U.S. patent application number 11/413616 was filed with the patent office on 2007-11-22 for interspinous process brace.
This patent application is currently assigned to WARSAW ORTHOPEDIC, INC.. Invention is credited to Kent M. Anderson, Aurelien Bruneau, Thomas Carls, Eric C. Lange, Roy Lim, Hai H. Trieu.
Application Number | 20070270824 11/413616 |
Document ID | / |
Family ID | 38656286 |
Filed Date | 2007-11-22 |
United States Patent
Application |
20070270824 |
Kind Code |
A1 |
Lim; Roy ; et al. |
November 22, 2007 |
Interspinous process brace
Abstract
An interspinous process brace is disclosed and can include a
superior component and an inferior component. The superior
component can include a superior spinous process bracket that can
engage a superior spinous process. The inferior component can
include an inferior spinous process bracket that can engage an
inferior spinous process. Further, the interspinous process brace
can be moved between a bent configuration and a straight
configuration. In the bent configuration, an overall height of the
interspinous process brace can be minimized to facilitate
installation between the superior spinous process and the inferior
spinous process.
Inventors: |
Lim; Roy; (Memphis, TN)
; Carls; Thomas; (Memphis, TN) ; Bruneau;
Aurelien; (Memphis, TN) ; Lange; Eric C.;
(Collierville, TN) ; Anderson; Kent M.; (Memphis,
TN) ; Trieu; Hai H.; (Cordova, TN) |
Correspondence
Address: |
LARSON NEWMAN ABEL POLANSKY & WHITE, LLP
5914 WEST COURTYARD DRIVE
SUITE 200
AUSTIN
TX
78730
US
|
Assignee: |
WARSAW ORTHOPEDIC, INC.
Warsaw
IN
|
Family ID: |
38656286 |
Appl. No.: |
11/413616 |
Filed: |
April 28, 2006 |
Current U.S.
Class: |
606/250 |
Current CPC
Class: |
A61B 17/7065
20130101 |
Class at
Publication: |
606/061 |
International
Class: |
A61F 2/30 20060101
A61F002/30 |
Claims
1. An interspinous process brace, comprising: a superior component
comprising a superior spinous process bracket configured to engage
a superior spinous process; and an inferior component comprising an
inferior spinous process bracket configured to engage an inferior
spinous process, wherein the interspinous process brace is movable
between a bent configuration and a straight configuration, wherein
in the bent configuration an overall height of the interspinous
process brace is minimized to facilitate installation between the
superior spinous process and the inferior spinous process.
2. The interspinous process brace of claim 1, further comprising a
central component connecting the superior component and the
inferior component, wherein the central component is configured to
allow the interspinous process brace to move between the bent
configuration and the straight configuration.
3. The interspinous process brace of claim 2, wherein a Young's
modulus of the inferior component and a Young's modulus of the
superior component are greater than a Young's modulus of the
central component.
4. The interspinous process brace of claim 2, wherein the superior
component and the inferior component are made from a first
biocompatible material and the central component is made from a
second biocompatible material.
5. The interspinous process brace of claim 4, wherein a Young's
modulus of the first biocompatible material is greater than a
Young's modulus of the second biocompatible material.
6. The interspinous process brace of claim 2, wherein the superior
component, the inferior component, the central component, or a
combination thereof are made from a biocompatible material.
7. The interspinous process brace of claim 6, wherein the superior
component and the inferior component are cross-linked.
8. The interspinous process brace of claim 7, wherein a Young's
modulus of the inferior component and a Young's modulus of the
superior component are greater than a Young's modulus of the
central component.
9. The interspinous process brace of claim 1, further comprising an
inferior spinous process engagement structure extending from the
inferior spinous process bracket.
10. The interspinous process brace of claim 9, further comprising a
superior spinous process engagement structure extending from the
superior spinous process bracket.
11. The interspinous process brace of claim 1, further comprising
an inferior tether configured to at least partially loop around the
inferior spinous process and bind the inferior spinous process to
the inferior spinous process bracket.
12. The interspinous process brace of claim 11, further comprising
a superior tether configured to at least partially loop around the
superior spinous process and bind the superior spinous process to
the superior spinous process bracket.
13. The interspinous process brace of claim 1, further comprising a
locking sleeve, wherein the locking sleeve is movable between an
unlocked position wherein the interspinous process brace is movable
to the bent configuration and a locked position wherein the
interspinous process brace is not movable to the bent
configuration.
14. The interspinous process brace of claim 13, further comprising
a locking pin configured to engage the locking sleeve and keep the
locking sleeve in the locked position.
15. The interspinous process brace of claim 1, further comprising a
central hinge connecting the superior component and the inferior
component, wherein the central hinge is configured to allow the
interspinous process brace to move between the bent configuration
and the straight configuration.
16. The interspinous process brace of claim 15, further comprising
a locking pin configured to engage the central hinge and prevent
the interspinous process brace from moving to the bent
configuration.
17. An interspinous process brace, comprising: a superior spinous
process bracket configured to engage a superior spinous process; an
inferior spinous process bracket configured to engage an inferior
spinous process; and a central component connecting the superior
spinous process bracket and the inferior spinous process bracket,
wherein the central component is configured to allow the
interspinous process brace to move between a bent configuration and
a straight configuration, wherein in the bent configuration an
overall height of the interspinous process brace is minimized to
facilitate installation between the superior spinous process and
the inferior spinous process.
18. The interspinous process brace of claim 17, further comprising
a posterior locking plate, wherein the posterior locking plate is
configured to prevent the interspinous process brace from moving to
the bent configuration.
19. The interspinous process brace of claim 18, wherein the
posterior locking plate is configured to be installed between the
superior spinous process bracket and the inferior spinous process
bracket adjacent to the central component.
20. The interspinous process brace of claim 19, further comprising
an anterior locking plate, wherein the anterior locking plate is
configured to prevent the interspinous process brace from moving to
the bent configuration.
21. The interspinous process brace of claim 20, wherein the
anterior locking plate is configured to be installed between the
superior spinous process bracket and the inferior spinous process
bracket adjacent to the central component.
22. (canceled)
23. A method of treating a spine, comprising: moving an
interspinous process brace to a bent configuration; installing the
interspinous process brace between a superior spinous process and
an inferior spinous process; and returning the interspinous process
brace to a straight configuration between the superior spinous
process and the inferior spinous process.
24.-30. (canceled)
31. A method of treating a spine, comprising: distracting a
superior spinous process and an inferior spinous process; moving an
interspinous process brace to a bent configuration; installing the
interspinous process brace between the superior spinous process and
the inferior spinous process; and returning the interspinous
process brace to a straight configuration between the superior
spinous process and the inferior spinous process.
32. A kit, comprising: at least two interspinous process braces,
each interspinous process brace comprising: a superior component
comprising a superior spinous process bracket configured to engage
a superior spinous process; and an inferior component comprising an
inferior spinous process bracket configured to engage an inferior
spinous process, wherein the interspinous process brace is movable
between a bent configuration and a straight configuration, wherein
in the bent configuration an overall height of the interspinous
process brace is minimized to facilitate installation between the
superior spinous process and the inferior spinous process.
33. A kit, comprising: an interspinous process brace, comprising: a
superior component comprising a superior spinous process bracket
configured to engage a superior spinous process; and an inferior
component comprising an inferior spinous process bracket configured
to engage an inferior spinous process, wherein the interspinous
process brace is movable between a bent configuration and a
straight configuration, wherein in the bent configuration an
overall height of the interspinous process brace is minimized to
facilitate installation between the superior spinous process and
the inferior spinous process; and a locking pin configured to
engage the interspinous process brace.
34. A method of treating a spine, comprising: moving an
interspinous process brace to a bent configuration; installing the
interspinous process brace between a superior spinous process and
an inferior spinous process; and returning the interspinous process
brace to a straight configuration in order to distract the superior
spinous process and the inferior spinous process.
35.-38. (canceled)
Description
FIELD OF THE DISCLOSURE
[0001] The present disclosure relates generally to orthopedics and
orthopedic surgery. More specifically, the present disclosure
relates to devices used to support adjacent spinous processes.
BACKGROUND
[0002] In human anatomy, the spine is a generally flexible column
that can take tensile and compressive loads. The spine also allows
bending motion and provides a place of attachment for keels,
muscles and ligaments. Generally, the spine is divided into three
sections: the cervical spine, the thoracic spine and the lumbar
spine. The sections of the spine are made up of individual bones
called vertebrae. Also, the vertebrae are separated by
intervertebral discs, which are situated between adjacent
vertebrae.
[0003] The intervertebral discs function as shock absorbers and as
joints. Further, the intervertebral discs can absorb the
compressive and tensile loads to which the spinal column may be
subjected. At the same time, the intervertebral discs can allow
adjacent vertebral bodies to move relative to each other a limited
amount, particularly during bending, or flexure, of the spine.
Thus, the intervertebral discs are under constant muscular and/or
gravitational pressure and generally, the intervertebral discs are
the first parts of the lumbar spine to show signs of
deterioration.
[0004] Facet joint degeneration is also common because the facet
joints are in almost constant motion with the spine. In fact, facet
joint degeneration and disc degeneration frequently occur together.
Generally, although one may be the primary problem while the other
is a secondary problem resulting from the altered mechanics of the
spine, by the time surgical options are considered, both facet
joint degeneration and disc degeneration typically have occurred.
For example, the altered mechanics of the facet joints and/or
intervertebral disc may cause spinal stenosis, degenerative
spondylolisthesis, and degenerative scoliosis.
BRIEF DESCRIPTION OF THE DRAWINGS
[0005] FIG. 1 is a lateral view of a portion of a vertebral
column;
[0006] FIG. 2 is a lateral view of a pair of adjacent
vertrebrae;
[0007] FIG. 3 is a top plan view of a vertebra;
[0008] FIG. 4 is a rear plan view of a first interspinous process
spacer with a locking sleeve unlocked;
[0009] FIG. 5 is a rear plan view of the first interspinous process
spacer with the locking sleeve locked;
[0010] FIG. 6 is a side plan view of the first interspinous process
spacer in a bent configuration;
[0011] FIG. 7 is a side plan view of the first interspinous process
spacer in a straight configuration with a locking sleeve
unlocked;
[0012] FIG. 8 is a side plan view of the first interspinous process
spacer in a straight configuration with the locking sleeve
locked;
[0013] FIG. 9 is a rear plan view of a second interspinous process
spacer;
[0014] FIG. 10 is a side plan view of the second interspinous
process spacer in a bent configuration;
[0015] FIG. 11 is a side plan view of the second interspinous
process spacer in a straight configuration;
[0016] FIG. 12 is a rear plan view of a third interspinous process
spacer;
[0017] FIG. 13 is a plan view of a posterior locking plate
configured to engage the third interspinous process spacer;
[0018] FIG. 14 is a rear plan view of the third interspinous
process spacer with the posterior locking plate engaged
therewith;
[0019] FIG. 15 is a side plan view of the third interspinous
process spacer in a bent configuration;
[0020] FIG. 16 is a side plan view of the third interspinous
process spacer in a straight configuration with a posterior locking
plate and an anterior locking plate disengaged there from;
[0021] FIG. 17 is a side plan view of the third interspinous
process spacer in the straight configuration with the posterior
locking plate and the anterior locking plate engaged therewith;
and
[0022] FIG. 18 is a rear plan view of a fourth interspinous process
spacer;
[0023] FIG. 19 is a side plan view of the fourth interspinous
process spacer in a bent configuration;
[0024] FIG. 20 is a side plan view of the fourth interspinous
process spacer in a straight configuration; and
[0025] FIG. 21 is a flow chart illustrating a method of treating a
spine.
DETAILED DESCRIPTION OF THE DRAWINGS
[0026] An interspinous process brace is disclosed and can include a
superior component and an inferior component. The superior
component can include a superior spinous process bracket that can
engage a superior spinous process. The inferior component can
include an inferior spinous process bracket that can engage an
inferior spinous process. Further, the interspinous process brace
can be moved between a bent configuration and a straight
configuration. In the bent configuration, an overall height of the
interspinous process brace can be minimized to facilitate
installation between the superior spinous process and the inferior
spinous process.
[0027] In another embodiment, an interspinous process brace is
disclosed and can include a superior spinous process bracket and an
inferior spinous process bracket. The superior spinous process
bracket can engage a superior spinous process and the inferior
spinous process bracket can engage an inferior spinous process. The
interspinous process brace can also include a central component
that can connect the superior spinous process bracket and the
inferior spinous process bracket. Additionally, the central
component can be configured to allow the interspinous process brace
to move between a bent configuration and a straight configuration.
In the bent configuration an overall height of the interspinous
process brace can be minimized to facilitate installation between
the superior spinous process and the inferior spinous process.
[0028] In still another embodiment, a method of treating a spine is
disclosed and can include moving an interspinous process brace to a
bent configuration and installing the interspinous process brace
between a superior spinous process and an inferior spinous process.
Further, the method can include returning the interspinous process
brace to a straight configuration between the superior spinous
process and the inferior spinous process.
[0029] In yet another embodiment, a method of treating a spine is
disclosed and can include distracting a superior spinous process
and an inferior spinous process, moving an interspinous process
brace to a bent configuration, and installing the interspinous
process brace between the superior spinous process and the inferior
spinous process. Also, the method can include returning the
interspinous process brace to a straight configuration between the
superior spinous process and the inferior spinous process.
[0030] In still yet another embodiment, a kit is disclosed and can
include at least two interspinous process braces. Each interspinous
process brace can include a superior component and an inferior
component. The superior component of each interspinous process
brace can include a superior spinous process bracket that can
engage a superior spinous process. Also, the inferior component of
each interspinous process brace can include an inferior spinous
process bracket that can engage an inferior spinous process.
Moreover, the interspinous process brace can be moved between a
bent configuration and a straight configuration. In the bent
configuration, an overall height of the interspinous process brace
can be minimized to facilitate installation between the superior
spinous process and the inferior spinous process.
[0031] In another embodiment, a kit is disclosed and can include an
interspinous process brace. The interspinous process brace can
include a superior component and an inferior component. The
superior component can include a superior spinous process bracket
that can engage a superior spinous process. The inferior component
can include an inferior spinous process bracket that can engage an
inferior spinous process. Further, the interspinous process brace
is movable between a bent configuration and a straight
configuration. In the bent configuration, an overall height of the
interspinous process brace can be minimized to facilitate
installation between the superior spinous process and the inferior
spinous process. The kit can also include a locking pin that can be
configured to engage the interspinous process brace.
[0032] In still another embodiment, a method of treating a spine is
disclosed and can include moving an interspinous process brace to a
bent configuration and installing the interspinous process brace
between a superior spinous process and an inferior spinous process.
Further, the method can include returning the interspinous process
brace to a straight configuration in order to distract the superior
spinous process and the inferior spinous process.
Description of Relevant Anatomy
[0033] Referring initially to FIG. 1, a portion of a vertebral
column, designated 100, is shown. As depicted, the vertebral column
100 includes a lumbar region 102, a sacral region 104, and a
coccygeal region 106. As is known in the art, the vertebral column
100 also includes a cervical region and a thoracic region. For
clarity and ease of discussion, the cervical region and the
thoracic region are not illustrated.
[0034] As shown in FIG. 1, the lumbar region 102 includes a first
lumbar vertebra 108, a second lumbar vertebra 110, a third lumbar
vertebra 112, a fourth lumbar vertebra 114, and a fifth lumbar
vertebra 116. The sacral region 104 includes a sacrum 118. Further,
the coccygeal region 106 includes a coccyx 120.
[0035] As depicted in FIG. 1, a first intervertebral lumbar disc
122 is disposed between the first lumbar vertebra 108 and the
second lumbar vertebra 110. A second intervertebral lumbar disc 124
is disposed between the second lumbar vertebra 110 and the third
lumbar vertebra 112. A third intervertebral lumbar disc 126 is
disposed between the third lumbar vertebra 112 and the fourth
lumbar vertebra 114. Further, a fourth intervertebral lumbar disc
128 is disposed between the fourth lumbar vertebra 114 and the
fifth lumbar vertebra 116. Additionally, a fifth intervertebral
lumbar disc 130 is disposed between the fifth lumbar vertebra 116
and the sacrum 118.
[0036] In a particular embodiment, if one of the intervertebral
lumbar discs 122, 124, 126, 128, 130 is diseased, degenerated,
damaged, or otherwise in need of repair, treatment of that
intervertebral lumbar disc 122, 124, 126, 128, 130 can be effected
in accordance with one or more of the embodiments described
herein.
[0037] FIG. 2 depicts a detailed lateral view of two adjacent
vertebrae, e.g., two of the lumbar vertebra 108, 110, 112, 114, 116
shown in FIG. 1. FIG. 2 illustrates a superior vertebra 200 and an
inferior vertebra 202. As shown, each vertebra 200, 202 includes a
vertebral body 204, a superior articular process 206, a transverse
process 208, a spinous process 210 and an inferior articular
process 212. FIG. 2 further depicts an intervertebral disc 216
between the superior vertebra 200 and the inferior vertebra
202.
[0038] Referring to FIG. 3, a vertebra, e.g., the inferior vertebra
202 (FIG. 2), is illustrated. As shown, the vertebral body 204 of
the inferior vertebra 202 includes a cortical rim 302 composed of
cortical bone. Also, the vertebral body 204 includes cancellous
bone 304 within the cortical rim 302. The cortical rim 302 is often
referred to as the apophyseal rim or apophyseal ring. Further, the
cancellous bone 304 is softer than the cortical bone of the
cortical rim 302.
[0039] As illustrated in FIG. 3, the inferior vertebra 202 further
includes a first pedicle 306, a second pedicle 308, a first lamina
310, and a second lamina 312. Further, a vertebral foramen 314 is
established within the inferior vertebra 202. A spinal cord 316
passes through the vertebral foramen 314. Moreover, a first nerve
root 318 and a second nerve root 320 extend from the spinal cord
316.
[0040] It is well known in the art that the vertebrae that make up
the vertebral column have slightly different appearances as they
range from the cervical region to the lumbar region of the
vertebral column. However, all of the vertebrae, except the first
and second cervical vertebrae, have the same basic structures,
e.g., those structures described above in conjunction with FIG. 2
and FIG. 3. The first and second cervical vertebrae are
structurally different than the rest of the vertebrae in order to
support a skull.
Description of a First Embodiment of an Interspinous Process
Brace
[0041] Referring to FIG. 4 through FIG. 8, a first interspinous
process brace is shown and is generally designated 400. As shown in
FIG. 4 and FIG. 5, the interspinous process brace 400 can include
an inferior component 402 and a superior component 404. Further,
the inferior component 402 can be coupled, or otherwise connected,
to the superior component 404 via a central component 406. In a
particular embodiment, the components 402, 404, 406 can be made
from one or more biocompatible materials. For example, the
materials can be metal containing materials, polymer materials, or
composite materials that include metals, polymers, or combinations
of metals and polymers.
[0042] In a particular embodiment, the metal containing materials
can be metals. Further, the metal containing materials can be
ceramics. Also, the metals can be pure metals or metal alloys. The
pure metals can include titanium. Moreover, the metal alloys can
include stainless steel, a cobalt-chrome-molybdenum alloy, e.g.,
ASTM F-999 or ASTM F-75, a titanium alloy, or a combination
thereof.
[0043] The polymer materials can include polyurethane materials,
polyolefin materials, polyaryletherketone (PAEK) materials,
silicone materials, hydrogel materials, or a combination thereof.
Further, the polyolefin materials can include polypropylene,
polyethylene, halogenated polyolefin, flouropolyolefin, or a
combination thereof. The polyaryletherketon (PAEK) materials can
include polyetherketone (PEK), polyetheretherketone (PEEK),
polyetherketoneketone (PEKK), polyetherketoneetherketoneketone
(PEKEKK), or a combination thereof. The hydrogels can include
polyacrylamide, poly-N-isopropylacrylamine, polyvinyl methylether,
polyvinyl alcohol, polyethyl hydroxyethyl cellulose, poly (2-ethyl)
oxazoline, polyethyleneoxide, polyethylglycol, polyethylene glycol,
polyacrylic acid, polyacrylonitrile, polyvinylacrylate,
polyvinylpyrrolidone, or a combination thereof. Alternatively, the
components 402, 404, 406 can be made from any other substantially
rigid biocompatible materials.
[0044] In a particular embodiment, the components 402, 404, 406 can
be made from the same biocompatible material. Further, the
components 402, 404, 406 can be monolithic. Alternatively, the
components 402, 404, 406 can be made from different biocompatible
materials. For example, the inferior component 402 and the superior
component 404 can be made from a first biocompatible material and
the central component 406 can be made from a second biocompatible
material. Also, the first biocompatible material can have a Young's
modulus that is substantially greater than a Young's modulus of the
second biocompatible material. Accordingly, as described in greater
detail below, an elasticity of the central component 406 can allow
the inferior component 402 to be bent, or folded, relative to the
superior component 404.
[0045] In a particular embodiment, the components 402, 404, 406 can
be made from the same biocompatible material. However, in a certain
embodiment, the inferior component 402 and the superior component
404 can be cross-linked, but not the central component 406. As
such, the Young's modulus of the inferior component 402 and the
superior component 404 can be greater than the central component
404.
[0046] As illustrated in FIG. 4 and FIG. 5, the inferior component
402 can include an inferior support post 410. An inferior lateral
arm 412 can extend from the inferior support post 410. Further, an
inferior spinous process bracket 414 can extend from the inferior
lateral arm 412.
[0047] In a particular embodiment, a lateral cross-section of the
inferior support post 410 can indicate that the inferior support
post 410 can be generally box-shaped. Alternatively, the inferior
support post 410 can be generally cylindrical, generally prismatic,
generally polyhedral, or a combination thereof.
[0048] As indicated in FIG. 4 and FIG. 5, the inferior spinous
process bracket 414 can be generally U shaped. Alternatively, the
inferior spinous process bracket 414 can be generally V shaped.
Further, the inferior spinous process bracket 414 can include an
inferior spinous process engagement structure 422 that extends from
the inferior spinous process bracket 414. In a particular
embodiment, the inferior spinous process engagement structure 422
can be one or more spikes, one or more teeth, a combination
thereof, or some other structure configured to engage a spinous
process.
[0049] The inferior component 402 can also include a first inferior
tether hole 430 and a second inferior tether hole 432. An inferior
tether 434 can span the inferior component 402, e.g., between the
first inferior tether hole 430 and the second inferior tether hole
432. Further, the inferior tether 434 can be looped at least
partially around a spinous process and can substantially maintain
the spinous process in contact with the inferior spinous process
bracket 414. The tether can comprise a biocompatible elastomeric
material that flexes during installation and provides a resistance
fit against the inferior process. Further, the tether can comprise
a substantially non-resorbable suture or the like.
[0050] As illustrated in FIG. 4 and FIG. 5, the superior component
404 can include a superior support post 450. A superior lateral arm
452 can extend from the superior support post 450. Further, a
superior spinous process bracket 454 can extend from the superior
lateral arm 452.
[0051] In a particular embodiment, the superior support post 450
can be sized and shaped similar to the inferior support post 410. A
lateral cross-section of the superior support post 450 can indicate
that the superior support post 450 can be generally box-shaped.
Alternatively, the superior support post 450 can be generally
cylindrical, generally prismatic, generally polyhedral, or a
combination thereof.
[0052] As indicated in FIG. 4 and FIG. 5, the superior spinous
process bracket 454 can be generally U shaped. Alternatively, the
superior spinous process bracket 454 can be generally V shaped.
Further, the superior spinous process bracket 454 can include a
superior spinous process engagement structure 462 that extends from
the superior spinous process bracket 454. In a particular
embodiment, the superior spinous process engagement structure 462
can be one or more spikes, one or more teeth, a combination
thereof, or some other structure configured to engage a spinous
process.
[0053] The superior component 404 can also include a first superior
tether hole 470 and a second superior tether hole 472. A superior
tether 474 can span the superior component 404, e.g., between the
first superior tether hole 470 and the second superior tether hole
472. Further, the superior tether 474 can be looped at least
partially around a spinous process and can substantially maintain
the spinous process in contact with the superior spinous process
bracket 454. The tether can comprise a biocompatible elastomeric
material that flexes during installation and provides a resistance
fit against the inferior process. Further, the tether can comprise
a substantially non-resorbable suture or the like.
[0054] FIG. 4 through FIG. 8 further indicate that the interspinous
process brace 400 can include a locking sleeve 480 that can be
slidably disposed around the inferior component 402, the superior
component 404, the central component 406, or a combination thereof.
The locking sleeve 480 can include a pair of inferior locking holes
482 and a pair of superior locking holes 484. Also, the inferior
component 402 can include a locking hole 486 and the superior
component 404 can include a locking hole 488.
[0055] In a particular embodiment, the locking sleeve 480 can be
moved along the interspinous process brace 400 until the inferior
locking holes 482 on the locking sleeve 480 are aligned with the
locking hole 486 in the inferior component 402 and the superior
locking holes 484 on the locking sleeve 480 are aligned with the
locking hole 488 in the superior component 404. Thereafter, as
shown in FIG. 5, an inferior locking pin 490 can be installed
through the inferior locking holes 482 on the locking sleeve 480
and the locking hole 486 in the inferior component 402. Also, a
superior locking pin 492 can be installed through the superior
locking holes 484 on the locking sleeve 480 and the locking hole
488 in the superior component 404.
[0056] FIG. 6 illustrates the locking sleeve 480 in an unlocked
position and the interspinous process brace 400 in a bent
configuration. FIG. 7 illustrates the locking sleeve 480 in an
unlocked position and the interspinous process brace 400 in a
straight configuration. Further, FIG. 8 illustrates the
interspinous process brace 400 in the straight configuration and
the locking sleeve 480 in a locked position. Accordingly, the
interspinous process brace 400 can be moved between the straight
configuration and the bent configuration to facilitate installation
between adjacent spinous processes.
[0057] More particularly, the interspinous process brace 400 can be
bent, or otherwise folded, as shown in FIG. 6, in order to reduce
an overall height of the interspinous process brace 400.
Thereafter, the interspinous process brace 400 can be place between
adjacent spinous processes and allowed to return to the straight
configuration, shown in FIG. 7. Further, after the interspinous
process brace 400 is allowed to return to the straight
configuration, the locking sleeve 480 can be moved to the locked
position, shown in FIG. 8, to prevent the interspinous process
brace 400 from returning to the bent configuration.
[0058] In a particular embodiment, when the interspinous process
brace 400 is properly installed between a superior vertebra and an
inferior vertebra, shown in FIG. 4, the inferior spinous process
bracket 414 can engage and support an inferior spinous process 500.
Further, the superior spinous process bracket 454 can engage and
support a superior spinous process 502. More specifically, the
inferior spinous process engagement structure 422 can extend
slightly into and engage the inferior spinous process 500. Also,
the superior spinous process engagement structure 462 can extend
slightly into and engage the superior spinous process 502.
Accordingly, the spinous process engagement structures 422, 462 and
the tethers 434, 474 can substantially prevent the interspinous
process brace 400 from migrating with respect to the spinous
processes 500, 502.
[0059] Also, in a particular embodiment, a distractor can be used
to increase a distance 510 between the superior spinous process 502
and the inferior spinous process 500 and the interspinous process
brace 400 can be installed to support the superior spinous process
502 and the inferior spinous process 500. After the interspinous
process brace 400 is installed, the distractor can be removed and
the interspinous process brace 400 can support the superior spinous
process 502 and the inferior spinous process 500 to substantially
prevent the distance 510 between the superior spinous process 502
and the inferior spinous process 500 from returning to a
pre-distraction value. Further, the interspinous process brace 400,
when locked, as described herein, the interspinous process brace
400 can dynamically resist compressive loads, tensile loads, or a
combination thereof. It may be desirable to allow the interspinous
process brace 400 to bend or flex after it is installed. Therefore,
the locking sleeve 480 may be omitted from the interspinous process
brace 400.
Description of a Second Embodiment of an Interspinous Process
Brace
[0060] Referring to FIG. 9 through FIG. 11, a second interspinous
process brace is shown and is generally designated 900. As shown,
the interspinous process brace 900 includes an inferior component
902 and a superior component 904. Further, the inferior component
902 can be coupled, or otherwise connected, to the superior
component 904 via a first central component 906 and a second
central component 908. In a particular embodiment, the components
902, 904, 906, 908 can be made from one or more biocompatible
materials. For example, the materials can be metal containing
materials, polymer materials, or composite materials that include
metals, polymers, or combinations of metals and polymers.
[0061] In a particular embodiment, the metal containing materials
can be metals. Further, the metal containing materials can be
ceramics. Also, the metals can be pure metals or metal alloys. The
pure metals can include titanium. Moreover, the metal alloys can
include stainless steel, a cobalt-chrome-molybdenum alloy, e.g.,
ASTM F-999 or ASTM F-75, a titanium alloy, or a combination
thereof.
[0062] The polymer materials can include polyurethane materials,
polyolefin materials, polyaryletherketone (PAEK) materials,
silicone materials, hydrogel materials, or a combination thereof.
Further, the polyolefin materials can include polypropylene,
polyethylene, halogenated polyolefin, flouropolyolefin, or a
combination thereof. The polyaryletherketon (PAEK) materials can
include polyetherketone (PEK), polyetheretherketone (PEEK),
polyetherketoneketone (PEKK), polyetherketoneetherketoneketone
(PEKEKK), or a combination thereof. The hydrogels can include
polyacrylamide, poly-N-isopropylacrylamine, polyvinyl methylether,
polyvinyl alcohol, polyethyl hydroxyethyl cellulose, poly (2-ethyl)
oxazoline, polyethyleneoxide, polyethylglycol, polyethylene glycol,
polyacrylic acid, polyacrylonitrile, polyvinylacrylate,
polyvinylpyrrolidone, or a combination thereof. Alternatively, the
components 902, 904 can be made from any other substantially rigid
biocompatible materials.
[0063] In a particular embodiment, the components 902, 904, 906,
908 can be made from the same biocompatible material. Further, the
components 902, 904, 906, 908 can be monolithic. Alternatively, the
components 902, 904, 906, 908 can be made from different
biocompatible materials. For example, the inferior component 902
and the superior component 904 can be made from a first
biocompatible material and the central components 906, 908 can be
made from a second biocompatible material. Also, the first
biocompatible material can have a Young's modulus that is
substantially greater than a Young's modulus of the second
biocompatible material. Accordingly, as described in greater detail
below, an elasticity of the central components 906, 908 can allow
the inferior component 902 to be bent, or folded, relative to the
superior component 904.
[0064] As illustrated in FIG. 9 and FIG. 10, the inferior component
902 can include a first inferior support post 910 and a second
inferior support post 912. A first inferior lateral arm 914 can
extend from the first inferior support post 910 and a second
inferior lateral arm 916 can extend from the second inferior
support post 912. Further, an inferior spinous process bracket 918
can extend between the first inferior lateral arm 914 and the
second inferior lateral arm 916.
[0065] In a particular embodiment, a lateral cross-section of the
inferior support posts 910, 912 can indicate that the inferior
support posts 910, 912 can be generally box-shaped. Alternatively,
the inferior support posts 910, 912 can be generally cylindrical,
generally prismatic, generally polyhedral, or a combination
thereof.
[0066] As indicated in FIG. 9 and FIG. 10, the inferior spinous
process bracket 918 can be generally U shaped. Alternatively, the
inferior spinous process bracket 918 can be generally V shaped.
Further, the inferior spinous process bracket 918 can include an
inferior spinous process engagement structure 940 that extends from
the inferior spinous process bracket 918. In a particular
embodiment, the inferior spinous process engagement structure 940
can be one or more spikes, one or more teeth, a combination
thereof, or some other structure configured to engage a spinous
process.
[0067] The inferior component 902 can also include an inferior
tether 942 that can be wrapped around the inferior component 902,
e.g., around the inferior spinous process bracket 918. In
particular embodiment, the inferior tether 942 can be looped at
least partially around a spinous process and can substantially
maintain the spinous process in contact with the inferior spinous
process bracket 918. The tether can comprise a biocompatible
elastomeric material that flexes during installation and provides a
resistance fit against the inferior process. Further, the tether
can comprise a substantially non-resorbable suture or the like.
[0068] As illustrated in FIG. 9 and FIG. 10, the superior component
904 can include a first superior support post 950 and a second
superior support post 952. A first superior lateral arm 954 can
extend from the first superior support post 950 and a second
superior lateral arm 956 can extend from the second superior
support post 952. Further, a superior spinous process bracket 958
can extend between the first superior lateral arm 954 and the
second superior lateral arm 956.
[0069] In a particular embodiment, the first superior support post
950 can be sized and shaped to match the first inferior support
post 910. Also, the second superior support post 952 can be sized
and shaped to match the second inferior support post 912. A lateral
cross-section of the superior support posts 950, 952 can indicate
that the superior support posts 950, 952 can be solid and generally
box-shaped. Alternatively, the superior support posts 950, 952 can
be generally cylindrical, generally prismatic, generally
polyhedral, or a combination thereof.
[0070] As indicated in FIG. 9 and FIG. 10, the superior spinous
process bracket 958 can be generally U shaped. Alternatively, the
superior spinous process bracket 958 can be generally V shaped.
Further, the superior spinous process bracket 958 can include a
superior spinous process engagement structure 980 that extends from
the superior spinous process bracket 958. In a particular
embodiment, the superior spinous process engagement structure 980
can be one or more spikes, one or more teeth, a combination
thereof, or some other structure configured to engage a spinous
process.
[0071] The superior component 904 can also include a superior
tether 982 that can be wrapped around the superior component 904,
e.g., around the superior spinous process bracket 958. In
particular embodiment, the superior tether 982 can be looped at
least partially around a spinous process and can substantially
maintain the spinous process in contact with the superior spinous
process bracket 958. The tether can comprise a biocompatible
elastomeric material that flexes during installation and provides a
resistance fit against the inferior process. Further, the tether
can comprise a substantially non-resorbable suture or the like.
[0072] FIG. 10 illustrates the interspinous process brace 900 in a
bent configuration. FIG. 11 illustrates the interspinous process
brace 900 in a straight configuration. Accordingly, the
interspinous process brace 900 can be moved between the straight
configuration and the bent configuration to facilitate installation
between adjacent spinous processes.
[0073] More particularly, the interspinous process brace 900 can be
bent, or otherwise folded, as shown in FIG. 10, in order to reduce
an overall height of the interspinous process brace 900.
Thereafter, the interspinous process brace 900 can be place between
adjacent spinous processes and allowed to return to the straight
configuration, shown in FIG. 11.
[0074] In a particular embodiment, when the interspinous process
brace 900 is properly installed between a superior vertebra and an
inferior vertebra, as shown in FIG. 9, the inferior spinous process
bracket 918 can engage and support an inferior spinous process
1000. Further, the superior spinous process bracket 958 can engage
and support a superior spinous process 1002. More specifically, the
inferior spinous process engagement structure 940 can extend
slightly into and engage the inferior spinous process 1000. Also,
the superior spinous process engagement structure 980 can extend
slightly into and engage the superior spinous process 1002.
Accordingly, the spinous process engagement structures 940, 980 and
the tethers 942, 982 can substantially prevent the interspinous
process brace 900 from migrating with respect to the spinous
processes 1000, 1002.
[0075] In a particular embodiment, a distractor can be used to
increase the distance 1010 between the superior spinous process
1002 and the inferior spinous process 1000 and the interspinous
process brace 900 can be installed to support the superior spinous
process 1002 and the inferior spinous process 1000. After the
interspinous process brace 900 is installed, the distractor can be
removed and the interspinous process brace 900 can support the
superior spinous process 1002 and the inferior spinous process 1000
to substantially prevent the distance 1010 between the superior
spinous process 1002 and the inferior spinous process 1000 from
returning to a pre-distraction value.
[0076] Further, the interspinous process brace 900 can include one
or more locking sleeves (not shown) similar to the locking sleeve
described in conjunction with the first interspinous process brace,
described above, in order to lock the interspinous process brace
900 and prevent the interspinous process brace 900 from returning
to the bent configuration. When locked, the interspinous process
brace 900 can dynamically resist compressive loads, tensile loads,
or a combination thereof.
Description of a Third Embodiment of an Interspinous Process
Brace
[0077] Referring to FIG. 12 through FIG. 17, a third interspinous
process brace is shown and is generally designated 1200. As shown,
the interspinous process brace 1200 can include an inferior spinous
process bracket 1202 and a superior spinous process bracket 1204.
The inferior spinous process bracket 1202 can be coupled to the
inferior spinous process bracket 1204 by a central component 1206.
In a particular embodiment, the brackets 1202, 1204 and the central
component 1206 can be made from one or more biocompatible
materials. For example, the materials can be metal containing
materials, polymer materials, or composite materials that include
metals, polymers, or combinations of metals and polymers.
[0078] In a particular embodiment, the metal containing materials
can be metals. Further, the metal containing materials can be
ceramics. Also, the metals can be pure metals or metal alloys. The
pure metals can include titanium. Moreover, the metal alloys can
include stainless steel, a cobalt-chrome-molybdenum alloy, e.g.,
ASTM F-999 or ASTM F-75, a titanium alloy, or a combination
thereof.
[0079] The polymer materials can include polyurethane materials,
polyolefin materials, polyaryletherketone (PAEK) materials,
silicone materials, hydrogel materials, or a combination thereof.
Further, the polyolefin materials can include polypropylene,
polyethylene, halogenated polyolefin, flouropolyolefin, or a
combination thereof. The polyaryletherketon (PAEK) materials can
include polyetherketone (PEK), polyetheretherketone (PEEK),
polyetherketoneketone (PEKK), polyetherketoneetherketoneketone
(PEKEKK), or a combination thereof. The hydrogels can include
polyacrylamide, poly-N-isopropylacrylamine, polyvinyl methylether,
polyvinyl alcohol, polyethyl hydroxyethyl cellulose, poly (2-ethyl)
oxazoline, polyethyleneoxide, polyethylglycol, polyethylene glycol,
polyacrylic acid, polyacrylonitrile, polyvinylacrylate,
polyvinylpyrrolidone, or a combination thereof. Alternatively, the
brackets 1202, 1204 can be made from any other substantially rigid
biocompatible materials.
[0080] In a particular embodiment, the brackets 1202, 1204 and the
central component 1206 can be made from the same biocompatible
material. Further, the brackets 1202, 1204 and the central
component 1206 can be monolithic. Alternatively, the brackets 1202,
1204 and the central component 1206 can be made from different
biocompatible materials. For example, the inferior spinous process
bracket 1202 and the superior spinous process bracket 1204 can be
made from a first biocompatible material and the central component
1206 can be made from a second biocompatible material. Also, the
first biocompatible material can have a Young's modulus that is
substantially greater than a Young's modulus of the second
biocompatible material. Accordingly, as described in greater detail
below, an elasticity of the central component 1206 can allow the
inferior spinous process bracket 1202 to be bent, or folded,
relative to the superior spinous process bracket 1204.
[0081] As indicated in FIG. 12 and FIG. 13, the inferior spinous
process bracket 1202 can be generally V shaped and can include a
first inferior support arm 1210 and a second inferior support arm
1212. Alternatively, the inferior spinous process bracket 1202 can
be generally U shaped. Further, the inferior spinous process
bracket 1202 can include an inferior spinous process engagement
structure 1214 that extends from the inferior spinous process
bracket 1202. In a particular embodiment, the inferior spinous
process engagement structure 1214 can be one or more spikes, one or
more teeth, a combination thereof, or some other structure
configured to engage a spinous process.
[0082] The inferior spinous process bracket 1202 can also include a
first inferior tether hole 1220 and a second inferior tether hole
1222. An inferior tether 1224 can span the inferior spinous process
bracket 1202, e.g., between the first inferior tether hole 1220 and
the second inferior tether hole 1222. Further, the inferior tether
1224 can be looped at least partially around a spinous process and
can substantially maintain the spinous process in contact with the
inferior spinous process bracket 1202. The tether can comprise a
biocompatible elastomeric material that flexes during installation
and provides a resistance fit against the inferior process.
Further, the tether can comprise a substantially non-resorbable
suture or the like.
[0083] Further, the superior spinous process bracket 1204 can be
generally V shaped and can include a first superior support arm
1230 and a second superior support arm 1232. Alternatively, the
superior spinous process bracket 1204 can be generally U shaped.
The superior spinous process bracket 1204 can also include a
superior spinous process engagement structure 1234 that extends
from the superior spinous process bracket 1204. In a particular
embodiment, the superior spinous process engagement structure 1234
can be one or more spikes, one or more teeth, a combination
thereof, or some other structure configured to engage a spinous
process.
[0084] The superior spinous process bracket 1204 can also include a
first superior tether hole 1240 and a second superior tether hole
1242. A superior tether 1244 can span the superior spinous process
bracket 1204, e.g., between the first superior tether hole 1240 and
the second superior tether hole 1242. Further, the superior tether
1244 can be looped at least partially around a spinous process and
can substantially maintain the spinous process in contact with the
superior spinous process bracket 1204. The tether can comprise a
biocompatible elastomeric material that flexes during installation
and provides a resistance fit against the inferior process.
Further, the tether can comprise a substantially non-resorbable
suture or the like.
[0085] As illustrated in FIG. 12, the central component 1206 can be
formed with an inferior locking hole 1280 and a superior locking
hole 1282. The locking holes 1280, 1282 can be configured to
receive respective locking pins, described below.
[0086] FIG. 13 illustrates a posterior locking plate 1300 that can
include an inferior locking hole 1302 and a superior locking hole
1304. Also, FIG. 13 illustrates an anterior locking plate 1350 that
can include an inferior locking hole 1352 and a superior locking
hole 1354. In a particular embodiment, as shown in FIG. 16 and FIG.
17, the locking plates 1300, 1350 can be placed around the central
component 1206 between the brackets 1202, 1204 such that the
central component 806 is sandwiched between the locking plates
1300, 1350. FIG. 14 illustrates the posterior locking plate 1300
installed between the inferior spinous process bracket 1202 and the
superior spinous process bracket 1204.
[0087] Further, as shown in FIG. 14 and FIG. 17, an inferior
locking pin 1400 can be installed through the inferior locking hole
1302 in the posterior locking plate 1300 and the inferior locking
hole 1280 in the central component 806. In a particular embodiment,
the inferior locking pin 1400 can threadably engage the inferior
locking hole 1352 formed in the anterior locking plate 1350. Also,
a superior locking pin 1402 can be installed through the superior
locking hole 1304 in the posterior locking plate 1300 and the
superior locking hole 1282 in the central component 1206. The
superior locking pin 1402 can threadably engage the superior
locking hole 1354 formed in the anterior locking plate 1350.
[0088] FIG. 15 illustrates the interspinous process brace 1200 in a
bent configuration with the locking plates 1300, 1350 disengaged
therefrom. FIG. 16 illustrates the interspinous process brace 1200
in a straight configuration with the locking plates 1300, 1350
disengaged therefrom. Further, FIG. 17 illustrates the interspinous
process brace 1200 in the straight configuration and the locking
plates 1300, 1350 engaged therewith. Accordingly, the interspinous
process brace 1200 can be moved between the straight configuration
and the bent configuration to facilitate installation between
adjacent spinous processes.
[0089] More particularly, the interspinous process brace 1200 can
be bent, or otherwise folded, as shown in FIG. 15, in order to
reduce an overall height of the interspinous process brace 1200.
Thereafter, the interspinous process brace 1200 can be place
between an inferior spinous process 1500 and a superior spinous
process 1502 and allowed to return to the straight configuration,
shown in FIG. 14 and FIG. 16. Further, after the interspinous
process brace 1200 is allowed to return to the straight
configuration, the locking plates 1300, 1350 can be installed, as
described herein, to prevent the interspinous process brace 1200
from returning to the bent configuration.
[0090] In a particular embodiment, a distractor can be used to
increase a distance 15 10 between the superior spinous process 1502
and the inferior spinous process 1500 and the interspinous process
brace 1200 can be installed to support the superior spinous process
1502 and the inferior spinous process 1500. After the interspinous
process brace 1200 is installed, the distractor can be removed and
the interspinous process brace 1200 can support the superior
spinous process 1502 and the inferior spinous process 1500 to
substantially prevent the distance 1510 between the superior
spinous process 1502 and the inferior spinous process 1500 from
returning to a pre-distraction value. Further, the interspinous
process brace 1200, when locked, can dynamically resist compressive
loads, tensile loads, or a combination thereof.
Description of a Fourth Embodiment of an Interspinous Process
Brace
[0091] Referring to FIG. 18 through FIG. 20, a first interspinous
process brace is shown and is generally designated 1800. As shown
in FIG. 18, the interspinous process brace 1800 can include an
inferior component 1802 and a superior component 1804. Further, the
inferior component 1802 can be coupled, or otherwise connected, to
the superior component 1804 via a central hinge 1806. A locking pin
1808 can be disposed within the central hinge 1806 in order to lock
the central hinge 1806. In an alternative embodiment, in lieu of a
hinge, a ball-and-socket joint (not shown) can couple the inferior
component 1802 and the superior component 1804. Further, a locking
sleeve, similar to the locking sleeve described above, can be used
to lock the central hinge 1806 instead of the locking pin 1808.
[0092] In a particular embodiment, the components 1802, 1804 can be
made from one or more biocompatible materials. For example, the
materials can be metal containing materials, polymer materials, or
composite materials that include metals, polymers, or combinations
of metals and polymers.
[0093] In a particular embodiment, the metal containing materials
can be metals. Further, the metal containing materials can be
ceramics. Also, the metals can be pure metals or metal alloys. The
pure metals can include titanium. Moreover, the metal alloys can
include stainless steel, a cobalt-chrome-molybdenum alloy, e.g.,
ASTM F-999 or ASTM F-75, a titanium alloy, or a combination
thereof.
[0094] The polymer materials can include polyurethane materials,
polyolefin materials, polyaryletherketone (PAEK) materials,
silicone materials, hydrogel materials, or a combination thereof.
Further, the polyolefin materials can include polypropylene,
polyethylene, halogenated polyolefin, flouropolyolefin, or a
combination thereof. The polyaryletherketon (PAEK) materials can
include polyetherketone (PEK), polyetheretherketone (PEEK),
polyetherketoneketone (PEKK), polyetherketoneetherketoneketone
(PEKEKK), or a combination thereof. The hydrogels can include
polyacrylamide, poly-N-isopropylacrylamine, polyvinyl methylether,
polyvinyl alcohol, polyethyl hydroxyethyl cellulose, poly (2-ethyl)
oxazoline, polyethyleneoxide, polyethylglycol, polyethylene glycol,
polyacrylic acid, polyacrylonitrile, polyvinylacrylate,
polyvinylpyrrolidone, or a combination thereof. Alternatively, the
components 1802, 1804 can be made from any other substantially
rigid biocompatible materials.
[0095] As illustrated in FIG. 18 and FIG. 19, the inferior
component 1802 can include an inferior support post 1810. An
inferior lateral arm 1812 can extend from the inferior support post
1810. Further, an inferior spinous process bracket 1814 can extend
from the inferior lateral arm 1812.
[0096] In a particular embodiment, a lateral cross-section of the
inferior support post 1810 can indicate that the inferior support
post 1810 can be generally box-shaped. Alternatively, the inferior
support post 1810 can be generally cylindrical, generally
prismatic, generally polyhedral, or a combination thereof.
[0097] As indicated in FIG. 18 and FIG. 19, the inferior spinous
process bracket 1814 can be generally U shaped. Alternatively, the
inferior spinous process bracket 1814 can be generally V shaped.
Further, the inferior spinous process bracket 1814 can include an
inferior spinous process engagement structure 1822 that extends
from the inferior spinous process bracket 1814. In a particular
embodiment, the inferior spinous process engagement structure 1822
can be one or more spikes, one or more teeth, a combination
thereof, or some other structure configured to engage a spinous
process.
[0098] The inferior component 1802 can also include a first
inferior tether hole 1830 and a second inferior tether hole 1832.
An inferior tether 1834 can span the inferior component 1802, e.g.,
between the first inferior tether hole 1830 and the second inferior
tether hole 1832. Further, the inferior tether 1834 can be looped
at least partially around a spinous process and can substantially
maintain the spinous process in contact with the inferior spinous
process bracket 1814. The tether can comprise a biocompatible
elastomeric material that flexes during installation and provides a
resistance fit against the inferior process. Further, the tether
can comprise a substantially non-resorbable suture or the like.
[0099] As illustrated in FIG. 18 and FIG. 19, the superior
component 1804 can include a superior support post 1850. A superior
lateral arm 1852 can extend from the superior support post 1850.
Further, a superior spinous process bracket 1854 can extend from
the superior lateral arm 1852.
[0100] In a particular embodiment, the superior support post 1850
can be sized and shaped similar to the inferior support post 1810.
A lateral cross-section of the superior support post 1850 can
indicate that the superior support post 1850 can be generally
box-shaped. Alternatively, the superior support post 1850 can be
generally cylindrical, generally prismatic, generally polyhedral,
or a combination thereof.
[0101] As indicated in FIG. 18 and FIG. 19, the superior spinous
process bracket 1854 can be generally U shaped. Alternatively, the
superior spinous process bracket 1854 can be generally V shaped.
Further, the superior spinous process bracket 1854 can include a
superior spinous process engagement structure 1862 that extends
from the superior spinous process bracket 1854. In a particular
embodiment, the superior spinous process engagement structure 1862
can be one or more spikes, one or more teeth, a combination
thereof, or some other structure configured to engage a spinous
process.
[0102] The superior component 1804 can also include a first
superior tether hole 1870 and a second superior tether hole 1872. A
superior tether 1874 can span the superior component 1804, e.g.,
between the first superior tether hole 1870 and the second superior
tether hole 1872. Further, the superior tether 1874 can be looped
at least partially around a spinous process and can substantially
maintain the spinous process in contact with the superior spinous
process bracket 1854. The tether can comprise a biocompatible
elastomeric material that flexes during installation and provides a
resistance fit against the inferior process. Further, the tether
can comprise a substantially non-resorbable suture or the like.
[0103] FIG. 19 illustrates the interspinous process brace 1800 in a
bent configuration. FIG. 20 illustrates the interspinous process
brace 1800 in a straight configuration. Accordingly, the
interspinous process brace 1800 can be moved between the straight
configuration and the bent configuration to facilitate installation
between adjacent spinous processes.
[0104] More particularly, the locking pin 1808 can be removed and
the interspinous process brace 1800 can be bent, or otherwise
folded, as shown in FIG. 19, in order to reduce an overall height
of the interspinous process brace 1800. Thereafter, the
interspinous process brace 1800 can be place between adjacent
spinous processes and returned to the straight configuration, shown
in FIG. 19. Further, after the interspinous process brace 1800 is
returned to the straight configuration, the locking pin 1808 can be
installed within the central hinge 1806, to prevent the
interspinous process brace 1800 from returning to the bent
configuration.
[0105] In a particular embodiment, when the interspinous process
brace 1800 is properly installed between a superior vertebra and an
inferior vertebra, shown in FIG. 18, the inferior spinous process
bracket 1814 can engage and support an inferior spinous process
1900. Further, the superior spinous process bracket 1854 can engage
and support a superior spinous process 1902. More specifically, the
inferior spinous process engagement structure 1822 can extend
slightly into and engage the inferior spinous process 1900. Also,
the superior spinous process engagement structure 1862 can extend
slightly into and engage the superior spinous process 1902.
Accordingly, the spinous process engagement structures 1822, 1862
and the tethers 1834, 1874 can substantially prevent the
interspinous process brace 1800 from migrating with respect to the
spinous processes 1900, 1902.
[0106] Also, in a particular embodiment, a distractor can be used
to increase a distance 1910 between the superior spinous process
1902 and the inferior spinous process 1900 and the interspinous
process brace 1800 can be installed to support the superior spinous
process 1902 and the inferior spinous process 1900. After the
interspinous process brace 1800 is installed, the distractor can be
removed and the interspinous process brace 1800 can support the
superior spinous process 1902 and the inferior spinous process 1900
to substantially prevent the distance 1910 between the superior
spinous process 1902 and the inferior spinous process 1900 from
returning to a pre-distraction value.
Description of a Method of Treating a Spine
[0107] Referring to FIG. 21, a method of treating a spine is shown
and commences at block 2100. At block 2100, a patient can be
secured on an operating table. Depending on the surgical approach
to be used, the patient can be secured in a prone position for a
posterior approach, a supine position for an anterior approach, a
lateral decubitus position for a lateral approach, or another
position well known in the art. At block 2102, the spine can be
exposed in order to expose adjacent spinous processes. Further, at
block 2104, a surgical retractor system can be installed to keep a
surgical field open.
[0108] Moving to block 2106, a superior vertebra and inferior
vertebra can be distracted. In a particular embodiment, the
superior vertebra and inferior vertebra can be distracted using a
distractor. At block 2108, a distance between the adjacent spinous
processes can be measured. Thereafter, at block 2110 it is
determined whether the distraction is correct, e.g., has the
superior vertebra and inferior vertebral been distracted such that
a distance between the adjacent spinous processes has reached a
value that a surgeon has deemed therapeutic. For example, the
superior vertebra and inferior vertebra can be distracted in order
to reduce or obviate impingement on a nerve root.
[0109] If the distraction is not correct, the method can return to
block 2106 and the superior vertebra and inferior vertebra can be
further distracted. Conversely, if the distraction is correct, the
method can move to block 2112 and an interspinous process brace can
be moved to a bent configuration. The interspinous process brace
can be an interspinous process brace in accordance with one or more
embodiments described herein. At block 2114, the interspinous
process brace can be installed between the adjacent spinous
processes. Further, at block 2116, the interspinous process brace
can be allowed to return to the straight configuration.
[0110] Moving to decision step 2118, it can be determined whether
to lock the interspinous process brace. In a particular embodiment,
this determination can be based on any degradation of the
particular vertebral joint that is being repair, any degradation of
the surrounding facet joints, any degradation of the adjacent
processes, or a combination thereof. If it is determined to lock
the interspinous process brace, the method can move to block 2120
and the interspinous process brace can be locked. For example, one
or more locking sleeves on the interspinous process brace can be
moved to a locked position to prevent the interspinous process
brace from bending. Alternatively, one or more locking plates can
be installed in the interspinous process brace to prevent the
interspinous process brace from bending. From block 2120, the
method proceeds to block 2122.
[0111] It is noted that multiple braces can be supplied in kit form
for field use with each brace corresponding to a different
distraction distance, such that the proper post distraction
positioning of the processes can be maintained. Alternatively or in
addition, the kit can contain locking pins and/or discrete,
separable locking plates if the brace configuration receives such
plates.
[0112] Returning to decision step 2118, if it is determined not to
lock the interspinous process brace, the method can move directly
to block 2122 and the surgical area can be irrigated. At block
2124, a distractor can be removed. Also, at block 2126, the
retractor system can be removed. Further, at block 2128, the
surgical wound can be closed. The surgical wound can be closed by
simply allowing the patient's skin to close due to the elasticity
of the skin. Alternatively, the surgical wound can be closed using
sutures, surgical staples, or any other suitable surgical technique
well known in the art. At block 2130, postoperative care can be
initiated. The method can end at state 2132.
[0113] In another embodiment, an interspinous process brace
according to one or more of the embodiments described herein can be
used to distract a superior spinous process and an inferior spinous
process. For example, the interspinous process brace can be bent
and placed between a superior spinous process and inferior spinous
process. Thereafter, the interspinous process brace can be
straightened. As the interspinous process brace is straightened, it
can distract the superior spinous process and the inferior spinous
process. After the spinous processes are distracted, the
interspinous process brace can remain in place.
[0114] Alternatively, the interspinous process brace can be used to
distract the spinous processes and an implant can be installed
between a superior vertebra and an inferior vertebra. After the
implant is installed between the superior vertebra and the inferior
vertebra, the interspinous process brace can be returned to the
bent configuration and removed. In a particular embodiment, the
implant can be a one-piece intervertebral prosthetic disc, a
two-piece intervertebral prosthetic disc, a three-piece
intervertebral prosthetic disc, a solid nucleus implant, an
inflatable nucleus implant, an expandable nucleus implant, a fusion
cage, or some other similar device.
CONCLUSION
[0115] With the configuration of structure described above, the
interspinous process brace provides a device that can be used to
treat a spine and substantially alleviate or minimize one or more
symptoms associated with disc degeneration, facet joint
degeneration, or a combination thereof. For example, the
interspinous process brace can installed between adjacent spinous
processes in order to support the spinous processes and maintain
them at or near a predetermined distance there between.
[0116] The above-disclosed subject matter is to be considered
illustrative, and not restrictive, and the appended claims are
intended to cover all such modifications, enhancements, and other
embodiments that fall within the true spirit and scope of the
present invention. Thus, to the maximum extent allowed by law, the
scope of the present invention is to be determined by the broadest
permissible interpretation of the following claims and their
equivalents, and shall not be restricted or limited by the
foregoing detailed description.
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