摘要:
An anti-adhesion device in the form of a fillable balloon having a wall structure permits suturing or other attachment of the balloon to surrounding tissues. The balloon may be filled with a gas, liquid, or gel, and may be constructed of a resorbable material. The balloon may contain one or more growth factors and one or more antibodies to the growth factors may also be provided. Cytokines may be incorporated into the wall structure. The associated surgical procedure includes suturing or otherwise attaching the balloon between healing tissues and surrounding tissues. The healing tissues may include the vagina and the surrounding tissues include the small intestines, the great vessels and the spine following anterior spinal surgery, or any other appropriate location(s). The balloon may be placed immediately after an open surgical procedure or, alternatively, through smaller incisions as part of a minimally invasive procedure. Thus, the balloon may be filled prior to introduction or following placement. In the preferred embodiment the balloon ruptures and resorbs after the surgically treated tissues are partly or completely healed.
摘要:
The present invention relates to medical devices and methods generally aimed at spinal surgery. In particular, the disclosed system and associated methods relate to performing spinal fixation.
摘要:
Check reins in the form of elongated members are used to limit the extreme range of motion which would otherwise be permitted by some ADR designs. The check reins serve two main purposes. First, they retain disc spacers, if present. Additionally, the wedge shape of ADRs and the removal of the Anterior Longitudinal Ligament (ALL) and a portion of the Annulus Fibrosus (AF) to insert the ADR from an anterior approach, favor anterior extrusion of disc spacers. In preferred embodiments the check reins are therefore limited to the anterior portion of the periphery of the ADR. Second, check reins serve to prevent excessive spinal motion. Again, although they may be helpful in other locations, anterior check reins help restore the motion limiting functions of the ALL and AF that were removed in anterior approaches to the spine.
摘要:
Methods and apparatus for treating disc herniation provide a conformable device which assumes a first shape associated with insertion and a second shape or expanded shape to occlude the defect which typically follows partial discectomy. The device may take different forms according to the invention, including patches size to cover the defect or plugs adapted to fill the defect. In a preferred embodiment, however, the device is a gel or other liquid or semi-liquid which solidifies to occlude the defect from within the body of the disc itself. In another preferred embodiment, a mesh screen is collapsed into an elongated form for the purposes of insertion, thereby minimizing the size of the requisite incision while avoiding delicate surrounding nerves. Such a configuration also permits the use of instrumentation to install the device, including, for example, a hollow tube or sheath adapted to hold the collapsed screen, and a push rod to expel the collapsed device out of the sheath for use in occluding the disc defect. A device according to the invention may further include one or more anchors to assist in permanently affixing the device with respect to the defect.
摘要:
A method for performing kyphoplasty is disclosed. A catheter having a balloon-like component is located at its distal end, is inserted into a fractured vertebra. A substance such as PMMA to fill the balloon and stabilize the fracture is injected through the catheter. The balloon is held in place until the material begins to set.
摘要:
Surgical implants are configured for placement posteriorly to a spinal canal between vertebral bodies to distract the spine and enlarge the spinal canal. In the preferred embodiments the device permits spinal flexion while limiting spinal extension, thereby providing an effective treatment for treating spinal stenosis without the need for laminectomy. The invention may be used in the cervical, thoracic, or lumbar spine. Numerous embodiments are disclosed, including elongated, length-adjustable components coupled to adjacent vertebral bodies using pedicle screws. The preferred embodiments, however, teach a device configured for placement between adjacent vertebral bodies and adapted to fuse to the lamina, facet, spinous process or other posterior elements of a single vertebra. Various mechanisms, including shape, porosity, tethers, and bone-growth promoting substances may be used to enhance fusion. The tether may be a wire, cable, suture, or other single or multi-filament member. Preferably, the device forms a pseudo-joint in conjunction with the non-fused vertebra. Alternatively, the device could be fused to the caudal vertebra or both the cranial and caudal vertebrae.
摘要:
Numerous joint replacement implant embodiments including a total knee replacement implant including a femoral component (102) having a wheel (104); and a tibial component (106) including a shock-adsorbing component with a piston assembly (110) and spring (112). Said implants contain a cushioning or shock-absorbing member to dampen axial loads and other forces. In many embodiments, fluid is force rapidly from the device wherein compression and dampening is achieved by valves or other pathways that allow for a slower return of the fluid back into the implant as the pressure is relieved.
摘要:
This invention is directed to improved methods and devices to attach arthroplasty devices, particularly the spine, distract the disc space, machine the disc space to improve the fit between ADRs and the vertebrae, to hold and remove ADRs, and to facilitate spinal fusion for a failed ADR surgery. One aspect of the invention places anchor devices in the spine during a first operation. Spinal devices are connected to the anchoring devices during a second procedure. The second procedure is generally performed months after the insertion of the anchoring devices. The time between the two procedures allows bone to grow into the anchoring devices. Minimal forces are exerted on the anchoring devices between the procedures. Other embodiments are described where a previously implanted ADR having a pair of opposing endplates is immobilized using a device the attached to the endplates, fits between the endplates, or both.
摘要:
This invention improves upon prior aft total disc replacements (TDRs) by more closely replicating the kinematics of a natural disc. The preferred embodiments feature two or more fixed centers of rotation (CORs) and an optional variable COR (VCOR) as the artificial disk replacement (ADR) translates from a fixed posterior COR that lies posterior to the COR of the TDR to facilitate normal disc motion. The use of two or more CORs allows more flexion and more extension than permitted by the facet joints and the artificial facet (AF). AF joint-like components may also be incorporated into the design to restrict excessive translation, rotation, and/or lateral bending.
摘要:
In a total knee replacement (TKR), the use of a cushion element provides better wear characteristics than polyethylene (“poly”) alone. Since a metal-on-metal, metal-on-ceramic, or ceramic-on-ceramic articulating surface has better wear characteristics than metal on poly, the invention essentially provides cushioning for metal/ceramic-on-metal/ceramic joint replacements. It also allows the use of elastomers for their cushioning properties rather than their surface wear and tensile strength characteristics. The contained compressible elements could also be used as a cushion below polyethylene components, polyethylene over metal components, unicondylar knee replacements, patellar components, and prosthetic components for other parts of the body, including the hip, elbow, shoulder, wrist, and ankle.