Devices and methods for inter-vertebral orthopedic device placement

• US 20060149278A1
• Filed: 11/23/2005
• Published: 07/06/2006
• Est. Priority Date: 11/24/2004
• Status: Active Grant

• Current Assignee: M. S. Abdou
• Original Assignee: M. S. Abdou
• Inventors: Abdou, M. S.
• Granted Patent: US 8,172,855 B2
• Time in Patent Office: Days
• US Class Current: 606/90
• CPC Class Codes: A61B 17/7062 Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs rib fixation devices A61B17/8076; Tools for such devices
• 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 17/7077 for moving bone anchors attached to vertebrae, thereby displacing the vertebrae
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2090/061 for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/062 penetration depth
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• 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 2/4611 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 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 2002/4658 for measuring dimensions, e.g. length
• CPC Class Codes: A61F 2002/4662 for measuring penetration depth
• CPC Class Codes: A61F 2002/4666 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61F 2002/4687 Mechanical guides for implantation instruments

Abstract

The disclosure relates to devices and methods for implantation of an orthopedic device between skeletal segments using limited surgical dissection. The implanted devices are used to adjust and maintain the spatial relationship(s) of adjacent bones. Depending on the implant design, the motion between the skeletal segments may be increased, limited, modified, or completely immobilized.

Claims

1. A distractor instrument, comprising:

a first distractor member that engages at a distal end to a first skeletal segment;

a second distractor member that engages at a distal to a second skeletal segment;

a distractor device mounted to proximal ends of the first and second distractor members;

a distraction actuator attached to the distractor device, wherein the distraction actuator is actuated to apply a distraction force to the first and second distractor members to distract the first and second skeletal segments relative to one another.

2. An instrument as in claim 1, further comprising a force indicator attached to the distractor device wherein the force indicator provides measurement of the distraction force.

3. An instrument as in claim 1, further comprising a localizing needle that attaches to the distractor device, wherein the localizing needle has a distal end that points to a target location for positioning an implant.

4. An instrument as in claim 1, further comprising an insertion device pivotably attached to the distractor device, wherein the insertion device is pivotable to an orientation so as to deliver an object into a targeted space.

5. An instrument as in claim 4, wherein the insertion device includes a connector portion and a curved portion, wherein the connector portion extends outwardly from the distractor device, and wherein the curved portion has a radius of curvature substantially equal to a distance defined by of the connector portion.

6. An instrument as in claim 5, wherein the insertion device pivots about a pivot axis such that a distal end of the curved portion pivots toward the targeted space.

7. An instrument as in claim 4, further comprising a trocar removably and slidably positioned inside the insertion device, the trocar having a sharpened tip.

8. An instrument as in claim 1, wherein the first and second distractor members each comprises an anchor that penetrates into the skeletal segment and an elongate sheath positioned over the anchor.

9. An instrument as in claim 4, wherein the insertion device has a guide shaft, and wherein the insertion device is pivotable to an orientation such that the guide shaft provides a passageway for the delivery of an orthopedic device into the space between the pair of skeletal segments.

10. An instrument as in claim 4, wherein the insertion device has a solid guide shaft and wherein the object is attached to a distal end of the guide shaft.

11. An instrument as in claim 1, further comprising:

a localizing needle that attaches to the distractor device, wherein the localizing needle has a distal end that points to a target location for positioning an implant; and

an insertion device pivotably attached to the distractor device, wherein the insertion device has a delivery end that pivots to the target location for delivery an object to the target location.

12. An instrument as in claim 4, further comprising a sizing device that couples to the insertion device, wherein the sizing device provides an indication as to the size the space between the skeletal segments, the sizing device including a tapered region that can be inserted into the space.

13. An instrument as in claim 12, wherein the sizing instrument reduces a distractor load on the distractor device as the sizing instruments is inserted into the space wherein reducing a load of the distractor device serves as a confirmation that the sizing instrument is properly positioned to measure a size of an object to be inserted into the space.

14. A distractor instrument, comprising:

first and second distraction members that each engage a respective skeletal segment, wherein the distraction members can be distracted to cause distraction of the skeletal segments.

15. An instrument as in claim 14, wherein at least one of the distractor members is an anchor that penetrates into a skeletal segment.

16. An instrument as in claim 14, wherein at least one of the distractor members is an elongate member that abuts a skeletal segment but does not penetrate the skeletal segment.

17. An instrument as in claim 14, wherein at least one of the distractor members clamps onto the skeletal segment.

18. An instrument as in claim 14, further comprising a distraction device connected to the distractor members for applying a distraction force to the distractor members.

19. An instrument as in claim 18, further comprising a measurement device for measuring the distractor force.

20. A method of distracting a pair of spinous processes, comprising:

using one or more distractor elements to engage the spinous processes to apply a distraction force to the spinous processes.

21. A method as in claim 20, wherein at least one of the distractor elements penetrates a vertebral body.

22. A method as in claim 20, wherein at least one of the distractor elements abuts a spinous process without penetrating the spinous process.

23. A minimally-invasive surgical procedure, comprising:

localizing a surgical point of interest using a localizing needle that points to the point of interest; and

placing an implant at the point of interest using the localizing needle as a guide.

24. A procedure as in claim 23, wherein the implant is placed using an inserter device that pivots about a central axis such that the inserter device travels along a curvilinear path that contains the localized point of interest.

25. A minimally-invasive surgical procedure, comprising:

localizing a surgical point of interest using an x-ray to identify the point of interest;

relating the point of interest to a delivery apparatus; and

delivering an implant to the point of interest using an inserter device that pivots about a central axis such that the inserter device travels along a curvilinear path that contains the localized point of interest.

26. A skeletal implant holder, comprising:

a hand-operated handle assembly;

a holder assembly attached to the handle assembly, the holder assembly configured to be removably attached to an implant, wherein the handle assembly can be actuated to secure the implant to the holder assembly and to detach the implant from the holder assembly, and wherein the holder assembly is configured to apply a first force to the implant in a first direction and a second force to the implant in a second direction opposite the first direction when the handle assembly is actuated.

27. A holder as in claim 26, wherein , upon actuation, a first portion of the implant remains stationary and at least a second portion of the implant move toward or away from the stationary portion.

28. A holder as in claim 26, wherein the holder assembly is curvilinear.

29. A holder assembly as in claim 26, wherein the holder assembly includes a lock ring that grabs an inside portion of the implant when the handle assembly is actuated to secure the implant to the holder assembly.

30. A holder assembly as in claim 26, wherein a distal edge of the holder assembly is wedge-shaped for fitting the holder assembly between a pair of skeletal segments.

32. An implant as in claim 30, further comprising a ratchet mechanism that couples the first segment to the second segment, wherein the ratchet mechanism is configured to lock the wing in the expanded configuration.

31. An implant for implanting between a pair of skeletal segments, comprising:

a first segment;

at least one wing attached to the first segment, the wing movable between a collapsed configuration and an expanded configuration wherein the wing can engage a skeletal segment as an anchor when in the expanded configuration; and

a second segment removably attached to the first segment, wherein the second segment can be detached from the first segment to disengage the wing from the skeletal segment.