Systems and methods for posterior dynamic stabilization of the spine

• US 8,900,271 B2
• Filed: 05/01/2012
• Issued: 12/02/2014
• Est. Priority Date: 10/20/2004
• Status: Active Grant

• Current Assignee: Board of Trustees of the Leland Stanford Junior University (Stanford University)
• Original Assignee: Board of Trustees of the Leland Stanford Junior University (Stanford University)
• Inventors: Kim, Daniel H.
• Primary Examiner(s): Prone, Christopher D
• Application Number:
  US13/461,026
• Publication Number:
  US 20130072985A1
• Time in Patent Office: 945 Days
• Field of Search: 623/17.11, 623/17.12, 623/17.15, 606246-249, 606/279
• US Class Current: 606/248
• CPC Class Codes: A61B 17/70 Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
• CPC Class Codes: A61B 17/7065 Devices with changeable shape, e.g. collapsible or having retractable arms to aid implantation; Tools therefor
• CPC Class Codes: A61B 17/7068 Devices comprising separate rigid parts, assembled in situ, to bear on each side of spinous processes; Tools therefor
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence

Abstract

Devices, systems and methods for dynamically stabilizing the spine are provided. The devices include an expandable spacer or member having an unexpanded configuration and an expanded configuration, wherein the expandable member in an expanded configuration has a size, volume and/or shape configured for positioning between the spinous processes of adjacent vertebrae in order to distract the vertebrae relative to each other. The systems include one or more expandable members and an expansion medium for injection within or for filling the interior of the expandable member via the port. The methods involve the implantation of one or more devices or expandable spacers.

Claims

1. A method for stabilizing at least one spinal segment of a subject, the method comprising:

moving a delivery instrument into the subject, wherein the delivery instrument is configured to drive an expandable device from an unexpanded configuration for delivery through at least a portion of the delivery istrument to an expanded configuration for stabilizing the at least one spinal segment, wherein the expandable device is configured to push apart superior spinous process of a superior vertebra and an inferior spinous process of an inferior vertebra a distance determined by operation of the delivery instrument;

positioning the expandable device between the superior spinous process and the inferior spinous process, the expandable device including a pair of superior apex portions, a superior engagement portion between the superior apex portions, a pair of inferior apex portions, and an inferior engagement portion between the inferior apex portions;

deploying the superior apex portions and the superior engagement portion such that the superior apex portions receive the superior spinous process and the superior engagement portion moves towards the superior spinous process;

deploying the inferior apex portions and the inferior engagement portion such that the inferior apex portions receive the inferior spinous process and the inferior engagement portion moves towards the inferior spinous process; and

separating the delivery instrument from the expandable device in the expanded configuration.

2. The method of claim 1, further comprising:

coupling at least one of the superior apex portions to the superior spinous process; and

coupling at least one of the inferior apex portions to the inferior spinous process.

3. The method of claim 2 wherein coupling the superior apex portion to the superior spinous process includes coupling a superior tab of the expandable device to a lateral side of the superior spinous process.

4. The method of claim 2 wherein coupling the inferior apex portion to the inferior spinous process includes coupling an inferior tab of the expandable device to a lateral side of the inferior spinous process.

5. The method of claim 1 wherein deploying the superior engagement portion and the inferior engagement portion includes:

moving the superior engagement portion into contact with an inferior region of the superior spinous process; and

moving the inferior engagement portion into contact with a superior region of the inferior spinous process.

6. The method of claim 1 wherein deploying the superior apex portions and the superior engagement portion and deploying the inferior apex portions and the inferior engagement portion provides distraction between the superior vertebra and the inferior vertebra.

7. The method of claim 1, further comprising moving the expandable device from the unexpanded configuration to the expanded configuration to position the superior spinous process between the superior apex portions and to position the inferior spinous process between the inferior apex portions.

8. The method of claim 1 wherein the expandable device has a substantially H-shaped configuration.

9. The method of claim 1, further comprising;

delivering a cannula of the delivery instrument through an opening in a spinous ligament of the subject;

moving the expandable device through the cannula while the expandable device is in the unexpanded configuration; and

delivering the expandable device out of the cannula to a space between the superior spinous process and the inferior spinous process to position the expandable device between the superior spinous process and the inferior spinous process.

10. A method for stabilizing at least one spinal segment, the method comprising:

moving an interspinous device between a superior spinous process of the superior vertebra and an inferior spinous process of an inferior vertebra; and

moving the interspinous device from a delivery configuration to a deployed H-shaped configuration using a delivery instrument operatively coupled to the interspinous device such that the interspinous device distracts the superior and inferior spinous processes based on an amount of expansion of the interspinous device controlled by the delivery instrument coupled to the interspinous device while the interspinous device in the deployed H-shaped configuration receives the superior spinous process and the inferior spinous process.

11. The method of claim 10, further comprising:

anchoring the interspinous device to the superior spinous process; and

anchoring the interspinous device to the inferior spinous process.

12. The method of claim 10 wherein moving the interspinous device from the delivery configuration to the deployed H-shaped configuration includes:

positioning a pair of superior apex portions of the interspinous device on opposing sides of the superior spinous process; and

positioning a pair of inferior apex portions of the interspinous device on opposing sides of the inferior spinous process.

13. The method of claim 10, further comprising:

coupling the interspinous device to the superior spinous process such that superior arms of the interspinous device extend in a superior direction along opposing lateral sides of the superior spinous process; and

coupling the interspinous device to the inferior superior spinous process such that inferior arms of the interspinous extend in an inferior direction along opposing lateral sides of the inferior spinous process.

14. The method of claim 10, further comprising anchoring the interspinous device to both the superior spinous process and the inferior spinous process.

15. The method of claim 10 wherein moving the interspinous device from the delivery configuration to the deployed H-shaped configuration includes:

moving a pair of superior apex portions of the interspinous device in a superior direction and along the superior spinous process; and

moving a pair of inferior apex portions of the interspinous device in an inferior direction and along the inferior spinous process.

16. The method of claim 10 wherein moving the interspinous device from the delivery configuration to the deployed H-shaped configuration includes:

contacting the superior spinous process with a substantially U-shaped superior portion of the interspinous device; and

contacting the inferior spinous process with a substantially U-shaped inferior portion of the interspinous device.

17. A method for stabilizing at least one spinal motion segment comprising a superior vertebra and an inferior vertebra, the method comprising:

positioning an interspinous device generally between a superior spinous process of the superior vertebra and an inferior spinous process of the inferior vertebra such that a pair of superior end portions of the interspinous device and a pair of inferior end portions of the interspinous device are positioned between the superior spinous process and the inferior spinous process;

moving the superior end portions along opposing sides of the superior spinous process using a delivery instrument while a main body of the interspinous device is positioned between the superior spinous process and the inferior spinous process;

moving the inferior end portions along opposing sides of the inferior spinous process using the delivery instrument while the main body of the interspinous device is positioned between the superior spinous process and the inferior spinous process; and

after moving the superior and inferior end portions along the opposing sides of the respective superior and inferior spinous processes, decoupling the delivery instrument from the interspinous device.

18. The method of claim 17 wherein moving the superior end portions of the interspinous device along opposing sides of the superior spinous process includes moving the superior end portions from a collapsed configuration to a deployed configuration, and wherein moving the inferior end portions of the interspinous device along opposing sides of the inferior spinous process includes moving the inferior end portions from a collapsed configuration to a deployed configuration.

19. The method of claim 17, further comprising:

moving a superior engagement portion of the interspinous device towards the superior spinous process, the superior engagement portion is positioned between the superior end portions; and

moving an inferior engagement portion of the interspinous device towards the inferior spinous process, the inferior engagement portion is positioned between the inferior end portions.

20. The method of claim 17, further comprising distracting the superior vertebra and the inferior vertebra using the interspinous device.

21. A method for stabilizing at least one spinal segment of a subject, the method comprising:

positioning a deployable device between a superior spinous process of a superior vertebra and an inferior spinous process of an inferior vertebra, wherein the deployable device is configured to be expanded by a delivery instrument from an unexpanded configuration for delivery through at least a portion of the delivery instrument to an expanded configuration for stabilizing the at least one spinal segment;

moving a pair of superior apex portions of the deployable device from a delivery position to a deployed position such that the superior spinous process is received between the superior apex portions;

moving a pair of inferior apex portions of the deployable device from a delivery position to a deployed position such that the inferior spinous process is received between the inferior apex portions; and

moving a superior engagement portion of the deployable device away from an inferior engagement portion of the deployable device such that the superior engagement portion contacts an inferior region of the superior spinous process and the inferior engagement portion contacts a superior region of the inferior spinous process to distract the superior and inferior spinous processes an amount determined by operation of the delivery instrument while the delivery instrument is couple to the deployable device, wherein the superior engagement portion is positioned between the superior apex portions, and wherein the inferior engagement portion is positioned between the inferior apex portions.

22. The method of claim 21, further comprising:

anchoring one of the superior apex portions to the superior spinous process; and

anchoring one of the inferior apex portions to the inferior spinous process.

23. The method of claim 21, further comprising:

moving a cannula of the delivery instrument toward an interspinous space between the superior and inferior spinous processes; and

delivering the deployable device out of a end of the cannula.