Systems and methods for posterior dynamic stabilization of the spine

• US 10,258,389 B2
• Filed: 04/18/2016
• Issued: 04/16/2019
• Est. Priority Date: 10/20/2004
• Status: Active Grant

• Current Assignee: Board of Trustees of the Leland Stanford Junior University (Stanford Management Co.)
• Original Assignee: Board of Trustees of the Leland Stanford Junior University (Stanford Management Co.)
• Inventors: Kim, Daniel H.
• Primary Examiner(s): Prone, Christopher D
• Application Number:
  US15/131,995
• Publication Number:
  US 20160317193A1
• Time in Patent Office: 1,093 Days
• 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 17/7067 Devices bearing against one or more spinous processes and also attached to another part of the spine; Tools therefor
• CPC Class Codes: A61B 17/7071 Implants for expanding or repairing the vertebral arch or wedged between laminae or pedicles; Tools therefor
• CPC Class Codes: A61B 17/7083 Tools for guidance or insertion of tethers, rod-to-anchor connectors, rod-to-rod connectors, or longitudinal elements
• 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 a mechanical actuation means for expanding the expandable member. The methods involve the implantation of one or more devices or expandable spacers.

Claims

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

delivering a spacer through a cannula and to a location between a first protrusion of a first vertebra and a second protrusion of a second vertebra using a lateral approach;

moving end portions of the spacer toward one another using a delivery device, which is coupled to the spacer and extends through the cannula; and

separating the delivery device from the spacer while the spacer is in an H-shaped configuration and a central section of the spacer is positioned between the first and second protrusions.

2. The method of claim 1, further comprising:

after delivering the spacer through the cannula, radially expanding the end portions and the central section to distract the first and second protrusions, wherein the first and second protrusions are first and second spinous processes, respectively.

3. The method of claim 1, further comprising expanding the spacer until a superior U-shaped region of the spacer holds the first protrusion and an inferior U-shaped region of the spacer holds the second protrusion.

4. The method of claim 1, further comprising radially expanding the central section and the end portions.

5. The method of claim 1, further comprising sliding one of the end portions along an elongate inner member of the spacer to cause expansion of both end portions.

6. The method of claim 1, further comprising causing relative movement between at least one of the end portions and a core member of the spacer to move the spacer from a delivery configuration toward the H-shaped configuration.

7. The method of claim 1, wherein the central section includes a retaining member configured to distract the first and second protrusions.

8. The method of claim 1, further comprising moving the spacer from a delivery configuration for delivery through the cannula to the H-shaped configuration, wherein the spacer in the delivery configuration has a first maximum diameter and in the H-shaped configuration has a second maximum diameter, and wherein the first maximum diameter is less than the second maximum diameter.

9. The method of claim 1, further comprising causing relative movement between an elongate member within the spacer and the central section to radially expand the end portions.

10. The method of claim 1, wherein the delivery device controllably moves the end portions of the spacer toward one another while the spacer is positioned directly between the first and second vertebrae, the method further comprising

expanding the spacer to gradually distract the first and second vertebrae contacting the central section of the spacer prior to separating the delivery device from the spacer.

11. A method for stabilizing a subject'"'"'s spine, the method comprising:

delivering a spacer through a cannula positioned in the subject;

delivering a central section of the spacer between a superior protrusion of a superior vertebra and an inferior protrusion of an inferior vertebra; and

after delivering the central section between the superior and inferior protrusions,

translating a first end portion toward a second end portion of the spacer using a delivery instrument coupled to the spacer and extending through the cannula such that the superior and inferior protrusions are contained between the first and second end portions, and

locking the spacer in a deployed configuration while the central section is positioned to contact and hold apart the superior and inferior protrusions.

12. The method of claim 11, further comprising:

actuating a segmented core member, which extends through at least a portion of the central section, to move the spacer toward the deployed configuration; and

after moving the spacer toward the deployed configuration, selectively adjusting a length of the segmented core member.

13. The method of claim 11, further comprising:

sequentially adjusting expansion of the spacer by moving a segmented core along the central section of the spacer, the segmented core is coupled to the delivery instrument that extends out of the subject.

14. The method of claim 11, further comprising expanding the central section to distract the superior and inferior protrusions before locking the spacer.

15. The method of claim 11, wherein the first end portion has a bore through which a core member extends, and wherein the core member is coupled to the second end portion.

16. A method comprising:

moving a spacer, in a delivery configuration, through a cannula positioned in a subject;

positioning a central section of the spacer at a location between a superior protrusion of a superior vertebra and an inferior protrusion of an inferior vertebra, the spacer including a first end portion and a second end portion;

moving the first end portion toward the second end portion such that (a) the first end portion extends along a first side of the superior protrusion and a first side of the inferior protrusion and (b) the second end portion extends along a second side of the superior protrusion and a second side of the inferior protrusion, wherein the first end portion is moved toward the second end portion using a delivery instrument coupled to the spacer and extending through the cannula; and

locking the spacer in an H-shape configuration.

17. The method of claim 16, after positioning the central section between the superior and inferior protrusions, the method further comprising:

expanding the first end portion; and

expanding the second end portion.

18. The method of claim 16, further comprising moving at least one of the first and second end portions through an interspinous space while the spacer is in the delivery configuration.

19. The method of claim 16, wherein the first end portion is moved toward the second end portion until a superior U-shaped region of the spacer holds the superior protrusion and an inferior U-shaped region of the spacer holds the inferior protrusion.