Abstract:
An improve spinal surgical implant used primarily in the posterior aspect of the spinal column for spinal reconstruction; revision surgery; deformity correction; and/or tumor surgery and/or trauma surgery of the cervical, thoracic and/or and lumbo-sacral spine.

Description:
[0001]     The present invention claims priority on co-pending U.S. Provisional Application Ser. No. 60/674,426 filed Apr. 25, 2005, which is incorporated herein by reference.  
         [0002]     The present invention is directed to implants, more particularly to spinal implants, and even more particularly to a device and method for using a device that is designed to secure to the spinal column. 
     
    
     BACKGROUND OF THE INVENTION  
       [0003]     The human spine is made up of a column of thirty-three bones and their adjoining structures. The bodies of these vertebrae are connected by anterior and posterior ligaments and by discs of fibrocartilage generally known as intervertebral discs. These discs are positioned between opposite faces of adjacent vertebral bodies. This column of vertebrae and intervertebral discs forms a central axis that supports the head and torso. These vertebrae also enclose an opening through which the spinal cord passes.  
         [0004]     One of the most costly health problems in society involves back pain and pathology of the spine. These problems can affect individuals of all ages and can result in great suffering to victims. Back pain can be caused by several factors such as congenital deformities, traumatic injuries, degenerative changes to the spine, and the like. Such changes can cause painful excessive motion, or collapse of a motion segment resulting in the contraction of the spinal canal and compression of the neural structures, causing debilitating pain, paralysis or both, which in turn can result in nerve root compression or spinal stenosis.  
         [0005]     Nerve conduction disorders can also be associated with intervertebral discs or the vertebrae themselves. One such condition is herniation of the intervertebral disc, in which a small amount of tissue protrudes from the sides of the disc into the foramen to compress the spinal cord. A second common condition involves the development of small bone spurs, termed osteophytes, along the posterior surface of the vertebral body, again impinging on the spinal cord.  
         [0006]     Upon identification of these abnormalities, surgery may be required to correct the problem. For those problems associated with the formation of osteophytes or herniations of the intervertebral disc, one such surgical procedure is intervertebral discectomy. In this procedure, the involved vertebrae are exposed and the intervertebral disc is removed, thus removing the offending tissue or providing access for the removal of the bone osteophytes. A second procedure, termed a spinal fusion, may then be required to fix the vertebrae together to prevent movement and maintain a space originally occupied by the intervertebral disc. Although this procedure may result in some minor loss and flexibility in the spine due to the relatively large number of vertebrae, the minor loss of mobility is typically acceptable.  
         [0007]     For the replacement of a vertebra of the human spinal column, for the distraction of the spinal column, for the stabilization of the vertebrae and likewise, it is known to apply pedicle screws. The pedicle screw is screwed into the pedicle of the vertebra and the head of the pedicle screw is connected to suitable provisions, for example to a stabilizing system, to distraction rods, etc. During the treatment of the spine, the pedicle screw is generally first rotated into the pedicle. Subsequently, the insertion of the rod is effected.  
         [0008]     A standard pedicle screw assembly comprises a screw having an externally threaded stem having in turn a head provided with parts allowing it to be secured to one end of a distraction rod. Typically two such pedicle screws are inserted into respective vertebrae and are secured to a rod to distract and/or stabilize a spinal column after, for instance, a disk operation. One commonly used pedicle screw is disclosed in German Patent No.  4 , 107 , 480 , which is incorporated herein by reference, and includes a head that has a pair of outwardly projecting parallel ridges with overhanging inner edges. A cap formed with a pair of complementary inwardly open slots fits with these ridges. The pedicle screw is threaded into the vertebrae, an end of the rod is fitted to its outer end, the cap is then slid transverse to the pedicle screw axis and parallel to the rod, over the rod to capture it, and finally a cap screw threaded into the cap and tightened to press the rod down against the head of the pedicle screw and thereby fix the rod, cap, and screw together. Many other pedicle screw designs have been developed to simplify the insertion of the pedicle screw into the pedicle, and/or to reduce damage to the pedicle screw and/or the pedicle during surgery. Some of these pedicle screw designs are disclosed in U.S. Pat. Nos.  5 , 882 , 350 ;  5 , 989 , 254 ;  5 , 997 , 539 ;  6 , 004 , 322 ;  6 , 004 , 349 ;  6 , 017 , 344 ;  6 , 053 , 917 ;  6 , 056 , 753 ,  6 , 083 , 227 ;  6 , 113 , 601 ;  6 , 183 , 472 ;  6 , 224 , 596 ;  6 , 368 , 319 ;  6 , 375 , 657 ; and  6 , 402 , 752 ; and the patents cited and disclosed in such patents. All these designs of pedicle screws are incorporated herein by reference.  
         [0009]     After the pedicle screw is inserted in the pedicle, the bone around the pedicle screw must heal to properly secure the pedicle screw in the bone. Any infection that occurs around the pedicle screw can slow the healing process and/or damage the bone around the pedicle screw thereby weakening the connection between the bone and pedicle screw. Typically, a patient is given antibiotics for several days after the surgery to reduce the occurrence of infection about the pedicle screw. The patient may also receive electrical stimulation during surgery to promote the healing process of the bone about the pedicle screw. Both of these techniques have improved the post-operative success of the surgical procedure; however, improved success rates are still needed.  
         [0010]     Although the use of pedicle screws are successfully used in a variety of surgical techniques, there are instances wherein the use of the pedicle screw may unnecessarily damage the bone. For instance, a particular vertebrae may be too small, too fragile, partially damaged, etc. to accept a pedicle screw. As such, a particular spinal procedure cannot be performed by use of pedicle screws. Situations also arise in that the orientation of the pedicle screw in the vertebrae is awkward, thereby complicating a spinal procedure that involves the connection of one or more other components to the pedicle screw.  
         [0011]     In view of these situations, there is a need for a device that can be secured to one or more vertebrae which device does not need to damage or otherwise penetrate into a vertebra and which device can be used to connect to other components of a stabilizing system, to distraction rods, etc.  
       SUMMARY OF THE INVENTION  
       [0012]     The present invention is directed to a spinal implant, and particularly to a spinal implant used primarily in the posterior aspect of the spinal column for spinal reconstruction; revision surgery; deformity correction; and/or tumor surgery and/or trauma surgery of the cervical, thoracic and/or and lumbo-sacral spine surgery; however, it will be appreciated that the implant can be used in other regions of the spine and/or for use in other or additional applications.  
         [0013]     In one non-limiting aspect of the invention, the spinal implant is designed to secure to one or more spinal vertebrae without having to penetrate or substantially penetrate into the vertebrae. In one non-limiting embodiment of the invention, the spinal implant is configured to at least partially clamp to one or more portions of a vertebra. This clamping configuration enables the spinal implant to be connected to one or more vertebrae without having to penetrate into the one or more vertebrae. As such, the spinal implant does not require drilling of insertion holes into the vertebrae, which insertion holes can i) cause damage to the vertebrae (e.g., fracturing and/or splitting of the vertebrae, etc.), and ii) require healing of the vertebrae about the device that has been inserted into the hole in the vertebrae prior to securing a stabilizing system, to distraction rods, etc. to the inserted device, thereby increasing procedure times and/or inconvenience to the patient.  
         [0014]     In one non-limiting aspect of the present invention, the spinal implant is in the form of a “clamp” which is designed to be applied to the posterior elements of one or more spinal vertebrae. In one non-limiting embodiment of the invention, the spinal implant includes two or more legs or arms that are used to at least partially secure the spinal implant to one or more vertebra. One or more of the arms or legs can be adjustable; however, this is not required. One or more of the arms or legs can include a grasping portion or foot portion that is used to at least partially engage and secure at least a portion of the arm or leg to the one or more vertebra. In one non-limiting aspect of this embodiment, the spinal implant includes two arms or legs. In another and/or alternative non-limiting aspect of this embodiment, the grasping portion includes an angulated section at an end portion of one or more of the arms or legs. This angulated section deviates by at least about 20° from the planar, generally a planar or slightly curved profile of the arm or legs of the spinal implant. In one non-limiting design, the angulated section is designed to at least partially hook onto a portion of one or more vertebra. In still another and/or alternative non-limiting aspect of this embodiment, one or more of the arms or legs can include one or more engaging structures (e.g., teeth, ribs, non-smooth surfaces, etc.) that are used to facilitate in engaging a portion of the arms or legs to a portion of one or more vertebra.  
         [0015]     In another and/or alternative non-limiting aspect of the present invention, the spinal implant is designed to be at least partially clamped within the interval between the superior margin of the lamina of a vertebra and the lateral margin of the pars interarticularis portion of the vertebra. In one non-limiting embodiment of the invention, the spinal implant is designed to span at least a portion of the length of the pars interarticularis of the vertebra. In one non-limiting aspect of this embodiment, the spinal implant is designed to span a portion of the length of the pars interarticularis of the vertebra. In another non-limiting aspect of this embodiment, the spinal implant is designed to span the full length of the pars interarticularis of the vertebra. In still another non-limiting aspect of this embodiment, the spinal implant is designed to span more than one vertebra (e.g., two vertebra, three vertebra, etc.). In yet another non-limiting aspect of this embodiment, the spinal implant is designed to be formed into a pedicle “claw” to enable the spinal implant to be affixed to a vertebra if the lamina or pars has been removed. In this non-limiting design, the spinal implant can create a different configuration of the pedicle “clamp” with the clamping of the superior and inferior walls of the pedicle. In accordance with these non-limiting aspects of the invention, the spinal implant is designed to provide a strong and secure permanent or temporary fixation to the posterior elements of a vertebra or to multiple vertebrae. The spinal implant is also designed to allow for one or more attachments to be placed upon and/or connected to the spinal implant, thus functioning in part as a platform and/or docking station for one or more other components that are used to address one or more spinal issues and/or one or more issues located near the spine.  
         [0016]     In still another and/or alternative non-limiting aspect of the invention, the spinal implant is designed to simplify spinal procedures and/or facilitate the improvement of the patient&#39;s health in that the spinal implant can facilitate in partially replacing or eliminating the need for lamina and transverse process hooks, pedicle screws, sub-laminar wires, and/or spinous process buttons. The spinal implant is believed to be especially useful in medical procedures involving the young and aging spine alike since the spinal implant can improve and, in most cases, provide a strong, if not the strongest, fixation possible in comparison to other devices which can have a higher percentage of failure.  
         [0017]     In yet another and/or alternative non-limiting aspect of the invention, the spinal implant can be used in a variety of spinal procedures. A few non-limiting examples of the potential use and applications of the spinal implant include, but are not limited to, Scoliosis surgery (e.g., Pediatric, Adult, Geriatric (i.e., “Aged”), Degenerative, Post Surgery, etc.); Degenerative Spine Conditions; Spine Fractures; Tumors; Small Pedicles that cannot be or are difficult to be accessed by a pedicle screw; Repair of Spondylolysis (Pars Defects); and/or Bone Anchor for an “artificial facet” type implant. As can be appreciated, other or additional applications of the spinal implant can be appreciated.  
         [0018]     In yet another and/or alternative non-limiting aspect of the invention, the spinal implant can include one or more of the following components: 1) a fixed or adjustable medial lamina clamp and/or foot (e.g., first clamp arm, etc.); 2) an adjustable hinged (or otherwise articulated) pars clamp and/or foot which (e.g., a lateral pars clamp and/or foot, etc.) (e.g., second clamp arm, etc.); 3) a set-screw and/or locking nut or other device or mechanical means for adjustments and/or tightening one or more components of the spinal implant; 4) an integral base (e.g., arm hub, etc.) which can include one or more docking stations—which may be threaded and/or constructed with another coupling device or mechanism; 5) one or more fixed and/or variable motion attachments that are at least partially designed to connected to one or more other components of a stabilizing system and/or other type of treatment system (e.g., modular heads; one or more attachment sites for rods, plates, and/or medication delivery devices, etc.); 6) one or more smooth surfaces, 7) one or more surfaces that are coated with one or more materials (e.g., medicines and/or drugs, adhesives, proteins, cells, antibodies, etc.); 8) one or more porous regions to allow for bone ingrowth into the clamp to facilitate in providing a permanent bond between the implant the spinal lamina and/or to allow for fluid flow (e.g., body fluids, medicine, drugs, cells, etc.) into and/or out of the spinal implant; and/or 9) one or more cross links connect to at least one side of a vertebra to another vertebra (e.g., force coupling) by use of one or more fixed or flexible couplers (i.e., cross links could connect single or multiple levels of vertebral bodies, etc.).  
         [0019]     In still yet another and/or alternative non-limiting aspect of the invention, the spinal implant can be manufactured in variable sizes to better meet the needs of the particular patient&#39;s anatomy.  
         [0020]     In a further and/or alternative non-limiting aspect ofthe present invention, the spinal implant can be constructed of a single material or from a combination of materials. Non-limiting materials that can be used to fully or partially form the spinal implant include, but are not limited to, metals, alloys, ceramics, polymers, plastics, memory metals, HA, fiber reenforced materials, mammalian bone, cartilage and/or other appropriate materials. The material used to form one or more portions of the spinal implant can be porous or non-porous, coated and/or non-coated. The material can include a bioactive and/or bioinert material. The material can be bioabsorbable or non-bioabsorbable. The material can include one more medicines or drugs. The spinal implant can also or alternatively include one or more drugs, medicine and/or other osteobiologics (e.g., BMPs, bone marrow concentrate, fillers, medicine, one or more biological agents, substitutes, etc.). The one or more drugs, medicine and/or other osteobiologics can thus form at least a portion of the spinal implant, be imbedded in at least a portion of the spinal implant and/or be coated on at least a portion of the spinal implant. As can be appreciated, different concentrations and/or different types of one or more drugs, medicine and/or other osteobiologics can be located on different portions of the spinal implant.  
         [0021]     In yet a further and/or alternative non-limiting aspect of the present invention, the spinal implant can be designed to permanently or detachably connect to a “Lamina Plate.” A Laminal Plate can be attached so as to replace or reconstruct the lamina or posterior wall of the spinal column. Such a Lamina Plate can include one or more smooth and/or porous regions, and can, among other goals, connect the spinal implant (e.g., right side, left side, etc.).  
         [0022]     In still yet another and/or alternative non-limiting aspect of the present invention, the spinal implant can be constructed with low profile features so as to inhibit or prevent possible injury and/or damage to neurological elements adjacent or near the spinal implant.  
         [0023]     In a further and/or alternative non-limiting aspect of the present invention, the spinal implant can be used in conjunction with innovative instrumentation to facilitate the preparation of the surgical site, the insertion of the spinal implant, the revisitation to the surgical site, and/or the attachment/disconnection of one or more components to the spinal implant device. Non-limiting examples of such innovate instruments include, but are not limited to, 1) An Inserter—Manipulator—Tightener which can be a single instrument or a set of instrument, 2) Exposure instrument(s), 3) Site prep instrument(s), 4) Inserter/remover instrument(s), and/or 5) Trial or sizing device(s). As can be appreciated, other or additional instruments can be used in conjunction with the spinal implant.  
         [0024]     In still a further and/or alternative non-limiting aspect of the present invention, the spinal implant can include a “Third Foot” attachment for 3-point fixation to one or more vertebra. Such a “Third Foot” arrangement can also be referred to as “The Long Arm” attachment of the spinal implant. In one non-limiting embodiment of the invention, the third arm is designed to be adjustably positionable. In this particular aspect of the invention, the third arm is able to be moveably positioned to a desired location to facilitate in securing the spinal implant to one or more vertebra. The length of the third can be selected so that the third is securable to the same vertebra as the first and second arm, or the third arm can have a length to secure to a vertebra other than the vertebra that the first and second arm are secured to. In another and/or alternative embodiment, third arm can be designed to be secured or locked in positioned once the third arm is properly oriented. The locking or securing arrangement can be accomplished by a variety of means such as, but not limited to, bolts, locking teeth, clamp, ribs, slots, screws, pins, etc.  
         [0025]     In yet a further and/or alternative non-limiting aspect of the present invention, the spinal implant can be configured so as to address the various needs of different portions of the mammalian spine, including but not limited to, cervical, thoracic, and lumbar-sacral” versions.  
         [0026]     In still yet a further and/or alternative non-limiting aspect of the present invention, the spinal implant can be designed to span more than one segment if one or more pars has been removed.  
         [0027]     In another and/or alternative non-limiting aspect of the present invention, the spinal implant can include a cap and/or other device to cover one or more openings in the spinal implant to 1) facilitate the revisitation to the spinal implant, 2) for the purpose of changing the one or more attachments and/or attachment methodology on the spinal implant, and/or 3) inserting and/or removing one or more drugs, medication, etc. in one or more cavities in the spinal implant. The cap, when used, can be made of one or more materials including, but not limited to, plastic, metal, etc. The cap can be biodegradable or non-biodegradable. The cap can include a threaded and/or other connection arrangement to permanently or removably secure the cap to the spinal implant.  
         [0028]     In still another and/or alternative non-limiting aspect of the present invention, the spinal implant can be designed so that a surgical site, the vertebra and/or the spinal implant can be re-visited from time to time as necessary. This capability can be instrumental in the future success of motion preservation implants (such as the concept of an artificial facet which would be designed and manufactured to be attached to a vertebra).  
         [0029]     In yet another and/or alternative non-limiting aspect of the present invention, the spinal implant can be designed to attach to the laminar portion of a vertebra for purposes of surgical treatment of a spinal condition.  
         [0030]     In still yet another and/or alternative non-limiting aspect of the present invention, the spinal implant can be designed to attach to two adjacent vertebrae for purposes of surgical treatment of a spinal condition.  
         [0031]     In a further and/or alternative non-limiting aspect ofthe present invention, the spinal implant can be designed to attach to two vertebrae’ laminae.  
         [0032]     In still a further and/or alternative non-limiting aspect of the present invention, the spinal implant can be designed to clamp onto at least a portion of the vertebral body by gripping onto the natural faces of the vertebra.  
         [0033]     In still yet a further and/or alternative non-limiting aspect of the present invention, the spinal implant can be designed to utilize a locking nut and/or other type of mechanism to affix, position and/or disconnect the spinal implant to the one or more vertebra.  
         [0034]     In another and/or alternative non-limiting aspect of the present invention, the spinal implant can be designed to utilize a hinged and/or articulated device to attach to one or more vertebral bodies, or a portion thereof.  
         [0035]     In still another and/or alternative non-limiting aspect of the present invention, the spinal implant can be designed to utilize a capping or covering device to cover one or more access ports of the surgical implant to keep the access port clear and/or avoid tissue ingrowth. The capping or covering device can be removable or non-removable. The capping or covering device can be biodegradable or non-biodegradable.  
         [0036]     In yet another and/or alternative non-limiting aspect of the present invention, the spinal implant can be designed to form an artificial facet onto a vertebral body to facilitate in improving a patient&#39;s spinal function.  
         [0037]     In still yet another and/or alternative non-limiting aspect of the present invention, the spinal implant can be used in a variety of methodologies. One non-limiting methodology that can include the use of the spinal implant includes 1) Performing at least one exposure procedure to access/prepare at least a portion of a surgical site (e.g., Surgical exposure via open or minimally-invasive surgery (“MIS”) approach, Preparing surface for bio-ingrowth; Small laminotmy, if necessary, in superior lamina, small laminotmy, if necessary, in lateral pars; etc.), 2) Determining the proper size of the spinal implant, 3) Positioning/securing the spinal implant to one or more vertebra, and 4) Connecting one or more components (e.g., third arm of the spinal implant, universal connector, modular connection head, connection extension, cross-link, rod, plate, motion preservation device, medicine/drug delivery device, electro-simulation device, etc.) to the spinal implant. As can be appreciated, many modifications of this methodology can be used in conjunction with the spinal implant. One non-limiting specific methodology that can include the use of the spinal implant, such non-limiting methodology includes 1) Performing at least one an exposure procedure to access/prepare at least a portion of the spine, 2) Determining the proper size of the spinal implant, 3) Securing the spinal implant to one or more vertebra, 4) Positioning/securing one or more components of the spinal implant for optimum fixation and position on one or more vertebra, 5) Reviewing position of the spinal implant (e.g., MIS review, radiological review, visual review, etc.), and 6) Connecting one or more components to the spinal implant. In another and/or alternative non-limiting specific methodology that can include the use of the spinal implant, such non-limiting methodology includes 1) Performing at least one an exposure procedure to access/prepare at least a portion of the spine, 2) Determining the proper size of the spinal implant, 3) Positioning/securing the spinal implant to one or more vertebra (e.g., engaging the medial lamina foot of spinal implant on a vertebra, next engaging the lateral pars foot of the spinal implant on the same or different vertebra, secure/tighten the feet of the spinal implant to the one or more vertebra (e.g., close or tighten clamp or other type of tightening mechanism across pars, etc.), etc.), 4) Manipulating/adjusting the position of the spinal implant on the vertebra and/or one or more components of the spinal implant to obtain the desired fixation and/or position of the spinal implant on the one or more vertebra, 5) Reviewing position of the spinal implant on the one or more vertebra, 6) Performing final tightening/positioning of the spinal implant on the one or more vertebra, 7) Repeating the above steps for the connection of one or more other spinal implants on the same or different vertebra, and 8) Connecting one or more components to the spinal implant. As can be appreciated, other or additional methodologies can be used with the spinal implant of the present invention.  
         [0038]     In still yet another and/or alternative non-limiting aspect of the present invention, the spinal implant can provide one or more of the following benefits: 1) Eliminates the need for a hospital or other medical facility to carry a large inventory of lamina hooks, wires, screws, buttons, etc:; 2) Enhances fixation to a vertebral body or multiple vertebral bodies (e.g., clamp design, cortical bone, etc.); 3) Allows for force coupling of the construct, if desired, for enhanced purchase and better control for manipulating the vertebra body and motion segment (deformity surgery); 4) Allows for bio-ingrowth capability for permanent fixation to lamina biologically; 5) Allows for the attachment of growth rods for pediatric scoliosis; 6) Provides a method of addressing the disease of Osteoporosis; 7) Facilitates in Motion Preservation in the spine, as compared to alternative surgical methodologies; 8) Allows Revision Surgery to be undertaken with greater ease than current devices; 9) Provides “lamina prosthesis” for repair or reconstruction surgery; 10) Creates or permits the formation of a permanent “docking” site that can be revisited by the surgeon or a subsequent surgeon; 11) Permits the ability to control vertebral motion or manipulation such as, but not limited to e-Rotation, 3-D contouring, etc.; 12) Provides similar advantages to standard pedicle screw fixation; 13) Allows for Uni or bilateral control or fixation; 14) Allows for Single or Multi-level construct using “links”; 15) Provides a substitute for pedicle screws (thus target surgeons that might be “squeamish” on using pedicle screws); 16) Provides a substitute for pedicle screws when pedicle screw usage is impractical (e.g., small, osteoporotic, missing pedicle, etc.); 17) Provides a replacement for pedicle screw prosthesis or, in the alternative, can be used to complement the pedicle screw prosthesis implant system; 18) Can be attached to or be used with pedicle screw instrumentation; 19) Can be attached to or be used with artificial vertebral body implant (e.g., 360°) reconstruction; 20) Can be created and/or be modified utilizing injection molding technology for customization; and/or 21) Can be staged using MIS approach for bio-ingrowth application, such as surgically inserting a sleeve into the site and, later, inserting this device into the fixed sleeve site. As can be appreciated, the spinal implant can have other or additional benefits.  
         [0039]     In a further and/or alternative non-limiting aspect ofthe present invention, the spinal implant can be used in a variety of treatments. Some of the diseases the spinal implant can be used to help in the treatment of include, but are not limited to: 1) Tumors, 2) Infections, 3) Revision surgery, and/or 4) Trauma.  
         [0040]     In still a further and/or alternative non-limiting aspect of the present invention, the spinal implant can be designed for bio-ingrowth. A Bio-ingrowth version of the spinal implant can be used with motion preservation devices by providing a solid fixation point to the bone minimizes loosening, and/or stress shielding and maximizes load sharing.  
         [0041]     In summary, the spinal implant is a new and innovative spine implant that can be used be used primarily in the posterior aspect of the spinal column for spinal reconstruction, revision surgery, deformity correction, tumor, and trauma surgery of the cervical, thoracic, and lumbo-sacral spine. The spinal implant can be designed to removably or irremovably “clamp” or secure onto the posterior elements of one or more spinal vertebrae. In one non-limiting embodiment, the spinal implant can be clamped within the interval between the superior margin of the lamina of a vertebra and the lateral margin of the pars interarticularis portion of the vertebra. The spinal implant can be designed to span the length of the pars interarticularis, or, secondarily, a portion thereof or, in the alternative, more than one vertebra&#39;s surface. The spinal implant, when secured to one or more vertebra, can provide strong permanent or temporary fixation to the posterior elements of a vertebra or multiple vertebrae and allow for a variety of attachments to be placed upon and/or connected to the spinal implant, thus functioning a platform and/or docking station for one or more other components. The spinal implant is envisioned to simplify spinal procedures and/or facilitate the improvement of the patient&#39;s health in that it can replace the need for lamina and transverse process hooks, pedicle screws, sub-laminar wires, and/or spinous process buttons. The primary market for the spinal implant is believed to be for the young and aging spine alike since the spinal implant is believed to provide improved and, in most cases, the strongest fixation possible in comparison to other devices which can have a high percent of failure. The spinal implant is believed to be usable to assist in Scoliosis surgery (e.g., Pediatric, Adult, Geriatric), Degenerative Post Surgery, Degenerative Spine Conditions, Spine Fractures, Tumors, Small Pedicles that cannot be accessed by a pedicle screw, Repair of Spondylolysis (Pars Defects), and/or a Bone Anchor for an “artificial facet” type implant. The spinal implant may have other uses. The spinal implant can be formed into a clamp-type device. When the spinal implant is a clamp-type device, the spinal implant can include one or more of the following components: 1) A fixed medial lamina clamp and/or foot; 2) An adjustable hinged (or otherwise articulated) pars clamp and/or foot which, in its primary embodiment, will be a lateral pars clamp and/or foot; 3) A set-screw or locking nut or other device or mechanical means for adjustments and/or tightening; 4) An integral base which might include docking station—which may be threaded or constructed with another coupling device or mechanism; 5) A variety of fixed and/or variable motion attachments to the docking station which might consist of, for example, Modular heads (see pedicle prosthesis system), Attachment sites for rods, plates, medication delivery devices, etc.; 6) Smooth or porous surfaces, coated which may be coated with an appropriate substance or not—If constructed with a porous surface, this would allow bone in-growth into the clamp providing a permanent bond between the implant the spinal lamina. The intent is that the surgical site, the vertebra and/or the clamp can be re-visited from time to time as necessary. This capability can be critical to the future success of motion preservation implants (such as the concept of an artificial facet which would be designed and manufactured to be attached to a vertebra); and/or 7) Cross Links to connect right to left side of one vertebra to another (force coupling) by means of fixed or flexible couplers. In this regard, it is contemplated that cross links could connect single or multiple levels of vertebral bodies. The spinal implant could also be designed as a pedicle “claw” to enable the device to be affixed to a vertebra if the lamina or pars has been removed). This design could create a different configuration of the pedicle “clamp” with the clamping of the superior and inferior walls of the pedicle. The spinal implant could be manufactured in variable sizes to better meet the needs of the particular patient&#39;s anatomy. The spinal implant can be constructed of a single material or of a combination of materials. Such materials could include metals, alloys, ceramics, plastics, memory metals, mammalian bone, cartilage and/or other appropriate materials. One or more spinal implants can be used in conjunctions with a “Lamina Plate.” The “Lamina Plate” can be attached to one or more vertebra so as to replace or reconstruct the lamina or posterior wall of the spinal column. Such a “Lamina Plate” could be smooth or porous. The“Lamina Plate” could be designed to connect to a one spinal implant or to a plurality of spinal implants. The spinal implant can be constructed with a low profile foot to minimize possible injury to the neurological elements adjacent or near the spinal implant. Innovative instrumentation can be used with the spinal implant to facilitate in the preparation of the surgical site, the insertion of the spinal implant, the revisitation to the surgical site, and/or the attachment of one or more components to the spinal implant. Some of these innovative instruments can include 1) An “Inserter-Manipulator-Tightener” which is envisioned as an All-in-one concept or, if appropriate, in multiple components, 2) Exposure instrument(s), 3) Site prep instrunent(s), 4) Inserter/remover instrument(s), and/or 5) Trial or sizing device(s). The spinal implant can include a “Third Foot” attachment for enhanced 3-point fixation (e.g., “A Long Arm” attachment). As can be appreciated, the spinal implant could include four or more feet. The spinal implant can be configured in one or more designs so as to address the various needs of different portions of the mammalian spine, including but not limited to cervical, thoracic, and lumbar-sacral” versions. The spinal implant can be design to span more than one segment if pars has been removed. The spinal implant can include one or more caps or other devices to at least partially cover one or more openings in the spinal implant. These one or more openings can be used to facilitate in the revisitation to the spinal implant, facilitate in changing the attachment arrangement and/or methodology of the spinal implant, facilitate in connecting one or more components to the spinal implant, and/or receive one or more medicine or drugs. The cap can be made of one or more materials including plastic, metal, etc. The cap can be threaded or connected to the spinal implant by one or more mechanical methodologies. The spinal implant can be designed to attach to the laminar portion of a vertebra for purposes of surgical treatment of a spinal condition. The spinal implant can be designed to onto two adjacent vertebrae for purposes of surgical treatment of a spinal condition. The spinal implant can be designed to attach to two vertebrae laminae. The spinal implant can be designed to clamp onto the vertebral body by gripping onto the natural faces of the vertebra. The spinal implant can be designed to include a locking nut or device to affix the spinal implant onto the vertebra. The spinal implant can be designed to include a hinged or articulated structure for use in attaching the spinal implant to a vertebral body, or a portion thereof. The spinal implant can be designed to include a capping device to cover one or more access ports of the spinal implant to keep the access port clear and/or avoid tissue ingrowth. The spinal implant can be designed to form one or more artificial facets on a vertebral body which can be used to improve a patient&#39;s spinal function. Many methodologies can be used with the spinal implant, depending in part on the configuration ofthe spinal implant. When the spinal implant is a clamped-shaped device that includes at least two arms or legs, the following non-limiting methodology can be used: 1) Exposure of a surgical site (e.g., Surgical exposure via Open or minimally-invasive surgery (“MIS”) approach, Preparation of one or more surfaces of the vertebra for bio-ingrowth, Small laminotmy in superior lamina, Small laminotmy in lateral pars, etc.); 2) Determine proper size of spinal implant; 3) Engage medial lamina foot on first leg of spinal implant; 4) Engage lateral pars foot on second leg of spinal implant; 5) Close or tighten clamp on spinal implant that is positioned across pars; 6) Manipulate position of spinal implant for optimum fixation and position; 7) Review position of spinal implant by MIS, radiological review, etc.; 8) Final tightening of spinal implant with set-screw or lock nut or other methodology; 9) Insert second spinal implant, if necessary; and 10) Attach one or more components to spinal implant (e.g., modular head, third or fourth “iong arm”, “lamina plate”, cross-link, longitudinal member (e.g., rod, plate, motion preservation device, etc.), etc.). The spinal implant can have a variety of benefits such as, but not limited to, 1) Eliminate the need for a hospital to carry a large inventory of lamina hooks, wires, screws, buttons, etc.; 2) Provide enhanced fixation to a vertebral body or multiple vertebral bodies-clamp design, cortical bone, etc.; 3) Allow for forced coupling of the construct, if desired, for enhanced purchase and better control for manipulating the vertebra body and motion segment (deformity surgery); 4) Allow for bio-ingrowth capability for permanent fixation to lamina biologically; 5) Allow for the attachment of growth rods for pediatric scoliosis; 6) Provides a method of addressing the disease of Osteoporosis; 7) Facilitate in motion preservation in the spine, as compared to alternative surgical methodologies; 8) Allows for revision surgery to be undertaken with greater ease than current devices; 9) Enables “lamina prosthesis” for repair or reconstruction surgery; 10) Allows for the treatment of Tumors, Infections, Revision surgery, Trauma, etc.; 11)Permits the creation of a permanent “docking” site that can be revisited by the surgeon or a subsequent surgeon, if necessary; 12) Permit the ability to control vertebral motion or manipulation (e.g., De-Rotation, 3-D contouring, etc.); 13) Provide similar advantages to standard pedicle screw fixation; 14) Allow for Uni or bilateral control or fixation; 15) Allow for Single or Multi-level construct using “links”; 16) Provide a substitute for pedicle screws when pedicle screws usage is impractical (small, osteoporotic, or missing pedicle); 17) Replace the pedicle screw prosthesis implant; 18) Provide a complement to the pedicle screw prosthesis implant system; 19) Can be attached to or be used with pedicel screw instrumentation; and/or 20) Can be attached to or be used with artificial vertebral body implant (360) reconstruction. The spinal implant can be at least partially formed of a material that has been created or modified utilizing injection molding technology so as to customize the spinal implant. The spinal implant can be staged using a MIS approach for bio-ingrowth application, such as surgically inserting a sleeve into the site and, later, inserting this device into the fixed sleeve site. The spinal implant can be designed so that at least a portion of the spinal implant promotes and/or allows bio-ingrowth to at least provide a solid fixation point to the bone, thereby minimizing loosening, and/or stress shielding and maximizes load sharing. The spinal implant can be formed of a variety of materials (e.g., solid metal, polymer, ceramic, memory metal, HA, etc.). The spinal implant can be at least partially coated with osteobiologics (BMPs, bone marrow concentrate, fillers, and substitutes.  
         [0042]     One non-limiting object of the present invention is the provision of a spinal implant that can be used be in the posterior aspect of the spinal column for spinal reconstruction, revision surgery, deformity correction, tumor, and trauma surgery ofthe cervical, thoracic, and/or lumbo-sacral spine.  
         [0043]     Another and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can removably or irremovably secure onto the posterior elements of one or more spinal vertebrae.  
         [0044]     Still another and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can be secured within the interval between the superior margin of the lamina of a vertebra and the lateral margin of the pars interarticularis portion of the vertebra.  
         [0045]     Yet another and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can span at least a portion of the length of the pars interarticularis, or span more than one vertebra&#39;s surface.  
         [0046]     Still yet another and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can provide strong permanent or temporary fixation to the posterior elements of a vertebra or multiple vertebrae.  
         [0047]     A further and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can allow for a variety of attachments to be placed upon and/or connected to the spinal implant.  
         [0048]     Still a further and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can simplify spinal procedures and/or facilitate the improvement of the patient&#39;s health.  
         [0049]     Yet a further and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can replace the need for lamina and transverse process hooks, pedicle screws, sub-laminar wires, and/or spinous process buttons.  
         [0050]     Still yet a further and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can eliminate the need for a hospital or other medical facility to carry a large inventory of lamina hooks, wires, screws, buttons, etc.  
         [0051]     Another and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can provide enhanced fixation to a vertebral body or multiple vertebral bodies.  
         [0052]     Still another and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can allow for bio-ingrowth capability for permanent fixation to lamina biologically.  
         [0053]     Yet another and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can allow for the attachment of growth rods for pediatric scoliosis.  
         [0054]     Still yet another and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can be used to treat the disease of Osteoporosis.  
         [0055]     A further and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can facilitate in motion preservation in the spine.  
         [0056]     Still a further and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can allow for revision surgery to be undertaken with greater ease.  
         [0057]     Yet a further and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can enable “lamina prosthesis” for repair or reconstruction surgery.  
         [0058]     Still yet a further and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can allow for the treatment of tumors, infections, revision surgery, and/or trauma to the spin or regions about the spine.  
         [0059]     Another and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can permit the creation of a permanent “docking” site for one or more components.  
         [0060]     Still another and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can permit the ability to control vertebral motion or manipulation.  
         [0061]     Yet another and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can provide similar advantages to standard pedicle screw fixation.  
         [0062]     Still Yet another and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can allow for unilateral or bilateral control or fixation.  
         [0063]     A further and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can allow for single or multi-level construct using “links”.  
         [0064]     Still a further and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can provide a substitute for pedicle screws.  
         [0065]     Yet a further and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can provide a complement to the pedicle screw prosthesis implant system.  
         [0066]     Still yet a further and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can be attached to or be used with pedicel screw instrumentation.  
         [0067]     Another and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can be attached to or be used with artificial vertebral body implant reconstruction.  
         [0068]     These and other advantages will become apparent to those skilled in the art upon the reading and following of this description taken together with the accompanying drawings. 
     
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0069]     Reference may now be made to the drawing, which illustrates an embodiment that the invention may take in physical form wherein:  
         [0070]      FIG. 1  is an elevation view of one non-limiting embodiment the spinal implant in accordance with the present invention connected to a vertebra;  
         [0071]      FIG. 2  is a cross-sectional view along line  2 - 2  of  FIG. 1 ;  
         [0072]      FIG. 3  is an exploded view of the spinal implant of  FIG. 1 ;  
         [0073]      FIG. 4  is an enlarged sectional view of the arm adjustment mechanism for two arms of the spinal implant of  FIG. 1 ;  
         [0074]      FIG. 5  is an enlarged sectional view of a non-limiting alternative arm adjustment mechanism for two arms of the spinal implant;  
         [0075]      FIG. 6  is an exploded view of the spinal implant that includes the arm adjustment mechanism of  FIG. 5 ;  
         [0076]      FIG. 7  is an enlarged sectional view of a non-limiting alternative arm adjustment mechanism for two arms of the spinal implant;  
         [0077]      FIG. 8  is an exploded view of the spinal implant that includes the arm adjustment mechanism of  FIG. 7 ;  
         [0078]      FIGS. 9A-9D , and  10 - 13  illustrate non-limiting alternative configurations of the arm adjustment mechanism of  FIG. 1 ;  
         [0079]      FIG. 14  is an elevation view of another non-limiting embodiment the spinal implant in accordance with the present invention; and,  FIG. 15  is a cross-sectional view along line  15 - 15  of  FIG. 14 . 
     
    
     DETAILED DESCRIPTION OF THE INVENTION  
       [0080]     Referring now to the preferred embodiment of the drawings, wherein the showings are for the purpose of illustrating a preferred embodiment of the invention only and not for the purpose of limiting the invention,  FIGS. 1-15  illustrate a spinal implant  100  in accordance with the present invention. As best illustrated in  FIG. 1 , the spinal implant is designed to be at least partially secured to the posterior elements of a spinal vertebra V. In particular, the spinal implant, as shown in  FIG. 1 , is secured to the vertebra V within the interval between the superior margin of the lamina of the vertebra and the lateral margin of the pars interarticularis portion of the vertebra. As can be appreciated, the spinal implant can be designed to span the full length of the pars interarticularis, a portion of the pars interarticularis, or connect to more than one vertebra. As best illustrated in  FIG. 1 , one or more spinal implants  100  can be secured to a vertebra.  
         [0081]     As illustrated in  FIGS. 3-8 , the spinal implant includes at least two arms  110 ,  120 . At least one arm is designed to be adjustably connected to an arm hub  130 . Each arm  110 ,  120  includes a body portion  112 ,  122  and an end foot  114 ,  124 . The body portion of both arms is illustrated are being generally planar or flat; however, it can be appreciated that the body portion can be slightly curved and/or include other configurations. The end foot on the end of each arm is designed to secure the end portion of the arms to a portion of a vertebra. Each foot is angularly oriented with respect to the body portion of the arms; however, this is not required. Each foot is illustrated as having a maximum angular orientation of over 90° relative to the longitudinal axis of the body portion. Typically, the maximum angular orientation is about 90-160°, and more typically about 90-130°; however, other angles can be used. As can be appreciated, the maximum angular orientation can be less than 90°. The angular orientation of the feet can be the same or different. The inner surface of each foot has a generally planar or slightly curved profile; however, it can be appreciated that one or more of the feet can include other configurations.  
         [0082]     Although not shown, the inner surface of one or more feet can include one or more structures and/or materials to facilitate in the gripping of the one or more feet of the arms to a portion of the vertebra; however, this is not required. For instance, one or more feet can include one or more gripping arrangements such as, but not limited to, one or more teeth, one or more ribs, one or more rough regions, etc.; however, this is not required. In addition or alternatively, an adhesive (e.g., bone cement, bio-grout, polymer adhesive, etc.) can be used to facilitate in the gripping of the one or more feet of the arms to a portion of the vertebra; however, this is not required. Furthermore, one or more portions of one or more feet can alternatively or additionally be porous and/or include one or more openings or cavities so as to promote bone ingrowth, and thereby facilitate in the gripping of the one or more feet of the arms to a portion of the vertebra; however, this is not required. The one or more porous regions can include one or more materials (e.g., bone, etc.), medication, drugs, etc. to promote and/or inhibit bone growth on one or more regions of the feet; however, this is not required. As can be appreciated, other or additional arrangements can be used to facilitate in the gripping and/or proper operation of the one or more feet of the arms on a portion of the vertebra.  
         [0083]     As illustrated in  FIGS. 3-8 , the body section and foot of each arm is formed of a single piece of material. Typically, the material is a metal material; however, other or additional materials can be used. As can be appreciated, the body portion and the foot of one or more arms can be formed of different materials. The body portion and foot of each arm is also illustrated as being about the same shape and size. As can be appreciated, the body portion and/or foot of each arm can be the same or different from another arm. For instance, the length, profile, thickness and/or cross-sectional shape of the body portion of each arm can be the same or different of the body portion of one or more other arms. Furthermore, the length, profile, thickness and/or cross-sectional shape of the foot of each arm can be the same or different from the foot of one or more other arms. Although not shown, the foot on one or more arms can be designed so as to be connected to the body portion by use of an adhesive, solder, weld, etc.; however, this is not required. As can further be appreciated, the foot can be designed so as to be adjustably oriented relative to the body portion by use of a hinge mechanism, a ratchet mechanism, ball/socket mechanism, etc.; however, this is not required. A set screw and/or other locking arrangement can be used to adjust and/or secure the adjustable foot in place; however, this is not required.  
         [0084]     The orientation of the two arms relative to one another can be accomplished in a variety of ways. As can be appreciated, the spinal implant can include more than two arms; however, this is not required. The arrangement used to orient the arms can be designed to orient the arms about one or more axes of the spinal implant. A first non-limiting arrangement is illustrated in  FIGS. 3 and 4 , a second non-limiting arrangement is illustrated in  FIGS. 5 and 6 , and a third non-limiting arrangement is illustrated in  FIGS. 7 and 8 . In all the examples illustrated in  FIGS. 3-8 , the spinal implant includes two arms that are adjustable along the longitudinal length of the spinal implant. As can be appreciated, these three arrangements merely illustrate a few of the possible arrangements that can be used to orient and set in position the arms relative to one another. As can be appreciated, the spinal implant can be designed such that one or more of the arms are not adjustable along the longitudinal axis of the spinal implant; however, this is not required. As can also be appreciated, one or more arms can be adjustably oriented in one or more less axes that one or more other arms; however, this is not required. For instance, one or more arms could be adjustably oriented in one or more axes of the spinal implant, and one or more arms could be adjustably oriented in no axis of the spinal implant. In another instance, one or more arms could be adjustably oriented in two or more axes of the spinal implant, and one or more arms could be adjustably oriented in only one axis of the spinal implant. In still another instance, one or more arms could be adjustably oriented in three axes of the spinal implant, and one or more arms could be adjustably oriented in two or one axes of the spinal implant.  
         [0085]     Referring again to  FIGS. 3 and 4 , arm hub  130  includes an arm opening  132  that enables front portions  116 ,  126  of arms  110 ,  120  to be at least partially telescopically received in the arm opening. Each of the front portions of the arms include two legs  117 ,  118 ,  127 ,  128  that are separated by a slot  119 ,  129 . The configuration of the front portions of the two arms is such that when both front portions of the arms are partially inserted into opening  132 , leg  118  of arm  110  partially enters slot  129  of arm  120  and leg  127  of arm  120  partially enters slot  119  of arm  110 . This engagement of the front portion of the arms in the arm hub is partially illustrated in  FIG. 4 . As illustrated by the arrows in  FIG. 4 , the two arms of the spinal implant are both adjustable along the longitudinal and latitudinal (i.e., 90° to a longitudinal axis) axes of the spinal implant. Once the arms are positioned on a portion of one or more vertebra, the arms can be set relative to one another by use of a set screw  140 . Set screw  140  is a threaded screw that is designed to be inserted into set opening  134  of arm hub  130 . The set opening is positioned on one side of the arm hub; however, it can be appreciated that the set opening can be position in other locations on the arm hub (e.g., bottom side, top side, front end, back end, etc.). It can also be appreciated that more than one set opening can be used to set the arms in position in the arm hub. The set opening includes a thread to receive the thread on set screw  140 . The head of the set screw includes a configuration that enables a tool to engage the top of the set screw so as to insert/remove the set screw from the set opening. When the set screw is inserted into the set opening, the front end of the set screw engages a side portion of leg  116  and causes the arm  110  to move into arm  120 , which in turn causes leg  129  to engage an inner side surface of opening  132 . The pressure exerted on arm  110  by the set screw causes the two arms to be set in position in arm hub  130 . Removal of the set screw from the set opening can enable the arms to be adjusted in the arm opening. As can be appreciated, arrangements other than the set screw can be used to set the arms relative to one another (e.g., set pin, adhesive, adhesive, clamp arrangement, etc.).  
         [0086]     Arm hub  130  also includes one or more connection arrangements  136 . As illustrated in  FIG. 3  and  4 , the connection arrangement  136  is positioned on the top surface of the arm hub. As can be appreciated, the connection arrangement  136  can be located on other regions of the arm hub. As also can be appreciated, the arm hub can include more than one connection arrangement. The one or more connection arrangements on the arm hub are designed to connection to a stabilizing system and/or other type of treatment system (e.g., modular heads; one or more attachment sites for rods, plates, and/or medication delivery devices, etc.), and/or connect another arm to the spinal implant. Connection arrangement  136 , as illustrated in  FIGS. 3 and 4 , includes a threaded cavity  138  designed to receive a threaded end of a stabilizing system and/or other type of treatment system such as, but not limited to, a threaded end of a rod R. As can be appreciated, the connection arrangement  136  can have many other and/or additional configurations (e.g., slot configuration, ball configuration, polyaxial head, etc.) so as to connect a variety of stabilizing systems and/or other type of treatment system to the spinal implant. Although not shown, the connection arrangement  136  can be designed to be removable so that other types of connection arrangements can be connected to the arm hub to enable other types of stabilizing systems and/or other type of treatment system to be connected to the spinal implant; however, this is not required. The connection arrangement  136  is illustrated as extending outwardly from a surface of the arm hub; however, this is not required. As can be appreciated, the connection arrangement can be formed at least partially internally in the arm hub such that little, if any, portion of the connection arrangement extends outwardly from the surface of the arm hub.  
         [0087]     Referring now to  FIGS. 5 and 6 , a different configuration of arms  110  and  120  is shown. The front portion of each of the arms includes a plurality of teeth  200 ,  210 . The teeth are designed to engage one other when a portion of each arm is positioned in the arm opening  132  of arm hub  130  and the set screw  140  is inserted into set opening  134  as illustrated in  FIG. 5 . The teeth configuration of the arms can be designed to create a ratcheting configuration for the arms when positioning the arms relative to one another; however, this is not required. As the set screw  140  is inserted into set opening  134  as illustrated by the arrow in  FIG. 5 , the front end of the screw engages the side of arm  110  and moves the arm into engagement with arm  120 , which in turn causes arm  120  to engage an inner wall of opening  132 . The pressure exerted by the set screw causes the two arms to be set in opening  132  of arm hub  130 . The removal of the set screw enables arms  110 ,  120  to be adjustable positioned in arm hub  130 . As can be appreciated, the location of opening  132  can be in other locations as described above with regard to  FIGS. 3 and 4 . As can be appreciated, other or additional mechanisms can be used to adjust/set one or more of the arms in arm hub  130  as described above with regard to  FIGS. 3 and 4 . The design of arms  110 ,  120  in  FIGS. 5 and 6  enables the arms to be adjusted along the longitudinal axis of the spinal implant as illustrated by the arrows in  FIG. 5 . Due to the configuration of the teeth on the arms, the arms are primarily adjustable on the longitudinal axis of the spinal implant; however, the teeth could be designed to enable one or both arms to be adjustable in an axis other than the longitudinal axis. A connection arrangement  136  having a threaded cavity  138  is positioned on the top surface of the arm hub. The connection arrangement is designed to connection to a stabilizing system and/or other type of treatment system, and/or connect another arm to the spinal implant. A variety of designs, orientations and number of connection arrangement can be used as described above with regard to  FIG. 3  and  4 .  
         [0088]     Referring now to  FIGS. 7 and 8 , a different configuration of the arms and arm hub is illustrated. Arm  110  includes a front portion  116  that includes an adjustment landing  300 . Arm  120  includes a front portion  126  that includes a stop landing  310 . As illustrated in  FIG. 7 , a portion of the front portions of both arms are designed to be insertable in arm opening  132  of arm hub  130 . Stop landing  310  limits the movement of arm  120  in one direction along the longitudinal axis of the spinal implant as shown in  FIG. 7 . Adjustment landing  300  on arm  110  is used to adjust the longitudinal position of arm  110 . An adjustment screw  140  is designed to be threaded into set opening  134  of arm hub  130 . As shown in  FIG. 7 , as the adjustment screw is threaded into set opening  134 , the front end of the set screw engages adjustment landing  300 , thereby pushing the front portion of arm  110  into the front portion of arm  120  to cause both arms to be set in arm hub  130 . As shown in  FIG. 7 , the arms are adjustable along the longitudinal axis of the spinal implant as illustrated by the arrows. This particular arm configuration can allow the one or both arms to be adjustable in an axis other than the longitudinal axis. As can be appreciated, the location of opening  132  can be in other locations on arm hub  130  as described above with regard to  FIGS. 3 and 4 . As also can be appreciated, other or additional mechanisms can be used to adjust/set one or more of the arms in arm hub  130  as described above with regard to  FIGS. 3 and 4 . A connection arrangement  136  having a threaded cavity  138  is positioned on the top surface of the arm hub. The connection arrangement is designed to connection to a stabilizing system and/or other type of treatment system, and/or connect another arm to the spinal implant. A variety of designs, orientations and number of connection arrangement can be used as described above with regard to  FIG. 3  and  4 .  
         [0089]     The three non-limiting configurations of the spinal implant illustrated in  FIGS. 3-8 , merely set forth three of a number of arrangements that can be used to adjustably position the one or more arms of the spinal implant relative to one another. Other non-limiting arrangements can include, but are not limited to, 1) one or more arms connected to the arm hub by a hinge, 2) one or more arms connected to the arm hub by a ball and socket arrangement, 3) one or more arms connected to the arm hub by a slot arrangement, 3) one or more arms secured to the arm hub by a threaded connection, etc. As illustrated in  FIGS. 3-8 , both arms of the spinal implant are adjustable in at least one axis of the spinal implant; however, it can be appreciated that one or more of the arms of the spinal implant are in a fixed positioned relative to the arm hub; however, this is not required.  
         [0090]     Referring now to FIGS.  9 A-D and  10 - 13 , there are illustrated a variety of arm hub configurations that could be used to connect to a variety of components of a stabilizing system and/or other type of treatment system. As can be appreciated, the various configurations of the arm hubs shown in FIGS.  9 A-D and  10 - 13  are non-limiting examples of just a few of the many arm hub configurations that can be used in conjunctions with the spinal implant of the present invention.  
         [0091]     Referring now to  FIG. 9A , there is illustrated an arm hum  130  having a similar configuration as the arm hub of  FIGS. 3 and 4  except that the connection arrangement  400  is in the shape of a polyaxial head. As can be appreciated, the polyaxial head can be used on other arm hubs such as, but not limited to, the arm hubs illustrated in  FIGS. 5-8 .  
         [0092]     Referring now to  FIG. 9B , there is illustrated an arm hum  130  having a similar configuration as the arm hub of  FIGS. 3 and 4  except that the connection arrangement  500  is in the shape of a ball. As can be appreciated, the ball-shaped connection arrangement can be used on other arm hubs such as, but not limited to, the arm hubs illustrated in  FIGS. 5-8 .  
         [0093]     Referring now to  FIGS. 9C and 9D , there is illustrated a modified version of the arm hub shown in  FIGS. 3 and 4 . The arm hub is absent a connection arrangement  136  on the top surface of the arm hub; however, it can be appreciated that a connection arrangement similar to connection arrangements  136 ,  400 ,  500  as discussed above could also be included on the arm hub. The connection arrangement on the side of arm hub  130  shown in  FIGS. 9C and 9  D is in the form of a partially spherical cavity  600 . The cavity  600  is accessed from the side of the arm hub by a tapered opening  610 . As can be appreciated, cavity  600  can be located in other or additional regions of the arm hub. Cavity  600  is designed to receive a universal connector device  700  that includes a two generally spherical shaped ends  710 ,  720  which are connected by a rod-shaped member  730 . As can be appreciated, end  720  have a variety of other shapes to enable end  720  to connect with and/or interact with a variety of stabilizing systems and/or other type of treatment systems. End  710  is designed to be at least partially positioned in cavity  600 . The shape of cavity  600  and end  710  enables connector device  700  to be moved in a variety of positioned as indicated by the arrows in  FIGS. 9C and 9D . The ability to move the connector device  700  in a variety of positions enhances the versatility of the spinal implant so that the spinal implant can be used with a variety of stabilizing systems and/or other type of treatment systems. The arm hub also includes a set opening  800  that is designed to receive a set screw  900 . As shown in  FIG. 9D , as the set screw is threaded into set opening  800 , the front end of the set screw enters cavity  700  and engages end  710  of connection device  700 , thereby pushing the end into the side of cavity  600  to cause end  710  to be substantially immovably positioned in cavity  600 . The head of the set screw is typically designed to allow an instrument to insert/remove the set screw in/from opening  800 ; however, this is not required. The loosening of the set screw  900  enables connector device  700  to again be adjusted, if so desired. As can be appreciated, the location of opening  800  can be in other locations on arm hub  130 . As also can be appreciated, other or additional mechanisms can be used to adjust/set end  710  in cavity  600 .  
         [0094]     Referring now to  FIG. 10 , there is illustrated another modified version of the arm hub shown in  FIGS. 3 and 4 . The arm hub is absent a connection arrangement  136  on the top surface of the arm hub; however, it can be appreciated that a connection arrangement similar to connection arrangements  136 ,  400 ,  500  as discussed above could also be included on the arm hub. The connection arrangement on the side of arm hub that is shown in  FIG. 10  is in the form of tubular slot  1000 . The tubular slot is illustrated as being positioned fully through the side of the arm hub; however, this is not required. As can be appreciated, the tubular slot can have other or additional cross-sectional shapes along the length of the slot (e.g., oval, polygonal, etc.). As can be appreciated, slot  1000  can be located in other or additional regions of the arm hub. Slot  1000  is designed to receive one or more components R of a stabilizing system and/or other type of treatment system (e.g., rod, etc.). As illustrated by the arrows, component R can be adjusted along the length of the slot. The tubular shape of slot  1000  in conjunction with the tubular shape of the end of component R enables component R to be rotated in the slot as indicated by the arrows; however, this is not required. The ability to move component R in a variety of positions enhances the versatility of the spinal implant so that the spinal implant can be used with a variety of stabilizing systems and/or other type of treatment systems. The arm hub also includes a set opening  1100  that is designed to receive a set screw  1200 . As the set screw is threaded into set opening  1   100 , the front end of the set screw enters slot  1000  and engages a portion of component R that is positioned in slot  1000 , thereby pushing a portion of component R into the side of slot  1000  and causing component R to be substantially immovably positioned in slot  1000 . The head of the set screw is typically designed to allow an instrument to insert/remove the set screw in/from opening  1100 ; however, this is not required. The loosening of the set screw  1200  enables component R to again be adjusted, if so desired. As can be appreciated, the location of opening  1100  can be in other locations on arm hub  130 . As also can be appreciated, other or additional mechanisms can be used to adjust/set component R in slot  1000 .  
         [0095]     Referring now to  FIGS. 11-13 , there is illustrated another modified version of the arm hub shown in  FIGS. 3 and 4 . The arm hub is absent a connection arrangement  136  on the top surface of the arm hub; however, it can be appreciated that a connection arrangement similar to connection arrangements  136 ,  400 ,  500  as discussed above could also be included on the arm hub. The connection arrangement on the side of arm hub that is shown in  FIGS. 11 and 13  is in the form of an angulated extension member  1300  that includes a connection arrangement on a side of the extension member that is in the form of a partially spherical cavity  1400 . The cavity  1400  is accessed from the side of the extension member by a tapered opening  1410 . As can be appreciated, cavity  1400  can be located in other or additional regions of the extension member. Cavity  1400  is designed to receive designed to receive one or more components R of a stabilizing system and/or other type of treatment system (e.g., rod, etc.). As best shown in  FIG. 13 , component R includes a generally spherical shaped end S. End S is designed to be at least partially positioned in cavity  1400 . The shape of cavity  1400  and end S enables component R to be moved in a variety of positions as indicated by the arrows in  FIGS. 11-13 . The ability to move component R in a variety of positions enhances the versatility of the spinal implant so that the spinal implant can be used with a variety of stabilizing systems and/or other type of treatment systems. As illustrated in  FIG. 13 , the extension member includes two section  1310 ,  1320 . Section  1310  is secured to the main body of arm hub  130 . Section  1310  is typically formed as a single piece with the main body of the arm hub and/or with the same material as the main body of arm hub  130  as shown in  FIG. 13 ; however, this is not required. The angular orientation of section  1310  is typically about 5-90°; however, other angles can be used. As shown in  FIG. 13 , the top surfaces of section  1310  and the main body of arm hub  130  lie generally in the same plane; however, this is not required. The front end of section  1310  forms about 50% of cavity  1400 ; however, it can be appreciated that the front end of section  1310  can be formed so as to accept more or less or no portion of cavity  1400 . A front side end portion of section  1310  forms about 50% of tapered opening  1410 ; however, it can be appreciated that the front side end of section  1310  can be formed so as to accept more or less or no portion of tapered opening  1410 . Section  1320  is illustrated as being separate and detachable from section  1310 ; however, this is not required. One side of section  1320  forms about 50% of cavity  1400 ; however, it can be appreciated that the side of section  1320  can be formed so as to accept more or less or no portion of cavity  1400 . A back side end portion of section  1320  forms about 50% of tapered opening  1410 ; however, it can be appreciated that the back side end of section  1320  can be formed so as to accept more or less or no portion of tapered opening  1410 . As can also be appreciated, the tapered opening can be formed in other or additional regions of the extension member  1300 . Section  1320  includes a connection passageway  1322  that is designed to receive a portion of a set screw  1500 . The body  1502  of the set screw is sized and shaped to pass into and through at least a portion of connection passageway  1322 . The head  1504  of the set screw has a size and/or shape that prevents the head from fully passing through connection passageway  1322 . As can be appreciated, a portion of connection passageway  1322  can include a recess, not shown that is designed to receive a portion of head  1504 ; however, this is not required. The front end face of section  1310  also includes a connection passageway  1312  that is designed to receive a portion of body  1502  of set screw  1500 . Connection passageway  1312  can include a thread that is designed to receive a thread on the body of set screw  1500 ; however, it can be appreciated that many connection arrangements can be used to secure sections  1310  and  1320  together by set screw  1500  and/or by one or more other or additional connection arrangements (e.g., adhesive, pin, latch, etc.). In the arrangement shown in  FIGS. 11-13 , the spherical end S of component R is inserted into cavity  1400  by loosening set screw  1500  so as to enable section  1310  and  1320  to be at least partially separated from one another. Once end S is positioned in cavity  1440 , component R is secured in positioned by tightening the set screw  1500 , The tightening of the set screw draws sections  1310  and  1320  together. The head of the set screw is typically designed to allow an instrument to insert/remove the set screw; however, this is not required. The loosening of the set screw  1500  enables component R to be again adjusted, if so desired. As can be appreciated, the location of passageways  1312 ,  1322  can be in other locations. As also can be appreciated, other or additional mechanisms can be used to adjust/set component R in cavity  1400 .  
         [0096]     One non-limiting methodology for inserting spinal implant  100  on vertebra V as illustrated in  FIGS. 1 and 2  is set forth; however, it will be appreciated that the spinal implant can be inserted on vertebra V in a different manner. Prior to inserting the spinal implant on a vertebra, an exposure procedure is performed to provide access to one or more vertebra, During this exposure procedure, one or more vertebra and/or a region about one or more vertebra may be prepared, treated, etc. prior to the insertion of the spinal implant. Prior to being the insertion process of the spinal implant, the proper size of the spinal implant is assessed. This assessment can take place prior to, during and/or after the exposure procedure. Once the proper spinal implant has been selected, one foot  112 ,  124  is inserted onto a portion of the vertebra. Typically, the first foot is positioned to engage the medial lamina of the vertebra. The foot can be adhesively secured to the vertebra, if desired. After the first foot is positioned on the vertebra, the second foot is then positioned on the vertebra such as, but not limited to, the lateral pars of the vertebra. This other foot can also or alternatively be adhesively secured to the vertebra, if desired. If the spinal implant includes more than two arm and feet, these additional feet can be positioned on the vertebra or a different vertebra. Once two or more feet of the spinal implant are positioned on Vertebra V, set screw  140  is tightened in opening  134  to secure arms  110 ,  120  in position relative to one another and relative to arm hub  130 . The position of the spinal implant on the vertebra can be reviewed to determine if the spinal implant is properly positioned on the vertebra. If the spinal implant needs to be adjusted on the vertebra, the set screw can be loosened and retightened until the spinal implant is properly positioned on the vertebra. Once the spinal implant is properly positioned on the vertebra a component R such as, but not limited to, a rod that fully forms or forms a portion of a stabilizing system and/or other type of treatment system is positioned in opening  138  of connection arrangement  136 . As set forth above, the spinal implant of the present invention can be used to secure one or more components of a stabilizing system and/or other type of treatment system to one or more vertebra with having to penetrate or substantially penetrate into the vertebra. As is appreciated, the spinal implant has many other or additional features and advantages as previously discussed above.  
         [0097]     Referring now to  FIGS. 14 and 15 , there is illustrated a modified spinal implant  100  that includes three arms. The structure of the spinal implant is similar to the structure of the spinal implant described in  FIGS. 1-13 . The spinal implant illustrated in  FIG. 14  includes two arms  110 ,  120  and a third arm  150 . At least one arm is designed to be adjustably connected to an arm hub  130 . Each arm  110 ,  120 ,  150  includes a body portion  112 ,  122 ,  152  and an end foot  114 ,  124 ,  154 . The body portion of the arms is illustrated are being generally planar or flat; however, it can be appreciated that the body portion can be slightly curved and/or include other configurations. The end foot on the end of each arm is designed to secure the end portion of the arms to a portion of a vertebra. Each foot is angularly oriented with respect to the body portion of the arms; however, this is not required. Each foot is illustrated as having a maximum angular orientation of over 90° relative to the longitudinal axis of the body portion. Typically, the maximum angular orientation is about 90-160°, and more typically about 90-130°; however, other angles can be used. As can be appreciated, the maximum angular orientation can be less than 90°. The angular orientation of the feet can be the same or different. The inner surface of each foot has a generally planar or slightly curved profile; however, it can be appreciated that one or more of the feet can include other configurations.  
         [0098]     Although not shown, the inner surface of one or more feet can include one or more structures and/or materials to facilitate in the gripping of the one or more feet of the arms to a portion of the vertebra; however, this is not required. For instance, one or more feet can include one or more gripping arrangements such as, but not limited to, one or more teeth, one or more ribs, one or more rough regions, etc.; however, this is not required. In addition or alternatively, an adhesive (e.g., bone cement, bio-grout, polymer adhesive, etc.) can be used to facilitate in the gripping of the one or more feet of the arms to a portion of the vertebra; however, this is not required. Furthermore, one or more portions of one or more feet can alternatively or additionally be porous and/or include one or more openings or cavities so as to promote bone ingrowth, and thereby facilitate in the gripping of the one or more feet of the arms to a portion of the vertebra; however, this is not required. The one or more porous regions can include one or more materials (e.g., bone, etc.), medication, drugs, etc. to promote and/or inhibit bone growth on one or more regions of the feet; however, this is not required. As can be appreciated, other or additional arrangements can be used to facilitate in the gripping and/or proper operation of the one or more feet of the arms on a portion of the vertebra.  
         [0099]     As illustrated in  FIGS. 14 and 15 , the body section and foot of each arm is formed of a single piece of material. Typically, the material is a metal material; however, other or additional materials can be used. As can be appreciated, the body portion and the foot of one or more arms can be formed of different materials. The body portion and foot of arms  110  and  120  are illustrated as being about the same shape and size. As can be appreciated, the body portion and/or foot of arms  110  and  120  can be the same or different from another arm. The body portion  152  of arm  150  is illustrated as being longer than the body portion of arms  110  and  120 ; however, this is not required. The foot  154  of arm  150  is illustrated as being about the same size of foot  124  of arm  120 ; however, this is not required. As such, the body portion and/or foot of the arms can be the same or different from another arm. For instance, the length, profile, thickness and/or cross-sectional shape of the body portion of each arm can be the same or different of the body portion of one or more other arms. Furthermore, the length, profile, thickness and/or cross-sectional shape of the foot of each arm can be the same or different from the foot of one or more other arms. Although not shown, the foot on one or more arms can be designed so as to be connected to the body portion by use of an adhesive, solder, weld, etc.; however, this is not required. As can further be appreciated, the foot can be designed so as to be adjustably oriented relative to the body portion by use of a hinge mechanism, a ratchet mechanism, ball/socket mechanism, etc.; however, this is not required. A set screw and/or other locking arrangement can be used to adjust and/or secure the adjustable foot in place; however, this is not required.  
         [0100]     The orientation of arms  110  and  120  relative to one another can be accomplished in a variety of ways. Non-limiting examples of a few ways the two arms can be oriented with respect to each other described and illustrated above with respect to  FIGS. 3-8 . As can be appreciated, these three arrangements merely illustrate a few of the possible arrangements that can be used to orient and set in position the arms relative to one another. As can be appreciated, the spinal implant can be designed such that one or more of the arms are not adjustable along the longitudinal axis of the spinal implant; however, this is not required. As can also be appreciated, one or more arms can be adjustably oriented in one or more less axes that one or more other arms; however, this is not required. For instance, one or more arms could be adjustably oriented in one or more axes of the spinal implant, and one or more arms could be adjustably oriented in no axis of the spinal implant. In another instance, one or more arms could be adjustably oriented in two or more axes ofthe spinal implant, and one or more arms could be adjustably oriented in only one axis of the spinal implant. In still another instance, one or more arms could be adjustably oriented in three axes of the spinal implant, and one or more arms could be adjustably oriented in two or one axes ofthe spinal implant.  
         [0101]     Referring again to  FIGS. 14 and 15 , arm hub  130  includes an arm opening that enables front portions of arms  110 ,  120  to be at least partially telescopically received in the arm opening. Once arms  110 ,  120  are positioned on a portion of one or more vertebra, the arms can be set relative to one another. As can be appreciated, many arrangements can be used to set arms  110  and  120  relative to one another (e.g., set screw, set pin, adhesive, adhesive, clamp arrangement, etc.).  
         [0102]     Arm hub  130  also includes one or more connection arrangements  136 . As illustrated in  FIGS. 14 and 15 , the connection arrangement  136  is positioned on the top surface of the arm hub. As can be appreciated, the connection arrangement  136  can be located on other regions of the arm hub. Connection arrangement  136  is illustrated as securing the front end  156  to arm hub  130 . The front end  156  includes an opening  158  that allow a base portion of connection arrangement  136  to pass through the opening and secure to arm hub  130 . The base portion of connection arrangement  136  can be threaded so that the head of the connection arrangement  136  can be tightened onto front end  156  to secure the third arm is position. As can be appreciated, many other or additional arrangements can be used to secure the third arm in position relative to the arm hub. In operation, the third arm can be positioned on the vertebra V prior to, during or after arm  110  and/or arm  120  is secured to the vertebra.  
         [0103]     Arm hub  130  can include more than one connection arrangement. The one or more connection arrangements on the arm hub can be designed to connection to a stabilizing system and/or other type of treatment system (e.g., modular heads; one or more attachment sites for rods, plates, and/or medication delivery devices, etc.), and/or connect another arm to the spinal implant several non-limiting configurations of the one or more configurations ofthe arm hub and/or the one or more configurations of the connection arrangements on the arm hub are described and illustrated in  FIGS. 3-13 .  
         [0104]     It will thus be seen that the objects set forth above, among those made apparent from the preceding description, are efficiently attained, and since certain changes may be made in the constructions set forth without departing from the spirit and scope ofthe invention, it is intended that all matter contained in the above description and shown in the accompanying drawings shall be interpreted as illustrative and not in a limiting sense. The invention has been described with reference to a preferred embodiment. Modifications and alterations will become apparent to those skilled in the art upon reading and understanding the detailed discussion of the invention provided herein. This invention is intended to include all such modifications and alterations insofar as they come within the scope of the present invention. It is also to be understood that the following claims are intended to cover all of the generic and specific features of the invention herein described and all statements of the scope of the invention, which, as a matter of language, might be said to fall therebetween.