摘要:
Apparatus and method for minimally invasive spinal surgery employs an elongated flexible guide element inserted so as to pass in through a first lateral posterior incision, through the spinal column anterior to the spinal cord, and out through a second lateral posterior incision contralateral to said first incision. The guide element is used to guide various elements to a desired position within the spinal column as part of the surgical procedure. Preferably, two hollow rigid tubes rigidly coupled outside the body in converging relation are used to define a working gap within the spinal column through which the guide element passes. This provides a platform for manipulation of tissues and introduction of implants anterior to the spinal cord. Procedures described include reinforcement of a degenerative intervertebral disc and restoration of a damaged vertebral body.
摘要:
A spinal implant is inserted between adjacent vertebrae to function as an disk prosthesis. The prosthesis has two plates fastened to adjacent vertebrae facing each other. The facing sides of the plates each have a depending skirt formed as concentric arcs of about 90 degrees. The skirts are either bowed or tapered in the axial direction. Depressions are centrally located between the arcs of the plates and a ball is universally movable in the depressions. A spring mechanism is centrally located in the plates to provide axial compression. One plate has a through bore and one plate has a receptacle, each, receiving a sleeve with a depression for holding the ball.
摘要:
A degenerated nucleus pulposus located in a central core region of an intervertebral disc within the annulus fibrosus is supplemented or replaced by a method wherein an amount of a biocompatible material is introduced into the central core region by a process including the steps of 1) forming a channel through a vertebral body adjacent to said intervertebral disc, extending from an exterior surface of the vertebral body to the central core region of the annulus fibrosus; 2) introducing an amount of a biocompatible material through the channel into the central core region of the annulus fibrosus; 3) pressurizing the biocompatible material through the channel to a postsurgical pressure sufficient to alleviate symptoms caused by the degenerated nucleus pulposus; and 4) sealing the channel while maintaining the sufficient postsurgical pressure. After sealing the channel, a vertebroplasty may optionally be performed in the vertebra.
摘要:
A spinal mobility preservation apparatus and methods are disclosed. The spinal mobility preservation apparatus may include a proximal body, an intermediate body, a distal body, and an expandable membrane. The proximal body and the distal body secure the mobility preservation apparatus to adjacent vertebral bodies. At least one of an intermediate body and an expandable membrane secure the proximal body to the distal body and provide a degree of support to a spinal motion segment defined by the adjacent vertebral bodies. A single proximal body and an expandable membrane may also compose a spinal mobility preservation apparatus. The proximal body secured to one of a superior or an inferior vertebral body and the expandable membrane extending into the intervertebral disc space to support the spinal motion segment.
摘要:
An artificial intervertebral disc and disc nucleus are described herein having chambers and dampening members. The dampening members may be within or outside of the main body of the device. The chambers may be filled with a suitable liquid, gas, or both, and separated by valves to regulate flow of fluid between chambers, within a dampening member, between the main body and dampening member, or all of the above. Chambers may be filled with responsive hydrogels, EPAM, or other suitable materials, and the device may have activation plates or members, a strain gauge, a pressure sensor, or other means for detecting changes in the materials and/or triggering desired changes in the materials in order to mimic the behavior of a healthy native disc or disc nucleus. A control system may be in communication with the device for receiving feedback and delivering stimuli to initiate desired changes in the fluids or other materials. Membranes may be of variable permeability and may be metallized to ensure as low permeability as possible. Dampening members may be filled during manufacture with carbon dioxide or other suitable gas which may be in a supercritical state and allowed to return to ambient temperature and gaseous state or by other means. Methods of manufacture, delivery of the artificial disc and related structures, and methods of treatment are also described.
摘要:
An orthopedic implant. The implant includes a metal portion having an internal three-dimensional cavity, the cavity having an opening to an outer surface of the metal portion, a ledge circumferentially surrounding at least a portion of the opening, and a porous metal insert formed in a three-dimensional shape conforming to the shape of the cavity and enclosed by the cavity without being bonded to the cavity. The insert is retained inside the cavity by the ledge.
摘要:
Compositions comprising carboxypolysaccharides (CPS) including carboxymethyl cellulose (CMC) and polyethylene glycols (PEGs) are provided where the PEG is a PEG-epoxide covalently linked to the CPS via an addition reaction. In certain embodiments, the PEG attaches to only one CPS, forming a decorated CPS. In other embodiments, bi-functional PEG molecules are attached to adjacent CPSs, thereby forming a covalently cross-linked composition. In certain of these embodiments, a PEG is linked to the CPS by way of an ether linkage, and in other embodiments, a PEG is linked to the CPS by way of an ester linkage, and in still further embodiments, PEG molecule(s) can be attached to CPS molecule(s) by way of both ether and ester linkages. Additional embodiments include PEG/CMC compositions where the PEG is a multi-branch PEG and/or a multi-arm PEG. PEG/CMC compositions can be made with desired viscoelastic properties, and such compositions can be used as space-filling materials, load-bearing materials, anti-adhesion compositions, for drug delivery vehicles or for lubrication of tissues and medical instruments.
摘要:
An implant for use in spinal surgery comprises a resilient element having an inflatable cavity. It is formed of a biologically compatible material and is arranged for placement between end plates of adjacent vertebra. The implant may also include a wound disc replacement element. A method of performing spinal surgery on a patient comprises securely mounting a patient onto a patient support table; imaging a spinal region of the patient; building up a three-dimensional image file of the spinal region of the patient; storing the image file; and utilizing the image file for planning and carrying out computer controlled spinal surgery on the patient utilizing the implant. A computer-controlled surgical implant system comprises a steerable endosurgical implanting assembly operative to install the implant at a desired location in a patient; and a computerized controlled, which operates the steerable endosurgical implanting assembly.
摘要:
An expandable device is introduced into a cancellous bone volume of a vertebral body through a percutaneous access path. The expandable device is expanded while disposed within the cancellous bone volume to create a cavity. A filling material including a biomaterial is placed within the cavity.
摘要:
A vertebral body is selected for treatment. The vertebral body has a cortical wall enclosing a cancellous bone volume. At least one maximum dimension for the cancellous bone volume is ascertained, and an expandable device is provided that has a predefined dimension when substantially expanded that is less than the maximum dimension. The expandable device is introduced into the vertebral body through a percutaneous access path while in an unexpanded condition. The expandable device is expanded while disposed within the cancellous bone volume from the unexpanded configuration toward the expanded configuration. An expansion barrier is provided in association with the expandable device that directs expansion of the expandable device in a desired direction to create a cavity in the cancellous bone volume.