: A61F 2002/30261 parallelepipedal
• CPC Class Codes: A61F 2002/30385 the rib and groove having non-parallel, e.g. conically-tapered, cooperating sides, e.g. having a trapezoidal front cross-section
• CPC Class Codes: A61F 2002/30387 Dovetail connection
• CPC Class Codes: A61F 2002/30392 Rotation
• CPC Class Codes: A61F 2002/304 with additional means for limiting said sliding
• CPC Class Codes: A61F 2002/30448 : using adhesives
• CPC Class Codes: A61F 2002/30449 : the adhesive being cement
• CPC Class Codes: A61F 2002/30462 : retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2002/30476 : locked by an additional locking mechanism
• CPC Class Codes: A61F 2002/3049 : using a slidable sleeve covering the connection
• CPC Class Codes: A61F 2002/305 : Snap connection
• CPC Class Codes: A61F 2002/30599 : stackable
• CPC Class Codes: A61F 2002/30604 : modular
• CPC Class Codes: A61F 2002/30616 : Sets comprising a plurality of prosthetic parts of different sizes or orientations
• CPC Class Codes: A61F 2002/30772 : Apertures or holes, e.g. of circular cross section
• CPC Class Codes: A61F 2002/4415 : elements of the prosthesis being arranged in a chain like manner
• CPC Class Codes: A61F 2002/4485 : comprising three or more adjacent spinal implants
• CPC Class Codes: A61F 2002/4627 : with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument
• CPC Class Codes: A61F 2002/4666 : for measuring force, pressure or mechanical tension
• CPC Class Codes: A61F 2210/0061 : swellable
• CPC Class Codes: A61F 2220/0025 : Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2220/005 : using adhesives
• 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 2230/0069 : cylindrical
• CPC Class Codes: A61F 2230/0082 : parallelepipedal
• CPC Class Codes: A61F 2250/0063 : Nested prosthetic parts
• CPC Class Codes: A61F 2250/0098 : radio-opaque, e.g. radio-opaque markers
• 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 2310/00071 : Nickel or Ni-based alloys
• CPC Class Codes: A61F 2310/00203 : containing alumina or aluminium oxide
• CPC Class Codes: A61F 2310/00239 : containing zirconia or zirconium oxide ZrO2
• CPC Class Codes: A61F 2310/00293 : containing a phosphorus-containing compound, e.g. apatite
• CPC Class Codes: A61F 2310/00353 : Bone cement, e.g. polymethylmethacrylate or PMMA
• CPC Class Codes: A61F 2310/00359 : Bone or bony tissue
• CPC Class Codes: A61F 2310/00365 : Proteins; Polypeptides; Degradation products thereof
• CPC Class Codes: Y10S 606/907 : Composed of particular material or coated
• CPC Class Codes: Y10S 606/912 : Radiolucent material
• CPC Class Codes: Y10S 606/914 : Toolkit for installing or removing spinal positioner or stabilizer

Abstract

An apparatus and method for distracting, in a given direction, and supporting two tissue surfaces. A plurality of wafers are consecutively inserted between the two tissue surfaces to create a column of wafers. The column of wafers is oriented between the tissue surfaces so as to expand in the given direction as the wafers are consecutively added to the column.

Claims

1. A method of treating tibial plateau compression fractures, comprising the steps of:

accessing the space under the tibial plateau in a tibia between two generally opposed surfaces of the fractured tibia; and

consecutively introducing a plurality of substantially rigid elements in contact with each other between the opposed surfaces to distract said opposed surfaces as said elements are received and support such distracted surfaces to reduce the fracture and support the tibial plateau.

2. The method of claim 1, wherein said elements are introduced in contact with each other generally in the direction of the axis of the tibia.

3. The method of claim 1 wherein said elements are introduced by moving at least one element to a different position upon introduction of a subsequent element.

4. The method of claim 3 wherein said at least one element is moved by contacting a surface thereof with a surface of said subsequent element.

5. The method of claim 4 wherein the accessing step includes the step of placing an elongated access channel in communication with the space between said opposing surfaces and introducing the elements through said channel.

6. The method of claim 5, further including the step of providing a bone filler in contact with the elements.

7. The method of claim 4 wherein said elements are wafers, said wafers being introduced between said opposing surfaces by stacking one wafer atop another wafer.

8. The method of claim 1, further including the step of providing an outer member and introducing said elements into said member.

9. The method of claim 1, wherein said elements have arcuate contact surfaces.

10. The method of claim 1, wherein said elements have generally flat contact surfaces.

11. A method of treating tibial plateau compression fractures, comprising the steps of:

accessing the space under the tibial plateau on a tibia between two generally opposed surfaces of the fractured tibia; and

stacking by consecutively introducing individually a plurality of generally flat and substantially rigid wafers in the tibia in the general direction of the axis of the tibia between the opposed surfaces to distract said opposed surfaces as said wafers are consecutively received and support such distracted surfaces to reduce the fracture and support the tibial plateau.

12. The method of claim 11, wherein said wafers are stacked by consecutively inserting said wafers one atop the other to form a column extending in the direction of the axis of the tibia.

13. The method of claim 12, wherein said wafers are consecutively inserted in a direction substantially normal to the axis of the tibia.

14. The method of claim 13, wherein said wafers are consecutively inserted by slidably moving one wafer along a surface of another wafer.

15. The method of claim 14, including the step of inserting between the opposing surfaces under the tibial plateau an elongated guide track along which the wafers travel during insertion.

16. The method of claim 15, including the step of inserting each wafer subsequent to the first wafer between the next preceding wafer and a base.

17. The method of claim 16, wherein the base is the guide track.

18. The method of claim 16, wherein the base is a wafer adjacent the next preceding wafer.

19. The method of claim 16, wherein the wafers have leading and trailing beveled ends, the method comprising the step of engaging the leading beveled end of one wafer with the trailing beveled end of the next preceding wafer to enable the one wafer to be inserted between the guide track and the next preceding wafer to thereby urge the preceding wafer away from the guide track in the direction of the axis of the tibia.

20. The method of claim 12, including the step of providing the fluent bone filler in an access path to the tibial plateau and in contact with the wafer column.

21. The method of claim 20, wherein the access path is an opening through a tibial lateral wall, the method including the step of providing the filler in the lateral wall opening.

22. The method of claim 12, wherein the accessing step includes the step of inserting under the tibial plateau an elongated access channel through which said wafers are inserted.

23. The method of claim 15, wherein the accessing step includes the step of inserting under the tibial plateau an elongated access channel having collapsible and expandable configurations, the method including the steps of inserting the access channel in its collapsed configuration under the tibial plateau and then expanding the access channel between the opposing surfaces laterally of its length and in a direction generally normal to the direction of the axis of the tibia to enable the access channel to receive the guide track therewithin.

24. The method of claim 11 including the step of applying a liquid to the wafers.

25. The method of claim 24, wherein the liquid is a solvent carried in micro spheres to enhance bonding wherein the micro spheres are ruptured during insertion of the wafer.

26. The method of claim 25, wherein the micro spheres further include and osteoinductive agent.

27. The method of claim 11 including the step of applying a hardenable fluent material designed for time-delayed activation.

28. The method of claim 11, wherein said wafers are non-removably maintained in the tibia.