U.S. patent application number 17/591085 was filed with the patent office on 2022-06-09 for apparatus for bone stabilization and distraction and methods of use.
The applicant listed for this patent is Spinal Elements, Inc.. Invention is credited to Jason Blain, Gregory Martin.
Application Number | 20220175424 17/591085 |
Document ID | / |
Family ID | 1000006164810 |
Filed Date | 2022-06-09 |
United States Patent
Application |
20220175424 |
Kind Code |
A1 |
Blain; Jason ; et
al. |
June 9, 2022 |
APPARATUS FOR BONE STABILIZATION AND DISTRACTION AND METHODS OF
USE
Abstract
In some embodiments, a method includes disposing a flexible band
through an aperture of a support member, the support member having
a fixation portion configured to secure the support member to a
first bone portion. The method includes advancing a portion of the
flexible band through an attachment portion of the flexible band
until the flexible band is secured to a second bone portion. The
method includes advancing a portion of the fixation portion of the
support member into the first bone portion until the support member
is secured to the first bone portion.
Inventors: |
Blain; Jason; (Encinitas,
CA) ; Martin; Gregory; (Carlsbad, CA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Spinal Elements, Inc. |
Carlsbad |
CA |
US |
|
|
Family ID: |
1000006164810 |
Appl. No.: |
17/591085 |
Filed: |
February 2, 2022 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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16287206 |
Feb 27, 2019 |
11272961 |
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17591085 |
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15215137 |
Jul 20, 2016 |
10251679 |
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16287206 |
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13804521 |
Mar 14, 2013 |
9421044 |
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15215137 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 2017/681 20130101;
A61B 17/7035 20130101; A61B 2017/567 20130101; A61B 17/7067
20130101; A61B 17/7064 20130101; A61B 17/7053 20130101; A61B
2017/7073 20130101 |
International
Class: |
A61B 17/70 20060101
A61B017/70 |
Claims
1-28. (canceled)
29. A method, comprising: disposing a flexible elongate body
through an aperture of a support member, the flexible elongate body
comprising a distal end portion, a body portion, and a proximal end
portion, the proximal end portion comprising an attachment portion;
advancing the distal end portion and the body portion through the
attachment portion to form a loop around a first bone portion,
wherein the attachment portion is configured to permit movement of
the body portion in a first direction but substantially limit the
movement of the body portion in a second direction; and positioning
the support member to define a distraction distance between the
first bone portion and a second bone portion, wherein the support
member is adjustable to define a plurality of distraction
lengths.
30. The method of claim 29, wherein positioning the support member
comprises: positioning a first member comprising the aperture;
positioning a second member configured to couple the second bone
portion; and positioning a third member configured to couple to the
first member and the second member.
31. The method of claim 30, wherein the first member and the second
member are independently positioned.
32. The method of claim 30, wherein the first member and the third
member are independently positioned.
33. The method of claim 30, wherein the second member and the third
member are independently positioned.
34. The method of claim 29, wherein positioning the support member
comprises positioning a coupler member relative to a rod.
35. The method of claim 29, further comprising positioning a
fixation member to maintain the distraction distance.
36. The method of claim 29, wherein the plurality of distraction
lengths are defined along a rod of the support member.
37. The method of claim 29, wherein the first bone portion is a
spinous process of a first vertebra.
38. The method of claim 29, wherein the second bone portion is a
transverse process of a second vertebra.
39. A method, comprising: coupling a flexible elongate body with a
support member, the flexible elongate body comprising a distal end
portion, a body portion, and a proximal end portion, the proximal
end portion comprising an attachment portion; advancing the distal
end portion and the body portion through the attachment portion to
form a loop around a first bone portion, wherein the attachment
portion is configured to permit movement of the body portion in a
first direction but substantially limit the movement of the body
portion in a second direction; and positioning the support member
laterally relative to the flexible elongate body, wherein the
support member defines a distraction distance between the first
bone portion and a second bone portion.
40. The method of claim 39, further comprising positioning a second
support member laterally relative to the flexible elongate
body.
41. The method of claim 39, wherein the first bone portion is a
spinous process of a first vertebra.
42. The method of claim 39, wherein positioning the support member
comprises coupling the support member to a right transverse process
of the second vertebra.
43. The method of claim 42, further comprising coupling a second
support member to a left transverse process of the second
vertebra.
44. A method, comprising: disposing a flexible elongate body
through an aperture of a support member, the flexible elongate body
comprising a distal end portion, a body portion, and a proximal end
portion, the proximal end portion comprising an attachment portion;
advancing the distal end portion and the body portion through the
attachment portion to form a loop around a first bone portion,
wherein the attachment portion is configured to permit movement of
the body portion in a first direction but substantially limit the
movement of the body portion in a second direction; and adjusting
the support member to define a distraction distance between the
first bone portion and a second bone portion by coupling a first
member of the support member at a first point of a plurality of
points and coupling a second member of the support member at a
second point of the plurality of points.
45. The method of claim 44, wherein adjusting the support member
comprises adjusting the first point and the second point along a
rod.
46. The method of claim 44, further comprising maintain the
distraction distance with a fixation member.
47. The method of claim 44, further comprising disposing the
flexible elongate body through an aperture of a second support
member.
48. The method of claim 44, further comprising adjusting a second
support member.
Description
BACKGROUND CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] The present application is a continuation of U.S.
application Ser. No. 16/287,206 filed on Feb. 27, 2019, which is a
continuation of U.S. application Ser. No. 15/215,137 filed on Jul.
20, 2016, which is a divisional of U.S. application Ser. No.
13/804,521 filed on Mar. 14, 2013, the disclosures of each of these
applications is incorporated by reference herein in their
entireties.
BACKGROUND
[0002] Some embodiments described herein relate generally to
methods and apparatus for stabilizing bone, for example,
stabilizing vertebrae by securing the articular processes of the
vertebrae.
[0003] Traumatic, inflammatory, and degenerative disorders of the
spine can lead to severe pain and loss of mobility. One source of
back and spine pain is related to degeneration of the facets of the
spine or facet arthritis. Bony contact or grinding of degenerated
facet joint surfaces can play a role in some pain syndromes. While
many technological advances have focused on the intervertebral disc
and artificial replacement or repair of the intervertebral disc,
relatively little advancement in facet repair has been made. Facet
joint and disc degeneration frequently occur together.
[0004] The current standard of care to address the degenerative
problems with the facet joints is to fuse the two adjacent
vertebrae. By performing this surgical procedure, the relative
motion between the two adjacent vertebrae is stopped, thus stopping
motion of the facets and any potential pain generated as a result
thereof. Procedures to fuse two adjacent vertebrae often involve
fixation and/or stabilization of the two adjacent vertebrae until
the two adjacent vertebrae fuse.
[0005] Injuries and/or surgical procedure on and/or effecting other
bones can also result in the desire to fixate and/or stabilize a
bone until the bone, or bone portions, can fuse, for example, to
stabilize a sternum after heart surgery, to stabilize a rib after a
break, etc. Current procedures to fixate and/or stabilize adjacent
vertebrae and/or other bones, however, can be slow and/or
complex.
[0006] Accordingly, a need exists for an apparatus and methods to
better stabilize and/or fixate a bone.
SUMMARY
[0007] In some embodiments, a method includes disposing a flexible
band through an aperture of a support member, the support member
having a fixation portion configured to secure the support member
to a first bone portion. The method includes advancing a portion of
the flexible band through an attachment portion of the flexible
band until the flexible band is secured to a second bone portion.
The method includes advancing a portion of the fixation portion of
the support member into the first bone portion until the support
member is secured to the first bone portion.
BRIEF DESCRIPTION OF THE DRAWINGS
[0008] FIG. 1 is a lateral elevational view of a portion of the
vertebral column.
[0009] FIG. 2A is an example of a superior view of an isolated
thoracic vertebra.
[0010] FIG. 2B is an example of a side view of an isolated thoracic
vertebra.
[0011] FIG. 3A is an example of a posterior elevational view of a
portion of the vertebral column.
[0012] FIG. 3B is an example of a posterior-oblique elevational
view of a portion of the vertebral column.
[0013] FIG. 4A is an example of a side view of a facet joint in the
cervical vertebrae.
[0014] FIG. 4B is an example of a superior view of a facet joint in
the cervical vertebrae.
[0015] FIG. 5A is an example of a side view of a facet joint in the
thoracic vertebrae.
[0016] FIG. 5B is an example of a superior view of a facet joint in
the thoracic vertebrae.
[0017] FIG. 6A is an example of a side view of a facet joint in the
lumbar vertebrae.
[0018] FIG. 6B is an example of a superior view of a facet joint in
the lumbar vertebrae.
[0019] FIG. 7 is a block diagram of a bone stabilization and
distraction apparatus according to an embodiment.
[0020] FIGS. 8A and 8B are schematic illustrations of a flexible
elongate body according to an embodiment.
[0021] FIGS. 9A-9C are various views of a flexible elongate body
according to another embodiment.
[0022] FIG. 10A is a posterior perspective view of a portion of the
vertebral column depicting a stabilized vertebra including bone
stabilization and distraction apparatus according to an
embodiment.
[0023] FIG. 10B is an enlarged view of a portion of the vertebral
column of FIG. 10A identified as region X.sub.1.
[0024] FIG. 11A is a posterior view of the portion of the vertebral
column depicting a stabilized vertebra including a bone
stabilization and distraction apparatus according to an
embodiment.
[0025] FIG. 11B is an enlarged view of a portion of the vertebral
column of FIG. 11A identified as region X.sub.2.
[0026] FIG. 12A is a posterior view of the portion of the vertebral
column depicting a stabilized vertebra including a bone
stabilization and distraction apparatus according to an
embodiment.
[0027] FIG. 12B is an enlarged view of a portion of the vertebral
column of FIG. 12A identified as region X.sub.3.
[0028] FIG. 13A is a posterior view of the portion of the vertebral
column depicting a stabilized vertebra including a bone
stabilization and distraction apparatus according to an
embodiment.
[0029] FIG. 13B is an enlarged view of a portion of the vertebral
column of FIG. 13A identified as region X.sub.4.
[0030] FIG. 14A is a posterior view of the portion of the vertebral
column depicting a stabilized vertebra including a bone
stabilization and distraction apparatus according to an
embodiment.
[0031] FIG. 14B is an enlarged view of a portion of the vertebral
column of FIG. 14A identified as region X.sub.5.
[0032] FIG. 15A is a posterior view of the portion of the vertebral
column depicting a stabilized vertebra including a bone
stabilization and distraction apparatus according to an
embodiment.
[0033] FIG. 15B is an enlarged view of a portion of the vertebral
column of FIG. 15A identified as region X.sub.6.
[0034] FIG. 16 is a flowchart illustrating a method of stabilizing
a bone portion according to an embodiment.
[0035] FIG. 17 is a flowchart illustrating a method of stabilizing
a bone portion according to an embodiment.
DETAILED DESCRIPTION
[0036] In some embodiments, a method includes disposing a flexible
band through an aperture of a support member, the support member
having a fixation portion configured to secure the support member
to a first bone portion. The method includes advancing a portion of
the flexible band through an attachment portion of the flexible
band until the flexible band is secured to a second bone portion.
The method includes advancing a portion of the fixation portion of
the support member into the first bone portion until the support
member is secured to the first bone portion.
[0037] In some embodiments, a method includes disposing a first
flexible band through a first aperture of a support member and
disposing a second flexible band through a second aperture of the
support member. The method includes advancing a portion of the
first flexible band through an attachment portion of the first
flexible band until the first flexible band is secured to a first
bone portion. The method includes advancing a portion of the second
flexible band through an attachment portion of the second flexible
band until the second flexible band is secured to a second bone
portion.
[0038] In some embodiments, an apparatus includes a flexible
elongate body including a distal end portion, a body portion, and
an attachment portion that is configured to receive the distal end
portion. The apparatus includes a support member including (1) a
first portion that includes an aperture configured to receive the
distal end portion of the first flexible elongate body; and (2) a
second portion configured to be coupled to a bone portion.
[0039] In some embodiments, an apparatus includes a flexible
elongate body including a distal end portion, a body portion, and
an attachment portion that is configured to receive the distal end
portion. The apparatus includes a support member including (1) an
aperture configured to receive the distal end portion of the
flexible elongate body, and (2) a fixation portion configured to
secure the support member to a first bone portion. The attachment
portion configured to receive the distal end portion of the
flexible elongate body when the body portion of the flexible
elongate body is surrounds a second bone portion.
[0040] In some embodiments, a kit includes a flexible band
configured to be secured to a first bone portion. The kit includes
a support member having an interface portion configured to receive
at least a portion of the flexible band, the support member having
a fixation portion configured to secure the support member to a
second bone portion such that the first bone portion and the second
bone portion are stabilized.
[0041] As used in this specification, the singular forms "a," "an"
and "the" include plural referents unless the context clearly
dictates otherwise. Thus, for example, the term "a ratchet" is
intended to mean a single ratchet or multiple ratchets. As used in
this specification, a substance can include any biologic and/or
chemical substance, including, but not limited to, medicine,
adhesives, etc. While exemplary references are made with respect to
vertebra, in some embodiments another bone can be involved. While
specific reference may be made to a specific vertebra, a subset of
vertebrae, and/or a grouping of vertebrae, it is understood that
any vertebra, subset, and/or grouping, or combination of vertebrae
can be used.
[0042] The words "proximal" and "distal" generally refer to the
direction closer to and away from, respectively, a center of a
body. The embodiments described herein, however, can be arranged in
any orientation relative to the center of the body. Thus, when
discussing the embodiments described herein (specifically a
flexible elongate body), the terms "proximal" and "distal" refer to
a direction closer to and away from, respectively, an attachment
connection or fastener mechanism, for example, the position of
which is visually presented with respect to specific embodiments in
the attached figures.
[0043] As shown in FIG. 1, the vertebral column 2 includes a series
of alternating vertebrae 4 and fibrous discs 6 that provide axial
support and movement to the upper portions of the body. The
vertebral column 2 typically comprises thirty-three vertebrae 4,
with seven cervical (C1-C7), twelve thoracic (T1-T12), five lumbar
(L1-15), five fused sacral (S1-S5) and four fused coccygeal
vertebrae. FIGS. 2A and 2B depict a typical thoracic vertebra. Each
vertebra includes an anterior body 8 with a posterior arch 10. The
posterior arch 10 includes two pedicles 12 and two laminae 14. The
two laminae 14 join posteriorly to form a spinous process 16.
Projecting from each side of the posterior arch 10 is a transverse
process 18, a superior process 20, and an inferior articular
process 22. The facets 24, 26 of the superior processes 20 and the
inferior articular processes 22 form facet joints 28 with the
articular processes of the adjacent vertebrae (see FIGS. 3A and
3B). The facet joints are synovial joints with cartilaginous
surfaces and a joint capsule.
[0044] The orientation of the facet joints vary, depending on the
level of the vertebral column. In the C1 and C2 vertebrae, for
example the facet joints are parallel to the transverse plane.
FIGS. 4A to 6B depict examples of the orientations of the facet
joints at different levels of the vertebral column. In the C3 to C7
vertebrae examples shown in FIGS. 4A and 4B, the facets are
oriented at a 45-degree angle to the transverse plane 30 and
parallel to the frontal plane 32, respectively. This orientation
allows the facet joints of the cervical vertebrae to flex, extend,
lateral flex and rotate. At a 45-degree angle in the transverse
plane 30, the facet joints of the cervical spine can guide, but do
not limit, the movement of the cervical vertebrae. FIGS. 5A and 5B
depict examples of the thoracic vertebrae, where the facets are
oriented at a 60-degree angle to the transverse plane 30 and a
20-degree angle to the frontal plane 32, respectively. This
orientation is capable of providing lateral flexion and rotation,
but only limited flexion and extension. FIGS. 6A and 6B illustrate
examples of the lumbar region, where the facet joints are oriented
at 90-degree angles to the transverse plane 30 and a 45-degree
angle to the frontal plane 32, respectively. The lumbar vertebrae
are capable of flexion, extension and lateral flexion, but little,
if any, rotation because of the 90-degree orientation of the facet
joints in the transverse plane. The actual range of motion along
the vertebral column can vary considerably with each individual
vertebra.
[0045] In addition to guiding movement of the vertebrae, the facet
joints also contribute to the load-bearing ability of the vertebral
column. One study by King et al. Mechanism of Spinal Injury Due to
Caudocephalad Acceleration, Orthop. Clin. North Am., 6:19 1975,
found facet joint load-bearing as high as 30% in some positions of
the vertebral column. The facet joints may also play a role in
resisting shear stresses between the vertebrae. Over time, these
forces acting on the facet joints can cause degeneration and
arthritis.
[0046] In some embodiments described herein, a bone stabilization
and distraction apparatus can be used to stabilize and/or fixate a
first vertebra to a second vertebra, and/or distract a first
vertebra relative to a second vertebra, to reduce the pain, to
reduce further degradation of a spine (e.g., a specific vertebra
and/or a specific disc of a spine), and/or until the first vertebra
and the second vertebra have fused. In some embodiments described
herein, a bone stabilization and distraction apparatus can be used
in conjunction with a bone fusion procedure, for example, in
conjunction with a fusion cage and/or bone cement. In such
embodiments, the bone stabilization and distraction apparatus can
stabilize one or more bones and/or maintain a distraction between
one or more bones while the bone fusion process takes place. The
bone stabilization and distraction apparatus and methods described
herein can include a bone distraction tool, for example, to define
an initial and/or final distraction between one or more bones prior
to or during installation of a bone stabilization and distraction
apparatus.
[0047] FIG. 7 is a schematic block diagram of a flexible elongate
body 140 (also referred to herein as "flexible band" or simply
"band") and a support member 120, according to an embodiment. The
band 140 includes at least a body portion 145, a distal end portion
148, and an attachment connection 150 (alternatively referred to
herein as "fastener mechanism"). The band 140 can be formed from
any suitable biocompatible material such as, for example, stainless
steel, titanium, polyether ether ketone (PEEK), nylon, or the like.
Moreover, the band 140 can be any suitable shape, size, or
configuration. In some embodiments, the size or shape of the band
140 can be associated with an intended usage. For example, in some
embodiments, a first band can be intended to stabilize and/or
fixate one or more cervical vertebra and a second band can be
intended to stabilize and/or fixate one or more lumbar vertebra. In
this manner, the first band can have a first size that is
substantially smaller than a second size of the second band. In
other embodiments, the size and shape need not be associated with
an intended usage.
[0048] The fastener mechanism 150 is configured to accept at least
a portion of distal end portion 148 and/or the body portion 145, as
further described herein. The fastener mechanism 150 is disposed at
a proximal end of the band 140. In some embodiments, the fastener
mechanism 150 defines a lumen (not shown in FIG. 7) configured to
accept at least a portion of distal end portion 148 and/or the body
portion 145. In some embodiments, the lumen of fastener mechanism
150 can have a cross-sectional area that is significantly smaller
than a cross-sectional area of at least a portion of the body
portion 145. In this manner, the portion of the body portion 145
can be prevented from advancing through fastener mechanism 150. In
some embodiments, the fastener mechanism 150 can include a ratchet
(not shown in FIG. 7) configured to engage a surface of the distal
end portion 148 and/or the body portion 145. In this manner, the
fastener mechanism 150 can be configured to allow the distal end
portion 148 and/or the body portion 145 to advance through fastener
mechanism 150 in a first direction and substantially limit the
movement of the distal end portion 148 and/or the body portion 145
in a second direction, opposite the first direction.
[0049] The body portion 145 is an elongate that extends from a
portion of the fastener mechanism 150. More specifically, the body
portion 145 of the band 140 can be monolithically (or unitarily)
formed with the fastener mechanism 150 such that the body portion
145 is an linear portion between the fastener mechanism 150 and the
distal end portion 148. In other embodiments, the body portion 145
can be formed separately from and coupled to the fastener mechanism
150 in any suitable manner (e.g., coupled via an adhesive, a weld,
a friction fit, a threaded fit, or the like). The body portion 145
can be any suitable configuration. For example, in some
embodiments, the body portion 145 can have a cross-sectional shape
that is polygonal (e.g., square, rectangular, trapezoidal, etc.) or
oval (e.g., circular, elliptical, oblong, etc.). In some
embodiments, the cross-sectional shape of the body portion 145 can
be associated with one or more characteristics of the bone or bone
portion against which the body portion 145 may contact. For
example, while the body portion 145 can have a substantially square
cross-sectional shape, a set of edges of the body portion 145 can
be rounded, partially rounded, and/or otherwise shaped to
compliment the shape of a bone or bone portion, and/or to reduce
digging or grinding into the bone or bone portion. In this manner,
use of band 140 can cause little or no damage to the bone or bone
portions contacted by band 140.
[0050] In some embodiments, the body portion 145 can define a
substantially uniform cross-sectional area along a longitudinal
axis (e.g., a centerline) of the band 140. In other embodiments,
the cross-sectional area of the body portion 145 can vary along the
longitudinal axis (centerline) of the band 140. For example, in
some embodiments, the body portion 145 can have a cross-sectional
area that is substantially tapered (i.e., reduced) from a proximal
end (e.g., adjacent the fastener mechanism 150) to a distal end
(e.g., adjacent the distal end portion 148). In some embodiments,
the cross-sectional area of the body portion 145 can be associated
with or complimentarily fit with the cross-sectional area of the
lumen defined by the fastener mechanism 150 (the attachment
connection 150 described above). In this manner, at least a portion
of the body portion 145 can have a cross-sectional area that is
sufficiently small such that the body portion 145 can be at least
partially disposed within the lumen of the fastener mechanism
150.
[0051] The body portion 145 can be configured to include a gear
rack (not shown in FIG. 7) configured to engage the ratchet (not
shown in FIG. 7) of the fastener mechanism 150. As described above,
the gear rack can be configured to engage the ratchet of the
fastening member 150 such that the ratchet allows the body portion
145 to travel through the fastener mechanism 150 in the first
direction and substantially limits the movement of the body portion
in the second direction, opposite the first direction. In some
embodiments, the gear rack can be configured to include a set of
individual gears that extend from a surface of the body portion
145. In other embodiments, the body portion 145 can define the set
of individual gears (e.g., the gears each include a top surface
that is disposed at or below a surface of the body portion 145).
The gears included in the set of gears can be any suitable shape,
size, or configuration. For example, in some embodiments, the gears
are substantially cubed. In other embodiments, the gears can be
triangular such that the gears form, for example, teeth. In this
manner, the gears included in the gear rack can be configured to
engage the ratchet of the fastener mechanism 150, as described
above.
[0052] The distal end portion 148 is configured to extend from the
body portion 145 of the band 140. More specifically, the distal end
portion 148 is disposed adjacent the distal end of the body portion
145 such that the body portion 145 is disposed between the distal
end portion 148 and the fastener portion 150. In some embodiments,
the distal end portion 148 can have a cross-sectional area that is
substantially similar to the cross-sectional area of the body
portion 145. In other embodiments, the distal end portion 148 can
have a cross-sectional area that is substantially smaller than the
cross-sectional area of the body portion 145. In such embodiments,
the distal end portion 148 and the body portion 145 can
collectively define a discontinuity defining a stepwise reduction
in the cross-sectional area. In other embodiments, the body portion
145 and/or the distal end portion 148 can define a tapered portion
such that the band 140 is tapered between smaller cross-sectional
area of the distal end portion 148 and the larger cross-sectional
area of the body portion 145.
[0053] While not shown in FIG. 7, in some embodiments, the distal
end portion 148 can include a gear rack that is substantially
similar to the gear rack of the body portion 145. In this manner,
the gear rack can extend substantially continuously across a
portion of the distal end portion 148 and a portion of the body
portion 145. In other embodiments, the distal end portion 148 of
the band 140 does not include or define a gear rack.
[0054] The support member 120 includes a first portion 122 and a
second portion 135. The support member 120 can be formed from any
suitable biocompatible material such as, for example, stainless
steel, titanium, polyether ether ketone (PEEK), nylon, or the like.
The first portion 122 can include an aperture (not shown in FIG. 7)
that is configured to receive the distal end portion 148 of band
140. In such embodiments, a proximal end portion of the first
portion 122 can define the aperture.
[0055] The second portion 135 is configured to be coupled to a bone
portion. In some embodiments, the second portion 135 can be
substantially similar to the first portion 122 and can include an
aperture that is configured to receive a distal end portion of a
second band 140 (not shown in FIG. 7) that is configured to
surround a bone portion. The second portion 135 can include a
fixation portion and can be configured to be coupled to a bone
portion. In such embodiments, the fixation portion of the second
portion 135 can include a screw, such as for example, a bone
screw.
[0056] In some embodiments, the support member 120 can includes a
third portion (not shown in FIG. 7) configured to couple the first
portion 122 to the second portion 135. In such embodiments, a
distal end portion of the first portion 122 can define a coupler
portion configured to secure the first portion 122 to the third
portion. In such embodiments, the coupler portion can include a
threaded portion and a screw portion. In some embodiments, the
second portion 135 can be coupled directly to the first portion 122
(see, e.g., FIG. 12A).
[0057] In use, the band 140 and the support member 120 can
stabilize a first vertebra and/or a second vertebra, and/or can be
configured to define a distraction between the first vertebra and
the second vertebra. In some uses, the band 140 and the support
member 120 can stabilize the first vertebra to a second vertebra by
securing an articular process of the first vertebra to an articular
process of a second vertebra by securing a facet of the articular
process of the first vertebra with a facet of the articular process
of the second vertebra (see, e.g., FIG. 10A). In some other uses,
the band 140 and the support member 120 can stabilize the first
vertebra to a second vertebra by securing an articular process of
the first vertebra to a transverse process of a second vertebra by
securing a facet of the articular process of the first vertebra
with a facet of the transverse process of the second vertebra (see,
e.g., FIGS. 11A and 13A). In yet some other uses, the band 140 and
the support member 120 can stabilize the first vertebra to a second
vertebra by securing an articular process of the first vertebra to
at least one of an articular process of the second vertebra, a
transverse process of the first vertebra, or to a transverse
process of a second vertebra by securing a facet of the articular
process of the first vertebra to at least one of a facet of the
articular process of the second vertebra, a facet of the transverse
process of the first vertebra, or a facet of the transverse process
of the second vertebra (see, e.g., FIG. 12A). In some other uses,
the band 140 and the support member 120 can stabilize the first
vertebra to a second vertebra by securing a transverse process of
the first vertebra to a transverse process of a second vertebra by
securing a facet of the transverse process of the first vertebra
with a facet of the transverse process of the second vertebra (see,
e.g., FIGS. 14A and 15A).
[0058] For example, the band 140 can be placed into a suitable
position relative to the first vertebra and/or the second vertebra,
and the distal end portion 148 of the band can be inserted into the
lumen of the fastener member 150 such that the body portion 145
substantially encircles at least a portion of the first vertebra
and/or the second vertebra. Similarly stated, the distal end
portion 148 can be inserted in to the lumen of the fastener
mechanism 150 such that the band 140 forms a loop about a process
of the first vertebra and/or a process of the second vertebra. In
this manner, the distal end portion 148 and/or the body portion 145
can be advanced through the lumen of the fastener mechanism 150
such that the volume disposed within the loop formed by the band
140 is reduced. Thus, the band 140 exerts a compressive force on
the articular process of the first vertebra and the articular
process of the second process.
[0059] In some instances, with the band 140 at least partially
tightened and/or fully tightened, a fixation portion of the second
portion 135 of the support member 120 can be fixed to a bone
portion, for example a transverse process of a vertebra. In some
instances, fixing the second portion 135 to a bone portion can
include advancing a fastener, for example a screw, through the
fixation portion and into the bone portion. In some instances, with
the band 140 at least partially tightened and/or fully tightened, a
distal end portion of a second band (not shown in FIG. 7) can be
disposed through an aperture (not shown in FIG. 7) of the second
portion 135 of the support member 120, and the distal end portion
of the second pand can be a secured to a bone portion as described
above with reference to band 140.
[0060] In some embodiments, a third portion (not shown in FIG. 7)
of the support member 120 can be disposed between the first portion
122 and the second portion 135. In such embodiments, the first
portion 122 can be coupled to the third portion at a first point
along a length of the third portion, and the second portion 135 can
be coupled to the third portion at a second point along the length
of the third portion. The first point and the second point can be
spaced apart to define a distraction between the first portion 122
and the second portion 135 to define a corresponding distraction
between a first vertebra and a second vertebra. In this manner, the
distance between the first point and the second point, e.g., the
distance between the first portion 122 and the second portion 135,
can be increased (or decreased) to increase (or decrease) the
distraction between the first vertebra and the second vertebra.
[0061] FIG. 8A is a side view and FIG. 8B is a top view of a
flexible elongate body 240 (also referred to herein as "band")
according to an embodiment. The band 240 can be similar to the band
140 described above and can include similar components. For
example, the band 240 includes an attachment connection 250 (also
referred to herein as "fastener mechanism") including a ratchet
262, a body portion 245 including a gear rack 247, and a distal end
portion 248. Accordingly, components of the band 240 that are
similar to corresponding components of the band 140 described above
with reference to FIG. 7 are not described in further detail
herein.
[0062] As shown in FIG. 8A, each gear 264 included in the gear rack
247 includes a cross sectional area that is rectangular in shape.
Said another way, each gear 264 can be a rectangular protrusion
configured to extend from a surface of the band 240 (e.g., the body
portion and/or the distal end portion 248). The gear rack 247 is
configured to engage the ratchet 262 of the fastener mechanism 250,
as further described herein. The fastener mechanism 250 defines a
lumen 266. The lumen 266 can be any suitable shape, size, or
configuration. For example, as shown in FIG. 8B the lumen 266 can
have a substantially circular cross-sectional area. The ratchet 262
extends from an inner surface of the fastener member 250 such that
the ratchet 262 substantially reduces the size (e.g., the
perimeter, circumference, and/or cross-sectional area) of the lumen
266. In this manner, the ratchet 266 can engage the gear rack 247.
More specifically, as described in detail with reference to FIG. 7,
the distal end portion 248 can be inserted into the lumen 266 of
the fastener mechanism 250 and advanced in a first direction such
that the gear rack 247 of the distal end portion 248 engages the
ratchet 262. In some embodiments, the distal end portion 248 can be
advanced through the lumen 266 a sufficient distance such that a
portion of the body portion 245 is disposed within the lumen 266.
In such embodiments, a portion of the gear rack 247 disposed on
(e.g., included in or defined by) the body portion 245 can engage
the ratchet 262. In this manner, the arrangement of the ratchet 262
and the gear rack 247 can be such that the distal end portion 248
can be moved in the first direction, thereby tightening the band
240, and the distal end portion 248 can be prevented from moving in
a second direction, opposite the first direction, thereby
preventing the band 240 from loosening.
[0063] The band 240 can be used in any suitable procedure to
stabilize and/or fixate a first bone portion to a second bone
portion. For example, in some embodiments, the band 240 can be
disposed about an articular process of a first vertebra and/or an
articular process of a second vertebra. In this manner, the distal
end portion 248 and/or the body portion 245 can be positioned
within the lumen 266 of the fastener mechanism 250 such that the
band 240 forms a loop of suitable tightness about the first
vertebra and/or the second vertebra. The band 240 can be used in
conjunction with any suitable support member configured to
facilitate the stabilization, fixation and/or distraction of the
first vertebra to the second vertebra.
[0064] In some embodiments, the band 240 can be used in any
procedure described in or similar to those in U.S. patent
application Ser. No. 12/859,009; filed Aug. 18, 2010, and titled
"Vertebral Facet Joint Drill and Method of Use" (referred to as
"the '009 application"), the disclosure of which is incorporated
herein by reference in its entirety. In some embodiments, the band
240 can be used in conjunction with a spacer such as those
described in the '009 application. For example, the spacer can be
implanted and deployed to restore the space between facets of a
superior articular process of a first vertebra and an inferior
articular process of an adjacent vertebra. The spacer can be
implanted and deployed to help stabilize adjacent vertebrae with
adhesives and/or to deliver a medication. For example, in some
embodiments, the spacer can be at least temporarily maintained in a
desired position via an adhesive while the band 240 is positioned
relative to the first vertebra and/or second vertebra. In some
embodiments, an adhesive can be used in conjunction with the band
240 to stabilize and/or fixate the first vertebra to the second
vertebra.
[0065] In some embodiments, the spacer can be, for example,
substantially disc shaped. In other embodiments, the spacer can be
other shapes, e.g., square, elliptical, or any other shape. The
spacer can include a first side and a second side. The first side
and/or the second side can be, for example, convex, concave, or
flat. Said another way, the first side of the spacer can be
concave, convex, or flat, and the second side of the spacer can be
concave, convex, or flat, for example, the first side can be
concave and the second side concave, the first side can be concave
and the second side convex, etc. The spacer can include the same
materials as band 140. In some embodiments, the spacer can include
substances configured to release medication and/or increase the
stability of a vertebra and/or band 140. As discussed above, the
substances can include a medicine(s) and/or an adhesive(s).
[0066] FIGS. 9A-9C illustrate a flexible elongate body 340 (also
referred to herein as "band") according to an embodiment. The band
340 can be similar to band 140 described above with reference to
FIG. 7 and can include similar components. By way of example, band
340 includes a fastener mechanism 350, a body portion 345, and a
distal end portion 348. As shown in FIGS. 9A-9C, the band 340 can
be monolithically (or unitarily) constructed in an elongate shape
and can have a substantially rectangular cross-sectional shape.
More specifically, the band 340 can have a substantially
rectangular shape including rounded edges configured to reduce
digging or grinding into the bone or portion thereof. The fastener
mechanism 350 defines a lumen 366 and includes ratchet 362. The
body portion 345 includes a gear rack 347 having a set of gears
364. In this manner, the distal end portion 348 can be inserted
into the lumen 366 of the fastener member 350 such that the gear
rack 347 engages the ratchet 362, as described in detail above.
[0067] FIGS. 10A and 10B depict a bone stabilization and
distraction apparatus, specifically a band 440, a band 440', a
support member 420, and a support member 420' stabilizing a
vertebra 4A of spinal column 2 with a vertebra 4B of spinal column
2, and defining a distraction between vertebra 4A and vertebra 4B.
The bands 440, 440' can be similar to the band 140 described above
and can include similar components. For example, the band 440
includes an attachment connection 450 (also referred to herein as
"fastener mechanism"). Support members 420, 420' can be similar to
the support member 120 described above and can include similar
components.
[0068] As shown in FIGS. 10A and 10B, the band 440 can be used to
stabilize a first vertebra 4A and a second vertebra 4B, and to
define a distraction between the first vertebra 4A and a second
vertebra 4B, via the spinous articular process SP4A (also referred
to herein as "process SP4A") of the first vertebra 4A and the
spinous articular process SP4B (also referred to herein as "process
SP4B") of the second vertebra 4B. Specifically, a distal end
portion (not shown) of the band 440 can be inserted into an
aperture 424 of a first portion 422 of a support member 420, and
the distal end portion of the band 440 can be inserted into the
aperture 424' of a first portion 422' of a support member 420'. The
fastener mechanism 450 can receive the distal end portion of the
band 440 such that the body portion 445 forms a loop that
substantially encircles the process SP4A of the first vertebra 4A.
Similarly, a distal end portion (not shown) of the band 440' can be
inserted into an aperture 436 of a second portion 435 of the first
support member 420 and the distal end portion of the band 440' can
be inserted into the aperture 436' of the second portion 435' of
the support member 420'. The fastener mechanism 450' can receive
the distal end portion (not shown) of the band 440' such that the
body portion 445' forms a loop that substantially encircles the
process SP4B of the second vertebra 4B, (as described in detail
above).
[0069] A third portion 430 of first support member 420 can be
disposed between first portion 422 and second portion 435. The
third portion 430 can be coupled to a coupler portion 426 of first
portion 420 at point P1 and can be coupled to a coupler portion 437
of second portion 435 at P2. Similarly a third portion 430' of
support member 420' can be disposed between first portion 422' and
second portion 435'. The third portion 430' can be coupled to a
coupler portion 426' of first portion 422' at point P1' (not
labeled in FIG. 10A) and can be coupled to a coupler portion 437'
of second portion 435' at point P2' (not labeled in FIG. 10A). A
length L1 between point P1 and point P2, along with a length L1'
between point P1' and point P2', can define a distraction between
vertebra 4A and vertebra 4B.
[0070] For example, support member 420 and support member 420' are
rigid structures that maintain a distraction by pushing on band 440
and band 440', which are fixedly coupled to process SP4A and
process SP4B. Specifically, first portion 422 and first portion
422' can push, in a first direction, on band 440, which is fixedly
coupled to process SP4A. Similarly, second portion 435 and second
portion 435' can push, in a second direction opposite the first
direction, on band 440', which is fixedly coupled to process
SP4B.
[0071] FIGS. 11A and 11B depict a bone stabilization and
distraction apparatus, specifically a band 540, a support member
520, and a support member 520' stabilizing a vertebra 4A of spinal
column 2 with a vertebra 4B of spinal column 2, and defining a
distraction between vertebra 4A and vertebra 4B. The band 540 can
be similar to the band 140 described above and can include similar
components, and support members 520, 520' can be similar to the
support member 120 described above and can include similar
components. For example, the band 540 includes an attachment
connection 550 (also referred to herein as "fastener
mechanism").
[0072] As shown in FIGS. 11A and 11B, the band 540, the support
member 520 and the support member 520' can be used to stabilize a
first vertebra 4A and a second vertebra 4B, and to define a
distraction between the first vertebra 4A and a second vertebra 4B,
via the spinous articular process SP4A (also referred to herein as
"process SP4A") of the first vertebra 4A and the transverse
articular process SP4B (also referred to herein as "process SP4B")
of the second vertebra 4B. Specifically, a distal end portion (not
shown) of the band 540 can be inserted into an aperture 524 of a
first portion 522 of the support member 520, and the distal end
portion of the band 540 can be inserted into the aperture 524' of
the first portion 522' of the support member 520'. The fastener
mechanism 550 can receive the distal end portion of the band 540
such that the body portion 545 forms a loop that substantially
encircles the process SP4A of the first vertebra 4A. A fastener 539
can be advanced through a fixation portion 538 of second portion
535 of support member 520 and into transverse process TP4B. A
fastener 539' can be advanced through a fixation portion 538' of
second portion 535' of support member 520' and into transverse
process TP4B'.
[0073] A third portion 530 of support member 520 can be disposed
between first portion 520 and second portion 535. The third portion
530 can be coupled to a coupler portion 526 of first portion 520 at
point P1 and can be coupled to a coupler portion 537 of second
portion 535 at P2. Similarly a third portion 530' of support member
520' can be disposed between first portion 520' and second portion
535'. The third portion 530' can be coupled to a coupler portion
526' of first portion 520' at point P1' (not labeled in FIG. 10A)
and can be coupled to a coupler portion 537' of second portion 535'
at point P2' (not labeled in FIG. 10A). A length L between point P1
and point P2, along with a length L' (not labeled in FIG. 10A)
between point P1' and point P2', can define a distraction between
vertebra 4A and vertebra 4B.
[0074] For example, support member 520 and support member 520' are
rigid structures that maintain a distraction by pushing on band 540
which is fixedly coupled to SP4A and processes TP4B, TP4B'.
Specifically, first portion 522 and first portion 522' can push, in
a first direction, on band 540, which is fixedly coupled to process
SP4A. Similarly, second portion 535 and second portion 535' can
push, in a second direction opposite the first direction, on
process TP4B and process TP4B', respectively.
[0075] FIGS. 12A and 12B depict a bone stabilization and
distraction apparatus, specifically a band 640, a support member
620, and a support member 620' stabilizing a vertebra 4A of spinal
column 2 with a vertebra 4B of spinal column 2, and defining a
distraction between vertebra 4A and vertebra 4B. The band 640 can
be similar to the band 140 described above and can include similar
components, and support members 620, 620' can be similar to the
support member 120 described above and can include similar
components. For example, the band 640 includes an attachment
connection 650 (also referred to herein as "fastener mechanism").
As seen in FIGS. 12A and 12B, unlike support member 520 of FIGS.
11A and 11B, which includes a first portion 522, a second portion
535 and a third portion 530, the support member 620 includes a
first portion 622, a second portion 635, a third portion 630, and a
fourth portion 665. The fourth portion 665 can be similar to the
second portion 635.
[0076] As shown in FIGS. 12A and 12B, the band 640, the support
member 620, and the support member 620' can be used to stabilize a
first vertebra 4A and a second vertebra 4B, and to define a
distraction between the first vertebra 4A and a second vertebra 4B,
via the spinous articular process SP4A (also referred to herein as
"process SP4A") of the first vertebra 4A and the transverse
articular processes TP4A, TP4A' (also referred to herein as
"process TP4A" and "process TP4A'") of the first vertebra 4A, and
via the spinous articular process SP4B (also referred to herein as
"process SP4B") of the second vertebra 4B and the transverse
articular processes TP4B, TP4B' (also referred to herein as
"process TP4B" and "process TP4B'") of the second vertebra 4B.
Specifically, a distal end portion (not shown) of the band 640 can
be inserted into an aperture 624 of a first portion 622 of the
support member 620, and the distal end portion of the band 640 can
be inserted into the aperture (not shown in FIG. 12A) of the first
portion 622' of the support member 620'. The fastener mechanism 650
can receive the distal end portion of the band 640 such that the
body portion 645 forms a loop that substantially encircles the
process SP4A and process SP4B. A fastener 639 can be advanced
through a fixation portion 638 of second portion 635 of support
member 620 and into transverse process TP4B. A fastener 669 can be
advanced through a fixation portion 668 of fourth portion 665 of
support member 620 and into transverse process TP4A. A fastener
(not shown in FIG. 12A) can be advanced through a fixation portion
638' of second portion 635' of support member 620' and into
transverse process TP4B'. A fastener 669' can be advanced through a
fixation portion 668' of fourth portion 665' of support member 620'
and into transverse process TP4A.
[0077] A third portion 630 of support member 620 can be disposed
through first portion 620 and between second portion 635 and fourth
portion 665. The third portion 630 can be coupled to a coupler
portion 626 of first portion 620, can be coupled to a coupler
portion 637 of second portion 635 at P2, and can be coupled to a
coupler portion 667 of fourth portion 665 at P1. Similarly a third
portion 630' of support member 620' can be disposed through first
portion 620' and between second portion 635' and fourth portion
665'. The third portion 630' can be coupled to a coupler portion
626' of first portion 620', can be coupled to a coupler portion
637' (not shown in FIG. 12A) of second portion 635' at P2' (not
shown in FIG. 12A), and can be coupled to a coupler portion 667'
(not shown in FIG. 12A) of fourth portion 665 at P1' (not shown in
FIG. 12A). A length L1 between point P1 and point P2, along with a
length L1' between point P1' and point P2', can define a
distraction between vertebra 4A and vertebra 4B.
[0078] For example, support member 620 and support member 620' are
rigid structures that maintain a distraction by pushing on
processes TP4B, TP4B' and processes TP4A, TP4A'. Specifically,
fourth portion 665 and fourth portion 665', which are fixedly
coupled to second portion 635 and second portion 635', can push, in
a first direction, on process TP4A and process TP4A', and second
portion 635 and second portion 635' can push, in a second direction
opposite the first direction, on process TP4B and process TP4B',
respectively.
[0079] FIGS. 13A and 13B depict a bone stabilization and
distraction apparatus, specifically a band 740 and a support member
720 stabilizing a vertebra 4A of spinal column 2 with a vertebra 4B
of spinal column 2, and defining a distraction between vertebra 4A
and vertebra 4B. The band 740 can be similar to the band 140
described above and can include similar components, and support
member 720 can be similar to the support member 120 described above
and can include similar components. For example, the band 740
includes an attachment connection 750 (also referred to herein as
"fastener mechanism").
[0080] As shown in FIGS. 13A and 13B, the band 740 and support
member 720 can be used to stabilize a first vertebra 4A and a
second vertebra 4B, and to define a distraction between the first
vertebra 4A and the second vertebra 4B, via the spinous articular
process SP4A (also referred to herein as "process SP4A") of the
first vertebra 4A and the transverse articular processes TP4B,
TP4B' (also referred to herein as "process TP4B" and "process
TP4B'") of the second vertebra 4B. Specifically, a distal end
portion (not labeled) of the band 740 can be inserted into an
aperture 724 of a first portion 722 of the support member 720. The
fastener mechanism 750 can receive the distal end portion of the
band 740 such that the body portion 745 forms a loop that
substantially encircles the process SP4A of the first vertebra 4A.
A fastener (not shown in FIG. 13A) can be advanced through a
fixation portion 738 of second portion 735 of support member 720
and into transverse process TP4B. A fastener 769 can be advanced
through a fixation portion 768 of fourth portion 765 of support
member 720 and into transverse process TP4B'. In some embodiments,
second portion 735 and/or second portion 735' can be moved along a
length of the first portion 722. In this manner, a location on
processes TP4A and/or TP4B where second portion 735 and/or second
portion 735' are fixed can be adjusted.
[0081] For example, support member 720 is a rigid structure that
maintains a distraction by pushing on processes TP4B, TP4B'.
Specifically, second portion 635 and fourth portion 665' can push,
in a first direction, on process TP4B and process TP4B'. Similarly,
portion 722 can push, in a second direction opposite the first
direction, on process SP4B.
[0082] FIGS. 14A and 14B depict a bone stabilization and
distraction apparatus, specifically a band 840, a band 840', a band
840'', a band 840''', a support member 820, and a support member
820' stabilizing a vertebra 4A of spinal column 2 with a vertebra
4B of spinal column 2, and defining a distraction between vertebra
4A and vertebra 4B. The bands 840, 840', 840'', and 840''' can be
similar to the band 140 described above and can include similar
components, and support members 820, 820' can be similar to the
support member 120 described above and can include similar
components. For example, the band 840 includes an attachment
connection 850 (also referred to herein as "fastener mechanism").
As seen in FIGS. 14A and 14B, unlike support member 520 of FIGS.
11A and 11B, which includes a first portion 522, a second portion
535 and a third portion 530, the support member 820 includes only a
first portion 822.
[0083] As shown in FIGS. 14A and 14B, the bands 840, 840', 840'',
and 840''' and the support members 820, 820' can be used to
stabilize a first vertebra 4A and a second vertebra 4B, and to
define a distraction between the first vertebra 4A and a second
vertebra 4B, via the transverse articular processes TP4A, TP4A'
(also referred to herein as "process TP4A" and "process TP4A'") of
the first vertebra 4A, and via the transverse articular processes
TP4B, TP4B' (also referred to herein as "process TP4B" and "process
TP4B'") of the second vertebra 4B. Specifically, a distal end
portion (not shown) of the band 840 can be inserted into an
aperture 824 of a portion 822 of the support member 820, and a
distal end portion of the band 840' can be inserted into the
aperture 824 of the portion 822 of the support member 820. The
fastener mechanism 850 can receive the distal end portion of the
band 840 such that the body portion 845 forms a loop that
substantially encircles the process TP4A. The fastener mechanism
850' can receive the distal end portion of the band 840' such that
the body portion 845' forms a loop that substantially encircles the
process TP4B. The process described above with reference to bands
840, 840', support member 820, and processes TP4A, TP4B can be
similarly applied to bands 840'', 840''', support member 820', and
processes TP4A', TP4B'.
[0084] As shown in FIGS. 14A and 14B, the distraction between
vertebra 4A and vertebra 4B can correspond to a length of the first
support member 820 and a length of the support member 820'. While
not shown in FIGS. 14A and 14B, the length of one or both of
support members 820, 820' can be adjustable (e.g., a single support
member can be configured to have a variety of length) or selectable
(e.g., a support member can be selected based on its length to
provide a particular distraction), and the distraction can be
changed depending on an adjusted length of one or both of support
members 820, 820' or based on the selected length of one or both of
support members 820, 820'.
[0085] FIGS. 15A and 15B depict bone stabilization and distraction
apparatus, specifically a band 940, a band 940', a support member
920, and a support member 920' stabilizing a vertebra 4A of spinal
column 2 with a vertebra 4B of spinal column 2, and defining a
distraction between vertebra 4A and vertebra 4B. The bands 940,
940' can be similar to the band 140 described above and can include
similar components, and support members 920, 920' can be similar to
the support member 120 described above and can include similar
components. For example, the band 940 includes an attachment
connection 950 (also referred to herein as "fastener mechanism").
As seen in FIGS. 15A and 15B, unlike support member 520 of FIGS.
11A and 11B, which includes a first portion 522 coupled to a second
portion 535 via a third portion 530, the support member 920
includes a first portion 922 directly coupled to the a second
portion 935.
[0086] As shown in FIGS. 15A and 15B, the bands 940, 940' and the
support members 920, 920' can be used to stabilize a first vertebra
4A and a second vertebra 4B, and to define a distraction between
the first vertebra 4A and a second vertebra 4B, via the transverse
articular processes TP4A, TP4A' (also referred to herein as
"process TP4A" and "process TP4A'") of the first vertebra 4A, and
via the transverse articular processes TP4B, TP4B' (also referred
to herein as "process TP4B" and "process TP4B'") of the second
vertebra 4B. Specifically, a distal end portion (not shown) of the
band 940 can be inserted into an aperture 924 of a portion 922 of
the support member 920. The fastener mechanism 950 can receive the
distal end portion of the band 940 such that the body portion 945
forms a loop that substantially encircles the process TP4A. A
fastener 939 can be advanced through a fixation portion 938 of
second portion 935 of support member 920 and into transverse
process TP4B The process described above with reference to bands
940 and support member 920, and processes TP4A, TP4B can be
similarly applied to bands 940' and support member 920', and
processes TP4A', TP4B'.
[0087] As shown in FIGS. 15A and 15B, the distraction between
vertebra 4A and vertebra 4B can correspond to a length of the
support member 920 and a length of the support member 920'. While
not shown in FIGS. 15A and 15B, the length of one or both of
support members 920, 920' can be adjustable (e.g., a single support
member can be configured to have a variety of length) or selectable
(e.g., a support member can be selected based on its length to
provide a particular distraction), and the distraction can be
changed depending on an adjusted length of one or both of support
members 920, 920' or based on the selected length of one or both of
support members 920, 920'.
[0088] FIG. 16 is a flowchart illustrating method 1090 of
stabilizing a first bone portion to a second bone portion. The
method 1090 includes disposing a flexible band through an aperture
of a support member, at 1091. The support member has a fixation
portion configured to secure the support member to a first bone
portion. The method 1090 includes advancing a portion of the
flexible band through an attachment portion of the flexible band
until the flexible band is secured to a second bone portion, at
1092. The method 1090 includes advancing a portion of the fixation
portion of the support member into the first bone portion until the
support member is secured to the first bone portion, at 1093. In
some embodiments, the method 1090 can includes disposing the
flexible band through an aperture of a second support member. In
such embodiments, the second support member can have a fixation
portion configured to secure the second support member to a third
bone portion. In such embodiments, the method can include advancing
a portion of the fixation portion of the second support member into
the third bone portion until the second support member is secured
to the third bone portion. In some embodiments, the method 1090 can
include adjusting a distance between a support portion of the
support member and the fixation portion of the support member to
define a distraction between the first bone portion and the second
bone portion. In some embodiments, the method 1090 can include
disposing the flexible band into contact with a fourth bone
portion. In such embodiments, the method 1090 can include advancing
the portion of the flexible band through the attachment portion of
the flexible band includes advancing the portion of the flexible
band through the attachment portion until the flexible band is
secured to the second bone portion.
[0089] FIG. 17 is a flowchart illustrating method 1190 of
stabilizing a first bone portion to a second bone portion. The
method 1190 includes disposing a first flexible band through a
first aperture of a support member, at 1191. The method 1190
includes disposing a second flexible band through a second aperture
of the support member, at 1192. The method 1190 includes advancing
a portion of the flexible band through an attachment portion of the
first flexible band until the first flexible band is secured to a
bone portion, at 1193. The method 1190 includes advancing a portion
of the flexible band through an attachment portion of the second
flexible band until the second flexible band is secured to a second
bone portion, at 1194. In some embodiments, the method 1190 can
include disposing a third flexible band through a first aperture of
a second support member. In such embodiments, the method 1190 can
include disposing a fourth flexible band through a second aperture
of the second support member. In such embodiments, the method 1190
can include advancing a portion of the third flexible band through
an attachment portion of the third flexible band until the third
flexible band is secured to a third bone portion. In such
embodiments, the method 1190 can include advancing a portion of the
fourth flexible band through an attachment portion of the fourth
flexible band until the fourth flexible band is secured to a fourth
bone portion. In some embodiments, the support member can have a
length that is adjustable, and the method 1190 can includes
adjusting the length of the support member to define a distraction
between the first bone portion and the second bone portion.
[0090] Any of the embodiments, described above can be packaged
independently or in any suitable combination. For example, in some
embodiments, a kit can include at least flexible elongate body
(e.g., a band) and a support member. For example, the band can be
similar to or the same as the bands 140-940. In this manner, the
flexible band is configured to stabilize, and or define a
distraction between, a first bone portion and/or a second bone
portion. The support member can include an interface portion
configured to receive at least a portion of the flexible band. For
example, the support member can be similar to or the same as
support members 120-920. In this manner the support member is
configured to stabilize, and or define a distraction between, a
first bone portion and/or a second bone portion. The support member
can includes a fixation portion configured to secure the support
member to a second bone portion such that the first bone portion
and the second bone portion are stabilized. In some embodiments,
the kit can include additional bands and/or support members
according to any of the embodiments described herein.
[0091] While various embodiments have been described above, it
should be understood that they have been presented by way of
example only, not limitation, and various changes in form and
details may be made. For example, while the embodiments are
illustrated here as being disposed about a spinous articular
process of a first vertebra and a spinous articular process of a
second vertebra, in other embodiments, a flexible elongate body
(e.g., a band) can be disposed about another portion of one or more
vertebra. In such embodiments, the band can be tightened about the
vertebrae to offset or correct misalignment of a portion of the
spine (e.g., scoliosis, or the like).
[0092] While the descriptions given are with reference to
stabilizing vertebra, another bone(s) such as for example, a
sternum and/or a rib(s) could be stabilized using the flexible
fastening bands described herein. In another example, a flexible
fastening band can be used to stabilize and/or fixate an
intramedullary (IM) rod or nail. For example, the flexible
fastening band can be used at different longitudinal locations
along an IM rod or nail, and used to couple adjacent bone portions
to the IM rod or nail. In such situations, a given flexible
fastening band can fix a first bone portion, the IM rod or nail,
and a second bone portion, all of which are positioned between the
distal portion and the attachment connection of the flexible
fastening band. In yet another example, a flexible fastening band
can be used to stabilize and/or fixate a bone fragment. While
various embodiments have been described above with regard to
natural bone spaces, (e.g., the space between an inferior
articulate process and a superior articulate process), in other
embodiments, the bone spacing can be man-made (e.g., sternum split
during a heart procedure), and/or due to an injury (e.g., broken
bone).
[0093] Where methods described above indicate certain events
occurring in certain order, the ordering of certain events can be
modified. Additionally, certain of the events can be performed
concurrently in a parallel process when possible, as well as
performed sequentially as described above. For example, while the
method 1090 described above includes advancing a portion of the
band into the attachment connection prior to advancing the a
portion of the fixation portion, in some embodiments, the portion
of the fixation portion can be at least partially advanced into a
bone portion prior to the portion of the band being advanced
through the attachment portion. In some embodiments, at least a
portion of the advancing of the portion of the fixation portion
into the bone portion and at least a portion of the advancing of
the portion of the band into the attachment connection can be done
concurrently (e.g., simultaneously or alternatively in relatively
small increments).
[0094] Any portion of the apparatus and/or methods described herein
may be combined in any combination, except mutually exclusive
combinations. The embodiments described herein can include various
combinations and/or sub-combinations of the functions, components
and/or features of the different embodiments described.
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