Methods and devices for spinal disc annulus reconstruction and repair

• US 9,114,025 B2
• Filed: 06/29/2011
• Issued: 08/25/2015
• Est. Priority Date: 10/20/1999
• Status: Expired due to Fees

• Current Assignee: KRT Investors, Inc.
• Original Assignee: KRT Investors, Inc.
• Inventors: Cauthen, Joseph C. III, Burns, Matthew M., Wales, Lawrence W., Dukart, Brian L., Wessman, Bradley J., Houfburg, Rodney L., Burmeister, Paul
• Primary Examiner(s): Ramana, Anu
• Application Number:
  US13/171,625
• Publication Number:
  US 20110257752A1
• Time in Patent Office: 1,518 Days
• Field of Search: 623 1711- 1716, 623/1.11, 623/1.12, 623/1.2, 623/1.22, 623/1.23, 606151-157
• US Class Current: 1/1
• CPC Class Codes: A61B 17/04 for suturing wounds; Holders or packages for needles or suture materials suture materials A61L17/00
• CPC Class Codes: A61B 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 17/0642 for bones, e.g. for osteosynthesis or connecting tendon to bone
• CPC Class Codes: A61B 17/1155 Circular staplers comprising a plurality of staples
• CPC Class Codes: A61B 2017/00004 (bio)absorbable, (bio)resorbable, resorptive for implantable prostheses A61F2210/0004
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0472 Multiple-needled, e.g. double-needled, instruments
• CPC Class Codes: A61B 2017/06052 Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle hollow suture needles A61B2017/061
• CPC Class Codes: A61B 2017/06176 with protrusions, e.g. barbs
• CPC Class Codes: A61B 2017/0641 having at least three legs as part of one single body
• CPC Class Codes: A61B 2017/0647 having one single leg, e.g. tacks
• CPC Class Codes: A61B 2017/0648 threaded, e.g. tacks with a screw thread
• CPC Class Codes: A61F 2/0063 Implantable repair or support meshes, e.g. hernia meshes
• 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 2/4601 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 2002/0072 Delivery tools therefor
• 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 2002/30092 : using shape memory or superelastic materials, e.g. nitinol
• CPC Class Codes: A61F 2002/30158 : trapezoidal
• CPC Class Codes: A61F 2002/30299 : umbrella-shaped or mushroom-shaped
• CPC Class Codes: A61F 2002/30579 : with mechanically expandable devices, e.g. fixation devices
• CPC Class Codes: A61F 2002/30777 : Oblong apertures
• CPC Class Codes: A61F 2002/30784 : Plurality of holes
• CPC Class Codes: A61F 2002/30841 : Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
• 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 2002/4627 : 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 2210/0004 : bioabsorbable
• CPC Class Codes: A61F 2210/0019 : operated at only one temperature whilst inside or touching the human body, e.g. constrained in a non-operative shape during surgery, another temperature only occurring before the operation
• CPC Class Codes: A61F 2230/0026 : trapezoidal
• CPC Class Codes: A61F 2230/0093 : Umbrella-shaped, e.g. mushroom-shaped
• CPC Class Codes: A61F 2310/00011 : Metals or alloys

Abstract

The present invention provides methods and devices for annulus disc repair with and without the use of a patch or stent. The methods and devices are particularly suited to the repair and/or reconstruction of the spinal disc wall (annulus) after surgical invasion or pathologic rupture, with reduced failure rate as compared to conventional surgical procedures.

Claims

1. A method of treating a defect of an intervertebral disc, comprising:

inserting an anchor into tissue in a first location proximate to the defect;

inserting a second anchor into the tissue in a second location proximate to the defect, and wherein the first and second anchors are connected to each other by an elongate element; and

adjusting a length of the elongate element by wrapping the elongate element on a tool; and

locking the elongate element after tensioning the elongate element.

2. The method of claim 1, wherein the anchors include T anchors.

3. The method of claim 1, wherein at least one the first and second anchors is a T-anchor.

4. The method of claim 1, wherein the elongate element is helically wrapped on the tool.

5. The method of claim 1, wherein helically wrapping the elongate element on the tool removes slack and tensions the elongate element.

6. The method of claim 1, wherein the tool is a device delivery tool.

7. The method of claim 1, wherein the defect is in the tissue of annulus fibrosus of the intervertebral disc.

8. The method of claim 1, wherein the elongate element is formed in a loop.

9. The method of claim 8, wherein the loop of the elongate element includes a slip knot.

10. The method of claim 9, wherein the loop of the elongate element is selectively adjustable.

11. The method of claim 9, further comprising:

tensioning the elongate element by pulling a terminal end of the loop which includes the slip knot.

12. The method of claim 1 wherein:

inserting the second anchor includes inserting the second anchor into the tissue in a second location opposite the defect from the first location; and

adjusting a length of the elongate element includes tensioning the elongate element across the defect to reapproximate the defect.

13. The method of claim 12 wherein inserting the first and second anchors includes inserting at least one of the first and second anchors into annular tissue.

14. The method of claim 1 and further including inserting a patch into the defect below a surface of an outer annular wall before inserting the first and second anchors.

15. The method of claim 14 wherein inserting the first and second anchors includes inserting the first and second anchors into the patch.

16. The method of claim 15 wherein:

inserting the second anchor includes inserting the second anchor into the tissue in a second location opposite the defect from the first location; and

adjusting a length of the elongate element includes tensioning the elongate element across the defect to reapproximate the defect.

17. The method of claim 14 wherein inserting the first and second anchor includes inserting at least one of the first and second anchors into the patch.

18. The method of claim 17 wherein:

inserting the second anchor includes inserting the second anchor into the tissue in a second location opposite the defect from the first location; and

adjusting a length of the elongate element includes tensioning the elongate element across the defect to reapproximate the defect.