Methods and systems for repairing an intervertebral disc using a transcorporal approach

• US 8,163,021 B2
• Filed: 11/25/2008
• Issued: 04/24/2012
• Est. Priority Date: 11/27/2007
• Status: Active Grant

• Current Assignee: Globus Medical, Inc.
• Original Assignee: Transcorp, Inc
• Inventors: Lowry, David, O'Farrell, Desmond, Tuinstra, Scott, Veldman, Roger
• Primary Examiner(s): Robert, Eduardo C
• Assistant Examiner(s): Kostelnik, Summer
• Application Number:
  US12/323,361
• Publication Number:
  US 20090143716A1
• Time in Patent Office: 1,246 Days
• Field of Search: 623 1711- 1716
• US Class Current: 623/17.11
• CPC Class Codes: A61B 17/1728 for holes for bone plates or plate screws
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 17/7059 Cortical plates A61B17/7007, A61B17/7058 take precedence
• CPC Class Codes: A61B 17/8827 with filtering, degassing, venting or pressure relief means
• CPC Class Codes: A61B 2017/00544 pneumatically
• CPC Class Codes: A61B 2017/564 Methods for bone or joint treatment
• 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 2/4611 of spinal prostheses
• 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 2002/2835 Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
• CPC Class Codes: A61F 2002/30563 having elastic means or damping means, different from springs, e.g. including an elastomeric core or shock absorbers
• CPC Class Codes: A61F 2002/30574 with an integral complete or partial collar or flange
• CPC Class Codes: A61F 2002/30576 with extending fixation tabs
• CPC Class Codes: A61F 2002/30583 filled with hardenable fluid, e.g. curable in-situ
• CPC Class Codes: A61F 2002/30601 telescopic
• CPC Class Codes: A61F 2002/30693 Air venting means
• CPC Class Codes: A61F 2002/3085 with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface
• CPC Class Codes: A61F 2002/444 for replacing the nucleus pulposus
• CPC Class Codes: A61F 2002/4685 : by means of vacuum
• CPC Class Codes: A61F 2210/0085 : hardenable in situ, e.g. epoxy resins

Abstract

The invention includes a system and methods for performing surgery on a spinal disc. The system includes an implantable bone plate with an access port to accommodate a bone cutting device, a spinal repair device insertable through the access port of the bone plate configured to occupy a surgically-formed vertebral channel from an anterior surface of the host vertebral body to a site central to an end plate of the host vertebral body, a trajectory control sleeve engageable to the bone plate to direct the trajectory of a cutting device, and a cutting device engageable within the trajectory control sleeve. Methods are directed to forming a vertebral channel and restoring the vertebral body and disc with devices that both repair the bone and the disc.

Claims

1. A method for accessing and repairing an intervertebral disc in the spine comprising:

engaging a trajectory control apparatus to a non-endplate surface of a vertebral body;

forming a transcorporal channel in a vertebral body with a trajectory that extends from a non end-plate surface to an end plate where a channel opening communicates into an intervertebral space;

implanting into the transcorporal channel a spinal repair device sized and configured to occupy at least a portion of the channel, the implanted spinal repair device comprising an internal lumen and a back flow control element located in the lumen;

evacuating substantially all gas from the intravertebral space; and

injecting a disc replacement material through the implanted spinal repair device and directly into a void within a space formerly occupied by at least a portion of the intervertebral disc and allowing gas from within the intervertebral space to escape through the spinal repair device during the injecting step, such that the void is substantially entirely filled with disc replacement material.

2. The method of claim 1 wherein forming a transcorporal channel that extends from a non end-plate surface comprises forming the channel from any of an anterior surface, a lateral surface, a posterior aspect of a pedicle, or a posterior, or posterolateral surface.

3. The method of claim 1 wherein the engaging step comprises implanting a bone plate portion of the trajectory control apparatus on the non-endplate surface of the vertebral body and then engaging a bone cutting tool holder portion of the trajectory control apparatus to the bone plate.

4. The method of claim 3 wherein implanting a bone plate on the non-endplate surface of the vertebral body comprises securing it to the surface with one or more fastening elements.

5. The method of claim 3 further comprising removing the bone plate after implanting it.

6. The method of claim 1 further comprising removing at least a portion of the intervertebral disc through the transcorporal channel before injecting the disc replacement material.

7. The method of claim 6 wherein removing at least a portion of the intervertebral disc comprises removing a nucleus pulposis and leaving an annulus fibrosis intact.

8. The method of claim 1 wherein forming the transcorporal channel comprises cutting bone with a bone-cutting tool.

9. The method of claim 1 wherein implanting the spinal repair device comprises compressively engaging an external surface of the spinal repair device with cancellous bone of the host vertebral body.

10. A method for accessing and repairing an intervertebral disc in the spine comprising:

engaging a trajectory control apparatus to a surface of a host vertebral body;

forming a transcorporal channel within a host vertebral body, the channel extending from a surface of the host vertebral body on a trajectory toward an intervertebral disc between the host vertebral body and an adjacent vertebral body, and extending at least as far as the end plate of the host vertebral body;

implanting a spinal repair device configured to fit into the channel and extending into the intervertebral space, the implanted spinal repair device comprising an internal lumen and a back flow control element located in the lumen;

evacuating substantially all gas from the intravertebral space; and

injecting a disc replacement material through the implanted spinal repair device and directly into a void within a space formerly occupied by at least a portion of the intervertebral disc and allowing gas from within the intervertebral space to escape through the spinal repair device during the injecting step, such that the void is substantially entirely filled with disc replacement material.

11. The method of claim 10 wherein forming a transcorporal channel that extends from a non end-plate surface comprises forming the channel from any of an anterior surface, a lateral surface, a posterior aspect of a pedicle, or a posterior, or posterolateral surface.

12. The method of claim 10 wherein implanting a spinal repair device comprises placing a distal portion of the device in intimate contact with the end plate tissue of the vertebral body and a proximal portion in intimate contact with cancellous bone tissue within the transcorporal channel.

13. The method of claim 10 wherein the engaging step comprises implanting a bone plate portion of the trajectory control apparatus on the non-endplate surface of the vertebral body and then engaging a bone cutting tool holder portion of the trajectory control apparatus to the bone plate.

14. The method of claim 13 wherein implanting a bone plate on the non-endplate surface of the vertebral body comprises securing it to the surface with one or more fastening elements.

15. The method of claim 13 further comprising removing the bone plate after implanting it.

16. The method of claim 10 further comprising removing at least a portion of the intervertebral disc through the transcorporal channel before implanting the spinal repair device.

17. The method of claim 16 wherein removing at least a portion of the intervertebral disc comprises removing a nucleus pulposis and leaving an annulus fibrosis intact.

18. The method of claim 10 wherein injecting a disc replacement material comprises replacing the portion of the disc with any of a liquid, a liquid that can solidify, a liquid-to-solid phase changing material, a fabric, or a solid, or any combination of these materials.

19. The method of claim 10 wherein forming the transcorporal channel comprises cutting bone with a bone-cutting tool.

20. The method of claim 10 wherein implanting the spinal repair device comprises compressively engaging an external surface of the spinal repair device with an internal surface of the transcorporal channel.

21. The method of claim 10 further comprising injecting a flowable disc material through a lumen in the spinal repair device into the intervertebral space.