Method of anchoring an implant in an intervertebral disc

• US 7,524,333 B2
• Filed: 05/26/2006
• Issued: 04/28/2009
• Est. Priority Date: 08/18/1999
• Status: Expired due to Term

• Current Assignee: Intrinsic Therapeutics, Inc.
• Original Assignee: Intrinsic Therapeutics, Inc.
• Inventors: Einhorn, Jacob, Moore, Robert Kevin, Lambrecht, Greg H.
• Primary Examiner(s): Robert; Eduardo C
• Assistant Examiner(s): George; Tara R
• Application Number:
  US11/442,483
• Publication Number:
  US 20060217812A1
• Time in Patent Office: 1,068 Days
• Field of Search: 623 1711- 1716, 623/16.11, 623/1.11, 623/1.2, 623/1.17, 623/23.7, 606/60, 606/246, 606215-217, 606228-231, 606/233, 606/279, 604/500
• US Class Current: 623/17.16
• 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 17/320016 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 17/70 Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/22077 with a part piercing the tissue A61B2017/22044 takes precedence
• CPC Class Codes: A61B 2017/320044 Blunt dissectors
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments
• 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 2/4455 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 2/4601 : 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 2002/4615 : of spacers
• 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 2002/4635 : 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

Methods of securing an implant within an intervertebral disc are provided. In some embodiments, systems for minimally invasive disc augmentation include an anulus augmentation component and a nucleus augmentation component. Both are suited for minimally invasive deployment. The nucleus augmentation component restores disc height and/or replaces missing nucleus pulposus. The anulus augmentation component shields weakened regions of the anulus fibrosis and/or resists escape of natural nucleus pulposus and/or the nucleus augmentation component. Methods and deployment devices are also disclosed. Methods of closing a defect in an anulus fibrosus of an intervertebral disc using a barrier are also provided.

Claims

1. A method of securing an implant within an intervertebral disc comprising the steps of:

providing a biocompatible support member adapted for implantation within the intervertebral disc, wherein said annulus comprises a defect;

wherein the defect is bordered by an outermost layer of the annulus and an innermost layer of the the annulus;

providing at least one bone anchor;

implanting the biocompatible support member entirely beyond the defect and positioning said support member entirely against the innermost lamella of the annulus to close said defect;

positioning said at least one bone anchor in the defect;

anchoring the biocompatible support member with said at least one bone anchor to at least one of an upper or lower vertebra along an endplate.

2. The method of claim 1, wherein the defect comprises a puncture.

3. The method of claim 1, wherein the defect comprises a tear.

4. The method of claim 1, further comprising inserting the biocompatible support member through said defect.

5. The method of claim 1, wherein the biocompatible support member is placed between an anulus and a nucleus of said intervertebral disc.

6. The method of claim 1, wherein the biocompatible support member comprises a barrier.

7. The method of claim 1, wherein the biocompatible support member comprises a concave mesh.

8. The method of claim 1, wherein the biocompatible support member comprises a concave mesh, wherein the concavity of said concave mesh is facing the nucleus.

9. The method of claim 1, further comprising providing a connection member.

10. The method of claim 1, further comprising:

providing a connection member;

coupling said connection member to said anchor; and

coupling said connection member to said support member.

11. The method of claim 1, wherein said at least one bone anchor comprises a dart.

12. The method of claim 1, wherein the biocompatible support member comprises a barrier, wherein said barrier comprises an enlarging means and a sealing means.

13. The method of claim 1, wherein the enlarging means comprises an integral fixation region that facilitates anchoring.

14. The method of claim 1, further comprising providing a bone anchor deployment tool.

15. The method of claim 14, wherein the step of anchoring the biocompatible support member comprises deploying said at least one bone anchor to at least one of the upper or lower vertebra at an angle less than about 180°

relative to said bone anchor deployment tool.

16. The method of claim 1, further comprising securing the biocompatible support member to tissue with a device selected from the group consisting of one or more of the following:

sutures, soft tissue anchors, and tissue adhesives.

17. The method of claim 1, wherein the step of implanting the biocompatible support member comprises implanting the biocompatible support member to reduce the flow of material from the nucleus into the defect.

18. The method of claim 1, wherein the defect is located in a herniated segment.

19. The method of claim 1, wherein the biocompatible support member spans the defect in more than one direction.

20. The method of claim 1, wherein the biocompatible support member is anchored to at least one of the upper or lower vertebra along an endplate, wherein the upper or lower endplate is located adjacent to said defect.