摘要:
A spinal alignment system is disclosed and includes vertebral connectors, elongated elements that link the vertebral connectors, and fasteners that lock the elongated elements in position. An elongated element has at least one shaped end that is received by a coupling member of the connector. The shaped end permits the elongated element to be angularly moveable with respect to the coupling member until locked in place with a fastener received in the coupling member. The elongated element also preferably includes a length adjustment mechanism, such as a telescoping or threaded section to provide a desired length in conjunction with a desired degree of alignment. Various coupling mechanisms are disclosed to provide multiple degrees of freedom prior to fixation.
摘要:
A method for stabilizing upper and lower spinal vertebrae having a disc space situated therebetween is described. First and second fasteners are inserted into the upper vertebra. Third and fourth fasteners are inserted into the lower vertebra, such that the first and third fasteners are substantially vertically aligned and the second and fourth fasteners are substantially vertically aligned. The first and third fasteners are connected with a first elongate element. The second and fourth fasteners are connected with a second elongate element. The first and fourth fasteners are connected with a third elongate element. The second and third fasteners are connected with a fourth elongate element.
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:
An artificial joint or disc replacement (ADR) broadly includes a pair of opposing endplate components, each attached to one of the upper and lower vertebrae, a cushioning component disposed between the endplate components, and a mechanism for coupling the cushioning component to one or both of the endplates. In the preferred embodiment, the cushioning component takes the form of a tire-like outer structure attached to an inner hub. A filler material is also preferably contained within the cushioning component. The filler material may be a gas, liquid, foam, or gel, including a hydrogel. One or both of the endplate components may include a modified surface to increase adherence to respective opposing bone surfaces.
摘要:
Improved methods and apparatus render ADR insertion safer and more precise. Certain surgical instruments according to the invention include a level enabling a user to align the instrument for proper placement of a surgical implant. A different surgical instrument includes two or more scopes mounted relative to the instrument permitting a user to simultaneously view more than one side of the instrument. A device for use with a surgical instrument having a long shaft includes a holder that surrounds at least a portion of the shaft allowing a user to control the instrument with both hands. A further surgical instrument comprises a set of retractors and one or more guards placed over the retractors for protecting the great vessels, nerves or other delicate structures during a surgical procedure. Surgical apparatus according to the invention comprises a platform mountable to an operating room table over a patient undergoing a surgical procedure, enabling a user to place their hands or attach an instrument while operating. Different surgical instruments include an indicator showing angular displacement or a wedge-shaped portion used for disc distraction. Also disclosed are blades designed for use with a power tool featuring a cutting edge configured such that rapid oscillation of the cutting tool reduces the pressure a user must apply the tool.
摘要:
Artificial disc replacement (ADR) components cooperate to limit axial rotation and/or lateral bending to a greater degree when the spine is extended than when the spine is a neutral to flexed position, thereby decreasing loads placed upon the facet joints. In the preferred embodiment, truncated articulating surfaces with non-articulating side surfaces allow increasing amounts of axial rotation and lateral bending as the total disc replacement (TDR) moves from full extension to full flexion. Limiting axial rotation and lateral bending of the TDR protects the facet joints and the Annulus Fibrosus, since the facet joints carry more load when the spine is extended than when the spine is flexed. Thus the invention serves to protect the facet joints while allowing normal or near-normal spinal motion.
摘要:
Artificial disc replacements (ADRS) are configured for implantation using a lateral, anterior-lateral, or posterior-lateral approach. A first component having a first segment resides in the disc space for articulation purposes, with a second segment adapted for fixation to the lateral outer surface of one of the vertebral bodies. A second component having a first segment resides in the disc space for articulation purposes, with a second segment adapted for fixation to the lateral outer surface of the other vertebral body. The first segments of the two components may articulate against one another without a spacer, or a spacer forming a mobile bearing may be disposed between the first segments of the two components. In the preferred embodiment, one or both of the two components are in the form of bent plates such that the second segment is positioned against a lateral wall for fixation. In the preferred embodiment, screws are used through the second segment and into a vertebral body. The screws are located in different vertical locations, and may diverge or converge vertically or horizontally to resist pull-out.
摘要:
A method of augmenting a nucleus pulposus within an annulus fibrosis. A material having a relatively thin, elongated first state is inserted through the annulus, after which it expands or otherwise assumes a shape that is more rounded when implanted. In the preferred embodiment, for introduction the material is relatively rigid or hard and relatively thin, resembling a needle or a nail. The size, shape, and consistency of the material allow the device to be pushed through the fibers of the annulus fibrosis, preferably without an incision, and into the nucleus pulposus and/or disc space. The resultant shape assists the nucleus pulposis in acting as a “shock absorber,” and the expansion of the material also makes extrusion unlikely. Various materials qualify for this purpose according to the invention. Materials that change shape with temperature include memory-effect alloys such as Nitinol and substances such as stearle methacrylate. Materials that change in shape in the presence of moisture include hydrogels and other substances that imbibe water. Materials that expand due to chemical reaction include various foams, and the like, some of which may be applied in two-part form.
摘要:
Devices such as a cylindrical bone dowel removed from a vertebra or other human or animal bone, alive or deceased are used to fill holes formed through a vertebral body. Synthetic nucleus replacements or biologic tissue and/or cells may be inserted through the hole. Single or multiple solid, gel, or liquid devices may be placed into the disc. The material may cure in-situ. The intradiscal device may be inserted an instrument that contains a hollow tube. A hollow tube, including the hollow tube of an insertion tool, may be placed into the hole drilled into the vertebra. Cannulated drill bits may placed over guide wires to drill the hole into the vertebra.