Method of performing a decompressive craniectomy

• US 8,439,956 B2
• Filed: 05/17/2007
• Issued: 05/14/2013
• Est. Priority Date: 06/09/2006
• Status: Active Grant

• Current Assignee: Gyrus Productions Incorporated
• Original Assignee: Gyrus Productions Incorporated
• Inventors: Ko, Kathryn
• Primary Examiner(s): Woodall, Nicholas
• Assistant Examiner(s): Waggle, Jr., Larry E
• Application Number:
  US11/749,990
• Publication Number:
  US 20070293865A1
• Time in Patent Office: 2,189 Days
• Field of Search: 162/21, 162/34, 163/74, 163/82, 16384-385, 163/87, 163/89, 128/898, 600104-105, 604/22, 606 45- 46, 606 70- 71, 606 82- 84, 606280-281, 606/286, 606/298, 606/301, 606/312, 606902-903, 623/17.19
• US Class Current: 606/281
• CPC Class Codes: A61B 17/688 for reattaching pieces of the skull
• CPC Class Codes: A61B 17/8061 specially adapted for particular bones A61B17/70 and A61B17/74 take precedence

Abstract

A method of performing a decompressive craniectomy includes removing a bone flap from a cranium, attaching one end of a movable plate to one end of the bone flap, and attaching another end of the movable plate to the cranium. The movable plate is configured to allow the bone flap to move to accommodate swelling of intracranial contents.

Claims

1. A method of performing a decompressive craniectomy, comprising:

removing a bone flap from a cranium;

fixing one end of a movable plate directly to one end of the bone flap; and

attaching another end of the movable plate to the cranium,

wherein the movable plate is configured to allow another end of the bone flap not attached to the movable plate to freely move away from the cranium so as to float with intracranial contents.

2. The method of claim 1, wherein the removing of the bone flap from the cranium comprises opening the cranium using an opening device and exposing the intracranial contents in order to gain access to the brain pathology.

3. The method of claim 2, wherein the opening of the cranium using an opening device comprises opening the cranium using an opening device adapted to operate through a portal access or adapted to operate with an endoscopic device.

4. The method of claim 1, wherein the fixing of the one end of the movable plate comprises fixing a first hinge plate of a unidirectional hinge to one end of the bone flap.

5. The method of claim 4, wherein the fixing of the first hinge plate to the bone flap comprises fixing the first hinge plate using bone fasteners.

6. The method of claim 5, wherein the bone fasteners comprise self drilling screws.

7. The method of claim 5, wherein the bone fasteners are made from a material selected from the group comprising titanium, titanium alloy, stainless steel, organic bioabsorbable substrates, or suture, or any combination of two or more thereof.

8. The method of claim 4, wherein the attaching of the other end of the movable plate comprises attaching a second hinge plate of the unidirectional hinge to the cranium.

9. The method of claim 8, wherein the attaching of the second hinge plate to the cranium comprises attaching the second hinge plate using bone fasteners.

10. The method of claim 9, wherein the bone fasteners comprise self drilling screws.

11. The method of claim 9, wherein the bone fasteners are made from a material selected from the group comprising titanium, titanium alloy, stainless steel, organic bioabsorbable substrate, or suture, or any combination of two or more thereof.

12. The method of claim 1, wherein the movable plate is a unidirectional hinge, the unidirectional hinge being rotatable between approximately 0°

and approximately 180°

such that the bone flap is allowed to move outwardly away from the cranium and is restricted from moving inwardly towards an interior cavity of the cranium.

13. The method of claim 12, wherein the movable plate is made from a material comprising titanium, titanium alloy, stainless steel, plastics, organic bioabsorbable substrate, or ceramics, or any combination of two or more thereof.

14. The method of claim 1, wherein the movable plate is made in an interwoven braided wire configuration.

15. The method of claim 14, wherein the interwoven braided wire configuration includes wires made from a material comprising titanium, titanium alloys, stainless steel, plastics, ceramics, or organic bioabsorbable substrates, or any combination of two or more thereof.

16. The method of claim 1, wherein the end of the bone flap not attached to the movable plate is able to move inwardly up to a cranium convexity edge when the swelling subsides.

17. The method of claim 12, further comprising attaching a plurality of unidirectional hinges to the cranium and to the bone flap.

18. The method of claim 1, further comprising attaching a plate to another end of the bone flap.

19. The method of claim 18, wherein the plate is made from a material comprising titanium, titanium alloys, stainless steel, plastics, ceramics, or organic bioabsorbable substrates, or any combination of two or more thereof.

20. The method of claim 18, wherein the attaching of the plate comprises attaching one end of the plate to the bone flap using bone fasteners.

21. The method of claim 20, wherein the attaching of the plate comprises attaching the plate such that another end of the plate abuts against the cranium.

22. The method of claim 20, wherein the attaching of the plate comprises attaching the plate such that another end of the plate does not abut against the cranium.

23. The method of claim 18, further comprising suturing a skin of the head on top of the bone flap.

24. The method of claim 23, further comprising opening the skin of the head when the swelling subsides to expose the plate and attaching one end of the plate to the cranium using bone fasteners.

25. The method of claim 22, further comprising rotating the plate such that the other end of the plate abuts against a surface of the cranium and attaching the other end of the plate to the cranium.

26. The method of claim 1, wherein the fixing of the one end of the movable plate comprises fixing one end of a rigid plate to the one end of the bone flap.

27. The method of claim 26, wherein the fixing of the one end of the rigid plate to the bone flap comprises fixing the one end of the rigid plate to the one end of the bone flap using bone fasteners.

28. The method of claim 27, wherein the bone fasteners comprise self drilling screws.

29. The method of claim 27, wherein the attaching of the other end of the movable plate comprises attaching another end of the rigid plate to the cranium.

30. The method of claim 29, wherein the attaching of the other end of the rigid plate to the cranium comprises attaching the other end of the rigid plate to the cranium using bone fasteners.

31. The method of claim 30, wherein the attaching of the other end of the rigid plate comprises attaching loosely the other end of the rigid plate by loosely attaching the bone fasteners to the cranium so as to allow movement the bone flap relative to the cranium.

32. The method of claim 31, wherein the bone fasteners comprise self drilling screws.

33. The method of claim 31, further comprising suturing a skin of the head on top of the bone flap.

34. The method of claim 33, further comprising opening the skin of the head to expose the loosely attached bone fasteners and tightening the loosely attached bone fasteners such that the bone flap is secured to the cranium.

35. The method of claim 34, prior to suturing the skin of the head on top of the bone flap, attaching a plate to another end of the bone flap using bone fasteners.

36. The method of claim 1, further comprising:

preventing an inner surface of the bone flap from moving radially inwardly beyond an inner surface of the cranium.

37. The method of claim 1, wherein the movable plate is configured to allow the bone flap to rotate about an axis.