Methods and devices for spinal correction

• US 9,456,817 B2
• Filed: 04/08/2014
• Issued: 10/04/2016
• Est. Priority Date: 04/08/2014
• Status: Active Grant

• Current Assignee: Depuy Synthes Products Incorporated (Johnson & Johnson)
• Original Assignee: Depuy Synthes Products Incorporated (Johnson & Johnson)
• Inventors: O'Neil, Michael J, Lomeli, Roman, Hawkins, John Riley, Ramsay, Christopher, Bootwala, Zoher, DiPietro, Jennifer, Griffin, John
• Primary Examiner(s): Hammond, Ellen C
• Application Number:
  US14/247,876
• Publication Number:
  US 20150282797A1
• Time in Patent Office: 910 Days
• US Class Current: 1/1
• CPC Class Codes: A61B 1/00087 Tools A61B17/00234 takes precedence
• CPC Class Codes: A61B 1/3135 for examination of the epidural or the spinal space
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2017/00106 ultrasonic
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/065 for measuring contact or contact pressure
• CPC Class Codes: A61B 2090/066 for measuring torque
• CPC Class Codes: A61B 2505/05 Surgical care
• CPC Class Codes: A61B 2562/04 Arrangements of multiple sensors of the same type
• CPC Class Codes: A61B 5/0071 by measuring fluorescence emission
• CPC Class Codes: A61B 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 5/1076 for measuring dimensions inside body cavities, e.g. using catheters A61B3/1005 takes precedence
• CPC Class Codes: A61B 5/4566 Evaluating the spine A61B5/4561 takes precedence
• CPC Class Codes: A61B 5/6853 with a balloon
• CPC Class Codes: A61B 8/0858 involving measuring tissue layers, e.g. skin, interfaces
• CPC Class Codes: A61B 8/0875 for diagnosis of bone A61B5/4504 takes precedence
• CPC Class Codes: A61B 8/12 : in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61B 90/06 : Measuring instruments not otherwise provided for
• CPC Class Codes: A61F 2/44 : for the spine, e.g. vertebrae, spinal discs
• 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 2/4611 : 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 2/4684 : Trial or dummy prostheses
• CPC Class Codes: A61F 2002/30405 : made by screwing complementary threads machined on the parts themselves
• CPC Class Codes: A61F 2002/30471 : connected by a hinged linkage mechanism, e.g. of the single-bar or multi-bar linkage type
• CPC Class Codes: A61F 2002/30507 : using a threaded locking member, e.g. a locking screw or a set screw
• CPC Class Codes: A61F 2002/30515 : using a locking wedge or block
• CPC Class Codes: A61F 2002/30537 : adjustable
• CPC Class Codes: A61F 2002/30538 : for adjusting angular orientation
• CPC Class Codes: A61F 2002/30556 : for adjusting thickness
• CPC Class Codes: A61F 2002/30579 : with mechanically expandable devices, e.g. fixation devices
• CPC Class Codes: A61F 2002/4633 : for selection of endoprosthetic joints or for pre-operative planning
• CPC Class Codes: A61F 2002/4658 : for measuring dimensions, e.g. length
• CPC Class Codes: A61F 2002/4666 : for measuring force, pressure or mechanical tension

Abstract

An expandable trial can include an inferior portion, a superior portion, and a middle expanding portion as well as load cells for monitoring the load on the trial. The trial may also include recesses on its lateral sides to provide spacing to accommodate a disc removal tool so tissue can be cleared monitoring load. In addition, neural foramen spacing can be monitoring to provide information about how much neural release has been achieved as the disc is cleaned and the spine is positioned and repositioned.

Claims

1. A system for spinal correction, comprising:

a disc removal tool, comprising;

a distal portion having a disc removal element;

a proximal portion; and

a shaft disposed longitudinally along an axis between the distal portion and the proximal portion; and

an expandable trial comprising;

an inferior portion having an inferior surface configured to contact an inferior vertebral body,

a superior portion having a superior surface configured to contact a superior vertebral body,

an expansion device disposed between the superior portion and the inferior portion and configured to increase the distance between the inferior portion and the superior portion, and

a first lateral side extending from the inferior surface to the superior surface, the first lateral side defining a recess configured to receive at least a portion of the disc removal tool; and

wherein the shaft of the disc removal tool is configured to be received at least partially in the recess of the first lateral side and wherein the shaft of the disc removal tool is disposed in the recess of the first lateral side and the shaft of the disc removal tool is disposed entirely between a plane defined by the superior surface and a plane defined by the inferior surface.

2. The system of claim 1 wherein the expandable trial comprises a second lateral side opposite the first lateral side and extending from the inferior surface to the superior surface, the second lateral side defining a recess configured to receive at least a portion of the disc removal tool.

3. The system of claim 1 wherein the inferior portion comprises at least one load sensor on the inferior surface disposed in a position to sense load imparted from the vertebral body onto the expandable trial and wherein at least one load sensor on the superior surface is disposed in a position to sense load imparted from the vertebral body onto the expandable trial.

4. The system of claim 3 wherein the inferior portion comprises at least four load sensors disposed proximate corners of the inferior surface and the superior portion comprises at least four load sensors disposed proximate corners of the superior surface.

5. The system of claim 1 wherein the expansion device comprises a rod with opposite threaded screw portions and a wedge threadingly mated to each screw portion, the wedges disposed to expand the inferior portion from the superior portion.

6. The system of claim 1 wherein the expansion device comprises a jack system disposed between the inferior portion and the superior portion to expand the inferior portion form the superior portion.

7. The system of claim 1 wherein the distal portion of the disc removal tool further comprises an articulating portion;

and

wherein the proximal portion of the disc removal tool further comprises a handle and a control device configured to articulate the articulating portion.

8. The system of claim 7 wherein the shaft comprises a longitudinal protrusion.

9. The system of claim 8 wherein the recess of the first lateral side includes a groove configured to receive the longitudinal protrusion.

10. The system of claim 7 wherein the disc removal element includes a cutting element.

11. The system of claim 10, wherein the cutting element is a box cutter.

12. The system of claim 11, further comprising a camera;

wherein the tool guide comprises a through-hole for receiving the camera; and

wherein the camera is disposed in the through-hole of the tool guide.

13. The system of claim 11, wherein the cutting element is pivotally connected to the shaft of the disc removal tool.

14. The system of claim 1,

wherein the superior portion of the expandable trial comprises a lateral portion having a lateral recess formed therein;

wherein the inferior portion of the expandable trial comprises a lateral portion having a lateral recess formed therein; and

wherein the lateral recess formed in the lateral portion of the superior portion and the lateral recess formed in the lateral portion of the inferior portion combine to define at least a portion of the recess configured to receive at least a portion of the disc removal tool.

15. The system of claim 14, wherein the lateral recess of the lateral portion of the superior portion is concave;

wherein the lateral recess of the lateral portion of the inferior portion is concave; and

wherein the recess configured to receive at least a portion of the disc removal tool is C-shaped.

16. The system of claim 1, further comprising a tool guide comprising a shaft mating portion that is sized and configured to receive the shaft of the disc removal tool;

the expandable trial further comprises a shaft, and the tool guide further comprises a portion that is sized and configured to mate to the shaft of the expandable trial.

17. A system for spinal correction, comprising:

a disc removal tool, comprising;

a distal portion having a disc removal element;

a proximal portion; and

a shaft disposed longitudinally along an axis between the distal portion and the proximal portion; and

an expandable trial comprising;

an inferior portion having an inferior surface configured to contact an inferior vertebral body,

a superior portion having a superior surface configured to contact a superior vertebral body,

an expansion device disposed between the superior portion and the inferior portion and configured to increase the distance between the inferior portion and the superior portion, and

a first lateral side extending from the inferior surface to the superior surface, the first lateral side defining a recess configured to receive at least a portion of the disc removal tool; and

wherein the shaft of the disc removal tool is configured to be received at least partially in the recess of the first lateral side; and

wherein the superior portion of the expandable trial comprises a lateral portion having a lateral recess formed therein;

wherein the inferior portion of the expandable trial comprises a lateral portion having a lateral recess formed therein; and

wherein the lateral recess formed in the lateral portion of the superior portion and the lateral recess formed in the lateral portion of the inferior portion combine to define at least a portion of the recess configured to receive at least a portion of the disc removal tool.

18. The system of claim 17, wherein the lateral recess of the lateral portion of the superior portion is concave;

wherein the lateral recess of the lateral portion of the inferior portion is concave; and

wherein the recess configured to receive at least a portion of the disc removal tool is C-shaped.

19. The system of claim 17 wherein the inferior portion comprises at least one load sensor on the inferior surface disposed in a position to sense load imparted from the vertebral body onto the expandable trial and wherein at least one load sensor on the superior surface disposed in a position to sense load imparted from the vertebral body onto the expandable trial.

20. The system of claim 17 wherein the distal portion of the disc removal tool further comprises an articulating portion;

and

wherein the proximal portion of the disc removal tool further comprises a handle and a control device configured to articulate the articulating portion.

21. The system of claim 20 wherein the shaft comprises a longitudinal protrusion.

22. The system of claim 21 wherein the recess of the first lateral side includes a groove configured to receive the longitudinal protrusion.