Surgical tether apparatus and methods of use
Inventors
Alamin, Todd • Fielding, Louis • Cahill, Colin • Kothari, Manish
Assignees
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Publication Number
US-8562653-B2
Publication Date
2013-10-22
Expiration Date
Abstract
A spinal treatment system includes a constraint device having an upper tether portion, a lower tether portion and a compliance member coupled therebetween. The upper tether portion is coupled with a superior spinous process of a spinal segment in a patient and the lower tether portion is coupled with an inferior spinous process or sacrum of the spinal segment. The length or tension in the constraint device is adjustable so that the construct of the tether portions and the compliance member provides a force resistant to flexion of the spinal segment. The system also includes a first prosthesis coupled with the spinal segment, wherein the constraint device modulates loads borne by the prosthesis or by tissue adjacent thereto.
Core Innovation
The invention describes a spinal treatment system and surgical approach that implants a first prosthesis into a patient and also implants a constraint device into the patient to provide post-operative spinal stability. The constraint device includes at least one tether portion and at least one compliance member coupled to the tether portion, and the compliance member comprises an elastic member, such that the constraint device resists spinal flexion through the tether/compliance construct.
At least one portion of the constraint device is engaged with a spinous process of a third vertebra superior to or inferior to the instrumented spinal segment, while at least one portion of the constraint device is attached to at least one portion of the fusion instrumentation. Length or tension in the constraint device is adjusted so that the construct provides an elastic force resistant to flexion and modulates loads borne by the first prosthesis or tissue adjacent thereto.
The invention is also described in the context of spinal fusion, including fusing a pair of adjacent vertebrae, instrumenting the pair, and implanting the constraint device superior or inferior to at least a portion of the instrumented pair. The constraint device comprises a compliance member with an elastic member and is engaged with a spinous process of a third vertebra superior or inferior to the fused vertebrae, and adjusting length or tension provides an elastic force resistant to flexion and modulates loads borne by the instrumented adjacent vertebrae and adjacent tissue.
Claims Coverage
The provided independent claims are clm-00001 and clm-00028. Across these claims, the coverage centers on an elastic, tether-based constraint device engaged with a spinous process adjacent to an instrumented or fused segment, coupled to fusion instrumentation, with length or tension adjusted to resist flexion and modulate loads.
Prosthesis with fusion instrumentation and tethered elastic constraint engaged with an adjacent spinous process
A surgical method implanting a first prosthesis comprising fusion instrumentation coupled to at least a portion of a spinal segment comprising a first and a second vertebra; implanting a constraint device having at least one tether portion and at least one compliance member coupled to the tether portion, with at least one portion engaged with a spinous process of a third vertebra superior to or inferior to the instrumented portion; attaching at least one portion of the constraint device to at least one portion of the fusion instrumentation; the compliance member comprising an elastic member; adjusting length or tension so the tether/compliance construct provides an elastic force resistant to flexion; and modulating loads borne by the first prosthesis or tissue adjacent thereto.
Fusion of adjacent vertebrae with instrumentation and tethered elastic constraint engaged with a spinous process of a third vertebra
A surgical method fusing a pair of adjacent vertebrae of a spinal segment in a patient; instrumenting the pair; implanting a constraint device into the patient superior to or inferior to at least a portion of the instrumented pair, with the constraint device comprising a compliance member having an elastic member; attaching a portion of the constraint device to the instrumentation of the adjacent fused vertebrae; engaging the constraint device with a spinous process of a third vertebra superior to or inferior to the pair of fused vertebrae; and adjusting length or tension to provide an elastic force resistant to flexion and modulating loads borne by the instrumented adjacent vertebrae and adjacent tissue.
Both independent claims require an elastic, tether-based constraint device coupled to spinal instrumentation and engaged with a spinous process of a vertebra adjacent to the instrumented or fused segment. In both claims, adjusting length or tension creates an elastic force resistant to flexion, and the device modulates loads borne by the prosthesis or fused vertebrae and adjacent tissue.
Stated Advantages
Provides an elastic force resistant to flexion of the spinal segment.
Modulates loads borne by the first prosthesis or tissue adjacent thereto.
Modulates loads borne by the instrumented adjacent vertebrae and tissue adjacent thereto.
Documented Applications
Spinal surgical treatment involving implantation of a first prosthesis with fusion instrumentation together with a tether-based constraint device engaged with a spinous process of a third vertebra.
Spinal fusion of a pair of adjacent vertebrae with instrumentation, combined with implantation and tension or length adjustment of a tethered elastic constraint device engaged with a spinous process of a third vertebra.
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