US20040158248A1 - Apparatus and methods for treating spinal discs - Google Patents

Apparatus and methods for treating spinal discs Download PDF

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Publication number
US20040158248A1
US20040158248A1 US10/773,508 US77350804A US2004158248A1 US 20040158248 A1 US20040158248 A1 US 20040158248A1 US 77350804 A US77350804 A US 77350804A US 2004158248 A1 US2004158248 A1 US 2004158248A1
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United States
Prior art keywords
disc
band
around
vertebrae
distal end
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Abandoned
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US10/773,508
Inventor
Richard Ginn
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Gateway Medical Inc
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Ensure Medical Inc
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Publication date
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Priority to US10/773,508 priority Critical patent/US20040158248A1/en
Publication of US20040158248A1 publication Critical patent/US20040158248A1/en
Assigned to ENSURE MEDICAL, INC. reassignment ENSURE MEDICAL, INC. CHANGE OF NAME (SEE DOCUMENT FOR DETAILS). Assignors: CORE MEDICAL, INC.
Assigned to GATEWAY MEDICAL, INC. reassignment GATEWAY MEDICAL, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: ENSURE MEDICAL, INC.
Abandoned legal-status Critical Current

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4611Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30003Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/3006Properties of materials and coating materials
    • A61F2002/30062(bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/442Intervertebral or spinal discs, e.g. resilient
    • A61F2002/4435Support means or repair of the natural disc wall, i.e. annulus, e.g. using plates, membranes or meshes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2210/00Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2210/0004Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof bioabsorbable
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10STECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S606/00Surgery
    • Y10S606/907Composed of particular material or coated
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10STECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S606/00Surgery
    • Y10S606/907Composed of particular material or coated
    • Y10S606/908Bioabsorbable material

Definitions

  • the present invention relates generally to treatment of spinal discs, and more particularly to apparatus and methods for treating ruptured or degenerated spinal discs using a band of material wrapped around the spinal disc.
  • spinal fixation i.e., fixing the vertebrae on either side of an injured disc relative to one another
  • spinal fixation i.e., fixing the vertebrae on either side of an injured disc relative to one another
  • This may involve inserting pedicle screws or other anchors into the vertebrae, and securing rods, wires, plates, and the like between the vertebrae, thereby substantially removing much of the forces acting on the disc during subsequent activity by the patient.
  • the injured disc may be removed and a fixation system used to anchor the adjacent vertebrae, while the vertebrae are fused to one another.
  • fixation and fusion procedures may substantially impair free movement by the patient, because relative movement of the vertebrae is intentionally fixed.
  • an injured disc may be completely removed and replaced with a prosthesis.
  • a portion of a disc may be removed, and a prosthesis used to fill the resulting cavity, such as those disclosed in U.S. Pat. Nos. 5,549,679 and 5,571,189, issued to Kuslich.
  • “hybrid” material may be implanted directly within a space created within a spinal disc, as disclosed in U.S. Pat. No. 5,964,807, issued to Gan et al., rather than removing the entire disc.
  • the present invention is directed to apparatus and methods for treating spinal discs, and more particularly to apparatus and methods for treating a ruptured or degenerated spinal disc using a band of material wrapped around the spinal disc.
  • an apparatus for treating a ruptured or degenerated spinal disc that includes a band of material.
  • the band of material which may be formed from biocompatible and/or bioabsorbable material, may have a length sufficient to wrap around an exterior of a spinal disc, and may have a width sufficient to cover a spinal disc and at least partially cover at least one vertebra adjacent the spinal disc.
  • one or both ends of the band may include a connector, e.g., threads, clips, and the like, for securing the ends to one another or to another portion of the band.
  • the band may include healing-promoting material coated thereon, impregnated therein or otherwise carried thereby.
  • an extra-cellular matrix material may be carried on at least one side of the band of material.
  • at least a portion of the band may be electrically conductive, and a source of electrical energy may be coupled to the electrically conductive portion of the band.
  • the apparatus may include an elongate member that includes a proximal end including a handle thereon, and a curved distal end including a connector element thereon.
  • the band may include a first end that is releasably connectable to the connector element on the elongate member.
  • the connector element includes a hook on the distal end of the elongate member, and one end of the band includes an opening for receiving the hook therein.
  • the apparatus may include a fork member including proximal and distal ends defining an axis therebetween.
  • the distal end may include a pair of tines, each tine including a transverse portion extending generally parallel to one another transversely with respect to the axis.
  • the transverse portion of each tine may include a tip and a heel disposed proximal to the tip. A length between the tip and the heel may be sufficient for engaging a first vertebra with the tip and pivotally engaging a second vertebra with the heel to adjust a distance between the first and second vertebrae.
  • the apparatus may include a guide member including a proximal end and a curved distal end having a radius of curvature corresponding substantially to an exterior perimeter of a spinal disc.
  • the guide member generally includes a lumen extending between the proximal and distal ends, the lumen having a size for receiving the band of material therethrough.
  • the lumen through the guide member is a slot including a height greater than a width of the band, the slot preferably having a height that extends substantially perpendicularly to the radius of curvature of the distal end. More preferably, the apparatus includes a pair of such guide members that are opposite hand from one another.
  • a method for treating a ruptured or degenerated spinal disc of a patient. Initially, an area adjacent an exterior of a spinal disc disposed between adjacent vertebrae is accessed. A band of material, such as that described above, may be wrapped around the disc to stabilize the disc in a desired position relative to surrounding anatomy. Preferably, the band engages at least one of the vertebrae when the band is wrapped around the disc to substantially secure the disc relative to the at least one of the vertebrae.
  • this may involve extending a distal end of an elongate member along a first lateral region of the disc around a posterior region of the disc to an opposite second lateral region of the disc.
  • a first end of the band may be connected to the distal end of the elongate member, and the elongate member may be pulled back around the posterior region of the disc, thereby directing the first end of the band around the posterior region of the disc.
  • At least one of the first end and a second end of the band may be secured to another portion of the band, thereby securing the band around the disc.
  • a tubular guide member may be inserted around a portion of the exterior of the disc, and the band may be inserted through the guide member to facilitate wrapping the band around a posterior region of the disc.
  • a pair of opposite-hand tubular guide members may be inserted around opposing lateral regions of the exterior of the disc.
  • the band may be inserted directly through the guide members or may be directed through the guide members using an elongate member previously advanced through the guide members, which may be used to pull the band through the guide members.
  • a location of at least one of the vertebrae may be adjusted relative to the disc before wrapping the band around the disc.
  • at least one of the vertebrae may be engaged between tines of a fork member, and the tines may be manipulated between the vertebrae to increase a space between the vertebrae.
  • the patient may be subjected to traction.
  • an extra-cellular matrix material may be placed between the band and the disc, e.g., to promote healing of the disc.
  • one or more layers of extra-cellular matrix material may be carried on an interior surface of the band such that the extra-cellular matrix material is placed against the disc when the band is wrapped around the disc.
  • energy may be applied to the disc to enhance healing of the disc.
  • at least a portion of the band may be electrically conductive, and a source of electrical energy may be coupled to the electrically conductive portion of the band. Electrical energy may be applied to the disc via the electrically conductive portion of the band, or alternatively, energy may be applied directly to the disc, e.g., using a separate energy device.
  • a method for treating a spinal region of a patient.
  • An area adjacent an anterior region of a spinal disc may be accessed, for example, by creating an incision in a ligament surrounding the disc to access an exterior of the disc.
  • An instrument may be inserted between the ligament and the exterior of the disc, e.g., through the incision, in order to access a posterior region of the disc.
  • a diagnostic or therapeutic procedure may be performed that involves accessing the posterior region of the disc.
  • a tubular guide member may be inserted around a portion of the exterior of the disc, e.g., between the ligament and the disc until a distal end of the instrument is disposed adjacent the posterior region of the disc.
  • One or more instruments may then be introduced through the tubular guide member to access the posterior region.
  • an imaging device such as an endoscope, may be inserted through the guide member or directly between the ligament and the disc to the posterior region. The imaging device may be used to observe the posterior region and/or to otherwise assist in diagnosing a patient's condition.
  • a therapeutic procedure may be performed at the posterior region of the disc.
  • a discectomy or other procedure may be performed that involves removing at least a portion of the disc from the posterior region, e.g., nucleus pulposus material that has leaked from within the disc.
  • a therapeutic agent may be introduced into the posterior region or surrounding tissue to promote healing, pain relief, and the like.
  • a band may be wrapped around the disc to stabilize the disc in a desired position relative to surrounding anatomy, as described above.
  • tissue structures adjacent the posterior region of the disc such as a facet joint or spinal cord, may be accessed from the posterior region to perform an intervention involving the accessed structure.
  • the apparatus and methods of the present invention may provide a minimally invasive approach for accessing the posterior region of a spinal disc, while minimizing exposure of the disc and/or the spinal column adjacent the disc.
  • FIG. 1 is a perspective view of a first embodiment of a system for treating spinal discs, in accordance with the present invention.
  • FIGS. 2 A- 2 D are perspective views of a portion of an exposed spinal column, showing a method for treating a spinal disc using the apparatus of FIG. 1.
  • FIGS. 3A and 3B are side views of a spinal column, showing a band of material implanted to treat a spinal disc, in accordance with the present invention.
  • FIGS. 4A and 4B are perspective views of a spinal disc, showing a method for treating the spinal disc using another embodiment of an apparatus, in accordance with the present invention.
  • FIG. 5 is a cross-sectional view of a spinal disc of FIG. 4A, taken along line 5 - 5 , and showing the anatomy surrounding the disc.
  • FIG. 1 shows a first embodiment of an apparatus 10 for treating a spinal disc (not shown), in accordance with the present invention.
  • the apparatus 10 generally includes a grasper 12 , and a band of material 14 releasably connected to the grasper 12 .
  • the apparatus 10 may also include a fork member 16 , as shown, for adjusting adjacent vertebrae (not shown).
  • the band of material 14 is an elongate panel of biocompatible material having first and second ends 18 , 20 defining a length “L” therebetween and defining a width “W.”
  • the length “L” is sufficiently long such that the band 14 may be wrapped around an exterior perimeter of a spinal disc (not shown) and the ends 18 , 20 overlapped or otherwise secured with one another.
  • the width “W” may be sufficiently wide to cover an entire surface of a spinal disc, and preferably is sufficiently wide to cover a spinal disc and at least partially cover one or both vertebrae on either side of the spinal disc (not shown).
  • the band 14 may include one or more panels of substantially nonporous material, or alternatively, of porous material.
  • the band 14 includes a pair of spaced apart strips or filaments 22 that extend between the first and second ends 18 , 20 ..
  • Webbing 24 e.g., made from one or more fibers, extend between the strips 22 .
  • the strips 22 and/or webbing may be formed from inelastic materials, or alternatively may be formed from elastic materials, which may enhance stabilization of a spinal disc about which the band 14 is wrapped, as explained further below.
  • the band 14 is bioabsorbable, such that it may remain within a patient's body until absorbed through natural excretion.
  • the band 14 may include one or more healing-promoting materials within the band 14 and/or otherwise carried by the band 14 .
  • an antibiotic, a steroid, an nsaid, an autologous therapeutics agent, e.g., a concentrated growth factor, or other therapeutic compounds may be impregnated within or coated over the strips 22 and/or webbing 24 .
  • the band 14 may carry one or more layers of naturally occurring extra-cellular matrix material, such as intestinal submucosa, stomach submucosa, bladder submucosa, and the like, e.g., along one or both side surfaces of the band 14 .
  • naturally occurring extra-cellular matrix material such as intestinal submucosa, stomach submucosa, bladder submucosa, and the like, e.g., along one or both side surfaces of the band 14 .
  • At least one of the first and'second ends 18 , 20 of the band 14 may include a connector (not shown) for securing the ends 18 , 20 to another portion of the band 14 .
  • the first and second ends 18 , 20 may be secured to one another for securing the band 14 around a spinal disc.
  • threads 26 extend from one or both ends 18 , 20 for tying the ends 18 , 20 to one another or to another portion of the band 14 .
  • one or more clips may be attached (or attachable) to one of the ends 18 , 20 that may be engaged with the band 14 on or adjacent the other of the ends 18 , 20 .
  • sutures or other threads may be stitched between the first and second ends 18 , 20 and/or elsewhere through the band 14 to secure the band 14 around a spinal disc.
  • the band 14 may be electrically conductive.
  • the strips 22 and/or the webbing 24 may include insulated electrically conductive pathways, e.g., wires, and/or electrically exposed areas, e.g., defining electrodes (not shown).
  • a source of electrical energy such as a radio frequency (“RF”) generator (also not shown), may be coupled to the conductive pathways, e.g., by coupling the energy source to one or both ends 18 , 20 of the band 14 .
  • RF radio frequency
  • a separate device may be provided that may be coupled to a source of energy, such as an RF generator, a laser, and the like, for applying energy directly to one or more regions of a spinal disc.
  • the device may include a handle on one end and an electrode, lens, or other element on its other end for applying energy.
  • the grasper 12 is an elongate member including a proximal end 28 having a handle, and a curved distal end 30 having a hook or other connector element 32 thereon.
  • the distal end 30 preferably terminates in a rounded distal tip 33 to facilitate substantially atraumatic insertion of the distal end 30 between tissue structures.
  • the hook 32 may be configured for releasably connecting one of the ends 18 , 20 of the band 14 to the distal end 30 of the grasper 12 .
  • the first end 18 of the band 14 may include a hole, slot, pocket, or other aperture 34 for receiving the hook 28 therein.
  • the grasper 12 may be formed from a substantially rigid biocompatible material, such as stainless steel, or may be semi-rigid such that the distal end 26 may be bent or otherwise formed based upon a specific anatomical situation, as explained further below.
  • the distal end 26 may be a flexible or semi-rigid wire that is biased to a predetermined curvature corresponding to an exterior perimeter of a spinal disc, but may be resiliently deflectable to other configurations, e.g., a substantially straight configuration, to facilitate insertion of the grasper 12 into a surgical site.
  • the fork member 16 includes proximal and distal ends 34 , 36 defining an axis 38 therebetween.
  • the distal end 36 includes a pair of tines 40 that include transverse portions that extend generally parallel to one another substantially transversely with respect to the axis 38 .
  • the tines 40 may extend away from one another in a curved configuration that defines a space therebetween corresponding to a portion of a spinal disc.
  • each of the tines 40 terminates in a distal tip 42 and includes a heel 44 disposed proximal to the tip 42 , e.g., at a base of the transverse portion of the respective tine 40 .
  • a height “H” between the tips 42 and the heels 44 may be sufficiently long to facilitate engaging and/or manipulating adjacent vertebrae, as described further below.
  • the apparatus 10 may be used to treat a spinal disc 90 that has ruptured, become misaligned, and/or otherwise degenerated.
  • the disc 90 is disposed between first and second vertebrae 92 , 94 with a spinal cord 96 disposed adjacent the vertebrae 92 , 94 .
  • spinal cord 96 disposed adjacent the vertebrae 92 , 94 .
  • body portions of the vertebrae 92 , 94 are shown, and other surrounding tissue structures, including the spinous process and transverse process of the vertebrae, nerve bundles extending from the spinal cord, and the like, have been eliminated.
  • the disc 90 may be accessed using conventional surgical procedures.
  • a surgical field is opened adjacent an exterior perimeter of the disc 90 that is exposed from an anterior approach, i.e., from a chest side of the patient.
  • An anterior approach may be particularly useful for accessing and treating discs between the cervical vertebrae, because of the minimal amount of intervening tissue between the skin and the spinal column.
  • An anterior approach may also avoid having to work around the spinous process and transverse process portions of the vertebrae in order to gain access to the spinal disc 90 .
  • a location of at least one of the vertebrae 92 , 94 may be adjusted relative to the disc 90 and/or relative to the other of the vertebrae 92 , 94 , e.g., to allow adjustment of the disc 90 if it has slipped or otherwise become misaligned.
  • the fork member 16 may be inserted around the disc 90 , such that the tines 38 straddle the disc 90 .
  • the fork member 16 may be adjusted until the heels 42 engage the first vertebra 92 and the tips 40 engage the second vertebra 94 .
  • the fork member 16 may then be pivoted with the heels 42 against the first vertebra 92 such that the tips 40 move the second vertebra 94 away from the first vertebra 92 to increase a space between the vertebrae 92 , 94 , as shown in FIG. 2B.
  • the fork member 16 may then be stabilized, for example, manually or by securing the proximal end 34 to a support, e.g., fixed to a surgical table (not shown).
  • a support e.g., fixed to a surgical table (not shown).
  • the patient may be subjected to traction in order to increase the spacing between and/or otherwise realign the vertebrae 92 , 94 , as is well known in the art.
  • the disc 90 may be adjusted, aligned, or otherwise manipulated, e.g., to prevent the disc 90 from impinging upon the spinal cord 96 or other nerves (not shown), and/or to create a channel around the perimeter of the disc 90 .
  • any nucleus pulposus (not shown) that has leaked through fissures in the annulus fibrosis of the disc 90 may be removed.
  • the distal end 30 of the grasper 12 may then be inserted around one lateral region of the disc 90 towards the posterior region of the disc 90 , i.e., between the disc 90 and the spinal cord 96 . Because of the rounded distal tip 33 , the distal end 30 may be advanced around the disc 90 substantially atraumatically until the distal tip 33 becomes accessible around the opposite lateral region of the disc 90 .
  • the first end 18 of the band 14 may be connected to the distal end 30 , for example, by receiving the hook 32 through the hole 34 in the band 14 .
  • the grasper 12 may then be pulled back around the disc 90 , thereby directing the first end 18 of the band 14 around the posterior region of the disc 90 , as shown in FIG. 2D.
  • the fork member 16 may be removed, and the band 14 secured tightly around the disc 90 , as shown in FIGS. 3A and 3B.
  • the first end 18 of the band 14 may be released from the grasper 12 , and the first and second ends 18 , 20 of the band 14 may be secured to one another.
  • threads 26 (not shown, see FIG. 1) on the first and second ends 18 , 20 may be tied to one another.
  • the first and second ends 18 , 20 may not overlap one another, but may end in close proximity to one another such that the threads 26 may be tied together.
  • one of the first and second ends 18 , 20 may be lapped over the other, and the threads 26 on the overlying end tied to an underlying portion of the band 14 .
  • one or more clips, sutures, or other mechanical fasteners may be used to secure the ends 18 , 20 to one another or to another portion of the band 14 .
  • an adhesive may be used to secure the ends 18 , 20 , and/or mere frictional contact between the overlying end and the underlying portion may adequately secure the band 14 around the disc 90 .
  • the band 14 is subjected to sufficient tension when it is wrapped around the disc 90 to stabilize the disc 90 and/or to secure the disc 90 relative to one or both adjacent vertebrae 92 , 94 .
  • all or a portion of the band 14 may be formed from elastic material, such that the band 14 may be stretched tightly around the exterior perimeter of the disc 90 . If the band 14 is formed from elastic material, it may also allow the fork member 16 to be removed after the band 14 has been secured around the disc 90 .
  • the band 14 may be sufficiently wide to cover the width of the disc.
  • the band 14 has a width “W” that is wider than the disc 90 such that the band 14 overlaps one or both adjacent vertebrae 92 , 94 , as shown in FIG. 3B.
  • the disc 90 may also be secured in substantial alignment with the adjacent vertebrae 92 , 94 .
  • the band 14 includes an open webbing 24 , and consequently is porous.
  • the band 14 may merely provide structural support for the underlying disc 90 , e.g., to stabilize the disc 90 relative to the adjacent vertebrae 92 , 94 .
  • the band 14 may compress the disc 90 , consequently squeezing closed any fissures, holes, and the like that have occurred in the annulus fibrosis of the disc 90 .
  • the band 14 may be formed from a substantially nonporous panel of material such that the band 14 may substantially seal any fissures in the disc 90 , thereby preventing nucleus pulposus material, and the like from leaking through the annulus fibrosis.
  • a substantially nonporous material may be provided between the band 14 and the exterior of the disc 90 .
  • one or more layers of naturally occurring extra-cellular material may be carried on an interior surface of the band 14 such that the material may be placed between the band 14 and the disc 90 .
  • such material may also promote healing, as is well known to those skilled in the art.
  • other materials that promote healing may be coated on and/or impregnated within the band 14 .
  • the band 14 may remain around the disc 90 until it is absorbed by the patient's body.
  • the band 14 may be merely biocompatible such that the band 14 may remain within the patient's body indefinitely or until the disc 90 has sufficiently healed.
  • a follow-up procedure may be performed to release the ends 18 , 20 of the band 14 and pull the band 14 around the disc 90 to remove it from the patient's body.
  • energy may be applied to the disc 90 to enhance healing, to cause scarring, and/or to enhance sealing of fissures or other leaks in the disc 90 .
  • the band 14 may be electrically conductive.
  • a source of electrical energy e.g., an RF generator (not shown) may be coupled to the electrically conductive portion of the band 14 .
  • electrical energy may be applied to the disc via the electrically conductive portion of the band 14 .
  • the power of the electrical energy may be relatively low, e.g., merely to enhance healing of the disc 90 .
  • the power may be relatively high, thereby causing scarring of the annulus fibrosis of the disc 90 , which may seal fissures through which nucleus pulposus may leak.
  • FIGS. 4A, 4B, and 5 another embodiment of an apparatus 110 is shown for treating a spinal disc 90 .
  • the apparatus 110 includes a grasper 12 , and a band of material 14 that are substantially identical to the embodiment described above.
  • the apparatus 110 includes a pair of guide members 150 for guiding the grasper 12 and/or the band 14 around the posterior region of the disc 90 .
  • the apparatus 110 may also include a fork member (not shown), similar to the previous embodiment.
  • Each guide member 150 is a semi-rigid or substantially rigid tubular body including a slotted lumen 152 extending between its proximal and distal ends 154 , 156 .
  • the proximal end 154 may be substantially straight, defining a longitudinal axis 158 , and may include an enlarged proximal opening 157 (shown in FIG. 5).
  • the distal end 156 of the guide member 150 may be curved, preferably having a radius of curvature similar to an exterior perimeter of the disc 90 .
  • the guide member 150 also has a cross-section including a height “h” (extending generally between the vertebrae adjacent the disc 90 ) that is greater than its width “w” (extending away from the exterior surface of the disc 90 ).
  • the band 14 may be received within the lumen 152 such that the width “W” of the band 14 is substantially less than the height “h” of the guide member 150 , thereby minimizing any folding or crumpling of the band 14 within the lumen 152 .
  • the distal end 156 of the guide member 150 terminates in a distal tip 160 that is disposed transversely and preferably substantially perpendicular to the axis 158 .
  • the distal end 30 of the grasper 12 has a shape that allows the distal end 30 to be directed easily through the lumens 152 of the guide members 150 .
  • the distal end 30 of the grasper 12 may have a flat ribbon shape or may have a generally round shape that is small enough to be inserted through the lumens 152 .
  • the apparatus 110 may be used to treat a spinal disc 90 that has ruptured, become misaligned, and/or otherwise degenerated, similar to the embodiment described above.
  • the spinal disc 90 is disposed between a first vertebra 92 , best seen in FIG. 4B, and a second vertebra, which has been eliminated for clarification.
  • the vertebrae include spinous process 92 a and transverse process 92 b defining a vertebral foramen 98 , through which a spinal cord 96 extends.
  • the disc 90 generally includes nucleus pulposus 90 a surrounded by annulus fibrosis 90 b, and is surrounded by ligament 100 , which may surround the entire spinal column along its length.
  • the disc 90 may be accessed, preferably from an anterior approach. This may involve creating incisions 102 in the ligament 100 at locations corresponding to lateral regions of the disc 90 .
  • the distal ends 156 of the guide members 150 may be inserted through the respective incisions 102 and advanced around an exterior surface of the disc 90 until the distal tips 160 are disposed opposite one another adjacent a posterior region of the disc 90 .
  • the distal ends 156 may be sufficiently flexible to facilitate substantially atraumatic advancement of the guide members 150 around the disc 90 . Once the distal ends 156 are fully inserted, the proximal ends 154 of the guide members 150 may extend proximally from the incisions 102 generally parallel to one another.
  • a location of at least one of the vertebrae adjacent the disc 90 may be adjusted, for example, using traction or a fork member (not shown), before inserting the guide members 150 , using a procedure similar to the embodiment described above.
  • a distal end 30 of the grasper 12 may be inserted into the lumen 152 of a first of the guide members 150 and advanced distally until the distal end 30 of the grasper 12 exits the distal end 156 of the first guide member 150 adjacent the posterior region of the disc 90 .
  • the grasper 12 may be manipulated further until the distal end 30 enters the lumen 152 at the distal end 156 of the second guide member 150 , whereupon the grasper 12 may be advanced further until the distal end 30 exits the proximal end 154 of the second guide member 150 .
  • the first end 18 of the band 14 may be connected to the distal end 30 of the grasper 12 .
  • the grasper 12 may then be pulled back through the guide members 150 , thereby directing the band 14 through the lumens 152 of the guide members 150 and around the posterior region of the disc 90 , as shown in FIGS. 4A and 5.
  • the first end 18 of the band 14 may be released from the distal end 30 of the grasper 12 .
  • the guide members 150 may be withdrawn from the incisions 102 , leaving the band 14 in place, as shown in FIG. 4B. Because of the slotted lumens 152 of the guide members 150 , the band 14 may extend completely across a height of the disc 90 and preferably at least partially covering one or both adjacent vertebrae 92 . The band 14 may then be secured tightly around the disc 90 , as shown in FIGS. 3A and 3B. For example, the first and second ends 18 , 20 of the band 14 may be secured to one another by threads (not shown), similar to the embodiment described above. Optionally, if necessary, one or both ends 18 , 20 of the band 14 may be trimmed before tightening and securing the band 14 around the disc 90 .
  • energy may be applied to the disc 90 to enhance healing, to cause scarring, and/or to enhance sealing of fissures or other leaks in the disc 90 .
  • the energy may be applied directly to one or more regions of the disc 90 or may be applied via conductive regions of the band 14 , similar to the embodiment described above.
  • the band 14 may remain around the disc 90 until it is absorbed by the patient's body, similar to the embodiment described above.
  • the band 14 may be merely biocompatible, such that the band 14 may remain within the patient's body indefinitely or until the disc 90 has sufficiently healed.
  • the apparatus and methods of the present invention may be performed alone or in conjunction with other procedures used to treat a spinal disc.
  • a band of material may be secured around a spinal disc after performing a procedure within an interior of a spinal disc, such as those disclosed in application Ser. No. 09/828,039, filed Apr. 6, 2001, entitled “Apparatus and Methods for Treating Spinal Discs,” the disclosure of which is expressly incorporated herein by reference.
  • one or more guide members in accordance with the present invention may be used to access a posterior region of a spinal disc in order to perform a diagnostic and/or therapeutic procedure at the posterior region of the spinal disc.
  • an imaging device such as an endoscope (not shown) may be inserted through the guide member to observe, monitor, or otherwise image the posterior region and/or surrounding tissue structures.
  • a therapeutic procedure may be performed at the posterior region of the disc, e.g., following an imaging or diagnostic procedure or concurrently with imaging (e.g., with multiple instruments, not shown, being introduced through separate guide members).
  • a discectomy or other procedure may be performed that involves removing at least a portion of the disc from the posterior region (not shown). For example, nucleus pulposus material that has leaked from within the disc may be removed.
  • a prosthesis may be implanted within the disc from the posterior region.
  • a therapeutic agent may be introduced into the posterior region or surrounding tissue to promote healing, pain relief, and the like.
  • a band may be wrapped around the disc to stabilize the disc in a desired position relative to surrounding anatomy, as described above.
  • access to the posterior region of a spinal disc may be used to perform other interventions involving tissue structures adjacent to or surrounding the disc, such as the spinal cord or a spinal facet joint.
  • instruments may be introduced between the disc and surrounding ligament, e.g., through the guide member, and directed to surrounding tissue structures in order to complete other procedures while minimizing exposure of a patient's spine.

Abstract

A band of biocompatible and/or bioabsorbable material is provided including threads on one or both of its ends. An area adjacent a spinal disc is accessed, and the band of material is wrapped around the disc to stabilize the disc and/or to facilitate healing. An elongate member is inserted around a posterior region of the disc, e.g., through tubular guide members. An end of the band is connected to a distal end of the elongate member, and the elongate member is pulled back around the disc to direct the band around the disc. The band is secured around the disc overlapping vertebrae adjacent the disc. Optionally, a relative location of the vertebrae is adjusted relative to the disc before wrapping the band around the disc, for example, using a fork member or traction. Energy may also be applied to the disc to enhance healing.

Description

    FIELD OF THE INVENTION
  • The present invention relates generally to treatment of spinal discs, and more particularly to apparatus and methods for treating ruptured or degenerated spinal discs using a band of material wrapped around the spinal disc. [0001]
  • BACKGROUND
  • Various apparatus and methods have been suggested for treating spinal discs when they rupture, degenerate, or otherwise become injured. For example, spinal fixation, i.e., fixing the vertebrae on either side of an injured disc relative to one another, is a commonly used treatment. This may involve inserting pedicle screws or other anchors into the vertebrae, and securing rods, wires, plates, and the like between the vertebrae, thereby substantially removing much of the forces acting on the disc during subsequent activity by the patient. In addition, the injured disc may be removed and a fixation system used to anchor the adjacent vertebrae, while the vertebrae are fused to one another. Such fixation and fusion procedures, however, may substantially impair free movement by the patient, because relative movement of the vertebrae is intentionally fixed. [0002]
  • In addition to fixation, an injured disc may be completely removed and replaced with a prosthesis. Alternatively, a portion of a disc may be removed, and a prosthesis used to fill the resulting cavity, such as those disclosed in U.S. Pat. Nos. 5,549,679 and 5,571,189, issued to Kuslich. In a further alternative, “hybrid” material may be implanted directly within a space created within a spinal disc, as disclosed in U.S. Pat. No. 5,964,807, issued to Gan et al., rather than removing the entire disc. [0003]
  • Accordingly, apparatus and methods for treating spinal discs would be considered useful. [0004]
  • SUMMARY OF THE INVENTION
  • The present invention is directed to apparatus and methods for treating spinal discs, and more particularly to apparatus and methods for treating a ruptured or degenerated spinal disc using a band of material wrapped around the spinal disc. [0005]
  • In accordance with one aspect of the present invention, an apparatus is provided for treating a ruptured or degenerated spinal disc that includes a band of material. The band of material, which may be formed from biocompatible and/or bioabsorbable material, may have a length sufficient to wrap around an exterior of a spinal disc, and may have a width sufficient to cover a spinal disc and at least partially cover at least one vertebra adjacent the spinal disc. In addition, one or both ends of the band may include a connector, e.g., threads, clips, and the like, for securing the ends to one another or to another portion of the band. [0006]
  • The band may include healing-promoting material coated thereon, impregnated therein or otherwise carried thereby. For example, an extra-cellular matrix material may be carried on at least one side of the band of material. Optionally, at least a portion of the band may be electrically conductive, and a source of electrical energy may be coupled to the electrically conductive portion of the band. [0007]
  • Optionally, the apparatus may include an elongate member that includes a proximal end including a handle thereon, and a curved distal end including a connector element thereon. The band may include a first end that is releasably connectable to the connector element on the elongate member. In an exemplary embodiment, the connector element includes a hook on the distal end of the elongate member, and one end of the band includes an opening for receiving the hook therein. [0008]
  • In addition, the apparatus may include a fork member including proximal and distal ends defining an axis therebetween. The distal end may include a pair of tines, each tine including a transverse portion extending generally parallel to one another transversely with respect to the axis. The transverse portion of each tine may include a tip and a heel disposed proximal to the tip. A length between the tip and the heel may be sufficient for engaging a first vertebra with the tip and pivotally engaging a second vertebra with the heel to adjust a distance between the first and second vertebrae. [0009]
  • In another embodiment, the apparatus may include a guide member including a proximal end and a curved distal end having a radius of curvature corresponding substantially to an exterior perimeter of a spinal disc. The guide member generally includes a lumen extending between the proximal and distal ends, the lumen having a size for receiving the band of material therethrough. Preferably, the lumen through the guide member is a slot including a height greater than a width of the band, the slot preferably having a height that extends substantially perpendicularly to the radius of curvature of the distal end. More preferably, the apparatus includes a pair of such guide members that are opposite hand from one another. [0010]
  • In accordance with another aspect of the present invention, a method is provided for treating a ruptured or degenerated spinal disc of a patient. Initially, an area adjacent an exterior of a spinal disc disposed between adjacent vertebrae is accessed. A band of material, such as that described above, may be wrapped around the disc to stabilize the disc in a desired position relative to surrounding anatomy. Preferably, the band engages at least one of the vertebrae when the band is wrapped around the disc to substantially secure the disc relative to the at least one of the vertebrae. [0011]
  • In one embodiment, this may involve extending a distal end of an elongate member along a first lateral region of the disc around a posterior region of the disc to an opposite second lateral region of the disc. A first end of the band may be connected to the distal end of the elongate member, and the elongate member may be pulled back around the posterior region of the disc, thereby directing the first end of the band around the posterior region of the disc. At least one of the first end and a second end of the band may be secured to another portion of the band, thereby securing the band around the disc. [0012]
  • In another embodiment, a tubular guide member may be inserted around a portion of the exterior of the disc, and the band may be inserted through the guide member to facilitate wrapping the band around a posterior region of the disc. Preferably, a pair of opposite-hand tubular guide members may be inserted around opposing lateral regions of the exterior of the disc. The band may be inserted directly through the guide members or may be directed through the guide members using an elongate member previously advanced through the guide members, which may be used to pull the band through the guide members. [0013]
  • Optionally, a location of at least one of the vertebrae may be adjusted relative to the disc before wrapping the band around the disc. For example, at least one of the vertebrae may be engaged between tines of a fork member, and the tines may be manipulated between the vertebrae to increase a space between the vertebrae. Alternatively, the patient may be subjected to traction. [0014]
  • If desired, an extra-cellular matrix material may be placed between the band and the disc, e.g., to promote healing of the disc. For example, one or more layers of extra-cellular matrix material may be carried on an interior surface of the band such that the extra-cellular matrix material is placed against the disc when the band is wrapped around the disc. [0015]
  • In addition, energy may be applied to the disc to enhance healing of the disc. For example, at least a portion of the band may be electrically conductive, and a source of electrical energy may be coupled to the electrically conductive portion of the band. Electrical energy may be applied to the disc via the electrically conductive portion of the band, or alternatively, energy may be applied directly to the disc, e.g., using a separate energy device. [0016]
  • In accordance with yet another aspect of the present invention, a method is provided for treating a spinal region of a patient. An area adjacent an anterior region of a spinal disc may be accessed, for example, by creating an incision in a ligament surrounding the disc to access an exterior of the disc. An instrument may be inserted between the ligament and the exterior of the disc, e.g., through the incision, in order to access a posterior region of the disc. A diagnostic or therapeutic procedure may be performed that involves accessing the posterior region of the disc. [0017]
  • For example, a tubular guide member may be inserted around a portion of the exterior of the disc, e.g., between the ligament and the disc until a distal end of the instrument is disposed adjacent the posterior region of the disc. One or more instruments may then be introduced through the tubular guide member to access the posterior region. For example, an imaging device, such as an endoscope, may be inserted through the guide member or directly between the ligament and the disc to the posterior region. The imaging device may be used to observe the posterior region and/or to otherwise assist in diagnosing a patient's condition. [0018]
  • In addition to or instead of imaging, a therapeutic procedure may be performed at the posterior region of the disc. For example, a discectomy or other procedure may be performed that involves removing at least a portion of the disc from the posterior region, e.g., nucleus pulposus material that has leaked from within the disc. A therapeutic agent may be introduced into the posterior region or surrounding tissue to promote healing, pain relief, and the like. In addition, a band may be wrapped around the disc to stabilize the disc in a desired position relative to surrounding anatomy, as described above. In addition, tissue structures adjacent the posterior region of the disc, such as a facet joint or spinal cord, may be accessed from the posterior region to perform an intervention involving the accessed structure. Thus, the apparatus and methods of the present invention may provide a minimally invasive approach for accessing the posterior region of a spinal disc, while minimizing exposure of the disc and/or the spinal column adjacent the disc. [0019]
  • Other objects and features of the present invention will become apparent from consideration of the following description taken in conjunction with the accompanying drawings.[0020]
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • FIG. 1 is a perspective view of a first embodiment of a system for treating spinal discs, in accordance with the present invention. [0021]
  • FIGS. [0022] 2A-2D are perspective views of a portion of an exposed spinal column, showing a method for treating a spinal disc using the apparatus of FIG. 1.
  • FIGS. 3A and 3B are side views of a spinal column, showing a band of material implanted to treat a spinal disc, in accordance with the present invention. [0023]
  • FIGS. 4A and 4B are perspective views of a spinal disc, showing a method for treating the spinal disc using another embodiment of an apparatus, in accordance with the present invention. [0024]
  • FIG. 5 is a cross-sectional view of a spinal disc of FIG. 4A, taken along line [0025] 5-5, and showing the anatomy surrounding the disc.
  • DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
  • Turning now to the drawings, FIG. 1 shows a first embodiment of an [0026] apparatus 10 for treating a spinal disc (not shown), in accordance with the present invention. The apparatus 10 generally includes a grasper 12, and a band of material 14 releasably connected to the grasper 12. Optionally, the apparatus 10 may also include a fork member 16, as shown, for adjusting adjacent vertebrae (not shown).
  • The band of [0027] material 14 is an elongate panel of biocompatible material having first and second ends 18, 20 defining a length “L” therebetween and defining a width “W.” Preferably, the length “L” is sufficiently long such that the band 14 may be wrapped around an exterior perimeter of a spinal disc (not shown) and the ends 18, 20 overlapped or otherwise secured with one another. The width “W” may be sufficiently wide to cover an entire surface of a spinal disc, and preferably is sufficiently wide to cover a spinal disc and at least partially cover one or both vertebrae on either side of the spinal disc (not shown).
  • The [0028] band 14 may include one or more panels of substantially nonporous material, or alternatively, of porous material. In the exemplary embodiment shown, the band 14 includes a pair of spaced apart strips or filaments 22 that extend between the first and second ends 18, 20.. Webbing 24, e.g., made from one or more fibers, extend between the strips 22. The strips 22 and/or webbing may be formed from inelastic materials, or alternatively may be formed from elastic materials, which may enhance stabilization of a spinal disc about which the band 14 is wrapped, as explained further below.
  • In a preferred embodiment, at least a portion of the [0029] band 14, and preferably all of the band 14, is bioabsorbable, such that it may remain within a patient's body until absorbed through natural excretion. In addition, the band 14 may include one or more healing-promoting materials within the band 14 and/or otherwise carried by the band 14. For example, an antibiotic, a steroid, an nsaid, an autologous therapeutics agent, e.g., a concentrated growth factor, or other therapeutic compounds, may be impregnated within or coated over the strips 22 and/or webbing 24. Alternatively, or in addition, the band 14 may carry one or more layers of naturally occurring extra-cellular matrix material, such as intestinal submucosa, stomach submucosa, bladder submucosa, and the like, e.g., along one or both side surfaces of the band 14.
  • At least one of the first and'second ends [0030] 18, 20 of the band 14 may include a connector (not shown) for securing the ends 18, 20 to another portion of the band 14. For example, the first and second ends 18, 20 may be secured to one another for securing the band 14 around a spinal disc. Preferably, threads 26 extend from one or both ends 18, 20 for tying the ends 18, 20 to one another or to another portion of the band 14. Alternatively, one or more clips (not shown) may be attached (or attachable) to one of the ends 18, 20 that may be engaged with the band 14 on or adjacent the other of the ends 18, 20. In a further alternative, sutures or other threads (not shown) may be stitched between the first and second ends 18, 20 and/or elsewhere through the band 14 to secure the band 14 around a spinal disc.
  • In an alternative embodiment, at least a portion of the [0031] band 14 may be electrically conductive. For example, the strips 22 and/or the webbing 24 may include insulated electrically conductive pathways, e.g., wires, and/or electrically exposed areas, e.g., defining electrodes (not shown). A source of electrical energy, such a radio frequency (“RF”) generator (also not shown), may be coupled to the conductive pathways, e.g., by coupling the energy source to one or both ends 18, 20 of the band 14. Alternatively, a separate device (not shown) may be provided that may be coupled to a source of energy, such as an RF generator, a laser, and the like, for applying energy directly to one or more regions of a spinal disc. The device may include a handle on one end and an electrode, lens, or other element on its other end for applying energy.
  • Returning to FIG. 1, the [0032] grasper 12 is an elongate member including a proximal end 28 having a handle, and a curved distal end 30 having a hook or other connector element 32 thereon. The distal end 30 preferably terminates in a rounded distal tip 33 to facilitate substantially atraumatic insertion of the distal end 30 between tissue structures. The hook 32 may be configured for releasably connecting one of the ends 18, 20 of the band 14 to the distal end 30 of the grasper 12. For example, the first end 18 of the band 14 may include a hole, slot, pocket, or other aperture 34 for receiving the hook 28 therein. The grasper 12 may be formed from a substantially rigid biocompatible material, such as stainless steel, or may be semi-rigid such that the distal end 26 may be bent or otherwise formed based upon a specific anatomical situation, as explained further below. In a further alternative, the distal end 26 may be a flexible or semi-rigid wire that is biased to a predetermined curvature corresponding to an exterior perimeter of a spinal disc, but may be resiliently deflectable to other configurations, e.g., a substantially straight configuration, to facilitate insertion of the grasper 12 into a surgical site.
  • The [0033] fork member 16 includes proximal and distal ends 34, 36 defining an axis 38 therebetween. The distal end 36 includes a pair of tines 40 that include transverse portions that extend generally parallel to one another substantially transversely with respect to the axis 38. The tines 40 may extend away from one another in a curved configuration that defines a space therebetween corresponding to a portion of a spinal disc. Preferably, each of the tines 40 terminates in a distal tip 42 and includes a heel 44 disposed proximal to the tip 42, e.g., at a base of the transverse portion of the respective tine 40. A height “H” between the tips 42 and the heels 44 may be sufficiently long to facilitate engaging and/or manipulating adjacent vertebrae, as described further below.
  • Turning to FIGS. [0034] 2A-2D, 3A, and 3B, the apparatus 10 may be used to treat a spinal disc 90 that has ruptured, become misaligned, and/or otherwise degenerated. Generally, the disc 90 is disposed between first and second vertebrae 92, 94 with a spinal cord 96 disposed adjacent the vertebrae 92, 94. For simplification, only the body portions of the vertebrae 92, 94 are shown, and other surrounding tissue structures, including the spinous process and transverse process of the vertebrae, nerve bundles extending from the spinal cord, and the like, have been eliminated.
  • Initially, the [0035] disc 90 may be accessed using conventional surgical procedures. Preferably, a surgical field is opened adjacent an exterior perimeter of the disc 90 that is exposed from an anterior approach, i.e., from a chest side of the patient. An anterior approach may be particularly useful for accessing and treating discs between the cervical vertebrae, because of the minimal amount of intervening tissue between the skin and the spinal column. An anterior approach may also avoid having to work around the spinous process and transverse process portions of the vertebrae in order to gain access to the spinal disc 90.
  • A location of at least one of the [0036] vertebrae 92, 94 may be adjusted relative to the disc 90 and/or relative to the other of the vertebrae 92, 94, e.g., to allow adjustment of the disc 90 if it has slipped or otherwise become misaligned. For example, as shown in FIG. 2A, the fork member 16 may be inserted around the disc 90, such that the tines 38 straddle the disc 90. The fork member 16 may be adjusted until the heels 42 engage the first vertebra 92 and the tips 40 engage the second vertebra 94. The fork member 16 may then be pivoted with the heels 42 against the first vertebra 92 such that the tips 40 move the second vertebra 94 away from the first vertebra 92 to increase a space between the vertebrae 92, 94, as shown in FIG. 2B.
  • The [0037] fork member 16 may then be stabilized, for example, manually or by securing the proximal end 34 to a support, e.g., fixed to a surgical table (not shown). Alternatively, the patient may be subjected to traction in order to increase the spacing between and/or otherwise realign the vertebrae 92, 94, as is well known in the art. If desired, the disc 90 may be adjusted, aligned, or otherwise manipulated, e.g., to prevent the disc 90 from impinging upon the spinal cord 96 or other nerves (not shown), and/or to create a channel around the perimeter of the disc 90. In addition, any nucleus pulposus (not shown) that has leaked through fissures in the annulus fibrosis of the disc 90 may be removed.
  • Returning to FIG. 2B, the [0038] distal end 30 of the grasper 12 may then be inserted around one lateral region of the disc 90 towards the posterior region of the disc 90, i.e., between the disc 90 and the spinal cord 96. Because of the rounded distal tip 33, the distal end 30 may be advanced around the disc 90 substantially atraumatically until the distal tip 33 becomes accessible around the opposite lateral region of the disc 90.
  • As shown in FIG. 2C, with the [0039] distal end 30 of the grasper 12 accessible, the first end 18 of the band 14 may be connected to the distal end 30, for example, by receiving the hook 32 through the hole 34 in the band 14. The grasper 12 may then be pulled back around the disc 90, thereby directing the first end 18 of the band 14 around the posterior region of the disc 90, as shown in FIG. 2D.
  • Once the [0040] band 14 has been directed around the posterior region of the disc 90, the fork member 16 may be removed, and the band 14 secured tightly around the disc 90, as shown in FIGS. 3A and 3B. To accomplish this, the first end 18 of the band 14 may be released from the grasper 12, and the first and second ends 18, 20 of the band 14 may be secured to one another. For example, threads 26 (not shown, see FIG. 1) on the first and second ends 18, 20 may be tied to one another. In this embodiment, the first and second ends 18, 20 may not overlap one another, but may end in close proximity to one another such that the threads 26 may be tied together. Alternatively, one of the first and second ends 18, 20 may be lapped over the other, and the threads 26 on the overlying end tied to an underlying portion of the band 14. In a further alternative, one or more clips, sutures, or other mechanical fasteners (not shown) may be used to secure the ends 18, 20 to one another or to another portion of the band 14. In yet another alternative, an adhesive may be used to secure the ends 18, 20, and/or mere frictional contact between the overlying end and the underlying portion may adequately secure the band 14 around the disc 90.
  • Preferably, the [0041] band 14 is subjected to sufficient tension when it is wrapped around the disc 90 to stabilize the disc 90 and/or to secure the disc 90 relative to one or both adjacent vertebrae 92, 94. To enhance this tension, all or a portion of the band 14 may be formed from elastic material, such that the band 14 may be stretched tightly around the exterior perimeter of the disc 90. If the band 14 is formed from elastic material, it may also allow the fork member 16 to be removed after the band 14 has been secured around the disc 90.
  • The [0042] band 14 may be sufficiently wide to cover the width of the disc. 90 Preferably, the band 14 has a width “W” that is wider than the disc 90 such that the band 14 overlaps one or both adjacent vertebrae 92, 94, as shown in FIG. 3B. Thus, when the band 14 is tightened, the disc 90 may also be secured in substantial alignment with the adjacent vertebrae 92, 94.
  • In the embodiment shown, the [0043] band 14 includes an open webbing 24, and consequently is porous. Thus, the band 14 may merely provide structural support for the underlying disc 90, e.g., to stabilize the disc 90 relative to the adjacent vertebrae 92, 94. In addition, the band 14 may compress the disc 90, consequently squeezing closed any fissures, holes, and the like that have occurred in the annulus fibrosis of the disc 90. Alternatively, the band 14 may be formed from a substantially nonporous panel of material such that the band 14 may substantially seal any fissures in the disc 90, thereby preventing nucleus pulposus material, and the like from leaking through the annulus fibrosis.
  • In yet a further alternative, a substantially nonporous material (not shown) may be provided between the [0044] band 14 and the exterior of the disc 90. For example, one or more layers of naturally occurring extra-cellular material, may be carried on an interior surface of the band 14 such that the material may be placed between the band 14 and the disc 90. In addition to sealing any fissures, such material may also promote healing, as is well known to those skilled in the art. Alternatively, or in addition, other materials that promote healing may be coated on and/or impregnated within the band 14.
  • If the [0045] band 14 is formed from bioabsorbable material, the band 14 may remain around the disc 90 until it is absorbed by the patient's body. Alternatively, the band 14 may be merely biocompatible such that the band 14 may remain within the patient's body indefinitely or until the disc 90 has sufficiently healed. In the latter example, a follow-up procedure may be performed to release the ends 18, 20 of the band 14 and pull the band 14 around the disc 90 to remove it from the patient's body.
  • In another embodiment, energy may be applied to the [0046] disc 90 to enhance healing, to cause scarring, and/or to enhance sealing of fissures or other leaks in the disc 90. For example, as described above, at least a portion of the band 14 may be electrically conductive. A source of electrical energy, e.g., an RF generator (not shown), may be coupled to the electrically conductive portion of the band 14. Once the band 14 is secured around the disc 90, electrical energy may be applied to the disc via the electrically conductive portion of the band 14. The power of the electrical energy may be relatively low, e.g., merely to enhance healing of the disc 90. Alternatively, the power may be relatively high, thereby causing scarring of the annulus fibrosis of the disc 90, which may seal fissures through which nucleus pulposus may leak.
  • Turning to FIGS. 4A, 4B, and [0047] 5, another embodiment of an apparatus 110 is shown for treating a spinal disc 90. Generally, the apparatus 110 includes a grasper 12, and a band of material 14 that are substantially identical to the embodiment described above. In addition, the apparatus 110 includes a pair of guide members 150 for guiding the grasper 12 and/or the band 14 around the posterior region of the disc 90. Optionally, the apparatus 110 may also include a fork member (not shown), similar to the previous embodiment.
  • Each [0048] guide member 150 is a semi-rigid or substantially rigid tubular body including a slotted lumen 152 extending between its proximal and distal ends 154, 156. The proximal end 154 may be substantially straight, defining a longitudinal axis 158, and may include an enlarged proximal opening 157 (shown in FIG. 5). The distal end 156 of the guide member 150 may be curved, preferably having a radius of curvature similar to an exterior perimeter of the disc 90. The guide member 150 also has a cross-section including a height “h” (extending generally between the vertebrae adjacent the disc 90) that is greater than its width “w” (extending away from the exterior surface of the disc 90). Thus, the band 14 may be received within the lumen 152 such that the width “W” of the band 14 is substantially less than the height “h” of the guide member 150, thereby minimizing any folding or crumpling of the band 14 within the lumen 152. The distal end 156 of the guide member 150 terminates in a distal tip 160 that is disposed transversely and preferably substantially perpendicular to the axis 158.
  • It will be appreciated that the [0049] distal end 30 of the grasper 12 has a shape that allows the distal end 30 to be directed easily through the lumens 152 of the guide members 150. For example, the distal end 30 of the grasper 12 may have a flat ribbon shape or may have a generally round shape that is small enough to be inserted through the lumens 152.
  • The apparatus [0050] 110 may be used to treat a spinal disc 90 that has ruptured, become misaligned, and/or otherwise degenerated, similar to the embodiment described above. Generally, the spinal disc 90 is disposed between a first vertebra 92, best seen in FIG. 4B, and a second vertebra, which has been eliminated for clarification. The vertebrae include spinous process 92 a and transverse process 92 b defining a vertebral foramen 98, through which a spinal cord 96 extends. The disc 90 generally includes nucleus pulposus 90 a surrounded by annulus fibrosis 90 b, and is surrounded by ligament 100, which may surround the entire spinal column along its length.
  • Initially, the [0051] disc 90 may be accessed, preferably from an anterior approach. This may involve creating incisions 102 in the ligament 100 at locations corresponding to lateral regions of the disc 90. The distal ends 156 of the guide members 150 may be inserted through the respective incisions 102 and advanced around an exterior surface of the disc 90 until the distal tips 160 are disposed opposite one another adjacent a posterior region of the disc 90. The distal ends 156 may be sufficiently flexible to facilitate substantially atraumatic advancement of the guide members 150 around the disc 90. Once the distal ends 156 are fully inserted, the proximal ends 154 of the guide members 150 may extend proximally from the incisions 102 generally parallel to one another.
  • Optionally, a location of at least one of the vertebrae adjacent the [0052] disc 90 may be adjusted, for example, using traction or a fork member (not shown), before inserting the guide members 150, using a procedure similar to the embodiment described above.
  • With particular reference to FIG. 4A, a [0053] distal end 30 of the grasper 12 may be inserted into the lumen 152 of a first of the guide members 150 and advanced distally until the distal end 30 of the grasper 12 exits the distal end 156 of the first guide member 150 adjacent the posterior region of the disc 90. The grasper 12 may be manipulated further until the distal end 30 enters the lumen 152 at the distal end 156 of the second guide member 150, whereupon the grasper 12 may be advanced further until the distal end 30 exits the proximal end 154 of the second guide member 150.
  • With the [0054] distal end 30 of the grasper 12 accessible, the first end 18 of the band 14 may be connected to the distal end 30 of the grasper 12. The grasper 12 may then be pulled back through the guide members 150, thereby directing the band 14 through the lumens 152 of the guide members 150 and around the posterior region of the disc 90, as shown in FIGS. 4A and 5. Once the first end 18 of the band 14 has been pulled out of the proximal end 154 of the first guide member 150, the first end 18 of the band 14 may be released from the distal end 30 of the grasper 12.
  • The [0055] guide members 150 may be withdrawn from the incisions 102, leaving the band 14 in place, as shown in FIG. 4B. Because of the slotted lumens 152 of the guide members 150, the band 14 may extend completely across a height of the disc 90 and preferably at least partially covering one or both adjacent vertebrae 92. The band 14 may then be secured tightly around the disc 90, as shown in FIGS. 3A and 3B. For example, the first and second ends 18, 20 of the band 14 may be secured to one another by threads (not shown), similar to the embodiment described above. Optionally, if necessary, one or both ends 18, 20 of the band 14 may be trimmed before tightening and securing the band 14 around the disc 90.
  • If desired, energy may be applied to the [0056] disc 90 to enhance healing, to cause scarring, and/or to enhance sealing of fissures or other leaks in the disc 90. The energy may be applied directly to one or more regions of the disc 90 or may be applied via conductive regions of the band 14, similar to the embodiment described above.
  • If the [0057] band 14 is formed from bioabsorbable material, the band 14 may remain around the disc 90 until it is absorbed by the patient's body, similar to the embodiment described above. Alternatively, the band 14 may be merely biocompatible, such that the band 14 may remain within the patient's body indefinitely or until the disc 90 has sufficiently healed.
  • The apparatus and methods of the present invention may be performed alone or in conjunction with other procedures used to treat a spinal disc. For example, a band of material may be secured around a spinal disc after performing a procedure within an interior of a spinal disc, such as those disclosed in application Ser. No. 09/828,039, filed Apr. 6, 2001, entitled “Apparatus and Methods for Treating Spinal Discs,” the disclosure of which is expressly incorporated herein by reference. [0058]
  • In addition, one or more guide members in accordance with the present invention may be used to access a posterior region of a spinal disc in order to perform a diagnostic and/or therapeutic procedure at the posterior region of the spinal disc. For example, an imaging device, such as an endoscope (not shown), may be inserted through the guide member to observe, monitor, or otherwise image the posterior region and/or surrounding tissue structures. [0059]
  • A therapeutic procedure may be performed at the posterior region of the disc, e.g., following an imaging or diagnostic procedure or concurrently with imaging (e.g., with multiple instruments, not shown, being introduced through separate guide members). A discectomy or other procedure may be performed that involves removing at least a portion of the disc from the posterior region (not shown). For example, nucleus pulposus material that has leaked from within the disc may be removed. In addition or alternatively, a prosthesis may be implanted within the disc from the posterior region. A therapeutic agent may be introduced into the posterior region or surrounding tissue to promote healing, pain relief, and the like. In addition, a band may be wrapped around the disc to stabilize the disc in a desired position relative to surrounding anatomy, as described above. [0060]
  • In addition, access to the posterior region of a spinal disc may be used to perform other interventions involving tissue structures adjacent to or surrounding the disc, such as the spinal cord or a spinal facet joint. Thus, instruments may be introduced between the disc and surrounding ligament, e.g., through the guide member, and directed to surrounding tissue structures in order to complete other procedures while minimizing exposure of a patient's spine. [0061]
  • While the invention is susceptible to various modifications, and alternative forms, specific examples thereof have been shown in the drawings and are herein described in detail. It should be understood, however, that the invention is not to be limited to the particular forms or methods disclosed, but to the contrary, the invention is to cover all modifications, equivalents and alternatives falling within the spirit and scope of the appended claims. [0062]

Claims (18)

What is claimed is:
1. A method for treating a ruptured or degenerated spinal disc of a patient, comprising:
accessing an area adjacent an exterior of a spinal disc disposed between adjacent vertebrae; and
wrapping a band of material around the disc to stabilize the disc in a desired position relative to surrounding anatomy.
2. The method of claim 1, wherein the band engages at least one of the vertebrae when the band is wrapped around the disc to substantially secure the disc relative to the at least one of the vertebrae.
3. The method of claim 1, wherein the accessing step comprises accessing an anterior region of the disc, and wherein the wrapping step comprises:
extending a distal end of an elongate member along a first lateral region of the disc around a posterior region of the disc to an opposite second lateral region of the disc;
connecting a first end of the band to the distal end of the elongate member;
pulling the elongate member back around the posterior region of the disc, thereby directing the first end of the band around the posterior region of the disc; and
securing at least one of the first end and a second end of the band to another portion of the band, thereby securing the band around the disc.
4. The method of claim 1, further comprising adjusting a location of at least one of the vertebrae relative to the disc.
5. The method of claim 4, wherein the adjusting step comprises:
engaging at least one of the vertebrae between tines of a fork member; and
manipulating the tines between the vertebrae to increase a space between the vertebrae.
6. The method of claim 4, wherein the adjusting step comprises subjecting the patient to traction.
7. The method of claim 1, further comprising placing an extra-cellular matrix material between the band and the disc.
8. The method of claim 7, wherein the band comprises the extra-cellular matrix material on an interior surface thereof, and wherein the extra-cellular matrix material is placed when the band is wrapped around the disc.
9. The method of claim 1, wherein the band comprises healing-promoting material for enhancing healing of damage to an annulus fibrosis of the disc.
10. The method of claim 1, wherein the band comprises nonporous material, and wherein the band substantially seals any leaks in the disc when the band is wrapped around the disc.
11. The method of claim 1, wherein the band comprises bioabsorbable material that remains around the disc until absorbed by the patient's body.
12. The method claim 1, further comprising applying energy to the disc to enhance healing of the disc.
13. The method of claim 12, wherein at least a portion of the band is electrically conductive, wherein the method further comprises coupling a source of electrical energy to the electrically conductive portion of the band, and wherein the applying energy step comprises applying electrical energy to the disc via the electrically conductive portion of the band.
14. The method of claim 12, wherein the applying energy step comprises applying electrical energy directly to one or more desired regions of the disc.
15. The method of claim 1, further comprising inserting a tubular guide member around a portion of the exterior of the disc, and wherein the wrapping step comprises directing the band through the guide member to facilitate wrapping the band around a posterior region of the disc.
16. The method of claim 1, further comprising inserting a pair of opposite-hand tubular guide members around opposing lateral regions of the exterior of the disc.
17. The method of claim 16, wherein the guide members are inserted around the disc until distal ends of the guide members are disposed adjacent a posterior region of the disc.
18. The method of claim 16, wherein the wrapping step comprises:
directing a distal end of an elongate member through lumens of the guide members;
connecting a first end of the band to the distal end of the elongate member; and
directing the distal end of the elongate member back through the lumens of the guide members to direct the band around the posterior region of the disc.
US10/773,508 2001-09-06 2004-02-05 Apparatus and methods for treating spinal discs Abandoned US20040158248A1 (en)

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Cited By (36)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20060241653A1 (en) * 2005-02-04 2006-10-26 Jones Daniel B Surgical hook instrument for gastric band closing
US20080208205A1 (en) * 2007-02-26 2008-08-28 Paul Edward Kraemer Cable system and methods
US20090275982A1 (en) * 2006-04-13 2009-11-05 Jean Taylor Device for treating vertebrae, including an interspinous implant
US20110112577A1 (en) * 2005-04-18 2011-05-12 Kyphon Sarl Interspinous process implant having deployable wings and method of implantation
US8048118B2 (en) 2006-04-28 2011-11-01 Warsaw Orthopedic, Inc. Adjustable interspinous process brace
US8083795B2 (en) 2006-01-18 2011-12-27 Warsaw Orthopedic, Inc. Intervertebral prosthetic device for spinal stabilization and method of manufacturing same
US8096994B2 (en) 2005-02-17 2012-01-17 Kyphon Sarl Percutaneous spinal implants and methods
US8097018B2 (en) 2005-02-17 2012-01-17 Kyphon Sarl Percutaneous spinal implants and methods
US8100943B2 (en) 2005-02-17 2012-01-24 Kyphon Sarl Percutaneous spinal implants and methods
US8105358B2 (en) 2008-02-04 2012-01-31 Kyphon Sarl Medical implants and methods
US8114131B2 (en) 2008-11-05 2012-02-14 Kyphon Sarl Extension limiting devices and methods of use for the spine
US8114136B2 (en) 2008-03-18 2012-02-14 Warsaw Orthopedic, Inc. Implants and methods for inter-spinous process dynamic stabilization of a spinal motion segment
US8114132B2 (en) 2010-01-13 2012-02-14 Kyphon Sarl Dynamic interspinous process device
US8118844B2 (en) 2006-04-24 2012-02-21 Warsaw Orthopedic, Inc. Expandable device for insertion between anatomical structures and a procedure utilizing same
US8118839B2 (en) 2006-11-08 2012-02-21 Kyphon Sarl Interspinous implant
US8128663B2 (en) 1997-01-02 2012-03-06 Kyphon Sarl Spine distraction implant
US8147548B2 (en) 2005-03-21 2012-04-03 Kyphon Sarl Interspinous process implant having a thread-shaped wing and method of implantation
US8147516B2 (en) 2005-02-17 2012-04-03 Kyphon Sarl Percutaneous spinal implants and methods
US8147526B2 (en) 2010-02-26 2012-04-03 Kyphon Sarl Interspinous process spacer diagnostic parallel balloon catheter and methods of use
US8157841B2 (en) 2005-02-17 2012-04-17 Kyphon Sarl Percutaneous spinal implants and methods
US8163018B2 (en) 2006-02-14 2012-04-24 Warsaw Orthopedic, Inc. Treatment of the vertebral column
US8167890B2 (en) 2005-02-17 2012-05-01 Kyphon Sarl Percutaneous spinal implants and methods
US8226653B2 (en) 2005-04-29 2012-07-24 Warsaw Orthopedic, Inc. Spinous process stabilization devices and methods
US8262698B2 (en) 2006-03-16 2012-09-11 Warsaw Orthopedic, Inc. Expandable device for insertion between anatomical structures and a procedure utilizing same
US8317831B2 (en) 2010-01-13 2012-11-27 Kyphon Sarl Interspinous process spacer diagnostic balloon catheter and methods of use
US8349013B2 (en) 1997-01-02 2013-01-08 Kyphon Sarl Spine distraction implant
US8372117B2 (en) 2009-06-05 2013-02-12 Kyphon Sarl Multi-level interspinous implants and methods of use
US8568454B2 (en) 1997-01-02 2013-10-29 Warsaw Orthopedic, Inc. Spine distraction implant and method
US8591549B2 (en) 2011-04-08 2013-11-26 Warsaw Orthopedic, Inc. Variable durometer lumbar-sacral implant
US8591548B2 (en) 2011-03-31 2013-11-26 Warsaw Orthopedic, Inc. Spinous process fusion plate assembly
US8641762B2 (en) 2006-10-24 2014-02-04 Warsaw Orthopedic, Inc. Systems and methods for in situ assembly of an interspinous process distraction implant
US8679161B2 (en) 2005-02-17 2014-03-25 Warsaw Orthopedic, Inc. Percutaneous spinal implants and methods
US8888816B2 (en) 2003-05-22 2014-11-18 Warsaw Orthopedic, Inc. Distractible interspinous process implant and method of implantation
US9078712B2 (en) 2009-04-15 2015-07-14 Warsaw Orthopedic, Inc. Preformed drug-eluting device to be affixed to an anterior spinal plate
US9414864B2 (en) 2009-04-15 2016-08-16 Warsaw Orthopedic, Inc. Anterior spinal plate with preformed drug-eluting device affixed thereto
EP3706148A1 (en) 2019-03-06 2020-09-09 ABB Power Grids Switzerland AG Electric transformer assembly, method for determining a thermal state of an electric transformer assembly, and determination device

Families Citing this family (186)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1253854A4 (en) * 1999-03-07 2010-01-06 Discure Ltd Method and apparatus for computerized surgery
US7717961B2 (en) 1999-08-18 2010-05-18 Intrinsic Therapeutics, Inc. Apparatus delivery in an intervertebral disc
EP1624832A4 (en) 1999-08-18 2008-12-24 Intrinsic Therapeutics Inc Devices and method for augmenting a vertebral disc nucleus
US7998213B2 (en) * 1999-08-18 2011-08-16 Intrinsic Therapeutics, Inc. Intervertebral disc herniation repair
US7972337B2 (en) 2005-12-28 2011-07-05 Intrinsic Therapeutics, Inc. Devices and methods for bone anchoring
WO2009033100A1 (en) * 2007-09-07 2009-03-12 Intrinsic Therapeutics, Inc. Bone anchoring systems
MXPA03003600A (en) 1999-08-18 2004-12-02 Intrinsic Orthopedics Inc Devices and method for nucleus pulposus augmentation and retention.
US8323341B2 (en) 2007-09-07 2012-12-04 Intrinsic Therapeutics, Inc. Impaction grafting for vertebral fusion
US7220281B2 (en) * 1999-08-18 2007-05-22 Intrinsic Therapeutics, Inc. Implant for reinforcing and annulus fibrosis
US6964674B1 (en) * 1999-09-20 2005-11-15 Nuvasive, Inc. Annulotomy closure device
US8632590B2 (en) 1999-10-20 2014-01-21 Anulex Technologies, Inc. Apparatus and methods for the treatment of the intervertebral disc
US8128698B2 (en) 1999-10-20 2012-03-06 Anulex Technologies, Inc. Method and apparatus for the treatment of the intervertebral disc annulus
US7052516B2 (en) 1999-10-20 2006-05-30 Anulex Technologies, Inc. Spinal disc annulus reconstruction method and deformable spinal disc annulus stent
US6592625B2 (en) 1999-10-20 2003-07-15 Anulex Technologies, Inc. Spinal disc annulus reconstruction method and spinal disc annulus stent
US7615076B2 (en) 1999-10-20 2009-11-10 Anulex Technologies, Inc. Method and apparatus for the treatment of the intervertebral disc annulus
US7951201B2 (en) 1999-10-20 2011-05-31 Anulex Technologies, Inc. Method and apparatus for the treatment of the intervertebral disc annulus
US7935147B2 (en) 1999-10-20 2011-05-03 Anulex Technologies, Inc. Method and apparatus for enhanced delivery of treatment device to the intervertebral disc annulus
US7004970B2 (en) 1999-10-20 2006-02-28 Anulex Technologies, Inc. Methods and devices for spinal disc annulus reconstruction and repair
US7674293B2 (en) 2004-04-22 2010-03-09 Facet Solutions, Inc. Crossbar spinal prosthesis having a modular design and related implantation methods
US20050261770A1 (en) * 2004-04-22 2005-11-24 Kuiper Mark K Crossbar spinal prosthesis having a modular design and related implantation methods
US6974478B2 (en) * 1999-10-22 2005-12-13 Archus Orthopedics, Inc. Prostheses, systems and methods for replacement of natural facet joints with artificial facet joint surfaces
US8187303B2 (en) 2004-04-22 2012-05-29 Gmedelaware 2 Llc Anti-rotation fixation element for spinal prostheses
US7691145B2 (en) 1999-10-22 2010-04-06 Facet Solutions, Inc. Prostheses, systems and methods for replacement of natural facet joints with artificial facet joint surfaces
US6805695B2 (en) 2000-04-04 2004-10-19 Spinalabs, Llc Devices and methods for annular repair of intervertebral discs
US20080109030A1 (en) 2001-04-24 2008-05-08 Houser Russell A Arteriotomy closure devices and techniques
US8992567B1 (en) 2001-04-24 2015-03-31 Cardiovascular Technologies Inc. Compressible, deformable, or deflectable tissue closure devices and method of manufacture
US9345460B2 (en) 2001-04-24 2016-05-24 Cardiovascular Technologies, Inc. Tissue closure devices, device and systems for delivery, kits and methods therefor
US8961541B2 (en) 2007-12-03 2015-02-24 Cardio Vascular Technologies Inc. Vascular closure devices, systems, and methods of use
US6736815B2 (en) * 2001-09-06 2004-05-18 Core Medical, Inc. Apparatus and methods for treating spinal discs
US8518036B2 (en) 2002-03-05 2013-08-27 Kimberly-Clark Inc. Electrosurgical tissue treatment method
US8043287B2 (en) * 2002-03-05 2011-10-25 Kimberly-Clark Inc. Method of treating biological tissue
US8882755B2 (en) * 2002-03-05 2014-11-11 Kimberly-Clark Inc. Electrosurgical device for treatment of tissue
US6896675B2 (en) 2002-03-05 2005-05-24 Baylis Medical Company Inc. Intradiscal lesioning device
US7744651B2 (en) 2002-09-18 2010-06-29 Warsaw Orthopedic, Inc Compositions and methods for treating intervertebral discs with collagen-based materials
US20040054414A1 (en) 2002-09-18 2004-03-18 Trieu Hai H. Collagen-based materials and methods for augmenting intervertebral discs
US20040078090A1 (en) 2002-10-18 2004-04-22 Francois Binette Biocompatible scaffolds with tissue fragments
CN100394989C (en) 2002-11-15 2008-06-18 华沙整形外科股份有限公司 Collagen-based materials and methods for augmenting intervertebral discs
US7069083B2 (en) * 2002-12-13 2006-06-27 Advanced Neuromodulation Systems, Inc. System and method for electrical stimulation of the intervertebral disc
CN1774220A (en) 2003-02-14 2006-05-17 德普伊斯派尔公司 In-situ formed intervertebral fusion device and method
US8197837B2 (en) 2003-03-07 2012-06-12 Depuy Mitek, Inc. Method of preparation of bioabsorbable porous reinforced tissue implants and implants thereof
US20040230304A1 (en) 2003-05-14 2004-11-18 Archus Orthopedics Inc. Prostheses, tools and methods for replacement of natural facet joints with artifical facet joint surfaces
US7608104B2 (en) 2003-05-14 2009-10-27 Archus Orthopedics, Inc. Prostheses, tools and methods for replacement of natural facet joints with artifical facet joint surfaces
US8226715B2 (en) * 2003-06-30 2012-07-24 Depuy Mitek, Inc. Scaffold for connective tissue repair
US7074238B2 (en) 2003-07-08 2006-07-11 Archus Orthopedics, Inc. Prostheses, tools and methods for replacement of natural facet joints with artificial facet joint surfaces
US10583220B2 (en) 2003-08-11 2020-03-10 DePuy Synthes Products, Inc. Method and apparatus for resurfacing an articular surface
US20050131406A1 (en) 2003-12-15 2005-06-16 Archus Orthopedics, Inc. Polyaxial adjustment of facet joint prostheses
US11395865B2 (en) 2004-02-09 2022-07-26 DePuy Synthes Products, Inc. Scaffolds with viable tissue
US8523904B2 (en) 2004-03-09 2013-09-03 The Board Of Trustees Of The Leland Stanford Junior University Methods and systems for constraint of spinous processes with attachment
US7458981B2 (en) 2004-03-09 2008-12-02 The Board Of Trustees Of The Leland Stanford Junior University Spinal implant and method for restricting spinal flexion
US20060135959A1 (en) * 2004-03-22 2006-06-22 Disc Dynamics, Inc. Nuclectomy method and apparatus
US20050209602A1 (en) * 2004-03-22 2005-09-22 Disc Dynamics, Inc. Multi-stage biomaterial injection system for spinal implants
US7824390B2 (en) 2004-04-16 2010-11-02 Kyphon SÀRL Spinal diagnostic methods and apparatus
US7452351B2 (en) 2004-04-16 2008-11-18 Kyphon Sarl Spinal diagnostic methods and apparatus
US7406775B2 (en) * 2004-04-22 2008-08-05 Archus Orthopedics, Inc. Implantable orthopedic device component selection instrument and methods
US7621952B2 (en) * 2004-06-07 2009-11-24 Dfine, Inc. Implants and methods for treating bone
US20060095138A1 (en) 2004-06-09 2006-05-04 Csaba Truckai Composites and methods for treating bone
AU2005277363A1 (en) 2004-08-18 2006-03-02 Fsi Acquisition Sub, Llc Adjacent level facet arthroplasty devices, spine stabilization systems, and methods
US20060106459A1 (en) * 2004-08-30 2006-05-18 Csaba Truckai Bone treatment systems and methods
US7857813B2 (en) * 2006-08-29 2010-12-28 Baxano, Inc. Tissue access guidewire system and method
US8430881B2 (en) 2004-10-15 2013-04-30 Baxano, Inc. Mechanical tissue modification devices and methods
US20100331883A1 (en) 2004-10-15 2010-12-30 Schmitz Gregory P Access and tissue modification systems and methods
US7578819B2 (en) 2005-05-16 2009-08-25 Baxano, Inc. Spinal access and neural localization
US7938830B2 (en) 2004-10-15 2011-05-10 Baxano, Inc. Powered tissue modification devices and methods
US9247952B2 (en) 2004-10-15 2016-02-02 Amendia, Inc. Devices and methods for tissue access
US8048080B2 (en) 2004-10-15 2011-11-01 Baxano, Inc. Flexible tissue rasp
US9101386B2 (en) 2004-10-15 2015-08-11 Amendia, Inc. Devices and methods for treating tissue
US8257356B2 (en) * 2004-10-15 2012-09-04 Baxano, Inc. Guidewire exchange systems to treat spinal stenosis
US8221397B2 (en) * 2004-10-15 2012-07-17 Baxano, Inc. Devices and methods for tissue modification
US7887538B2 (en) * 2005-10-15 2011-02-15 Baxano, Inc. Methods and apparatus for tissue modification
US8617163B2 (en) 2004-10-15 2013-12-31 Baxano Surgical, Inc. Methods, systems and devices for carpal tunnel release
US20110190772A1 (en) 2004-10-15 2011-08-04 Vahid Saadat Powered tissue modification devices and methods
US7555343B2 (en) 2004-10-15 2009-06-30 Baxano, Inc. Devices and methods for selective surgical removal of tissue
US7918849B2 (en) 2004-10-15 2011-04-05 Baxano, Inc. Devices and methods for tissue access
US8062300B2 (en) 2006-05-04 2011-11-22 Baxano, Inc. Tissue removal with at least partially flexible devices
US8221461B2 (en) 2004-10-25 2012-07-17 Gmedelaware 2 Llc Crossbar spinal prosthesis having a modular design and systems for treating spinal pathologies
US7559932B2 (en) 2004-12-06 2009-07-14 Dfine, Inc. Bone treatment systems and methods
US8048083B2 (en) 2004-11-05 2011-11-01 Dfine, Inc. Bone treatment systems and methods
US7722620B2 (en) 2004-12-06 2010-05-25 Dfine, Inc. Bone treatment systems and methods
US8070753B2 (en) 2004-12-06 2011-12-06 Dfine, Inc. Bone treatment systems and methods
US20090264939A9 (en) * 2004-12-16 2009-10-22 Martz Erik O Instrument set and method for performing spinal nuclectomy
US8496686B2 (en) * 2005-03-22 2013-07-30 Gmedelaware 2 Llc Minimally invasive spine restoration systems, devices, methods and kits
US7632313B2 (en) 2005-04-29 2009-12-15 Jmea Corporation Disc repair system
US7608108B2 (en) * 2005-04-29 2009-10-27 Jmea Corporation Tissue repair system
US8702718B2 (en) 2005-04-29 2014-04-22 Jmea Corporation Implantation system for tissue repair
US20060247623A1 (en) * 2005-04-29 2006-11-02 Sdgi Holdings, Inc. Local delivery of an active agent from an orthopedic implant
US20060247776A1 (en) * 2005-05-02 2006-11-02 The Board Of Trustees Of The Leland Stanford Junior University Systems and methods for augmenting intervertebral discs
US20060253199A1 (en) * 2005-05-03 2006-11-09 Disc Dynamics, Inc. Lordosis creating nucleus replacement method and apparatus
US20060253198A1 (en) * 2005-05-03 2006-11-09 Disc Dynamics, Inc. Multi-lumen mold for intervertebral prosthesis and method of using same
JP4907908B2 (en) * 2005-06-29 2012-04-04 ルネサスエレクトロニクス株式会社 Driving circuit and display device
AU2006279558B2 (en) 2005-08-16 2012-05-17 Izi Medical Products, Llc Spinal tissue distraction devices
US8591583B2 (en) 2005-08-16 2013-11-26 Benvenue Medical, Inc. Devices for treating the spine
US8540723B2 (en) 2009-04-14 2013-09-24 Dfine, Inc. Medical system and method of use
US8777479B2 (en) 2008-10-13 2014-07-15 Dfine, Inc. System for use in bone cement preparation and delivery
US9066769B2 (en) 2005-08-22 2015-06-30 Dfine, Inc. Bone treatment systems and methods
WO2007028120A2 (en) * 2005-09-01 2007-03-08 Dfine, Inc. Systems and methods for sensing retrograde flows of bone fill material
US7533672B2 (en) 2005-09-06 2009-05-19 Synthes Usa, Llc Methods and apparatus for vascular protection in spinal surgery
AU2006302190B2 (en) * 2005-10-10 2012-01-19 Chad Anthony Barrie Artificial spinal disc replacement system and method
US8092456B2 (en) 2005-10-15 2012-01-10 Baxano, Inc. Multiple pathways for spinal nerve root decompression from a single access point
US8366712B2 (en) 2005-10-15 2013-02-05 Baxano, Inc. Multiple pathways for spinal nerve root decompression from a single access point
US8062298B2 (en) 2005-10-15 2011-11-22 Baxano, Inc. Flexible tissue removal devices and methods
WO2007126428A2 (en) 2005-12-20 2007-11-08 Archus Orthopedics, Inc. Arthroplasty revision system and method
US20070233250A1 (en) * 2006-02-07 2007-10-04 Shadduck John H Systems for treating bone
US20070213718A1 (en) * 2006-02-14 2007-09-13 Sdgi Holdings, Inc. Treatment of the vertebral column
US20070213717A1 (en) * 2006-02-14 2007-09-13 Sdgi Holdings, Inc. Biological fusion in the vertebral column
US20070227547A1 (en) * 2006-02-14 2007-10-04 Sdgi Holdings, Inc. Treatment of the vertebral column
WO2007124201A2 (en) * 2006-02-23 2007-11-01 Saratech, Inc. System s and methods for repairing an annulus
US8221468B2 (en) * 2006-05-11 2012-07-17 Gaines Jr Robert W Use of bioabsorbable materials for anterior extradiscal correction of thoracolumbar pathologies
US8399619B2 (en) 2006-06-30 2013-03-19 Warsaw Orthopedic, Inc. Injectable collagen material
US8118779B2 (en) 2006-06-30 2012-02-21 Warsaw Orthopedic, Inc. Collagen delivery device
US20080027456A1 (en) * 2006-07-19 2008-01-31 Csaba Truckai Bone treatment systems and methods
US8702755B2 (en) 2006-08-11 2014-04-22 Gmedelaware 2 Llc Angled washer polyaxial connection for dynamic spine prosthesis
US20080065218A1 (en) * 2006-09-13 2008-03-13 O'neil Michael J Annulus fibrosus repair devices and techniques
US20080172126A1 (en) * 2006-10-03 2008-07-17 Reynolds Martin A Nucleus pulposus injection devices and methods
US8029541B2 (en) 2006-10-19 2011-10-04 Simpirica Spine, Inc. Methods and systems for laterally stabilized constraint of spinous processes
ES2364417T3 (en) 2006-10-19 2011-09-01 The Board Of Trustees Of The Leland Stanford Junior University SYSTEMS FOR THE LIMITATION OF SPINE APOPHYSIS WITH CLAMPS.
US8162982B2 (en) 2006-10-19 2012-04-24 Simpirica Spine, Inc. Methods and systems for constraint of multiple spine segments
US8187307B2 (en) 2006-10-19 2012-05-29 Simpirica Spine, Inc. Structures and methods for constraining spinal processes with single connector
US8105382B2 (en) 2006-12-07 2012-01-31 Interventional Spine, Inc. Intervertebral implant
US8696679B2 (en) 2006-12-08 2014-04-15 Dfine, Inc. Bone treatment systems and methods
US20080177389A1 (en) * 2006-12-21 2008-07-24 Rob Gene Parrish Intervertebral disc spacer
CA2678006C (en) 2007-02-21 2014-10-14 Benvenue Medical, Inc. Devices for treating the spine
US20080249529A1 (en) * 2007-03-15 2008-10-09 Depuy Spine, Inc. Dual incision disc repair device and method
WO2008124533A1 (en) 2007-04-03 2008-10-16 Dfine, Inc. Bone treatment systems and methods
WO2008137428A2 (en) 2007-04-30 2008-11-13 Dfine, Inc. Bone treatment systems and methods
US8403961B2 (en) 2007-06-22 2013-03-26 Simpirica Spine, Inc. Methods and devices for controlled flexion restriction of spinal segments
US20100036424A1 (en) 2007-06-22 2010-02-11 Simpirica Spine, Inc. Methods and systems for increasing the bending stiffness and constraining the spreading of a spinal segment
US8900307B2 (en) 2007-06-26 2014-12-02 DePuy Synthes Products, LLC Highly lordosed fusion cage
US9597118B2 (en) 2007-07-20 2017-03-21 Dfine, Inc. Bone anchor apparatus and method
WO2009032363A1 (en) 2007-09-06 2009-03-12 Baxano, Inc. Method, system and apparatus for neural localization
US8192436B2 (en) 2007-12-07 2012-06-05 Baxano, Inc. Tissue modification devices
EP2471493A1 (en) 2008-01-17 2012-07-04 Synthes GmbH An expandable intervertebral implant and associated method of manufacturing the same
US9445854B2 (en) 2008-02-01 2016-09-20 Dfine, Inc. Bone treatment systems and methods
US9161798B2 (en) * 2008-02-01 2015-10-20 Dfine, Inc. Bone treatment systems and methods
US8487021B2 (en) 2008-02-01 2013-07-16 Dfine, Inc. Bone treatment systems and methods
US20100030220A1 (en) * 2008-07-31 2010-02-04 Dfine, Inc. Bone treatment systems and methods
CA2720580A1 (en) 2008-04-05 2009-10-08 Synthes Usa, Llc Expandable intervertebral implant
US9180416B2 (en) 2008-04-21 2015-11-10 Dfine, Inc. System for use in bone cement preparation and delivery
US8308771B2 (en) 2008-06-06 2012-11-13 Simpirica Spine, Inc. Methods and apparatus for locking a band
EP2296567B1 (en) 2008-06-06 2014-03-12 Simpirica Spine, Inc. Apparatus for locking a band
EP2296566A4 (en) 2008-06-06 2013-01-02 Simpirica Spine Inc Methods and apparatus for deploying spinous process constraints
US8409206B2 (en) 2008-07-01 2013-04-02 Baxano, Inc. Tissue modification devices and methods
US8398641B2 (en) 2008-07-01 2013-03-19 Baxano, Inc. Tissue modification devices and methods
US9314253B2 (en) 2008-07-01 2016-04-19 Amendia, Inc. Tissue modification devices and methods
EP2339976B1 (en) 2008-07-09 2016-03-16 Icon Orthopaedic Concepts, LLC Ankle arthrodesis nail and outrigger assembly
US8414584B2 (en) 2008-07-09 2013-04-09 Icon Orthopaedic Concepts, Llc Ankle arthrodesis nail and outrigger assembly
CA2730732A1 (en) 2008-07-14 2010-01-21 Baxano, Inc. Tissue modification devices
EP2328494B1 (en) 2008-09-03 2014-10-22 Simpirica Spine, Inc. Apparatus for coupling a prosthesis to a spinal segment
US8163022B2 (en) 2008-10-14 2012-04-24 Anulex Technologies, Inc. Method and apparatus for the treatment of the intervertebral disc annulus
US8226723B2 (en) * 2008-11-20 2012-07-24 Dynatek Laboratories, Inc. Self-retaining artificial spinal disc, and associated methods
US8182533B2 (en) * 2009-01-19 2012-05-22 Richard Perkins Annular repair device and method
WO2010088621A1 (en) 2009-02-02 2010-08-05 Simpirica Spine, Inc. Sacral tether anchor and methods of use
US20100217272A1 (en) * 2009-02-20 2010-08-26 Holt Development Llc Method and apparatus for positioning implant between spinous processes
WO2010104975A1 (en) 2009-03-10 2010-09-16 Simpirica Spine, Inc. Surgical tether apparatus and methods of use
US8529606B2 (en) 2009-03-10 2013-09-10 Simpirica Spine, Inc. Surgical tether apparatus and methods of use
EP2405840B1 (en) 2009-03-10 2024-02-21 Empirical Spine, Inc. Surgical tether apparatus
JP5582619B2 (en) 2009-03-13 2014-09-03 バクサノ,インク. Flexible nerve position determination device
US20100249783A1 (en) * 2009-03-24 2010-09-30 Warsaw Orthopedic, Inc. Drug-eluting implant cover
US20100247600A1 (en) * 2009-03-24 2010-09-30 Warsaw Orthopedic, Inc. Therapeutic drug eluting implant cover and method of making the same
US9526620B2 (en) 2009-03-30 2016-12-27 DePuy Synthes Products, Inc. Zero profile spinal fusion cage
WO2010114853A1 (en) 2009-03-30 2010-10-07 Simpirica Spine, Inc. Methods and apparatus for improving shear loading capacity of a spinal segment
US8394102B2 (en) 2009-06-25 2013-03-12 Baxano, Inc. Surgical tools for treatment of spinal stenosis
US8211126B2 (en) 2009-09-22 2012-07-03 Jmea Corporation Tissue repair system
US9393129B2 (en) 2009-12-10 2016-07-19 DePuy Synthes Products, Inc. Bellows-like expandable interbody fusion cage
US8460319B2 (en) 2010-01-11 2013-06-11 Anulex Technologies, Inc. Intervertebral disc annulus repair system and method
US9592063B2 (en) 2010-06-24 2017-03-14 DePuy Synthes Products, Inc. Universal trial for lateral cages
US8979860B2 (en) 2010-06-24 2015-03-17 DePuy Synthes Products. LLC Enhanced cage insertion device
TW201215379A (en) 2010-06-29 2012-04-16 Synthes Gmbh Distractible intervertebral implant
EP2624774A4 (en) 2010-10-06 2014-01-15 Simpirica Spine Inc Device and accessories for limiting flexion
US9402732B2 (en) 2010-10-11 2016-08-02 DePuy Synthes Products, Inc. Expandable interspinous process spacer implant
US9204959B2 (en) * 2012-02-02 2015-12-08 Smith & Nephew, Inc. Implantable biologic holder
AU2014209124A1 (en) 2013-01-28 2015-09-17 Cartiva, Inc. Systems and methods for orthopedic repair
US9737294B2 (en) 2013-01-28 2017-08-22 Cartiva, Inc. Method and system for orthopedic repair
US9522070B2 (en) 2013-03-07 2016-12-20 Interventional Spine, Inc. Intervertebral implant
CN104161555A (en) * 2014-08-27 2014-11-26 何渝军 Breast surgery fixing system
US11426290B2 (en) 2015-03-06 2022-08-30 DePuy Synthes Products, Inc. Expandable intervertebral implant, system, kit and method
CN109688981A (en) 2016-06-28 2019-04-26 Eit 新兴移植技术股份有限公司 Distensible, adjustable angle intervertebral cage
JP7023877B2 (en) 2016-06-28 2022-02-22 イーアイティー・エマージング・インプラント・テクノロジーズ・ゲーエムベーハー Expandable and angle-adjustable range-of-motion intervertebral cage
WO2018066921A2 (en) * 2016-10-06 2018-04-12 아주대학교 산학협력단 Device for supporting semilunar cartilage hoop stress
US10888433B2 (en) 2016-12-14 2021-01-12 DePuy Synthes Products, Inc. Intervertebral implant inserter and related methods
US10398563B2 (en) 2017-05-08 2019-09-03 Medos International Sarl Expandable cage
US11344424B2 (en) 2017-06-14 2022-05-31 Medos International Sarl Expandable intervertebral implant and related methods
US10940016B2 (en) 2017-07-05 2021-03-09 Medos International Sarl Expandable intervertebral fusion cage
US11446156B2 (en) 2018-10-25 2022-09-20 Medos International Sarl Expandable intervertebral implant, inserter instrument, and related methods
US11426286B2 (en) 2020-03-06 2022-08-30 Eit Emerging Implant Technologies Gmbh Expandable intervertebral implant
US11850160B2 (en) 2021-03-26 2023-12-26 Medos International Sarl Expandable lordotic intervertebral fusion cage
US11752009B2 (en) 2021-04-06 2023-09-12 Medos International Sarl Expandable intervertebral fusion cage

Citations (88)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3678158A (en) * 1971-05-11 1972-07-18 Worthington Bio Chem Corp Treatment of herniated intervertebral discs of mammals
US3875595A (en) * 1974-04-15 1975-04-08 Edward C Froning Intervertebral disc prosthesis and instruments for locating same
US3941127A (en) * 1974-10-03 1976-03-02 Froning Edward C Apparatus and method for stereotaxic lateral extradural disc puncture
US3944114A (en) * 1974-03-20 1976-03-16 Koninklijke Emballage Industrie Van Leer B.V. Screw threaded plastic plug
US3964480A (en) * 1974-10-03 1976-06-22 Froning Edward C Apparatus for sterotaxic lateral extradural disc puncture
US4439423A (en) * 1981-05-13 1984-03-27 Smith Laboratories, Inc. Chymopapain and method for its use
US4638799A (en) * 1985-06-13 1987-01-27 Moore Robert R Needle guide apparatus for discolysis procedures
US4682587A (en) * 1985-05-07 1987-07-28 Pneumedic Corp. Compound force sacro-lumbar support belt
US4719108A (en) * 1981-05-13 1988-01-12 Smith Laboratories, Inc. Chymopapain composition and method for its use
US4744364A (en) * 1987-02-17 1988-05-17 Intravascular Surgical Instruments, Inc. Device for sealing percutaneous puncture in a vessel
US4772287A (en) * 1987-08-20 1988-09-20 Cedar Surgical, Inc. Prosthetic disc and method of implanting
US4796315A (en) * 1986-01-27 1989-01-10 Crew Randolph E Rotationally contoured lumbar cushion
US4852568A (en) * 1987-02-17 1989-08-01 Kensey Nash Corporation Method and apparatus for sealing an opening in tissue of a living being
US4863477A (en) * 1987-05-12 1989-09-05 Monson Gary L Synthetic intervertebral disc prosthesis
US4878915A (en) * 1987-01-22 1989-11-07 Brantigan John W Surgical prosthetic implant facilitating vertebral interbody fusion
US4968298A (en) * 1988-09-12 1990-11-06 Michelson Gary K Interspace irrigator
US5015247A (en) * 1988-06-13 1991-05-14 Michelson Gary K Threaded spinal implant
US5021059A (en) * 1990-05-07 1991-06-04 Kensey Nash Corporation Plug device with pulley for sealing punctures in tissue and methods of use
US5061274A (en) * 1989-12-04 1991-10-29 Kensey Nash Corporation Plug device for sealing openings and method of use
US5092894A (en) * 1990-02-13 1992-03-03 Kenny Charles H Stabilized meniscus prosthesis
US5114032A (en) * 1990-10-12 1992-05-19 Laidlaw Willam S Plug for sealing preservative in wood
US5123926A (en) * 1991-02-22 1992-06-23 Madhavan Pisharodi Artificial spinal prosthesis
US5192301A (en) * 1989-01-17 1993-03-09 Nippon Zeon Co., Ltd. Closing plug of a defect for medical use and a closing plug device utilizing it
US5192302A (en) * 1989-12-04 1993-03-09 Kensey Nash Corporation Plug devices for sealing punctures and methods of use
US5195541A (en) * 1991-10-18 1993-03-23 Obenchain Theodore G Method of performing laparoscopic lumbar discectomy
US5201729A (en) * 1990-01-12 1993-04-13 Laserscope Method for performing percutaneous diskectomy using a laser
US5222974A (en) * 1991-11-08 1993-06-29 Kensey Nash Corporation Hemostatic puncture closure system and method of use
US5275616A (en) * 1990-10-01 1994-01-04 Quinton Instrument Company Insertion assembly and method of inserting a vessel plug into the body of a patient
US5306254A (en) * 1992-10-01 1994-04-26 Kensey Nash Corporation Vessel position locating device and method of use
US5411520A (en) * 1991-11-08 1995-05-02 Kensey Nash Corporation Hemostatic vessel puncture closure system utilizing a plug located within the puncture tract spaced from the vessel, and method of use
US5549679A (en) * 1994-05-20 1996-08-27 Kuslich; Stephen D. Expandable fabric implant for stabilizing the spinal motion segment
US5595563A (en) * 1995-09-05 1997-01-21 Moisdon; Roger G. F. Method and apparatus for maintaining the position of body parts
US5599287A (en) * 1995-10-03 1997-02-04 Peach U.S., Inc. Hyperextension orthotic apparatus useful for treating pain associated with spinal disorders
US5601556A (en) * 1994-03-18 1997-02-11 Pisharodi; Madhavan Apparatus for spondylolisthesis reduction
US5628756A (en) * 1993-01-06 1997-05-13 Smith & Nephew Richards Inc. Knotted cable attachment apparatus formed of braided polymeric fibers
US5645565A (en) * 1995-06-13 1997-07-08 Ethicon Endo-Surgery, Inc. Surgical plug
US5674296A (en) * 1994-11-14 1997-10-07 Spinal Dynamics Corporation Human spinal disc prosthesis
US5690674A (en) * 1996-07-02 1997-11-25 Cordis Corporation Wound closure with plug
US5720748A (en) * 1993-02-10 1998-02-24 Spine-Tech, Inc. Spinal stabilization surgical apparatus
US5728146A (en) * 1995-06-29 1998-03-17 The Procter & Gamble Company Thermal neck wrap having wing shape and means for position maintenance
US5800549A (en) * 1997-04-30 1998-09-01 Howmedica Inc. Method and apparatus for injecting an elastic spinal implant
US5800550A (en) * 1996-03-13 1998-09-01 Sertich; Mario M. Interbody fusion cage
US5830125A (en) * 1993-08-12 1998-11-03 Scribner-Browne Medical Design Incorporated Catheter introducer with suture capability
US5871525A (en) * 1992-04-13 1999-02-16 Ep Technologies, Inc. Steerable ablation catheter system
US5888223A (en) * 1995-12-08 1999-03-30 Bray, Jr.; Robert S. Anterior stabilization device
US5888220A (en) * 1994-05-06 1999-03-30 Advanced Bio Surfaces, Inc. Articulating joint repair
US5888224A (en) * 1993-09-21 1999-03-30 Synthesis (U.S.A.) Implant for intervertebral space
US5893890A (en) * 1994-03-18 1999-04-13 Perumala Corporation Rotating, locking intervertebral disk stabilizer and applicator
US5897593A (en) * 1997-03-06 1999-04-27 Sulzer Spine-Tech Inc. Lordotic spinal implant
US5957929A (en) * 1997-05-02 1999-09-28 Micro Therapeutics, Inc. Expandable stent apparatus and method
US5964807A (en) * 1996-08-08 1999-10-12 Trustees Of The University Of Pennsylvania Compositions and methods for intervertebral disc reformation
US5972015A (en) * 1997-08-15 1999-10-26 Kyphon Inc. Expandable, asymetric structures for deployment in interior body regions
US5972031A (en) * 1995-02-14 1999-10-26 Biedermann; Lutz Space holder in particular for a vertebra or an intervertebral disk
US6022376A (en) * 1997-06-06 2000-02-08 Raymedica, Inc. Percutaneous prosthetic spinal disc nucleus and method of manufacture
US6048346A (en) * 1997-08-13 2000-04-11 Kyphon Inc. Systems and methods for injecting flowable materials into bones
US6056749A (en) * 1999-03-15 2000-05-02 Spineology, Inc. Method and device for fixing and correcting spondylolisthesis anteriorly
US6066108A (en) * 1998-06-08 2000-05-23 Lundberg; Leslie C. Method and apparatus for treating and preventing sacroiliac joint injuries
US6066154A (en) * 1994-01-26 2000-05-23 Kyphon Inc. Inflatable device for use in surgical protocol relating to fixation of bone
US6077268A (en) * 1994-03-29 2000-06-20 Sdgi Holdings, Inc. Variable angle surgical cable crimp assembly and method
US6077570A (en) * 1994-12-27 2000-06-20 Noritake Co., Ltd. Surface-decorated articles by noble metals utilizable in an electronic range method for producing same and liquid gold for insulating overglaze decoration
US6095149A (en) * 1996-08-13 2000-08-01 Oratec Interventions, Inc. Method for treating intervertebral disc degeneration
US6126682A (en) * 1996-08-13 2000-10-03 Oratec Interventions, Inc. Method for treating annular fissures in intervertebral discs
US6146419A (en) * 1999-05-13 2000-11-14 Board Of Trustees Of The University Method for forming a hollow prosthesis
US6186518B1 (en) * 1999-04-12 2001-02-13 Sportsfx Suspension system for inline skates
US6206921B1 (en) * 1999-02-22 2001-03-27 Peter A. Guagliano Method of replacing nucleus pulposus and repairing the intervertebral disk
US6206923B1 (en) * 1999-01-08 2001-03-27 Sdgi Holdings, Inc. Flexible implant using partially demineralized bone
US6206922B1 (en) * 1995-03-27 2001-03-27 Sdgi Holdings, Inc. Methods and instruments for interbody fusion
US6221109B1 (en) * 1999-09-15 2001-04-24 Ed. Geistlich Söhne AG fur Chemische Industrie Method of protecting spinal area
US6248131B1 (en) * 1994-05-06 2001-06-19 Advanced Bio Surfaces, Inc. Articulating joint repair
US6264695B1 (en) * 1999-09-30 2001-07-24 Replication Medical, Inc. Spinal nucleus implant
US20020022856A1 (en) * 2000-08-14 2002-02-21 Wesley Johnson Transverse cavity device and method
US6402750B1 (en) * 2000-04-04 2002-06-11 Spinlabs, Llc Devices and methods for the treatment of spinal disorders
US20020077701A1 (en) * 2000-12-15 2002-06-20 Kuslich Stephen D. Annulus-reinforcing band
US20020147497A1 (en) * 2001-04-06 2002-10-10 Integrated Vascular Systems, Inc. Methods for treating spinal discs
US6481440B2 (en) * 1999-09-13 2002-11-19 Medtronic, Inc. Lamina prosthesis for delivery of medical treatment
US6482235B1 (en) * 1999-08-18 2002-11-19 Intrinsic Orthopedics, Inc. Devices and methods of vertebral disc augmentation
US20020173791A1 (en) * 2001-05-17 2002-11-21 Howland Robert S. Spinal fixation apparatus with enhanced axial support and methods for use
US6508839B1 (en) * 1999-08-18 2003-01-21 Intrinsic Orthopedics, Inc. Devices and methods of vertebral disc augmentation
US20030032965A1 (en) * 2001-08-13 2003-02-13 Schneiderman Gary Andrew Surgical guide system for stabilization of the spine
US6530933B1 (en) * 1998-12-31 2003-03-11 Teresa T. Yeung Methods and devices for fastening bulging or herniated intervertebral discs
US6562033B2 (en) * 2001-04-09 2003-05-13 Baylis Medical Co. Intradiscal lesioning apparatus
US6579291B1 (en) * 2000-10-10 2003-06-17 Spinalabs, Llc Devices and methods for the treatment of spinal disorders
US6610094B2 (en) * 1995-11-08 2003-08-26 Sulzer Orthopaedie Ag Intervertebral prosthesis
US20040010308A1 (en) * 2000-01-18 2004-01-15 Mindguard Ltd. Implantable composite device and corresponding method for deflecting embolic material in blood flowing at an arterial bifurcation
US6736815B2 (en) * 2001-09-06 2004-05-18 Core Medical, Inc. Apparatus and methods for treating spinal discs
US6805695B2 (en) * 2000-04-04 2004-10-19 Spinalabs, Llc Devices and methods for annular repair of intervertebral discs
US7025771B2 (en) * 2000-06-30 2006-04-11 Spineology, Inc. Tool to direct bone replacement material
US7201774B2 (en) * 1999-10-08 2007-04-10 Ferree Bret A Artificial intervertebral disc replacements incorporating reinforced wall sections

Family Cites Families (19)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US34866A (en) * 1862-04-01 Improvement in files
US16583A (en) * 1857-02-10 godfrey
US4643178A (en) * 1984-04-23 1987-02-17 Fabco Medical Products, Inc. Surgical wire and method for the use thereof
US4606335A (en) * 1984-08-20 1986-08-19 Highland Orthopedic Center Cerclage wire passer
USRE34866E (en) 1987-02-17 1995-02-21 Kensey Nash Corporation Device for sealing percutaneous puncture in a vessel
GB8716925D0 (en) * 1987-07-17 1987-08-26 Mehdian S M H Apparatus for treatment of spinal disorders
US6120502A (en) * 1988-06-13 2000-09-19 Michelson; Gary Karlin Apparatus and method for the delivery of electrical current for interbody spinal arthrodesis
US5217463A (en) * 1990-04-11 1993-06-08 Mikhail W F Michael Method for performing knee surgery and retractors for use therein
US5330489A (en) * 1992-10-09 1994-07-19 United States Surgical Corporation Sternum closure buckle
US6007570A (en) 1996-08-13 1999-12-28 Oratec Interventions, Inc. Apparatus with functional element for performing function upon intervertebral discs
US6183518B1 (en) 1999-02-22 2001-02-06 Anthony C. Ross Method of replacing nucleus pulposus and repairing the intervertebral disk
US6371990B1 (en) * 1999-10-08 2002-04-16 Bret A. Ferree Annulus fibrosis augmentation methods and apparatus
US20030040796A1 (en) * 1999-10-08 2003-02-27 Ferree Bret A. Devices used to treat disc herniation and attachment mechanisms therefore
WO2001028464A1 (en) 1999-10-20 2001-04-26 Anulex Technologies, Inc. Spinal disc annulus reconstruction method and spinal disc annulus stent
AUPQ362199A0 (en) * 1999-10-22 1999-11-18 Kaladelfos, George Intra-vaginal sling placement device
US7014633B2 (en) 2000-02-16 2006-03-21 Trans1, Inc. Methods of performing procedures in the spine
US6752831B2 (en) * 2000-12-08 2004-06-22 Osteotech, Inc. Biocompatible osteogenic band for repair of spinal disorders
US6645211B2 (en) * 2001-02-07 2003-11-11 Howmedica Osteonics Corp. Orthopedic support system and method of installation
US6827743B2 (en) * 2001-02-28 2004-12-07 Sdgi Holdings, Inc. Woven orthopedic implants

Patent Citations (98)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3678158A (en) * 1971-05-11 1972-07-18 Worthington Bio Chem Corp Treatment of herniated intervertebral discs of mammals
US3944114A (en) * 1974-03-20 1976-03-16 Koninklijke Emballage Industrie Van Leer B.V. Screw threaded plastic plug
US3875595A (en) * 1974-04-15 1975-04-08 Edward C Froning Intervertebral disc prosthesis and instruments for locating same
US3941127A (en) * 1974-10-03 1976-03-02 Froning Edward C Apparatus and method for stereotaxic lateral extradural disc puncture
US3964480A (en) * 1974-10-03 1976-06-22 Froning Edward C Apparatus for sterotaxic lateral extradural disc puncture
US4719108A (en) * 1981-05-13 1988-01-12 Smith Laboratories, Inc. Chymopapain composition and method for its use
US4439423A (en) * 1981-05-13 1984-03-27 Smith Laboratories, Inc. Chymopapain and method for its use
US4682587A (en) * 1985-05-07 1987-07-28 Pneumedic Corp. Compound force sacro-lumbar support belt
US4638799A (en) * 1985-06-13 1987-01-27 Moore Robert R Needle guide apparatus for discolysis procedures
US4796315A (en) * 1986-01-27 1989-01-10 Crew Randolph E Rotationally contoured lumbar cushion
US4878915A (en) * 1987-01-22 1989-11-07 Brantigan John W Surgical prosthetic implant facilitating vertebral interbody fusion
US4744364A (en) * 1987-02-17 1988-05-17 Intravascular Surgical Instruments, Inc. Device for sealing percutaneous puncture in a vessel
US4852568A (en) * 1987-02-17 1989-08-01 Kensey Nash Corporation Method and apparatus for sealing an opening in tissue of a living being
US4863477A (en) * 1987-05-12 1989-09-05 Monson Gary L Synthetic intervertebral disc prosthesis
US4772287A (en) * 1987-08-20 1988-09-20 Cedar Surgical, Inc. Prosthetic disc and method of implanting
US4904260A (en) * 1987-08-20 1990-02-27 Cedar Surgical, Inc. Prosthetic disc containing therapeutic material
US5015247A (en) * 1988-06-13 1991-05-14 Michelson Gary K Threaded spinal implant
US4968298A (en) * 1988-09-12 1990-11-06 Michelson Gary K Interspace irrigator
US5192301A (en) * 1989-01-17 1993-03-09 Nippon Zeon Co., Ltd. Closing plug of a defect for medical use and a closing plug device utilizing it
US5061274A (en) * 1989-12-04 1991-10-29 Kensey Nash Corporation Plug device for sealing openings and method of use
US5192302A (en) * 1989-12-04 1993-03-09 Kensey Nash Corporation Plug devices for sealing punctures and methods of use
US5201729A (en) * 1990-01-12 1993-04-13 Laserscope Method for performing percutaneous diskectomy using a laser
US5092894A (en) * 1990-02-13 1992-03-03 Kenny Charles H Stabilized meniscus prosthesis
US5021059A (en) * 1990-05-07 1991-06-04 Kensey Nash Corporation Plug device with pulley for sealing punctures in tissue and methods of use
US5275616B1 (en) * 1990-10-01 1996-01-23 Quinton Instr Insertion assembly and method of inserting a vessel plug into the body of a patient
US5275616A (en) * 1990-10-01 1994-01-04 Quinton Instrument Company Insertion assembly and method of inserting a vessel plug into the body of a patient
US5114032A (en) * 1990-10-12 1992-05-19 Laidlaw Willam S Plug for sealing preservative in wood
US5123926A (en) * 1991-02-22 1992-06-23 Madhavan Pisharodi Artificial spinal prosthesis
US5195541A (en) * 1991-10-18 1993-03-23 Obenchain Theodore G Method of performing laparoscopic lumbar discectomy
US5222974A (en) * 1991-11-08 1993-06-29 Kensey Nash Corporation Hemostatic puncture closure system and method of use
US5411520A (en) * 1991-11-08 1995-05-02 Kensey Nash Corporation Hemostatic vessel puncture closure system utilizing a plug located within the puncture tract spaced from the vessel, and method of use
US5871525A (en) * 1992-04-13 1999-02-16 Ep Technologies, Inc. Steerable ablation catheter system
US5306254A (en) * 1992-10-01 1994-04-26 Kensey Nash Corporation Vessel position locating device and method of use
US5628756A (en) * 1993-01-06 1997-05-13 Smith & Nephew Richards Inc. Knotted cable attachment apparatus formed of braided polymeric fibers
US5720748A (en) * 1993-02-10 1998-02-24 Spine-Tech, Inc. Spinal stabilization surgical apparatus
US5830125A (en) * 1993-08-12 1998-11-03 Scribner-Browne Medical Design Incorporated Catheter introducer with suture capability
US5888224A (en) * 1993-09-21 1999-03-30 Synthesis (U.S.A.) Implant for intervertebral space
US6066154A (en) * 1994-01-26 2000-05-23 Kyphon Inc. Inflatable device for use in surgical protocol relating to fixation of bone
US6093207A (en) * 1994-03-18 2000-07-25 Pisharodi; Madhavan Middle expanded, removable intervertebral disk stabilizer disk
US5893890A (en) * 1994-03-18 1999-04-13 Perumala Corporation Rotating, locking intervertebral disk stabilizer and applicator
US5601556A (en) * 1994-03-18 1997-02-11 Pisharodi; Madhavan Apparatus for spondylolisthesis reduction
US6077268A (en) * 1994-03-29 2000-06-20 Sdgi Holdings, Inc. Variable angle surgical cable crimp assembly and method
US5888220A (en) * 1994-05-06 1999-03-30 Advanced Bio Surfaces, Inc. Articulating joint repair
US6248131B1 (en) * 1994-05-06 2001-06-19 Advanced Bio Surfaces, Inc. Articulating joint repair
US5549679A (en) * 1994-05-20 1996-08-27 Kuslich; Stephen D. Expandable fabric implant for stabilizing the spinal motion segment
US5571189A (en) * 1994-05-20 1996-11-05 Kuslich; Stephen D. Expandable fabric implant for stabilizing the spinal motion segment
US5674296A (en) * 1994-11-14 1997-10-07 Spinal Dynamics Corporation Human spinal disc prosthesis
US5865846A (en) * 1994-11-14 1999-02-02 Bryan; Vincent Human spinal disc prosthesis
US6156067A (en) * 1994-11-14 2000-12-05 Spinal Dynamics Corporation Human spinal disc prosthesis
US6001130A (en) * 1994-11-14 1999-12-14 Bryan; Vincent Human spinal disc prosthesis with hinges
US6077570A (en) * 1994-12-27 2000-06-20 Noritake Co., Ltd. Surface-decorated articles by noble metals utilizable in an electronic range method for producing same and liquid gold for insulating overglaze decoration
US5972031A (en) * 1995-02-14 1999-10-26 Biedermann; Lutz Space holder in particular for a vertebra or an intervertebral disk
US6206922B1 (en) * 1995-03-27 2001-03-27 Sdgi Holdings, Inc. Methods and instruments for interbody fusion
US5645565A (en) * 1995-06-13 1997-07-08 Ethicon Endo-Surgery, Inc. Surgical plug
US5728146A (en) * 1995-06-29 1998-03-17 The Procter & Gamble Company Thermal neck wrap having wing shape and means for position maintenance
US5595563A (en) * 1995-09-05 1997-01-21 Moisdon; Roger G. F. Method and apparatus for maintaining the position of body parts
US5599287A (en) * 1995-10-03 1997-02-04 Peach U.S., Inc. Hyperextension orthotic apparatus useful for treating pain associated with spinal disorders
US6610094B2 (en) * 1995-11-08 2003-08-26 Sulzer Orthopaedie Ag Intervertebral prosthesis
US5888223A (en) * 1995-12-08 1999-03-30 Bray, Jr.; Robert S. Anterior stabilization device
US5800550A (en) * 1996-03-13 1998-09-01 Sertich; Mario M. Interbody fusion cage
US5690674A (en) * 1996-07-02 1997-11-25 Cordis Corporation Wound closure with plug
US5964807A (en) * 1996-08-08 1999-10-12 Trustees Of The University Of Pennsylvania Compositions and methods for intervertebral disc reformation
US6126682A (en) * 1996-08-13 2000-10-03 Oratec Interventions, Inc. Method for treating annular fissures in intervertebral discs
US6095149A (en) * 1996-08-13 2000-08-01 Oratec Interventions, Inc. Method for treating intervertebral disc degeneration
US6547810B1 (en) * 1996-08-13 2003-04-15 Oratec Interventions, Inc. Method for treating intervertebral discs
US6122549A (en) * 1996-08-13 2000-09-19 Oratec Interventions, Inc. Apparatus for treating intervertebral discs with resistive energy
US5897593A (en) * 1997-03-06 1999-04-27 Sulzer Spine-Tech Inc. Lordotic spinal implant
US5800549A (en) * 1997-04-30 1998-09-01 Howmedica Inc. Method and apparatus for injecting an elastic spinal implant
US5957929A (en) * 1997-05-02 1999-09-28 Micro Therapeutics, Inc. Expandable stent apparatus and method
US6022376A (en) * 1997-06-06 2000-02-08 Raymedica, Inc. Percutaneous prosthetic spinal disc nucleus and method of manufacture
US6048346A (en) * 1997-08-13 2000-04-11 Kyphon Inc. Systems and methods for injecting flowable materials into bones
US5972015A (en) * 1997-08-15 1999-10-26 Kyphon Inc. Expandable, asymetric structures for deployment in interior body regions
US6066108A (en) * 1998-06-08 2000-05-23 Lundberg; Leslie C. Method and apparatus for treating and preventing sacroiliac joint injuries
US6530933B1 (en) * 1998-12-31 2003-03-11 Teresa T. Yeung Methods and devices for fastening bulging or herniated intervertebral discs
US6206923B1 (en) * 1999-01-08 2001-03-27 Sdgi Holdings, Inc. Flexible implant using partially demineralized bone
US6206921B1 (en) * 1999-02-22 2001-03-27 Peter A. Guagliano Method of replacing nucleus pulposus and repairing the intervertebral disk
US6056749A (en) * 1999-03-15 2000-05-02 Spineology, Inc. Method and device for fixing and correcting spondylolisthesis anteriorly
US6186518B1 (en) * 1999-04-12 2001-02-13 Sportsfx Suspension system for inline skates
US6146419A (en) * 1999-05-13 2000-11-14 Board Of Trustees Of The University Method for forming a hollow prosthesis
US6508839B1 (en) * 1999-08-18 2003-01-21 Intrinsic Orthopedics, Inc. Devices and methods of vertebral disc augmentation
US6482235B1 (en) * 1999-08-18 2002-11-19 Intrinsic Orthopedics, Inc. Devices and methods of vertebral disc augmentation
US6481440B2 (en) * 1999-09-13 2002-11-19 Medtronic, Inc. Lamina prosthesis for delivery of medical treatment
US6221109B1 (en) * 1999-09-15 2001-04-24 Ed. Geistlich Söhne AG fur Chemische Industrie Method of protecting spinal area
US6264695B1 (en) * 1999-09-30 2001-07-24 Replication Medical, Inc. Spinal nucleus implant
US7201774B2 (en) * 1999-10-08 2007-04-10 Ferree Bret A Artificial intervertebral disc replacements incorporating reinforced wall sections
US20040010308A1 (en) * 2000-01-18 2004-01-15 Mindguard Ltd. Implantable composite device and corresponding method for deflecting embolic material in blood flowing at an arterial bifurcation
US6805695B2 (en) * 2000-04-04 2004-10-19 Spinalabs, Llc Devices and methods for annular repair of intervertebral discs
US6402750B1 (en) * 2000-04-04 2002-06-11 Spinlabs, Llc Devices and methods for the treatment of spinal disorders
US7025771B2 (en) * 2000-06-30 2006-04-11 Spineology, Inc. Tool to direct bone replacement material
US20020022856A1 (en) * 2000-08-14 2002-02-21 Wesley Johnson Transverse cavity device and method
US6579291B1 (en) * 2000-10-10 2003-06-17 Spinalabs, Llc Devices and methods for the treatment of spinal disorders
US20020077701A1 (en) * 2000-12-15 2002-06-20 Kuslich Stephen D. Annulus-reinforcing band
US6712853B2 (en) * 2000-12-15 2004-03-30 Spineology, Inc. Annulus-reinforcing band
US20020147497A1 (en) * 2001-04-06 2002-10-10 Integrated Vascular Systems, Inc. Methods for treating spinal discs
US6562033B2 (en) * 2001-04-09 2003-05-13 Baylis Medical Co. Intradiscal lesioning apparatus
US20020173791A1 (en) * 2001-05-17 2002-11-21 Howland Robert S. Spinal fixation apparatus with enhanced axial support and methods for use
US20030032965A1 (en) * 2001-08-13 2003-02-13 Schneiderman Gary Andrew Surgical guide system for stabilization of the spine
US6736815B2 (en) * 2001-09-06 2004-05-18 Core Medical, Inc. Apparatus and methods for treating spinal discs

Cited By (47)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8821548B2 (en) 1997-01-02 2014-09-02 Warsaw Orthopedic, Inc. Spine distraction implant and method
US8740943B2 (en) 1997-01-02 2014-06-03 Warsaw Orthopedic, Inc. Spine distraction implant and method
US8128663B2 (en) 1997-01-02 2012-03-06 Kyphon Sarl Spine distraction implant
US8617211B2 (en) 1997-01-02 2013-12-31 Warsaw Orthopedic, Inc. Spine distraction implant and method
US8349013B2 (en) 1997-01-02 2013-01-08 Kyphon Sarl Spine distraction implant
US8568454B2 (en) 1997-01-02 2013-10-29 Warsaw Orthopedic, Inc. Spine distraction implant and method
US8568455B2 (en) 1997-01-02 2013-10-29 Warsaw Orthopedic, Inc. Spine distraction implant and method
US8888816B2 (en) 2003-05-22 2014-11-18 Warsaw Orthopedic, Inc. Distractible interspinous process implant and method of implantation
US20060241653A1 (en) * 2005-02-04 2006-10-26 Jones Daniel B Surgical hook instrument for gastric band closing
US8679161B2 (en) 2005-02-17 2014-03-25 Warsaw Orthopedic, Inc. Percutaneous spinal implants and methods
US8100943B2 (en) 2005-02-17 2012-01-24 Kyphon Sarl Percutaneous spinal implants and methods
US8097018B2 (en) 2005-02-17 2012-01-17 Kyphon Sarl Percutaneous spinal implants and methods
US8096994B2 (en) 2005-02-17 2012-01-17 Kyphon Sarl Percutaneous spinal implants and methods
US8221458B2 (en) 2005-02-17 2012-07-17 Kyphon Sarl Percutaneous spinal implants and methods
US8167890B2 (en) 2005-02-17 2012-05-01 Kyphon Sarl Percutaneous spinal implants and methods
US8157841B2 (en) 2005-02-17 2012-04-17 Kyphon Sarl Percutaneous spinal implants and methods
US8147516B2 (en) 2005-02-17 2012-04-03 Kyphon Sarl Percutaneous spinal implants and methods
US8591546B2 (en) 2005-03-21 2013-11-26 Warsaw Orthopedic, Inc. Interspinous process implant having a thread-shaped wing and method of implantation
US8147548B2 (en) 2005-03-21 2012-04-03 Kyphon Sarl Interspinous process implant having a thread-shaped wing and method of implantation
US8128702B2 (en) 2005-04-18 2012-03-06 Kyphon Sarl Interspinous process implant having deployable wings and method of implantation
US20110112577A1 (en) * 2005-04-18 2011-05-12 Kyphon Sarl Interspinous process implant having deployable wings and method of implantation
US8226653B2 (en) 2005-04-29 2012-07-24 Warsaw Orthopedic, Inc. Spinous process stabilization devices and methods
US8083795B2 (en) 2006-01-18 2011-12-27 Warsaw Orthopedic, Inc. Intervertebral prosthetic device for spinal stabilization and method of manufacturing same
US8163018B2 (en) 2006-02-14 2012-04-24 Warsaw Orthopedic, Inc. Treatment of the vertebral column
US8262698B2 (en) 2006-03-16 2012-09-11 Warsaw Orthopedic, Inc. Expandable device for insertion between anatomical structures and a procedure utilizing same
US20090275982A1 (en) * 2006-04-13 2009-11-05 Jean Taylor Device for treating vertebrae, including an interspinous implant
US8118844B2 (en) 2006-04-24 2012-02-21 Warsaw Orthopedic, Inc. Expandable device for insertion between anatomical structures and a procedure utilizing same
US8048118B2 (en) 2006-04-28 2011-11-01 Warsaw Orthopedic, Inc. Adjustable interspinous process brace
US8641762B2 (en) 2006-10-24 2014-02-04 Warsaw Orthopedic, Inc. Systems and methods for in situ assembly of an interspinous process distraction implant
US8118839B2 (en) 2006-11-08 2012-02-21 Kyphon Sarl Interspinous implant
US20080208205A1 (en) * 2007-02-26 2008-08-28 Paul Edward Kraemer Cable system and methods
US8105358B2 (en) 2008-02-04 2012-01-31 Kyphon Sarl Medical implants and methods
US8114136B2 (en) 2008-03-18 2012-02-14 Warsaw Orthopedic, Inc. Implants and methods for inter-spinous process dynamic stabilization of a spinal motion segment
US8317832B2 (en) 2008-03-18 2012-11-27 Warsaw Orthopedic, Inc. Implants and methods for inter-spinous process dynamic stabilization of spinal motion segment
US8114131B2 (en) 2008-11-05 2012-02-14 Kyphon Sarl Extension limiting devices and methods of use for the spine
US9414864B2 (en) 2009-04-15 2016-08-16 Warsaw Orthopedic, Inc. Anterior spinal plate with preformed drug-eluting device affixed thereto
US9078712B2 (en) 2009-04-15 2015-07-14 Warsaw Orthopedic, Inc. Preformed drug-eluting device to be affixed to an anterior spinal plate
US8372117B2 (en) 2009-06-05 2013-02-12 Kyphon Sarl Multi-level interspinous implants and methods of use
US8114132B2 (en) 2010-01-13 2012-02-14 Kyphon Sarl Dynamic interspinous process device
US8317831B2 (en) 2010-01-13 2012-11-27 Kyphon Sarl Interspinous process spacer diagnostic balloon catheter and methods of use
US8147526B2 (en) 2010-02-26 2012-04-03 Kyphon Sarl Interspinous process spacer diagnostic parallel balloon catheter and methods of use
US8840617B2 (en) 2010-02-26 2014-09-23 Warsaw Orthopedic, Inc. Interspinous process spacer diagnostic parallel balloon catheter and methods of use
US8591548B2 (en) 2011-03-31 2013-11-26 Warsaw Orthopedic, Inc. Spinous process fusion plate assembly
US8591549B2 (en) 2011-04-08 2013-11-26 Warsaw Orthopedic, Inc. Variable durometer lumbar-sacral implant
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WO2003055396A2 (en) 2003-07-10
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US20040172132A1 (en) 2004-09-02
JP2005528132A (en) 2005-09-22
WO2003055396A3 (en) 2003-12-04
EP1424949A2 (en) 2004-06-09
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AU2002365075A8 (en) 2003-07-15
WO2003055396A9 (en) 2004-05-13

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