Method of rehabilitating an anulus fibrosus

• US 8,025,698 B2
• Filed: 04/27/2009
• Issued: 09/27/2011
• Est. Priority Date: 08/18/1999
• Status: Expired due to Fees

• Current Assignee: Intrinsic Therapeutics, Inc.
• Original Assignee: Intrinsic Therapeutics, Inc.
• Inventors: Lambrecht, Gregory H.
• Primary Examiner(s): Robert; Eduardo C
• Assistant Examiner(s): CARTER, TARA ROSE E
• Application Number:
  US12/430,787
• Publication Number:
  US 20090292322A1
• Time in Patent Office: 883 Days
• Field of Search: 606/232, 606/246, 623 1711- 1716
• US Class Current: 623/17.16
• 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 17/70 Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
• 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
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• 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
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• 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
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• 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
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• CPC Class Codes: A61F 2002/4635 : using minimally invasive surgery
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• CPC Class Codes: A61F 2230/0013 : Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped
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• CPC Class Codes: A61F 2310/00017 : Iron- or Fe-based alloys, e.g. stainless steel
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• CPC Class Codes: A61F 2310/00365 : Proteins; Polypeptides; Degradation products thereof
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• 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

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 rehabilitating a weakened anulus fibrosus, comprising:

identifying an intervertebral disc comprising a weakened anulus fibrosus and a nucleus pulposus,

wherein said anulus fibrosus comprises a defect,

wherein said anulus fibrosus comprises an outermost layer, an innermost layer, and a plurality of successive intermediate layers between the outermost layer and the innermost layer,

providing a barrier for placement into said intervertebral disc;

inserting said barrier through said defect;

placing said barrier entirely between two neighboring intermediate layers of the anulus fibrosus such that the entire barrier is substantially parallel with portions of the two neighboring intermediate layers and such that said barrier spans said defect, thereby minimizing the extrusion of said nucleus pulposus through said defect; and

securing said barrier within said intervertebral disc.

2. The method of claim 1, wherein securing said barrier comprises anchoring the barrier with at least one bone anchor to at least one of a surrounding vertebral body.

3. The method of claim 1, wherein securing said barrier comprises suturing the barrier to the intervertebral disc.

4. The method of claim 1, wherein securing said barrier comprises adhering the barrier to the intervertebral disc with an adhesive.

5. The method of claim 1, wherein the barrier is larger than said defect and is placed to extend past the defect in more than one direction.

6. The method of claim 1, wherein the barrier is larger than said defect and is placed to extend past the defect in both directions, thereby contacting healthy tissue on both sides of the defect.

7. The method of claim 1, wherein said barrier comprises an enlarging means and a sealing means.

8. The method of claim 1, wherein said barrier is seeded with cells.

9. The method of claim 1, wherein said barrier comprises at least one growth factor.

10. The method of claim 1, wherein said barrier promote tissues ingrowth.

11. The method of claim 1, wherein the defect comprises a pre-existing tear in the anulus.

12. The method of claim 1, wherein the defect comprises a surgically-created puncture.

13. The method of claim 1, wherein the defect comprises a herniated segment of the anulus.

14. A method of rehabilitating a weakened anulus fibrosis fibrosus, comprising:

identifying an intervertebral disc comprising a weakened anulus fibrosis fibrosus,

wherein said anulus fibrosus comprises a weakened portion,

wherein said anulus fibrosus comprises an outermost layer, an innermost layer, and a plurality of successive intermediate layers between the outermost layer and the innermost layer,

inserting a barrier into said anulus;

placing said barrier entirely between two neighboring intermediate layers of the anulus fibrosus such that the entire barrier is substantially parallel with portions of the two neighboring intermediate layers to support the weakened portion of the anulus, thereby reducing herniation of said intervertebral disc,

securing said barrier within said intervertebral disc.

15. The method of claim 14, wherein said weakened portion comprises a defect.

16. The method of claim 14, wherein securing said barrier comprises anchoring the barrier with said at least one bone anchor to at least one of a surrounding vertebral body.

17. The method of claim 14, wherein securing said barrier comprises suturing the barrier to the intervertebral disc.

18. The method of claim 14, wherein securing said barrier comprises adhering the barrier to the intervertebral disc with an adhesive.