Source: http://www.google.fr/patents/US8790372
Timestamp: 2017-10-19 02:14:06
Document Index: 283383847

Matched Legal Cases: ['Application No. 60', 'Application No. 61', 'Application No. 07863431', 'Application No. 07852824', 'Application No. 07844408', 'Application No. 10765340', 'Application No. 07854186']

Brevet US8790372 - Methods and systems for constraint of multiple spine segments - Google Brevets
Methods, apparatus and systems for constraining spinous processes to elastically limit flexion of two or more adjacent spinal segments rely on placing a tether structure over at least three adjacent vertebral bodies or two adjacent vertebral bodies and the sacrum. The tether structures may be continuous,...http://www.google.fr/patents/US8790372?utm_source=gb-gplus-shareBrevet US8790372 - Methods and systems for constraint of multiple spine segments
Numéro de publication US8790372 B2
Numéro de demande US 13/427,551
Autre référence de publication US8162982, US20090264932, US20120184998, WO2010121188A1
Numéro de publication 13427551, 427551, US 8790372 B2, US 8790372B2, US-B2-8790372, US8790372 B2, US8790372B2
Citations de brevets (248), Citations hors brevets (59), Référencé par (2), Classifications (5), Événements juridiques (2)
US 8790372 B2
placing a tether structure over spinous processes of at least three adjacent vertebral bodies, or of at least two adjacent vertebral bodies and a sacrum, wherein the structure elastically couples an upper spinous process and a lower spinous process or sacrum so as to limit flexion therebetween without substantially limiting extension thereof, and
6. A method as in claim 3, wherein a portion of the tether structure extends through a space between adjacent vertebral bodies.
7. A method as in claim 6, wherein the portion of the tether structure extending through the space between adjacent vertebral bodies extends therethrough without inhibiting extension between the adjacent vertebral bodies.
8. A method as in claim 1, wherein the tether structure is disposed around a first surface of a spinous process, and the method further comprises positioning a second tether structure around a second surface of the spinous process, wherein the second surface is opposite the first surface, and wherein the second tether positioned on the spinous process such that one tether is anteriorly disposed relative to the other tether structure.
9. A method as in claim 1, wherein a lower one of the vertebral bodies is selected from the group consisting of L4, L5, and the sacrum.
10. A method as in claim 1, wherein spaces between the adjacent vertebral bodies are free from structure which would inhibit extension.
11. A method as in claim 1, wherein the tether structure comprises one or more band elements in series with one or more compliance members.
12. A method as in claim 11, wherein the one or more band elements are substantially non-compliant, and the one or more compliance members comprise spring-like or elastic regions.
13. A method as in claim 1, wherein the tether structure comprises at least two compliance members, further comprising positioning the compliance members to lie symmetrically on opposite sides of the spinous processes and to be substantially parallel to each other.
14. A method as in claim 13, wherein the at least two compliance members are positioned entirely lateral to the spinous processes.
15. A method as in claim 1, wherein the tether structure comprises at least four compliance members, further comprising positioning pairs of the compliance members to lie symmetrically on opposite sides of the spinous processes and to be substantially parallel to each other.
16. A method as in claim 1, wherein the tether structure comprises a first compliance member having a first elasticity and a second compliance member having a second elasticity, the first compliance member superior to the second compliance member, and wherein the first elasticity is different than the second elasticity.
17. A method as in claim 1, wherein the tether structure comprises a first pair of compliance members and a second pair of compliance members, wherein the first pair of compliance members each have a first elasticity and the second pair of compliance members each have a second elasticity, the first elasticity being different than the second elasticity, and wherein the first pair of compliance members are superior to the second pair of compliance members.
18. A method as in claim 1, wherein the tether structure is disposed over the upper spinous process, the lower spinous process or sacrum, and an intermediate spinous process disposed therebetween, and wherein the tether structure comprises a first loop encircling the lower spinous process or sacrum and the intermediate spinous process so as to substantially prevent flexion therebetween, and wherein the tether structure comprises a second loop superior to the first loop, the second loop having one or more compliance members and disposed over the upper spinous process and coupled with the first loop so as to provide a force resistant to flexion of a superior spinal segment relative to the inferior spinal segment.
19. A method as in claim 18, wherein the first loop and the second loop are adjustable independently from each other.
20. A method as in claim 18, further comprising joining the first loop and the second loop together with one or more connectors.
21. A method as in claim 18, wherein a portion of the first loop extends through the space between the intermediate spinous process and the upper spinous process without inhibiting extension between therebetween.
22. A method as in claim 1, wherein the tether structure is disposed over the upper spinous process, the lower spinous process or sacrum, and an intermediate spinous process disposed therebetween, and wherein the tether structure comprises an outer loop encircling the lower spinous process or sacrum, the intermediate spinous process, and the upper spinous process so as to substantially prevent flexion therebetween, and wherein the tether structure further comprises an inner loop encircling the lower spinous process and the intermediate spinous process so as to substantially prevent flexion therebetween.
23. A method as in claim 22, wherein the outer loop and the inner loop are adjustable independently from each other.
24. A method as in claim 22, further comprising joining the outer loop and the inner loop together with one or more connectors.
25. A method as in claim 22, wherein a portion of the inner loop extends through the space between the intermediate spinous process and the upper spinous process without inhibiting extension between therebetween.
26. A method as in claim 1, wherein the tether structure provides an elastic stiffness in compression below 3 N/mm.
27. A method as in claim 26, wherein the elastic stiffness in compression is below 0.5 N/mm.
The present application is a divisional of and claims the benefit of U.S. patent application Ser. No. 12/426,119 filed Apr. 17, 2009, which is a continuation-in-part of and claims priority to International PCT Application No. PCT/US2007/081822 filed Oct. 18, 2007, which claims priority to U.S. Provisional Patent Application No. 60/862,085 filed Oct. 19, 2006; U.S. patent application Ser. No. 12/426,119 also is a non-provisional of, and claims the benefit of U.S. Provisional Patent Application No. 61/158,892 filed Mar. 10, 2009; the entire contents of each of the above applications are incorporated herein by reference.
U.S. 2005/0216017A1 has been described above. Other patents and published applications of interest include: U.S. Pat. Nos. 4,966,600; 5,011,494; 5,092,866; 5,116,340; 5,282,863; 5,395,374; 5,415,658; 5,415,661; 5,449,361; 5,456,722; 5,462,542; 5,496,318; 5,540,698; 5,609,634; 5,645,599; 5,725,582; 5,902,305; Re. 36,221; 5,928,232; 5,935,133; 5,964,769; 5,989,256; 6,053,921; 6,312,431; 6,364,883; 6,378,289; 6,391,030; 6,468,309; 6,436,099; 6,451,019; 6,582,433; 6,605,091; 6,626,944; 6,629,975; 6,652,527; 6,652,585; 6,656,185; 6,669,729; 6,682,533; 6,689,140; 6,712,819; 6,689,168; 6,695,852; 6,716,245; 6,761,720; 6,835,205; Published U.S. patent application Ser. Nos. U.S. 2002/0151978; U.S. 2004/0024458; U.S. 2004/0106995; U.S. 2004/0116927; U.S. 2004/0117017; U.S. 2004/0127989; U.S. 2004/0172132; U.S. 2005/0033435; U.S. 2005/0049708; U.S. 2006/0069447; Published PCT Application Nos. WO 01/28442 A1; WO 02/03882 A2; WO 02/051326 A1; WO 02/071960 A1; WO 03/045262 A1; WO 2004/052246 A1; WO 2004/073532 A1; and Published Foreign Application Nos. EP 0322334 A1; and FR 2 681 525 A1.
The present invention provides spinal implants, implant systems, and methods for constraining spinous processes to elastically limit flexion of two or more adjacent spinal segments. As used herein, the phrase “spinal segment” is synonymous with the phrase “functional spinal unit (FSU)” and intended to mean the smallest physiological motion unit of the spine that exhibits biomechanical characteristics similar to those of the entire spine. A spinal segment or FSU consists of two adjacent vertebrae, the intervertebral disc and all adjoining ligaments between them and excludes other connecting tissues such as muscles. The three joint complex that results is sometimes referred to as the “articular triad.” Another term for the FSU is spinal motion segment. These definitions are taken from White A A, Panjabi M M. (1990), Clinical Biomechanics of the Spine, Philadelphia, J B Lippincott. The methods comprise placing a tether structure over the spinous processes of at least three adjacent vertebral bodies, or over the spinous processes of two adjacent vertebral bodies and a sacrum, wherein the structure elastically couples the at least two non-adjacent spinous processes or one spinous process and a non-adjacent sacrum. The spinous processes and optionally a sacrum can be interconnected and elastically coupled in a variety of ways.
FIG. 2 illustrates a spinal implant of the type described in U.S. 2005/0216017A1.
The present invention provides methods, devices, and systems for constraining the flexion of two or more adjacent spinal segments by elastically restraining two or more spinous processes or at least one spinous process and an anchor region on a sacrum. Such restraint is achieved using a tether structure which spans at least three spinous processes or a pair of spinous processes and the sacrum (more specifically, the spinous processes on L4 and L5 as well as an anchor region on the sacrum). The tethers used will typically be in the form of a contiguous tether structure. By “contiguous” it means that the tether may comprise one or more elongate component(s), such as strap(s), cable(s), ribbon(s), or the like, which may be constructed or modified to provide for a desired elastic coupling of one or more spinous processes and optionally an anchor location on the sacrum. Alternatively, the “contiguous” tether structures may comprise a plurality of components, such as the straps, bands, cables, or the like, as mentioned above, together with compliance structures which provide for-the desired elastic coupling. In the latter case, the straps, etc., will typically be non-compliant, effecting little or no elongation in response to tension, while the compliance members will provide the desired level of elastically coupling. Combinations of compliant elongate components and separate compliance members will also be possible.
FIG. 10 illustrates a system including a tether structure 24, generally as described with reference to FIG. 4 above, and a second tether structure 90 which is similar to tether structure 80, except that it is adapted only to extend around a single spinous process (SP5) and to be anchored into the sacrum S. Attachment may be provided in a variety of ways as described in copending application Ser. No. 11/827,980 and 61/149,224, both previously incorporated herein by reference. The second tether structure may be attached using a dowel implanted in the sacrum, using alar screws, using superior articular facet screws, using toggle anchors (T-tags) placed in holes formed in a superior articular facet of S1, using hooks attached to the dorsal S1 foramen, or the like. The tether structure 24 and tether structure 90 could be deployed without any interconnection, as generally shown in FIG. 10. Often, however, it might be desirable to interconnect the tether structures at their crossover points 92 a, 92 b, generally adjacent to the two sides of SP5. The attachment could be accomplished using a crimp structure (not shown) or by otherwise tying, welding, or fusing the tether structures together.
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Classification aux États-Unis 606/248
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:ALAMIN, TODD;BENNETT, IAN;FIELDING, LOUIS;AND OTHERS;SIGNING DATES FROM 20090520 TO 20090526;REEL/FRAME:027912/0624