Method and apparatus for post-operative tuning of a spinal implant

• US 9,867,721 B2
• Filed: 04/25/2003
• Issued: 01/16/2018
• Est. Priority Date: 01/30/2003
• Status: Active Grant

• Current Assignee: Medtronic Navigation Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Navigation Incorporated (Medtronic Plc)
• Inventors: Hunter, Mark
• Primary Examiner(s): Weatherby, Ellsworth
• Application Number:
  US10/423,515
• Publication Number:
  US 20040152972A1
• Time in Patent Office: 5,380 Days
• Field of Search: 128899, 600424
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/15 Guides therefor arrangements for guiding straight saw blades in general B23D51/025
• CPC Class Codes: A61B 17/1703 using imaging means, e.g. by X-rays
• CPC Class Codes: A61B 17/175 for preparing the femur for hip prosthesis insertion
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 2017/00199 with a console, e.g. a control panel with a display
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2034/102 Modelling of surgical devices, implants or prosthesis
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/108 Computer aided selection or customisation of medical implants or cutting guides
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2072 Reference field transducer attached to an instrument or patient
• CPC Class Codes: A61B 2034/252 indicating steps of a surgical procedure
• CPC Class Codes: A61B 2034/254 being adapted depending on the stage of the surgical procedure
• CPC Class Codes: A61B 2034/256 having a database of accessory information, e.g. including context sensitive help or scientific articles
• CPC Class Codes: A61B 2090/363 Use of fiducial points
• CPC Class Codes: A61B 2090/365 augmented reality, i.e. correlating a live optical image with another image
• CPC Class Codes: A61B 2090/374 NMR or MRI
• CPC Class Codes: A61B 2090/376 : using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2090/3983 : Reference marker arrangements for use with image guided surgery
• CPC Class Codes: A61B 34/20 : Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 34/25 : User interfaces for surgical systems
• CPC Class Codes: A61B 34/30 : Surgical robots
• CPC Class Codes: A61B 90/10 : for stereotaxic surgery, e.g. frame-based stereotaxis
• CPC Class Codes: A61F 2/32 : for the hip
• CPC Class Codes: A61F 2/34 : Acetabular cups
• CPC Class Codes: A61F 2/36 : Femoral heads ; Femoral endoprostheses
• CPC Class Codes: A61F 2/441 : made of inflatable pockets or chambers filled with fluid, e.g. with hydrogel
• CPC Class Codes: A61F 2/4425 : made of articulated components
• CPC Class Codes: A61F 2/4607 : of hip femoral endoprostheses
• CPC Class Codes: A61F 2/4609 : of acetabular cups
• CPC Class Codes: A61F 2/4657 : Measuring instruments used for implanting artificial joints for surgical instruments A61B90/06
• CPC Class Codes: A61F 2/48 : Operating or control means, e.g. from outside the body, control of sphincters
• 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 2002/30476 : locked by an additional locking mechanism
• CPC Class Codes: A61F 2002/305 : Snap connection
• CPC Class Codes: A61F 2002/30517 : using a locking plate
• CPC Class Codes: A61F 2002/30538 : for adjusting angular orientation
• CPC Class Codes: A61F 2002/30548 : for adjusting fluid pressure
• CPC Class Codes: A61F 2002/30565 : having spring elements
• CPC Class Codes: A61F 2002/30578 : having apertures, e.g. for receiving fixation screws
• CPC Class Codes: A61F 2002/30579 : with mechanically expandable devices, e.g. fixation devices
• CPC Class Codes: A61F 2002/30586 : having two or more inflatable pockets or chambers
• CPC Class Codes: A61F 2002/30624 : Hinged joint, e.g. with transverse axle restricting the movement
• CPC Class Codes: A61F 2002/30649 : Ball-and-socket joints
• CPC Class Codes: A61F 2002/30668 : Means for transferring electromagnetic energy to implants
• CPC Class Codes: A61F 2002/3067 : for data transfer
• CPC Class Codes: A61F 2002/30677 : Means for introducing or releasing pharmaceutical products, e.g. antibiotics, into the body
• CPC Class Codes: A61F 2002/3069 : Revision endoprostheses
• CPC Class Codes: A61F 2002/449 : comprising multiple spinal implants located in different intervertebral spaces or in different vertebrae
• CPC Class Codes: A61F 2002/4632 : using computer-controlled surgery, e.g. robotic surgery
• CPC Class Codes: A61F 2002/4635 : using minimally invasive surgery
• CPC Class Codes: A61F 2002/4666 : for measuring force, pressure or mechanical tension
• CPC Class Codes: A61F 2002/4668 : for measuring angles
• CPC Class Codes: A61F 2002/467 : for measuring fluid pressure
• CPC Class Codes: A61F 2002/4681 : by applying mechanical shocks, e.g. by hammering
• CPC Class Codes: A61F 2220/0025 : Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2220/0091 : connected by a hinged linkage mechanism, e.g. of the single-bar or multi-bar linkage type
• CPC Class Codes: A61F 2250/0001 : Means for transferring electromagnetic energy to implants
• CPC Class Codes: A61F 2250/0002 : for data transfer
• CPC Class Codes: A61F 2250/0006 : for adjusting angular orientation
• CPC Class Codes: A61F 2250/0013 : for adjusting fluid pressure
• CPC Class Codes: G16Z 99/00 : Subject matter not provided for in other main groups of this subclass
• CPC Class Codes: Y02A 90/10 : Information and communication technologies [ICT] supporting adaptation to climate change, e.g. for weather forecasting or climate simulation

Abstract

A tunable implant, system, and method enables a tunable implant to be adjusted within a patient. The tunable implant includes a securing mechanism to secure the implant in the patient, a actuation portion that enables the implant to move and an adjustment portion that permits adjustment of the implant after the implant has been positioned within the patient. The method of adjusting the tunable implant includes analyzing the operation of the implant, determining if any adjustments are necessary and adjusting the implant to improve implant performance. The implant system includes both the tunable implant and a telemetric system that is operable to telemetrically receive data from the tunable implant where the data is used to determine if adjustment of the tunable implant is necessary. The system also includes an instrument assembly that is used for performing spinal surgery where the instrument assembly includes a mounting platform and a jig.

Claims

1. A tunable implant configured to be positioned within a patient, said tunable implant comprising:

a pair of support plates, each support plate having a flange extending at a non-zero angle relative to each support plate, wherein each flange is operable to engage a side of a vertebra of the patient;

a bladder mechanism including a plurality of bladders between said pair of support plates, wherein each bladder includes a sensor to sense a parameter; and

a bladder control system positioned within said bladder mechanism operable to receive said parameter from each sensor and to adjust a pressure in each bladder of the plurality of bladders in a real time manner;

wherein each support plate includes a first segment and a second segment connected with a hinge and configured to enable the tunable implant to be folded in a manner to make said tunable implant substantially smaller than in an unfolded state, wherein said first segment is folded towards said second segment via said hinge, and unfolded for fixation to the vertebra during implantation.

2. The tunable implant as defined in claim 1 wherein each flange defines a passageway operable to receive a bone screw to secure the tunable implant to the vertebra.

5. The tunable implant as defined in claim 1 wherein said bladder control system is operable to be actuated telemetrically in a non-surgical procedure.

6. The tunable implant as defined in claim 1 wherein said bladder control system includes a resonant circuit.

3. A tunable implant configured to be positioned within a patient, said tunable implant comprising:

a pair of support plates, each support plate having a flange extending at a non-zero angle relative each support plate and configured to engage a vertebra;

an adjustable portion having a plurality of regions, each region having a sensor and at least one force control beam configured to apply a force to a spring in each region, wherein upon adjusting said adjustable portion to effect at least one of a range of motion or a stiffness of said adjustable portion, said tunable implant provides a changed performance;

wherein each sensor is operable to sense at least one of a force parameter or a temperature parameter; and

a force control system positioned within said implant operable to receive said force parameter or temperature parameter from each sensor and is operable to adjust said adjustable portion by adjusting a tension on said spring in each region with each force control beam in a real-time manner.

4. The tunable implant as defined in claim 3 wherein said force parameter is selected from a group comprising pressure, stress, strain, loading force, torsional force, and frictional force.

8. The tunable implant as defined in claim 4 wherein said at least one hinge comprises a first hinge and a second hinge.

7. A tunable implant system comprising:

a tunable implant configured to be positioned within a patient, said tunable implant comprising;

a pair of support plates, each support plate having a flange extending at a non- zero angle relative to each support plate, wherein each flange is operable to engage a side of a vertebra of the patient;

a bladder mechanism including a plurality of bladders between said pair of support plates, wherein each bladder includes a sensor to sense a parameter; and

a bladder control system positioned within said bladder mechanism operable to receive said parameter from each sensor and to adjust a pressure in each bladder of the plurality of bladders in a real time manner;

wherein each support plate includes a first segment and a second segment connected with at least one hinge and configured to enable said tunable implant to be folded in a manner to make said tunable implant substantially smaller than in an unfolded state, wherein said tunable implant is configured to be folded during insertion for implantation, wherein said first segment is folded towards said second segment via said at least one hinge, and unfolded for fixation to the vertebra during implantation; and

a patient sensor operable to be attached to the patient during a motion analysis;

wherein said bladder control system positioned within said bladder mechanism is operable to receive sensed parameters from said patient sensor.

9. The tunable implant system as defined in claim 7 wherein said tunable implant comprises a plurality of said tunable implants.

10. The tunable implant system as defined in claim 9 wherein each said bladder control system is operable to be controlled telemetrically.