Devices and methods for stabilizing tissue and implants

• US 9,545,268 B2
• Filed: 03/12/2014
• Issued: 01/17/2017
• Est. Priority Date: 10/26/2004
• Status: Expired due to Fees

• Current Assignee: P TECH, LLC
• Original Assignee: P TECH, LLC
• Inventors: Bonutti, Peter M.
• Primary Examiner(s): LAWSON, MATTHEW JAMES
• Application Number:
  US14/205,592
• Publication Number:
  US 20140194933A1
• Time in Patent Office: 1,042 Days
• Field of Search: 606/247, 606/248, 623 1711- 1716
• US Class Current: 1/1
• 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 17/7064 Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor
• CPC Class Codes: A61B 17/7067 Devices bearing against one or more spinous processes and also attached to another part of the spine; Tools therefor
• CPC Class Codes: A61B 17/842 Flexible wires, bands or straps A61B17/72, A61B17/82, A61B17/86 take precedence
• CPC Class Codes: A61B 2017/00398 using powered actuators, e.g. stepper motors, solenoids
• CPC Class Codes: A61B 2017/00951 adhesive
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61F 2/0063 Implantable repair or support meshes, e.g. hernia meshes
• CPC Class Codes: A61F 2/08 Muscles; Tendons; Ligaments sutures A61B17/04
• CPC Class Codes: A61F 2/0811 Fixation devices for tendons or ligaments
• CPC Class Codes: A61F 2/30749 Fixation appliances for connecting prostheses to the body
• CPC Class Codes: A61F 2/4405 for apophyseal or facet joints, i.e. between adjacent spinous or transverse processes devices implanted between spinous or transverse processes A61B17/7062
• 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 2002/30462 retained or tied with a rope, string, thread, wire or cable
• 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: A61L 27/58 Materials at least partially resorbable by the body

Abstract

An implant for repairing a joint between a first bone and a second bone includes a first section constructed of a substantially rigid material and a graft constructed of soft tissue having a first end and a second end. The first section has a first end surface configured for positioning against the first bone. The graft is configured for stabilizing the first section relative to the first bone. A first fastener is configured for mounting to the graft and the first section to anchor the graft to the first section. A second fastener is configured for mounting to the graft and the first bone to anchor the graft to the first bone.

Claims

1. A method for stabilizing a patient'"'"'s spine, the method comprising:

a) performing a surgical procedure on the spine;

b) securing a first fastener to a first spinous process of a first vertebra;

c) securing a second fastener to a first inferior facet portion and a second superior facet portion of a second vertebra;

d) securing a tensioning member to the first and second fasteners;

e) tightening the tensioning member to draw the first fastener toward the second fastener;

f) securing a fourth tensioning member to an anterior longitudinal ligament of the spine, the anterior longitudinal ligament having a weakened portion that is weakened as a result of the surgical procedure of step (a), the anterior longitudinal ligament including an upper end at a first side of the weakened portion and a lower end at a second side of the weakened portion, the fourth tensioning member secured to the upper end;

g) securing the fourth tensioning member to the lower end; and

h) tightening the fourth tensioning member to draw the upper end toward the lower end.

2. The method of claim 1, further comprising:

i) securing a third fastener to a second spinous process of the second vertebra;

j) securing the tensioning member to the third fastener, the tensioning member comprised of a suture; and

k) tightening the suture to draw the third fastener toward the second fastener, the second fastener extending through a facet joint between the first inferior facet portion and the second superior facet portion.

3. The method of claim 1, further comprising:

i) securing a fourth fastener to a second inferior facet portion of the second vertebra;

j) securing the tensioning member to the fourth fastener; and

k) tightening the tensioning member to draw the second fastener toward the fourth fastener, the fourth fastener extending through a facet joint between the second inferior facet portion and a third superior facet portion of a third vertebra.

4. The method of claim 1, further comprising:

i) securing a fifth fastener to a first superior facet portion of the first vertebra;

j) securing the tensioning member to the fifth fastener; and

k) tightening the tensioning member to draw the second fastener toward the fifth fastener, the fifth fastener extending through a facet joint between the first superior facet portion and a fourth inferior facet portion of a fourth vertebra.

5. The method of claim 1, further comprising:

l) placing a plate adjacent the first spinous process and a second spinous process;

m) securing the plate to the first and second spinous processes with sixth and seventh fasteners, respectively;

n) securing the tensioning member to the sixth and seventh fasteners; and

o) tightening the tensioning member to draw the sixth and seventh fasteners toward the spinous processes, respectively.

6. The method of claim 5, further comprising:

p) securing an eighth fastener to a third spinous process of a third vertebra;

q) securing the plate to the third spinous process with a ninth fastener;

r) securing a second tensioning member to the eighth and ninth fasteners; and

s) tightening the second tensioning member to bias the ninth fastener and the plate toward the eighth fastener.

7. The method of claim 5, further comprising:

p) securing a tenth fastener to a fourth spinous process of a fourth vertebra;

q) securing the plate to the fourth spinous process with an eleventh fastener;

r) securing a third tensioning member to the tenth and eleventh fasteners; and

s) tightening the third tensioning member to bias the eleventh fastener and the plate toward the tenth fastener.

8. A method for stabilizing a patient'"'"'s spine, the method comprising:

a) performing a surgical procedure on the spine;

b) securing a second fastener to a first inferior facet portion of a first vertebra of the spine;

c) securing a fourth fastener to a second inferior facet portion of a second vertebra of the spine;

d) securing a tensioning member to the second and fourth fasteners;

e) tightening the tensioning member to draw the second fastener toward the fourth fastener

f) securing a third fastener to a second spinous process of the second vertebra;

g) securing a first fastener to a first spinous process of the first vertebra;

h) securing the tensioning member to the first fastener extending from the second fastener;

i) securing the tensioning member to the third fastener extending from the second fastener; and

j) tightening the tensioning member to draw the first fastener toward the second fastener and the third fastener toward the second fastener;

respectively.

9. The method of claim 8, further comprising:

k) securing a fifth fastener to a first upper facet portion of the first vertebra;

l) securing the tensioning member to the fifth fastener; and

m) tightening the tensioning member to draw the fifth fastener toward the second fastener.

10. The method of claim 8, further comprising:

k) placing a plate adjacent to first and second spinous processes of the first and second vertebrae;

l) securing the plate to the first and second spinous processes with sixth and seventh fasteners, respectively;

m) securing the tensioning member to the sixth and seventh fasteners; and

n) tightening the tensioning member to draw the sixth and seventh fasteners toward the first and second spinous processes, respectively.

11. The method of claim 10, further comprising:

o) securing an eighth fastener to a third spinous process of a third vertebra;

p) securing the plate to the third spinous process with a ninth fastener;

q) securing a second tensioning member to the eighth and ninth fasteners; and

r) tightening the second tensioning member to bias the ninth fastener and the plate toward the third spinous process.

12. The method of claim 11, further comprising:

s) securing a tenth fastener to a fourth spinous process of a fourth vertebra;

t) securing the plate to the fourth spinous process with an eleventh fastener;

u) securing a third tensioning member to the tenth and eleventh fasteners; and

v) tightening the third tensioning member to bias the eleventh fastener and the plate toward the fourth spinous process.

13. A method for stabilizing a patient'"'"'s spine, the method comprising:

a) performing a surgical procedure on the spine;

b) securing a first fastener to a first spinous process of a first vertebra;

c) securing a second fastener to a third spinous process of a third vertebra;

d) securing a tensioning member to the first and second fasteners such that the tensioning member extends past and proximate a second spinous process of a second vertebra; and

e) tightening the tensioning member to draw the first fastener toward the second fastener and the first spinous process toward the third spinous process.

14. The method of claim 13, further comprising:

f) securing a third fastener to a fourth spinous process of a fourth vertebra;

g) securing a fourth fastener to a first inferior facet portion of the first vertebra and a second superior facet portion of the second vertebra;

h) securing a second tensioning member to the third fastener;

i) securing the second tensioning member to the fourth fastener; and

j) tightening the second tensioning member to draw the third fastener toward the fourth fastener.

15. The method of claim 13, further comprising:

f) securing a fifth fastener to a second inferior facet portion of the second vertebra;

g) securing a sixth fastener to a third superior facet portion of the third vertebra;

h) securing a third tensioning member to the fifth fastener;

i) securing the third tensioning member to the sixth fastener such that the third tensioning member extends through a facet joint between the second inferior facet portion and the third superior facet portion; and

j) tightening the third tensioning member to draw the fifth fastener toward the sixth fastener.

16. The method of claim 13, further comprising:

f) securing a ligament graft to a first vertebral body of the first vertebra with a seventh fastener; and

g) securing the ligament graft to a second vertebral body of the second vertebra with an eighth fastener.

17. The method of claim 13, further comprising:

f) securing a ninth fastener to an anterior longitudinal ligament of the spine proximate a first vertebral body of the first vertebra;

g) securing a tenth fastener to the anterior longitudinal ligament proximate a second vertebral body of the second vertebra;

h) securing a fourth tensioning member to the ninth and tenth fasteners; and

i) tightening the fourth tensioning member to draw the ninth fastener toward the tenth fastener.

18. The method of claim 17, wherein the anterior longitudinal ligament includes a weakened portion between the ninth and tenth fasteners and further comprising:

j) securing a second ligament graft to the anterior longitudinal ligament across the weakened portion with one of the ninth and tenth fasteners and the fourth tensioning member.

19. The method of claim 17, wherein the anterior longitudinal ligament includes a weakened portion between the ninth and tenth fasteners, the fourth tensioning member extending from the ninth fastener through the anterior longitudinal ligament, through a first vertebral body of the first vertebra, through a first intervertebral disc between the first and second vertebrae, through a second vertebral body of the second vertebra and through the anterior longitudinal ligament proximate the tenth fastener such that the fourth tensioning member has a generally curved shape when mounted between the ninth and tenth fasteners, the tensioning member and the fourth tensioning member comprised of sutures.