Methods of repairing herniated segments in the disc

• US 8,409,284 B2
• Filed: 01/10/2011
• Issued: 04/02/2013
• 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): Stewart, Alvin J.
• Application Number:
  US12/987,966
• Publication Number:
  US 20110118844A1
• Time in Patent Office: 813 Days
• Field of Search: 623 1711- 1716, 606/139, 606/144, 606/148, 606/151, 606/213, 606/279
• US Class Current: 623/17.11
• 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 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
• 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

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 augmentation component. Methods and deployment devices are also disclosed. Method of supporting and augmenting a nucleus pulposus by inserting a flexible biocompatible material into the disc space using an anchoring means are also provided.

Claims

1. A method of treating an intervertebral disc comprising:

identifying a herniated anulus segment protruding outward from a natural border of an intervertebral disc,

wherein the herniated anulus segment comprises a defect;

implanting a first anchor and a biocompatible support member in the intervertebral disc;

positioning said first anchor such that at least a portion of said first anchor is in contact with an innermost surface of the anulus at a first location adjacent the defect in said anulus;

positioning said biocompatible support member such that at least a portion of said biocompatible support member is in contact with the innermost surface of the anulus at a second location adjacent the defect in said anulus;

connecting said first anchor and said biocompatible support member with a suture; and

applying tension and tightening said suture, thereby substantially closing said defect and maintaining the natural border of the intervertebral disc.

2. The method of claim 1, wherein said suture comprises woven material.

3. The method of claim 1, wherein said defect comprises a pre-existing hole in said anulus.

4. The method of claim 1, wherein said defect comprises an access hole formed in the herniated anulus segment.

5. The method of claim 1, wherein said suture is coupled with at least one of said first anchor and said biocompatible support member.

6. The method of claim 1, wherein said second location is spaced from the first location.

7. The method of claim 1, further comprising implanting one or more additional anchors in the disc.

8. The method of claim 1, wherein the biocompatible support member is an anchor.

9. The method of claim 1, wherein the first anchor and the biocompatible support member comprise metal.

10. A method of treating an intervertebral disc comprising:

identifying a herniated anulus segment protruding outward from a natural border of an intervertebral disc,

wherein the herniated anulus segment comprises a defect;

providing a support member;

providing a fixation device;

positioning the support member such that at least a portion of said support member is in contact with an inner surface of an anulus lamella at a first location adjacent the defect in said anulus;

positioning the fixation device in anulus tissue at a second location adjacent the defect;

connecting the fixation device to the support member with a connection member; and

applying tension and tightening said connection member, thereby substantially closing said defect and constraining the herniated segment to the natural border of the intervertebral disc.

11. The method of claim 10, wherein said support member is a first anchor and wherein said fixation device is a second anchor.

12. The method of claim 10, wherein said support member is a barrier.

13. The method of claim 11, wherein said connection member is a suture.

14. The method of claim 13, wherein the suture comprises woven material.

15. The method of claim 11, wherein said first anchor and said second anchor comprise metal.

16. The method of claim 10, wherein positioning the fixation device in anulus tissue at a second location adjacent the defect comprises positioning the fixation device in contact with the inner surface of the anulus lamella.

17. The method of claim 10, wherein the fixation device and the support member are connected prior to positioning the support member and the fixation device.

18. The method of claim 10, wherein the defect comprises an access hole formed in the herniated anulus segment.

19. The method of claim 10, further comprising positioning a third anchor in contact with the inner surface of the anulus lamella at a third location adjacent the defect in said anulus.

20. The method of claim 19, further comprising positioning a fourth anchor in contact with the innermost surface of the anulus lamella at a fourth location adjacent the defect in said annulus, wherein the fourth location is spaced from the third location.