U.S. patent number 3,693,616 [Application Number 05/155,796] was granted by the patent office on 1972-09-26 for device for correcting scoliotic curves.
Invention is credited to Robert Roaf, John Thomas Matthew Wright.
United States Patent |
3,693,616 |
Roaf , et al. |
September 26, 1972 |
DEVICE FOR CORRECTING SCOLIOTIC CURVES
Abstract
An implantable spinal stabilizing device, developed initially
for correcting and maintaining the correction of scoliotic curves,
but also useful for fixing spinal fractures and dislocations,
involves a pair of spaced parallel rigid bars, each bar having a
succession of apertures. The bars are located on opposite sides of
the spinous processes, between the spinous and respective
transverse processes, and held in this location by tape laced
through the bar apertures and around the spinous laminae or
transverse processes. The tape is tensioned and secured by plugs in
the relevant apertures, and the overall assembly serves to
stabilize the spine in a required configuration.
Inventors: |
Roaf; Robert (Liverpool,
EN), Wright; John Thomas Matthew (Southport,
EN) |
Family
ID: |
10318631 |
Appl.
No.: |
05/155,796 |
Filed: |
June 23, 1971 |
Foreign Application Priority Data
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Jun 26, 1970 [GB] |
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31,141/70 |
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Current U.S.
Class: |
606/250 |
Current CPC
Class: |
A61B
17/7049 (20130101) |
Current International
Class: |
A61B
17/70 (20060101); A61f 005/00 () |
Field of
Search: |
;128/69,92R,92B,92D,92G |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Gaudet; Richard A.
Assistant Examiner: Yasko; J.
Claims
We claim:
1. An implantable spinal stabilizing device comprising two rigid
bars to be located one at each side of the spinous processes
between the spinous and respective transverse processes and
including a length of tape, each of said bars having a plurality of
apertures therein and disposed in a sequence along the bar for
receipt of said tape in laced engagement therewith while embracing
adjacent transverse processes or laminae, means for securing said
tape to said bars, and rigid spacer means for holding said bars in
substantially parallel spaced apart relationship at opposite sides
of the spinous processes.
2. A device according to claim 1 wherein said apertures are tapered
in a common direction through said bars, and said securing means
comprise a plurality of tapered plugs for individual engagement in
said apertures having tape laced therethrough.
3. A device according to claim 2 wherein said plugs have serrated
side surfaces.
4. A device according to claim 2 wherein said securing means
further comprises two cover plates for respective connection along
said bars over the larger ends of said apertures.
5. A device according to claim 1 wherein slots are provided between
one side of each of said bars and the respective apertures therein
to facilitate lacing of tape without threading.
6. A device according to claim 1 wherein said spacer means comprise
two rigid bars of shorter length than the first-mentioned bars,
said first bars and spacer bars being adapted for interconnection
at their ends to form a rigid generally rectangular assembly.
7. A device according to claim 6 wherein each of said first bars
extend beyond its connection points with said spacer bars, has a
plurality of said apertures extending between said points, and has
at least one aperture therein beyond each of said points.
8. A device according to claim 1 wherein: said apertures provided
with slots between one side of each of said bars and the respective
apertures, and said apertures are tapered in a common direction
through said bars; said securing means comprise a plurality of
tapered serrated plugs for individual engagement in said apertures
having tape laced therethrough; and said spacer means comprise two
rigid bars of shorter length than the first mentioned bars, said
first bars and spacer bars being adapted for interconnection at
their ends to form a rigid generally rectangular assembly.
Description
This invention relates to spinal stabilizing devices and more
particularly, but not exlusively, such devices for correcting
scoliotic curves and maintaining the correction.
Devices are known for correcting and maintaining the correction of
scoliotic curves which comprise a rod and a pair of oppositely
directed hooks at the ends of the rod. In application of the
device, the hooks are engaged with vertebrae at the ends of the
curve and a distractional force is applied to the portion of the
spine between the hooks by increasing the length of the rod,
whereby the laterally displaced and rotated vertebrae are drawn
into their required positions. Such devices operate by distracting
a portion of the spine and large forces have to be applied by the
hooks on the vertebrae engaged therewith in order to correctly
re-dispose the displaced vertebrae. The amount of force applied has
to be carefully controlled by the surgeon to avoid fracture of the
bone.
It is an object of the present invention to provide an improved
device relative to those just mentioned.
According to the present invention there is provided an implantable
spinal stabilizing device comprising two rigid bars to be located
one at each side of the spinous processes between the spinous and
respective transverse processes, each of said bars having a
plurality of apertures therein and disposed in a sequence along the
bar for receipt of tape in laced engagement therewith while
embracing adjacent transverse processes or laminae, means for
securing said tape to said bars, and rigid spacer means for holding
said bars in substantially parallel spaced apart relationship at
opposite sides of the spinous processes.
The apertures in the bars may be tapered therethrough and the means
for securing the tapes to the bars may then conveniently be tapered
plugs having their tapered surfaces serrated. Cover plates may be
provided for attachment to each bar to retain such tape securement
plugs in situ in their apertures.
For convenience, slots may be provided between respective apertures
and one side of each bar so that tapes can be slid through the
slots into the apertures, thereby avoiding the necessity to thread
the tapes through apertures.
An embodiment of the invention will now be described, by way of
example, with reference to the accompanying drawing, in which:
FIG. 1 illustrates an exploded perspective view of a device in
accordance with the present invention;
FIG. 2 is a posterior view of a portion of a spine with the device
illustrated in FIG. 1 attached thereto;
FIG. 3 is a superior section view on the line III-III in FIG. 2,
and
FIG. 4 is a sagittal sectional view on the line IV-IV of FIG.
3.
The device illustrated in the drawing comprises two like rigid bars
1 and 3 formed of stainless steel or other material suitable for
implantation in the human body. Each of these bars is formed with a
plurality of apertures 5 therethrough, which apertures are
distributed along the bar, are tapered in the same sense through
the bar, and have substantially parallel longitudinal axes.
Each bar also includes two threaded bores 7 for threaded engagement
with screws 9 to secure transverse spacer members 11 to the bars.
These bores 7 are located towards respectively opposite ends of
each bar. The members 11 are each in the form of a cross-bar having
stepped formation at each end to provide a shoulder which engages
the nearer side of a bar connected thereto.
Each bar further includes two further threaded bores 13,
respectively adjacent the bores 7, for threaded engagement with
screws 15 to secure cover plates 17 of strip form to the bars 1 and
3. These plates are omitted from FIG. 2 for the sake of
clarity.
Each aperture 5 has associated with it a slot 19 which extends from
the aperture to a common side surface of the relevant bar so that
each aperture is open to the exterior of the bar not only at its
ends but also through the respective slot 19.
A plurality of tapered plugs 21 are provided for location in the
tapered apertures 5, and these plugs have serrated side surfaces to
enhance their securement of location in the apertures.
Two tapes 23 are provided for respective use with the bars. The
tapes 23 are formed of terylene or other strong flexible material
suitable for implantation in the human body.
Appropriate parts and surfaces of the illustrated components are
rounded and smoothed to avoid damage to adjacent tissue and the
like when the device is implanted.
The first step in implantation, after exposure of the site, is to
pass the tapes in and out of the laminae. For example, as seen in
FIG. 4, one of the tapes is looped behind four laminae, namely a
first, a third, and a fifth and sixth, with loops of tape
upstanding over the second and fourth laminae. The tape at the
other side of the spinous processes may follow a similar, but not
necessarily identical, path. To facilitate this insertion of the
tapes behind the laminae, laminectomy may be necessary. The bars 1
and 3 are then brought up to the spine at opposite sides of the
spinous processes 25, between the spinous processes 25 and the
respective transverse processes 27, and are joined together by the
spacer members 11.
The upstanding end portions of the tapes and the upstanding loop
portions are introduced into appropriate apertures 5 of the bars by
slipping them through the slots 19. One end portion of each tape is
secured to its respective bar by inserting a plug 21 in the
aperture 5 through which the end portion extends so as to grip the
tape between the plug and the bounding surface of the aperture. The
slack in the tapes is worked towards their free, unsecured ends to
progressively tighten the tapes from their secured ends. By this
action, the vertebrae in the curve are displaced and rotated into
contact with the bars and the curve is thereby corrected, and this
correction is held by insertion of plugs into the successive
apertures through which the tapes extend.
The free ends of the tapes above the bars are cut off short and the
cover plates 17 are secured to the bars. The cover plates 17 are
disposed somewhat closer to the bars than is illustrated in FIGS. 3
and 4 of the drawings and serve to retain a plug should one tend to
loosen.
If the gaps between adjacent laminae are too small to allow a tape
to be disposed therein, the natural gaps may be enlarged by removal
of bone.
In some cases a loop may embrace not one but two laminae, this
being a matter of convenience. For example, it will be observed
that the distance between the aperture 5 at the end of each bar and
the next adjacent aperture 5 in the bar is considerably greater
than the distance between other adjacent apertures 5 since the
former distance spans a region of the bar accommodating the spacer
member and cover plate securement screws. If then an aperture at
the end of a bar is used, it will normally be convenient to employ
a tape loop embracing two laminae in this region.
It will be appreciated from these last comments that the bars will
normally be provided with more apertures than required for any one
particular implant application, whereby a common form of bar is
useful in different applications. Even so, provision of a small
number of different, standard bar lengths may be appropriate to
give a surgeon a fuller choice. In the same way a range of spacer
members 11 of differing effective lengths may be provided so that a
surgeon can choose particular spacer members to attain the desired
spacing of the bars.
While reference has been made principally to passage of tape around
laminae, the tape can equally well be passed around the transverse
processes.
It will be realized that because, in use of the present invention,
the forces being applied to correct the curve are forces acting
approximately on radii of the curve, they may be less than those
which have to be applied in the case of prior known devices which
operate by distraction. Also, only a very small amount of bone
removal, if any, is required. Furthermore, the transverse processes
and laminae represent substantial bodies of bone for reaction with
the tapes as compared to the anchorage available to the prior known
distraction rods.
A further advantage believed to be present in use of a device
according to the present invention is that the correction is
maintained even when growth occurs because the mechanical
arrangement of the device is such that growth, and hence movement,
of the vertebrae relative to the device does not result in
reduction of the correcting force applied by the device.
It is to be understood that the terms scoliosis and scoliotic are
used herein in their broader meanings as including kyphosis and
kyphotic, and lordosis and lordotic. Devices in accordance with the
invention are suitable for correcting and maintaining the
correction of curves which are strictly termed kyphotic and
lordotic.
Details of one embodiment of the present invention as described
above and illustrated are as follows:
The tapes were made of terylene, being one-half inch wide, and
having a breaking strain of about 200 lbs. (Messrs. Beresford,
Birchenhall & Co. Ltd., Type C 772).
The length of the bars was 8 inches but a range of bars between 5
inches and 8 inches long will be usual. The bars were of
rectangular cross-section of sides 0.45 and 0.312 inch with the
smaller side being parallel to the axes of the apertures.
The plug apertures were 0.817 inches at their narrower ends and
tapered with an included angle of 10.degree.. The center-to-center
spacing of the main groups of apertures was 0.375 inch.
Spacers with lengths in the range 1.15 to 1.775 inches, and so
formed as to provide distances between the center lines of the bars
in the range 0.82 to 1.445 inches, were provided.
In conclusion, it is noted that, while the present invention has
been conceived and developed primarily for use in correcting
scoliotic curves, devices according to the invention can also be
used for fixing spinal fractures and dislocations. It will be
appreciated that no special adaption of the devices is required
since they already serve to stabilize the spinal column in an
appropriate manner.
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