Vertebral anchoring methods

• US 8,394,146 B2
• Filed: 07/01/2011
• Issued: 03/12/2013
• Est. Priority Date: 12/28/2005
• Status: Active Grant

• Current Assignee: Intrinsic Therapeutics, Inc.
• Original Assignee: Intrinsic Therapeutics, Inc.
• Inventors: Boyajian, Thomas, Velagic, Almir, Moore, Robert Kevin, Tarapata, Christopher, Einhorn, Jacob, Lambrecht, Gregory, Kavanaugh, Sean
• Primary Examiner(s): Truong, Kevin T
• Assistant Examiner(s): BECCIA, CHRISTOPHER J
• Application Number:
  US13/175,278
• Publication Number:
  US 20110264227A1
• Time in Patent Office: 620 Days
• Field of Search: 606/60, 606/70, 606/71, 606/74, 606/75, 606246-279, 606280-299, 606300-331, 623 1711- 1716
• 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 17/0642 for bones, e.g. for osteosynthesis or connecting tendon to bone
• CPC Class Codes: A61B 17/0682 for applying U-shaped staples or clamps, e.g. without a forming anvil
• CPC Class Codes: A61B 17/68 Internal fixation devices , including fasteners and spinal fixators, even if a part thereof projects from the skin bone staples A61B17/0642
• CPC Class Codes: A61B 17/7056 Hooks with specially-designed bone-contacting part
• CPC Class Codes: A61B 17/8085 with pliable or malleable elements or having a mesh-like structure, e.g. small strips A61B17/8071, A61B17/8076 take precedence
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61B 2017/0647 having one single leg, e.g. tacks
• CPC Class Codes: A61B 2017/0649 Coils or spirals
• 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 2002/4435 Support means or repair of the natural disc wall, i.e. annulus, e.g. using plates, membranes or meshes

Abstract

Embodiments of the invention relate generally to tissue anchors and methods of delivering same to the intervertebral disc or other sites within the body. In some embodiments, the anchors provide pull-out resistance, stability and/or maximize contact with tissue involving a minimum amount of penetration. In some embodiments, delivery methods are minimally invasive and include linear, lateral, and off-angle implantation or driving of anchors along, against or within tissue surfaces.

Claims

1. A method of establishing an anchor along an endplate adjacent an intervertebral disc, comprising:

identifying a vertebral body comprising an outer surface and an endplate,

wherein the outer surface is offset at an angle substantially perpendicular from the endplate and extends around a circumference of the vertebral body;

identifying a defect in an intervertebral disc adjacent said vertebral body;

providing a prosthetic barrier coupled to a bone anchor,

wherein the prosthetic barrier is configured to repair the defect in the intervertebral disc,

wherein the bone anchor comprises a neck,

wherein said neck has a length defined by a sharpened leading edge and a trailing end,

wherein said neck comprises an attachment site along at least a portion of its length,

wherein said attachment site is attachable to the prosthetic barrier,

wherein the attachment site is configured to extend above the endplate,

wherein said neck comprises a bottom portion terminating in a keel portion,

wherein said keel portion comprises a sharpened leading edge,

wherein the attachment site is offset relative to both the anchor'"'"'s angle of insertion and said neck to present said attachment site along the endplate, while said keel portion is inserted into the outer surface of the vertebral body;

advancing the sharpened leading edge of the keel portion within the outer surface while simultaneously advancing the attachment site, and thereby the prosthetic barrier, along and across the endplate,

wherein the bone anchor is driven within the outer surface of the vertebral body along a trajectory that is substantially perpendicular to the outer surface of the vertebral body and substantially parallel to the endplate;

countersinking said bone anchor within said outer surface of the vertebral body such that no portion of said bone anchor lies beyond said outer surface of the vertebral body; and

positioning the prosthetic barrier to close the defect.

2. The method of claim 1, wherein the keel portion comprises two keels that form an angle of about 180 degrees relative to each other, and wherein the neck is perpendicular to said keels to form a “

T”

shape.

3. The method of claim 1, wherein the prosthetic barrier comprises a polymer and the anchor comprises titanium.

4. The method of claim 1, wherein the prosthetic barrier and the anchor form a unitary construct.

5. The method of claim 1, wherein the prosthetic barrier comprises a mesh.

6. The method of claim 1, wherein the prosthetic barrier comprises a patch.

7. The method of claim 1, wherein the prosthetic barrier comprises a collapsible implant.

8. The method of claim 1, further comprising expanding at least one of the anchor or the prosthetic barrier.

9. The method of claim 1, wherein the attachment site comprises at least one device selected from the group consisting of:

a fabric, a wire, a linkage, a fastener component, a hook eye, a loop, and a plate.

10. A method of establishing an anchor along an endplate adjacent an intervertebral disc, comprising:

identifying a vertebral body comprising an outer surface and an endplate,

wherein the outer surface of the vertebral body is offset at an angle substantially perpendicular from the endplate and extends around a circumference of the vertebral body;

providing a prosthetic barrier coupled to a bone anchor,

wherein the bone anchor comprises a neck,

wherein said neck has a length defined by a sharpened leading edge and a trailing end,

wherein said neck comprises an attachment site along at least a portion of its length,

wherein said neck comprises a keel portion extending substantially perpendicularly from a bottom portion of the neck,

wherein the attachment site is offset relative to both the anchor'"'"'s angle of insertion and said neck to present said attachment site along the endplate, while said keel portion is inserted into the outer surface of the vertebral body;

advancing a sharpened leading edge of the keel portion directly within the outer surface of the vertebral body while simultaneously advancing the attachment site, and thereby the prosthetic barrier, along and across the endplate,

wherein the keel portion is driven within the outer surface of the vertebral body along a trajectory that is substantially perpendicular to the outer surface of the vertebral body and substantially parallel to the endplate; and

countersinking said anchor within said outer surface of the vertebral body such that no portion of said anchor lies beyond said outer surface of the vertebral body.

11. The method of claim 10, further comprising identifying a defect in anulus tissue of the intervertebral disc.

12. The method of claim 11, wherein the defect comprises a hole.

13. The method of claim 12, further comprising positioning the prosthetic barrier to close the defect.

14. The method of claim 11, wherein the defect is a herniated segment of anulus tissue.

15. The method of claim 14, further comprising positioning the prosthetic barrier to contact the herniated segment and return the herniated segment to a preherniated border of the anulus, thereby preserving and containing the herniated segment.

16. A method of establishing an anchor along an endplate adjacent an intervertebral disc, comprising:

identifying a vertebral body comprising an outer surface and an endplate,

wherein the outer surface of the vertebral body is offset at an angle substantially perpendicular from the endplate and extends around a circumference of the vertebral body;

wherein the identified vertebral body is adjacent an intervertebral disc having a herniated anulus segment;

providing a prosthetic device coupled to a bone anchor,

wherein the prosthetic device is configured to contain the herniated anulus segment,

wherein the bone anchor comprises a neck,

wherein said neck has a length defined by a sharpened leading edge and a trailing end,

wherein said neck comprises an attachment site along at least a portion of its length,

wherein said neck comprises a keel portion extending substantially perpendicularly from a bottom portion of the neck,

advancing a sharpened leading edge of the keel portion directly within the outer surface of the vertebral body while simultaneously advancing the attachment site, and thereby the prosthetic device, along and across the endplate,

wherein the keel portion is driven within the outer surface of the vertebral body along a trajectory that is substantially perpendicular to the outer surface of the vertebral body and substantially parallel to the endplate; and

countersinking said anchor within said outer surface of the vertebral body such that no portion of said anchor lies beyond said outer surface of the vertebral body.

17. The method of claim 16, further comprising positioning the prosthetic device to contact the herniated anulus segment and return the herniated anulus segment to a preherniated border of the anulus, thereby preserving and containing the herniated segment.

18. The method of claim 16, wherein the prosthetic device comprises a prosthetic barrier.

19. The method of claim 18, wherein the prosthetic barrier comprises a polymer.

20. The method of claim 16, wherein the bone anchor comprises titanium.