Plates configured to rigidly fix fragments of a pars interarticularis to one another

An apparatus for securing a vertebra during healing of a fracture within a pars area of the vertebra is described. In certain embodiments, the apparatus is a plate that has an outer shape similar to a shape of a pedicle and/or lamina of the vertebra, and an inner section that facilitates access to the pars area when the plate is secured to the vertebra.

BACKGROUND

Spondylolysis is a condition in which a crack or fracture occurs in rear portions of vertebrae of a patient's spinal column. The spinal column includes a ring of bone located at the middle and posterior portion of the spinal column that protects the spinal cord within the spinal column. The specific area that becomes cracked or fractured is known as the pars interarticularis, or pars, and is the area between a pedicle and lamina of a vertebra.

The crack or fracture, often known as a “pars fracture” or “pars defect,” is generally caused by excessive or repeated strain to the pars area, although congenital effects may also cause a pars fracture. Spondylolysis commonly occurs in the lower back at lumbar vertebra number five (L5). For example, Spondyloysis may affect athletes that repeatedly bend backwards, such as athletes in gymnastics, karate, and/or football.

Under strain, a vertebra will initially add bone cells around an injured area. However, once the strain is too great, or too violent, a stress fracture will form in the vertebra. Such a fracture will often occur within the pars, and multiple and/or persistent fractures lead to a pars defect.

In some cases, a pars defect will occur on two sides of a vertebra. When this occurs, a vertebra may translate or move towards or away from neighboring vertebrae, leading to a condition know as Spondylolisthesis.

In order to illustrate where Spondyloysis occurs,FIGS. 1A-1Bdepict views of a pars fracture or defect within a vertebra.FIG. 1Aillustrates a side view100of vertebrae of a spinal column. Vertebra110is separated from vertebra120by a disk115. Vertebra110is a healthy vertebra, with a pedicle112and lamina114surrounding a pars area. In contrast, vertebra120in an unhealthy or affected vertebra, with a pedicle122and lamina124surrounding a pars fracture or defect125. That is, the pars fracture125occurs in vertebra120between a pedicle122and lamina124of the vertebra.

FIG. 1Bdepicts the pars defect from another view, namely from a top view130of the vertebra120. The pars fracture125is located between the pedicle122and the lamina124, and may cause separation of the lamina124from the pedicle122. Once separated, or partially separated, the lamina124may translate or move relative to the pedicle122, causing pain and/or other problems.

Conventional treatment of Spondyloysis, Spondylolisthesis, and other conditions due to fractures in the pars interarticularis of a vertebra include (1) the fusing together of vertebral segments surrounding a pars fracture or (2) the attempting to repair the pars fracture. However, there are disadvantages with conventional treatments.

Fusing vertebral segments together often leads to a loss of motion across an affected area, which may cause additional stress to surrounding vertebrae and accelerate arthritis and other conditions within the vertebrae.

Conventional repair procedures, such as using wires or screws to hold vertebral fragments together, suffer from high failure rates, because the procedures often do not maintain fractured vertebral fragments in proper position during a bone grafting or other treatments.

In some cases, plates are used during surgical repairs within the spine. For example, a first reference, U.S. Published Patent Application No. 2010/0082067, to Kondrashov, entitled “System and Method to Stabilize a Spinal Column Including a Spinolaminar Locking Plate,” discloses an anchoring plate adapted to stabilize a spinal column. The anchoring plate may have a shape that conforms to a lamina of a targeted vertebra, but is used and configured in order to stabilize a spinal column and reduce compression of spinal nerves.

As another example, a second reference, U.S. Published Patent Application No. 2005/0119657, to Goldsmith, entitled “Facet Triangle Spinal Fixation Device and Method of Use,” discloses a device adapted to bilaterally secure two vertebrae together.

In both examples, the disclosed plates are generally utilized to stabilize a spinal column and proximate verterbrae within a spinal column.

While aforementioned medical devices and treatments are generally suitable for a particular purpose, such devices are not sufficiently suitable for the purpose discussed in the present invention. Thus, it is clear that there exists a need in the art for a treatment device that overcomes these problems and progresses the state of the art, as well as one that provides there additional benefits enumerated in the present application.

SUMMARY OF THE INVENTION

In view of the foregoing disadvantages inherent in the art, in accordance with a first preferred embodiment of the present invention, an apparatus configured and/or adapted to attach to a pars area of a vertebra is described. In some examples of the present invention, the plate is formed of a shape similar to a shape of a pedicle and/or lamina of the vertebra.

That is, in some embodiments, the plate may be configured to include an anatomical geometry similar to a geometry of an anatomical region in which the plate is attached during rigid fixation of a pars fracture. The geometry, or shape, may be similar to a geometry of a pedicle, a geometry of a lamina, or a geometry of both the pedicle and the lamina surrounding a pars fracture.

As mentioned, it is contemplated by the present disclosure that the plate may include an outer section that conforms to a shape of an attachment region, such as a pedicle and/or lamina, and an inner section that facilitates access to a fractured area when the plate is attached to a vertebra.

Furthermore, it is contemplated by the present disclosure that the plate include or be part of a support structure, and may include a fragment fixation section and a support section, whereby the plate provides for the rigid fixation of vertebral fragments and for the support of an affected vertebra.

Thus, in certain embodiments, the plate is configured and/or adapted to facilitate attachment to a pars area of a vertebra to provide rigid fixation during bone grafting and subsequent healing of a fracture within the pars area, while providing other inherent benefits.

By using the plates described herein, the success of repairing pars fractures and/or pars defects may be increased with respect to conventional approaches or treatment techniques.

Thus, there has been summarized and outlined, generally in broad form, a plurality of the most important features of the present invention. While this summary is presented so that the novelty of the present contribution to the related art may be better appreciated, it will further be apparent that additional features of the invention described hereinafter (which will form the subject matter of the claims appended hereto) will further define the scope, novelty, and in certain instances the improvements upon any existing art. The following description provides specific details for a thorough understanding of, and enabling description for, various examples of the technology. One skilled in the art will understand that the technology may be practiced without many of these details and it is to be readily understood that the invention presented herein is not limited in its application to the details of construction and to the arrangements of the components set forth in the following description or illustrated in the various figures integrated and categorized herein. For example, in some instances, well-known structures and functions have not been shown or described in detail to avoid unnecessarily obscuring the description of the examples of the technology. It is intended that the terminology used in the description presented below be interpreted in its broadest reasonable manner, even though it is being used in conjunction with a detailed description of certain examples of the technology. Although certain terms may be emphasized below, any terminology intended to be interpreted in any restricted manner will be overtly and specifically defined as such in this Detailed Description section. Those skilled in the art will appreciate that the disclosure of the present invention may readily be utilized as a basis for the designing of other similar structures, methods and systems for carrying out the various purposes and objectives of the present invention. Thus, the claims as set forth shall allow for such equivalent constructions insofar as they do not depart from the spirit and scope of the present invention as described herein.

DETAILED DESCRIPTION OF THE PRESENT INVENTION

A detailed illustrative embodiment of the present invention is disclosed herein. However, techniques of manufacture and resulting structures in accordance with the present invention may be embodied in a wide variety of forms and modes, some of which may be quite different from those in the disclosed embodiment. Consequently, the specific structural details disclosed herein are merely representative, yet in that regard, they are deemed to afford the best embodiment for purposes of disclosure and to provide a basis for the claims herein which define the scope of the present invention. The following presents a detailed description of several examples of the present invention.

Moreover, well known methods, procedures, and substances for both carrying out the objectives of the present invention and illustrating the preferred embodiment are incorporated herein but have not been described in detail as not to unnecessarily obscure novel aspects of the present invention.

The apparatus or device described herein (e.g., “pars plate”) is a novel device configured to attach to a vertebra to assist during healing of a pars fracture of the vertebra. The pars plate may be formed in a shape similar to the vertebra or section of the vertebra in order to facilitate attachment and use within a compact and complexly structured area of the spinal column, and so on. Such a device may provide an alternative path for the treatment of pars fractures, among other benefits.

Turning toFIG. 2, provided is a perspective view of a plate configured to be attached to a pars area of a vertebra. The plate200includes a pedicle section210having a pedicle attachment hole212and a lamina section220having lamina attachment holes222and spinous process attachment holes224. The attachment holes212,222,224may be configured to receive screws or other attachment devices that attach the plate200to a vertebra.

The plate200also includes an open section215, which provides access to a fracture when the plate is attached to a pars area. The open section215may be configured as shown in the Figure, or may include an opening of various sizes and/or shapes, depending on the size and/or shape of the vertebra, the size and/or shape of the affected area of the vertebra, the size and/or shape of a fracture within the pars area, and so on.

The pedicle section210and lamina section220of the plate200may be formed having an I-beam cross section, and are adapted to conform to the shape of the pars area in which the plate200is attached. The shape of the plate200will now be discussed with respect to the shape of a vertebra in which the plate200is attached.

FIG. 3is a perspective view300of a plate attached to a pars area of a vertebra340. The vertebra340includes a pedicle350and a lamina360, which includes a spinous, or transverse, process365. The depicted vertebra has a fracture370in the pars area between the pedicle350and the lamina360. When fractured, the vertebra340is fragmented into a vertebral fragment380that includes the pedicle350, and a vertebral fragment390that includes the lamina360.

A plate310used for rigid fixation of the fracture370is attached to the vertebra in order to rigidly fix the vertebral fragment380containing the pedicle350to the vertebral fragment390containing the lamina360in order to facilitate successful healing of the fracture370.

The plate310includes a pedicle section320that is of a shape similar to the shape of the pedicle350. The pedicle section320of the plate310includes a hole or opening that enables a screw322to fix the pedicle section320of the plate310to the pedicle350. Additionally, in some examples the plate310may be attached to the vertebral fragment380at various different areas of the vertebral fragment380in addition to the manner depicted.

As shown, the pedicle section320of the plate310is shaped and/or is formed having a geometry that is similar to a shape and/or anatomical geometry of the pedicle350. Shaping the pedicle section320in such a manner enables the plate310to conform to the area in which it is fixed, which allows for the plate to be placed within such a dense, complex area of a spinal column, among other benefits.

The plate310also includes a lamina section330that is of a shape similar to a shape and/or anatomical geometry of the lamina360. The lamina section330of the plate310includes one or more attachment sections, includes attachment sections that facilitate using lamina screws332to attach the plate310to the lamina360, attachment sections that facilitate using spinous process screws334to attach the plate310to the spinous process365, and so on. Additionally, in some examples the plate310may be attached to the vertebral fragment390at various different areas of the vertebral fragment390in addition to the manner depicted.

As shown, the lamina section330of the plate310is shaped and/or is formed having a geometry that is similar to a shape and/or geometry of the lamina360and/or spinous process365. Shaping the lamina section330in such a manner enables the plate310to conform to the area in which it is fixed, which allows for the plate to be placed within such a dense, complex area of a spinal column, among other benefits.

In certain embodiments, the plate310includes an opening315or inner portion that provides access to the fracture370within the pars area of the vertebra340. That is, the plate310may be configured to give surgeons access to a fracture370in order to perform bone grafting procedures while the plate310rigidly maintains the vertebral fragments together, may be configured to allow for local vascular in-growth of the fracture370, may be configured to enable access of the fracture370for post operation CT Scan imaging procedures, and so on.

Thus, in certain embodiments, the plate310includes an outer portion that is shaped similar to areas of a vertebra in which the plate attaches and is shaped similar to the areas of the vertebra in which the plate attaches, and an inner portion that enables access to a fractured or repaired area of the vertebra.

Determining the Size and/or Shape of the Pars Plate

In addition to conforming to the shape of the attachment areas of a vertebra, the plate, in certain embodiments, may also be formed of a size that conforms to the size of the attachment areas. In some cases, plates of differing sizes, such as sizes based on anatomical averages of sizes of the vertebra, may be formed. A left plate may be formed, a right plate may be formed, a bilateral plate may be formed, and so on. However, in some cases, a more specific sized and/or shaped plate may be required.

In certain embodiments, the size and shape of a plate may be determined based on images or other information associated with the area in which the plate is to be attached.FIG. 4is a flow diagram illustrating a routine400for configuring and manufacturing a plate used to rigidly fix a pedicle to a lamina.

FIG. 4and the following discussion provide a brief, general description of a suitable computing environment in which a plate configuration system can be implemented. Although not required, aspects of the system are described in the general context of computer-executable instructions, such as routines executed by a general-purpose computer, e.g., a server computer, wireless device, or personal computer. Those skilled in the relevant art will appreciate that the system can be practiced with other communications, data processing, or computer system configurations, including: Internet appliances, network PCs, mini-computers, mainframe computers, medical computing devices, and the like. Indeed, the terms “computer” and “computing system” are generally used interchangeably herein, and refer to any of the above devices and systems, as well as any data processor.

Aspects of the system can be embodied in a special purpose computer or data processor that is specifically programmed, configured, or constructed to perform one or more of the computer-executable instructions or routines explained in detail herein. Aspects of the system can also be practiced in distributed computing environments where tasks or modules are performed by remote processing devices, which are linked through a communications network, such as a Local Area Network (LAN), Wide Area Network (WAN), Storage Area Network (SAN), Fibre Channel, or the Internet. In a distributed computing environment, program modules may be located in both local and remote memory storage devices.

Aspects of the system may be stored or distributed on computer-readable media, including magnetically or optically readable computer discs, hard-wired or preprogrammed chips (e.g., EEPROM semiconductor chips), nanotechnology memory, biological memory, or other tangible data storage media. Indeed, computer implemented instructions, data structures, screen displays, and other data under aspects of the system may be distributed over the Internet or over other networks (including wireless networks), on a propagated signal on a propagation medium (e.g., an electromagnetic wave(s), a sound wave, etc.) over a period of time, or they may be provided on any analog or digital network (packet switched, circuit switched, or other scheme). Those skilled in the relevant art will recognize that portions of the system reside on a server computer, while corresponding portions reside on a client computer, and thus, while certain hardware platforms are described herein, aspects of the system are equally applicable to nodes on a network.

In step410, a system, such as a plate configuration system, receives an image or images of an affected area of a vertebra. The received images may be two-dimensional and/or three-dimensional images, providing information about images areas in all dimensions.

For example, the image may be a partial or full image of a vertebra, a partial or full image of a lamina area, a partial or full image of a pedicle area, a partial or full image of a fracture area, a partial or full image of a pars area, and so on. The image may be taken using a number of different imaging techniques, such as radiography (e.g., x-rays), X-Ray computed tomography (e.g. CT Scans), and so on.

In step420, the system extracts information from the received image or images. For example, the system may extract information associated with sizes of areas of an affected vertebra, such as sizes of the vertebra, sizes of a pedicle, sizes of a lamina, sizes of a spinous process, sizes of the fractures area, sizes of the pars area, sizes associated with distances between the vertebra and other surrounding vertebrae, and so on. The system may extract other information, such as information associated with a shape of various areas of the vertebra, information associated with a bone density of various areas of the vertebra, and so on.

In step430, the system configures a plate to be attached to the vertebra based on the extracted information. For example, the system may generate a schematic of a plate based on the size and/or shape information extracted from the received images.

In step440, the system manufactures a plate according to the determined configuration. For example, the system manufactures a plate that is based on the generated schematic. Thus, the system may be utilizes to form plates that are optimizes in size and/or shape to the area in which they are to be attached. Such optimization may facilitate the use of plates in virtually every patient that suffers from Spondylolysis, such as very large or small patients, patients that have abnormal spinal column geometries, patients that have abnormal vertebra geometries, and so on.

Thus, in certain embodiments, the plates described herein further and expand upon the state of the art by providing devices that rigidly fix vertebral fragments together, improving over the conventional practice of using wires or other unsuitable fixation practices.

Other Plate Configurations

In alternative embodiments, the pars plate, such as plates200and310, may be formed in a variety of different configurations.FIGS. 5A-5Care perspective views of various configurations of plates to be attached to a pars area of a vertebra.

FIG. 5Adepicts a configuration in which a plate500is configured to run along a bottom portion of a lamina. The plate500includes a pedicle section510, a lamina section520, and an opening505or inner section. The pedicle section510includes or is shaped to include a hole512that facilitates use of a screw to attach the plate500to a pedicle of a vertebra. The lamina section includes lamina holes522and spinous process holes524that facilitate use of screws to attach the plate500to a lamina of a vertebra. The plate500is configured to provide an opening505or access area, which enables a fracture to be accessible when the plate500is attached to a vertebra.

FIG. 5Bdepicts a configuration in which a plate530is configured to run along a top portion of a lamina. The plate530includes a pedicle section540, a lamina section550, and an opening535or inner section. The pedicle section540includes or is shaped to include a hole542that facilitates use of a screw to attach the plate530to a pedicle of a vertebra. The lamina section includes lamina holes552and spinous process holes554that facilitate use of screws to attach the plate530to a lamina of a vertebra. The plate530is configured to provide an opening535or access area, which enables a fracture to be accessible when the plate530is attached to a vertebra.

FIG. 5Cdepicts a configuration in which a plate560is formed of two pieces, one formed to run along a bottom portion of a lamina, and one formed to run along a top portion of the lamina. The plate560includes an upper piece570having a pedicle section574that includes or is shaped to include an attachment point that facilitates use of a screw to attach the upper piece570to a pedicle of a vertebra, and a lamina section that includes lamina holes572that facilitate use of screws to attach the upper piece570to a lamina of a vertebra.

The plate560also includes a lower piece580having a pedicle section584that includes or is shaped to include an attachment point that facilitates use of a screw to attach the lower piece580to a pedicle of a vertebra, and a lamina section that includes lamina holes582that facilitate use of screws to attach the lower piece580to a lamina of a vertebra.

The plate560is configured to provide an opening565or access area, which enables a fracture to be accessible when the plate560is attached to a vertebra.

Of course, one of ordinary skill in the art will realize that other configurations may be utilized when forming plates to be attached to rigidly fix vertebral fragment together when repairing pars fractures. For example, plates having multiple (e.g., two or more) pieces may be formed, plates having various cross-sectional configurations may be formed, plates having various internal opening layouts may be formed, plates configure to treat dual fractures may be formed, and so on.

In certain embodiments, a plate may be part of an integrated support device within the spinal column. That is, the plate may be configured to attach to vertebral fragments associated with a pars fracture as well as surrounding vertebrae, in order to provide additional fixation during the healing process of the fracture, among other things.

FIG. 6depicts a view600of a support plate630that provides both fixation of vertebral fragments and attachment between an affected vertebra and surround vertebrae. The support plate630includes a fragment fixation section632and a support section634. The support plate630utilizes the fragment fixation section632, as described herein, to rigidly fix vertebral fragments of a vertebra620that contains a fracture625. Furthermore, the support plate630includes a support section634that fixes the affected vertebra620to a surrounding vertebra610via the support plate, providing bilateral support to the affected vertebra while rigidly fixing the vertebral fragments, among other things.

The support section634may include an attachment portion636that attaches the plate630, via the support section634to surrounding vertebrae. For example, the attachment portion636may include an opening that enables a screw to attach the support section634to vertebra610, may include a wire or wiring mechanism that attaches the support section634to vertebra610, may include a portion that facilitates fusion of the vertebra610to the plate630or to affected vertebra620, and so on.

Thus, in certain embodiments, the support plate600furthers and expands upon the state of the art by providing a device that both rigidly fixes vertebral fragments together, improving over the conventional practice of using wires, and attaches an affected vertebra to surrounding vertebrae, improving over the conventional practice of fusing vertebrae together.

While certain aspects of the device are presented below in certain claim forms, the inventor contemplates the various aspects of the system in any number of claim forms. Accordingly, the inventor reserves the right to add additional claims after filing the application to pursue such additional claim forms for other aspects of the system.