Apparatus for spinal fixation and methods of use

Information

  • Patent Grant
  • 10426524
  • Patent Number
    10,426,524
  • Date Filed
    Monday, October 16, 2017
    6 years ago
  • Date Issued
    Tuesday, October 1, 2019
    4 years ago
Abstract
In some embodiments, a method comprises forming a lumen in a first bone portion and forming a lumen in a second bone portion. The method further includes inserting a portion of a flexible fastening band through the lumen in the first bone portion and through the lumen in the second bone portion, and inserting the portion of the flexible fastening band into a fastener mechanism monolithically formed with the flexible fastening band. The method further includes advancing the portion of the flexible fastening band through the fastener mechanism until the first bone portion and the second bone portion are stabilized.
Description
BACKGROUND

Some embodiments described herein relate generally to methods and apparatus for stabilizing bone, for example, stabilizing vertebrae by securing the articular processes of the vertebrae.


Traumatic, inflammatory, and degenerative disorders of the spine can lead to severe pain and loss of mobility. One source of back and spine pain is related to degeneration of the facets of the spine or facet arthritis. Bony contact or grinding of degenerated facet joint surfaces can play a role in some pain syndromes. While many technological advances have focused on the intervertebral disc and artificial replacement or repair of the intervertebral disc, relatively little advancement in facet repair has been made. Facet joint and disc degeneration frequently occur together.


The current standard of care to address the degenerative problems with the facet joints is to fuse the two adjacent vertebrae. By performing this surgical procedure, the relative motion between the two adjacent vertebrae is stopped, thus stopping motion of the facets and any potential pain generated as a result thereof. Procedures to fuse two adjacent vertebrae often involve fixation and/or stabilization of the two adjacent vertebrae until the two adjacent vertebrae fuse.


Injuries and/or surgical procedure on and/or effecting other bones can also result in the desire to fixate and/or stabilize a bone until the bone, or bone portions, can fuse, for example, to stabilize a sternum after heart surgery, to stabilize a rib after a break, etc. Current procedures to fixate and/or stabilize adjacent vertebrae and/or other bones, however, can be slow and/or complex.


Accordingly, a need exists for an apparatus and methods to better stabilize and/or fixate a bone.


SUMMARY

In some embodiments, a method comprises forming a lumen in a first bone portion and forming a lumen in a second bone portion. The method further includes inserting a portion of a flexible fastening band through the lumen in the first bone portion and through the lumen in the second bone portion, and inserting the portion of the flexible fastening band into a fastener mechanism monolithically formed with the flexible fastening band. The method further includes advancing the portion of the flexible fastening band through the fastener mechanism until the first bone portion and the second bone portion are stabilized.





BRIEF DESCRIPTION OF THE DRAWINGS


FIG. 1 is a lateral elevational view of a portion of the vertebral column.



FIG. 2A is an example of a superior view of an isolated thoracic vertebra.



FIG. 2B is an example of a side view of an isolated thoracic vertebra.



FIG. 3A is an example of a posterior elevational view of a portion of the vertebral column.



FIG. 3B is an example of a posterior-oblique elevational view of a portion of the vertebral column.



FIG. 4A is an example of a side view of a facet joint in the cervical vertebrae.



FIG. 4B is an example of a superior view of a facet joint in the cervical vertebrae.



FIG. 5A is an example of a side view of a facet joint in the thoracic vertebrae.



FIG. 5B is an example of a superior view of a facet joint in the thoracic vertebrae.



FIG. 6A is an example of a side view of a facet joint in the lumbar vertebrae.



FIG. 6B is an example of a superior view of a facet joint in the lumbar vertebrae.



FIG. 7 is a block diagram of a flexible elongate body according to an embodiment.



FIGS. 8A and 8B are schematic illustrations of a flexible elongate body according to an embodiment.



FIG. 9A is a posterior perspective view of a portion of the vertebral column depicting a stabilized vertebra including a flexible elongate body, a spacer, and an anchor, according to an embodiment.



FIG. 9B is an enlarged view of a portion of the vertebral column of FIG. 9A identified as region X1.



FIG. 10A is a posterior view of the portion of the vertebral column of FIG. 9A depicting the stabilized vertebra including the flexible elongate body, the spacer, and the anchor.



FIG. 10B is an enlarged view of a portion of the vertebral column of FIG. 10A identified as region X2.



FIGS. 11A-11C are various views of a flexible elongate body according to another embodiment.



FIG. 12A is a posterior perspective view of a portion of the vertebral column depicting a stabilized vertebra including the flexible elongate body illustrated in FIGS. 11A-11C and a spacer.



FIG. 12B is an enlarged view of a portion of the vertebral column of FIG. 12A identified as region X3.



FIGS. 13A-13C are various views of a flexible elongate body according to yet another embodiment.



FIG. 14A is a posterior perspective view of a portion of the vertebral column depicting a stabilized vertebra including the flexible elongate body illustrated in FIGS. 12A-12C.



FIG. 14B is an enlarged view of a portion of the vertebral column of FIG. 14A identified as region X4.



FIG. 15 is a posterior perspective view of a portion of the vertebral column depicting a stabilized vertebra including a flexible elongate body and a spacer, according to an embodiment.



FIG. 16 is a flowchart illustrating a method of stabilizing a bone portion according to an embodiment.





DETAILED DESCRIPTION

In some embodiments, a method comprises forming a lumen in a first bone portion and forming a lumen in a second bone portion. The method further includes inserting a portion of a flexible fastening band through the lumen in the first bone portion and through the lumen in the second bone portion, and inserting the portion of the flexible fastening band into a fastener mechanism monolithically formed with the flexible fastening band. The method further includes advancing the portion of the flexible fastening band through the fastener mechanism until the first bone portion and the second bone portion are stabilized.


In some embodiments, an apparatus includes a flexible elongate body and an anchor. The flexible elongate body includes a distal end portion, a body portion, and an attachment connection. The attachment connection receives the distal end portion of the flexible elongate body when the body portion is disposed in contact with a first bone portion and a second bone portion. The anchor receives a fastener configured to secure the flexible elongate body to the first bone portion via the anchor.


In some embodiments, a kit includes a flexible band and a fastener. The flexible band includes an interface portion configured to receive the fastener. The flexible band is configured to stabilize a first bone portion and a second bone portion. The fastener is configured to anchor the flexible band to the first bone portion such that the first bone portion, the second bone portion, and the flexible band are stabilized after being anchored.


As used in this specification, the singular forms “a,” “an” and “the” include plural referents unless the context clearly dictates otherwise. Thus, for example, the term “a ratchet” is intended to mean a single ratchet or a combination of ratchets. As used in this specification, a substance can include any biologic and/or chemical substance, including, but not limited to, medicine, adhesives, etc. While exemplary references are made with respect to vertebra, in some embodiments another bone can be involved. While specific reference may be made to a specific vertebra, a subset of vertebrae, and/or a grouping of vertebrae, it is understood that any vertebra, subset, and/or grouping, or combination of vertebrae can be used.


The words “proximal” and “distal” generally refer to the direction closer to and away from, respectively, a center of a body. The embodiments described herein, however, can be arranged in any orientation relative to the center of the body. Thus, when discussing the embodiments described herein (specifically a flexible elongate body), the terms “proximal” and “distal” refer to a direction closer to and away from, respectively, an attachment connection or fastener mechanism, the position of which is visually presented with respect to specific embodiments in the attached figures.


As shown in FIG. 1, the vertebral column 2 includes a series of alternating vertebrae 4 and fibrous discs 6 that provide axial support and movement to the upper portions of the body. The vertebral column 2 typically comprises thirty-three vertebrae 4, with seven cervical (C1-C7), twelve thoracic (T1-T12), five lumbar (L1-15), five fused sacral (S1-S5) and four fused coccygeal vertebrae. FIGS. 2A and 2B depict a typical thoracic vertebra. Each vertebra includes an anterior body 8 with a posterior arch 10. The posterior arch 10 includes two pedicles 12 and two laminae 14. The two laminae 14 join posteriorly to form a spinous process 16. Projecting from each side of the posterior arch 10 is a transverse process 18, a superior process 20, and an inferior articular process 22. The facets 24, 26 of the superior processes 20 and the inferior articular processes 22 form facet joints 28 with the articular processes of the adjacent vertebrae (see FIGS. 3A and 3B). The facet joints are synovial joints with cartilaginous surfaces and a joint capsule.


The orientation of the facet joints vary, depending on the level of the vertebral column. In the C1 and C2 vertebrae, for example the facet joints are parallel to the transverse plane. FIGS. 4A to 6B depict examples of the orientations of the facet joints at different levels of the vertebral column. In the C3 to C7 vertebrae examples shown in FIGS. 4A and 4B, the facets are oriented at a 45-degree angle to the transverse plane 30 and parallel to the frontal plane 32, respectively. This orientation allows the facet joints of the cervical vertebrae to flex, extend, lateral flex and rotate. At a 45-degree angle in the transverse plane 30, the facet joints of the cervical spine can guide, but do not limit, the movement of the cervical vertebrae. FIGS. 5A and 5B depict examples of the thoracic vertebrae, where the facets are oriented at a 60-degree angle to the transverse plane 30 and a 20-degree angle to the frontal plane 32, respectively. This orientation is capable of providing lateral flexion and rotation, but only limited flexion and extension. FIGS. 6A and 6B illustrate examples of the lumbar region, where the facet joints are oriented at 90-degree angles to the transverse plane 30 and a 45-degree angle to the frontal plane 32, respectively. The lumbar vertebrae are capable of flexion, extension and lateral flexion, but little, if any, rotation because of the 90-degree orientation of the facet joints in the transverse plane. The actual range of motion along the vertebral column can vary considerably with each individual vertebra.


In addition to guiding movement of the vertebrae, the facet joints also contribute to the load-bearing ability of the vertebral column. One study by King et al. Mechanism of Spinal Injury Due to Caudocephalad Acceleration, Orthop. Clin. North Am., 6:19 1975, found facet joint load-bearing as high as 30% in some positions of the vertebral column. The facet joints may also play a role in resisting shear stresses between the vertebrae. Over time, these forces acting on the facet joints can cause degeneration and arthritis.


In some embodiments described herein, a flexible elongate body can be anchored to a first vertebra via an anchor and can be used to stabilize and/or fixate a first vertebra to a second vertebra to reduce the pain, to reduce further degradation of a spine (e.g., a specific vertebra and/or a specific disc of a spine), and/or until the first vertebra and the second vertebra have fused. FIG. 7 is a schematic block diagram of a flexible elongate body 140 (also referred to herein as “flexible band” or simply “band”) and an anchor 180, according to an embodiment. The band 140 includes at least a body portion 145, a distal end portion 148, and an attachment connection 150 (alternatively referred to herein as “fastener mechanism”). The band 140 can be formed from any suitable biocompatible material such as, for example, stainless steel, titanium, polyether ether ketone (PEEK), nylon, or the like. Moreover, the band 140 can be any suitable shape, size, or configuration. In some embodiments, the size or shape of the band 140 can be associated with an intended usage. For example, in some embodiments, a first band can be intended to stabilize and/or fixate one or more cervical vertebra and a second band can be intended to stabilize and/or fixate one or more lumbar vertebra. In this manner, the first band can have a first size that is substantially smaller than a second size of the second band. In other embodiments, the size and shape need not be associated with an intended usage.


The fastener mechanism 150 is configured to accept at least a portion of distal end portion 148 and/or the body portion 145, as further described herein. The fastener mechanism 150 is disposed at a proximal end of the band 140. In some embodiments, the fastener mechanism 150 defines a lumen (not shown in FIG. 7) configured to accept at least a portion of distal end portion 148 and/or the body portion 145. In some embodiments, the lumen of fastener mechanism 150 can have a cross-sectional area that is significantly smaller than a cross-sectional area of at least a portion of the body portion 145. In this manner, the portion of the body portion 145 can be prevented from advancing through fastener mechanism 150. In some embodiments, the fastener mechanism 150 can include a ratchet (not shown in FIG. 7) configured to engage a surface of the distal end portion 148 and/or the body portion 145. In this manner, the fastener mechanism 150 can be configured to allow the distal end portion 148 and/or the body portion 145 to advance through fastener mechanism 150 in a first direction and substantially limit the movement of the distal end portion 148 and/or the body portion 145 in a second direction, opposite the first direction.


The body portion 145 is a linear elongate that extends from a portion of the fastener mechanism 150. More specifically, the body portion 145 of the band 140 can be monolithically formed with the fastener mechanism 150 such that the body portion 145 is a linear elongate portion between the fastener mechanism 150 and the distal end portion 148. In other embodiments, the body portion 145 can be coupled to the fastener mechanism 150 in any suitable manner (e.g., coupled via an adhesive, a weld, a friction fit, a threaded fit, or the like). The body portion 145 can be any suitable configuration. For example, in some embodiments, the body portion 145 can have a cross-sectional shape that is polygonal (e.g., square, rectangular, trapezoidal, etc.) or oval (e.g., circular, elliptical, oblong, etc.). In some embodiments, the cross-sectional shape of the body portion 145 can be associated with one or more characteristics of the bone or bone portion against which the body portion 145 may contact. For example, while the body portion 145 can have a substantially square cross-sectional shape, a set of edges of the body portion 145 can be rounded, partially rounded, and/or otherwise shaped to compliment the shape of a bone or bone portion, and/or to reduce digging or grinding into the bone or bone portion. In this manner, use of band 140 may cause little or no damage to the bone or bone portions contacted by band 140.


In some embodiments, the body portion 145 can define a substantially uniform cross-sectional area along a longitudinal axis (e.g., a centerline) of the band 140. In other embodiments, the cross-sectional area of the body portion 145 can vary along the longitudinal axis (centerline) of the band 140. For example, in some embodiments, the body portion 145 can have a cross-sectional area that is substantially tapered (i.e., reduced) from a proximal end (e.g., adjacent the fastener mechanism 150) to a distal end (e.g., adjacent the distal end portion 148). In some embodiments, the cross-sectional area of the body portion 145 can be associated with the cross-sectional area of the lumen defined by the fastener mechanism 150 (the attachment connection 150 described above). In this manner, at least a portion of the body portion 145 can have a cross-sectional area that is sufficiently small such that the body portion 145 can be at least partially disposed within the lumen of the fastener mechanism 150.


The body portion 145 can be configured to include a gear rack (not shown in FIG. 7) configured to engage the ratchet (not shown in FIG. 7) of the fastener mechanism 150. As described above, the gear rack can be configured to engage the ratchet of the fastening member 150 such that the ratchet allows the body portion 145 to travel through the fastener mechanism 150 in the first direction and substantially limits the movement of the body portion in the second direction, opposite the first direction. In some embodiments, the gear rack can be configured to include a set of individual gears that extend from a surface of the body portion 145. In other embodiments, the body portion 145 can define the set of individual gears (e.g., the gears each include a top surface that is disposed at or below a surface of the body portion 145). The gears included in the set of gears can be any suitable shape, size, or configuration. For example, in some embodiments, the gears are substantially cubed. In other embodiments, the gears can be triangular such that the gears form, for example, teeth. In this manner, the gears included in the gear rack can be configured to engage the ratchet of the fastener mechanism 150, as described above.


The distal end portion 148 is configured to extend from the body portion 145 of the band 140. More specifically, the distal end portion 148 is disposed adjacent the distal end of the body portion 145 such that the body portion 145 is disposed between the distal end portion 148 and the fastener portion 150. In some embodiments, the distal end portion 148 can have a cross-sectional area that is substantially similar to the cross-sectional area of the body portion 145. In other embodiments, the distal end portion 148 can have a cross-sectional area that is substantially smaller than the cross-sectional area of the body portion 145. In such embodiments, the distal end portion 148 and the body portion 145 can collectively define a discontinuity defining a stepwise reduction in the cross-sectional area. In other embodiments, the body portion 145 and/or the distal end portion 148 can define a tapered portion such that the band 140 is tapered between smaller cross-sectional area of the distal end portion 148 and the larger cross-sectional area of the body portion 145.


While not shown in FIG. 7, in some embodiments, the distal end portion 148 can include a gear rack that is substantially similar to the gear rack of the body portion 145. In this manner, the gear rack can extend substantially continuously across a portion of the distal end portion 148 and a portion of the body portion 145. In other embodiments, the distal end portion 148 of the band 140 need not include or define a gear rack.


The anchor 180 is configured to receive a fastener 185 to secure the band 140 to a bone portion. In some embodiments, the anchor 180 is monolithically formed with the band 140. For example, in some embodiments, the anchor 180 can be disposed on or within the body portion 145 and can define an aperture (not shown in FIG. 7) configured to receive the fastener 185 (e.g., a mechanical fastener such as a screw, bolt, staple, nail, etc.). In other embodiments, the anchor 180 is a protrusion extending from the body portion 145 in a substantially perpendicular direction (e.g., relative to the longitudinal axis of the band 140). In other embodiments, the anchor 180 can be a protrusion that extends in an angular direction from the body portion 145 or the distal end portion 148 (e.g., non-perpendicular to the body portion 145 or the distal end portion 148). In some embodiments, the anchor 180 can be a portion of the band 140 including a surface configured to receive the fastener 185. For example, in such embodiments, the anchor 180 can have a surface configured to receive a biocompatible adhesive or tape.


In some embodiments, the anchor 180 can be formed independently from the band 140 and can be at least partially disposed about the band 140 to secure the band 140 to the bone portion. For example, in some embodiments, the anchor 180 can define a second aperture configured to receive the distal end portion 148 of the band 140. In this manner, the anchor 180 can define a strap or loop configured to be slid into any suitable position along the distal end portion 148 and/or the body portion 145. In some embodiments, the anchor 180 can form a hook (e.g., a J-hook, an L-hook, etc.). In this manner, the anchor 180 can be configured to engage at least three sides of the band 140. In such embodiments, the anchor 180 can include an edge configured to engage a surface of the bone portion to retain the band 140 between the edge and the fastener 185 when the fastener 185 is disposed within the second aperture (e.g., defined by the anchor 180) and the bone portion, as described in further detail herein.


In use, the band 140 can be configured, for example, to stabilize a vertebra (e.g., a first vertebra) and/or a second vertebra by securing an articular process of the first vertebra to an articular process of a second vertebra. More specifically, the band 140 can be configured to stabilize the first vertebra and/or a second vertebra by securing an articular process of the first vertebra to an articular process of a second vertebra by securing a facet of the articular process of the first vertebra with a facet of the articular process of the second vertebra. For example, the band 140 can be placed into a suitable position relative to the first vertebra and/or the second vertebra, and the distal end portion 148 of the band can be inserted into the lumen of the fastener member 150 such that the body portion 145 substantially encircles at least a portion of the first vertebra and the second vertebra. Similarly stated, the distal end portion 148 can be inserted in to the lumen of the fastener mechanism 150 such that the band 140 forms a loop about the articular process of the first vertebra and the articular process of the second vertebra. In this manner, the distal end portion 148 and/or the body portion 145 can be advanced through the lumen of the fastener mechanism 150 such that the volume disposed within the loop formed by the band 140 is reduced. Thus, the band 140 exerts a compressive force on the articular process of the first vertebra and the articular process of the second process. While not shown in FIG. 7, in some embodiments, a spacer can be disposed between the articular process of the first vertebra and the articular process of the second process such that a desired distance between the articular process of the first vertebra and the articular process of the second process is maintained. In some embodiments, the spacer can include and/or define a portion configured to reduce slippage of the band 140 along a surface of the first vertebra and/or the second vertebra. Examples of spacers are further defined below with respect to specific embodiments.


With the band 140 at least partially tightened about the articular process of the first vertebra and the articular process of the second vertebra, the fastener 185 can be inserted into the anchor 180 and advanced into a portion of the articular process of the first vertebra and/or second vertebra. In some embodiments, the fastener 185 can be advanced through a pre-drilled hole of the articular process. In other embodiments, the fastener 185 can be configured to self-tap into the articular process (e.g., when the fastener is a self taping screw). In this manner, the anchor 180 can be affixed to the articular process of the first vertebra and/or the second vertebra such that the anchor 180 secures the band 140 to the first vertebra and/or the second vertebra. In this manner, the distal end portion 148 and/or the body portion 145 can be advanced through the lumen defined by the fastener mechanism 150 to stabilize and/or fixate the first vertebra to the second vertebra. Furthermore, by affixing the anchor 180 to the first vertebra and/or the second vertebra, the anchor 180 can substantially reduce slippage of the band 140 relative to the first vertebra and/or the second vertebra.


While not explicitly described above, in embodiments wherein the anchor 180 is independently formed, the anchor 180 can be disposed about the distal end portion 148 and/or the body portion 145 prior to inserting the distal end portion 148 into the lumen of the fastener member 150. While being described above as being partially tightened about the first vertebra and the second vertebra prior to affixing the anchor 180, in other embodiments, the anchor can be affixed to the first vertebra and/or the second vertebra prior to inserting the distal end portion 148 into the fastener mechanism 150. Conversely, in some embodiments, the band 140 can be tightened to a desired amount prior to the anchor 180 being affixed to the first vertebra and/or the second vertebra.



FIG. 8A is a side view and FIG. 8B is a top view of a flexible elongate body 240 (also referred to herein as “band”) according to an embodiment. The band 240 can be similar to the band 140 described above and can include similar components. For example, the band 240 includes an attachment connection 250 (also referred to herein as “fastener mechanism”) including a ratchet 262, a body portion 245 including a gear rack 247, and a distal end portion 248. Accordingly, components of the band 240 that are similar to corresponding components of the band 140 described above with reference to FIG. 7 are not described in further detail herein.


As shown in FIG. 8A, each gear 264 included in the gear rack 247 includes a cross sectional area that is rectangular in shape. Said another way, each gear 264 can be a rectangular protrusion configured to extend from a surface of the band 240 (e.g., the body portion and/or the distal end portion 248). The gear rack 247 is configured to engage the ratchet 262 of the fastener mechanism 250, as further described herein. The fastener mechanism 250 defines a lumen 266. The lumen 266 can be any suitable shape, size, or configuration. For example, as shown in FIG. 8B the lumen 266 can have a substantially circular cross-sectional area. The ratchet 262 extends from an inner surface of the fastener member 250 such that the ratchet 262 substantially reduces the size (e.g., the perimeter, circumference, and/or cross-sectional area) of the lumen 266. In this manner, the ratchet 266 can engage the gear rack 247. More specifically, as described in detail with reference to FIG. 7, the distal end portion 248 can be inserted into the lumen 266 of the fastener mechanism 250 and advanced in a first direction such that the gear rack 247 of the distal end portion 248 engages the ratchet 262. In some embodiments, the distal end portion 248 can be advanced through the lumen 266 a sufficient distance such that a portion of the body portion 245 is disposed within the lumen 266. In such embodiments, a portion of the gear rack 247 disposed on (e.g., included in or defined by) the body portion 245 can engage the ratchet 262. In this manner, the arrangement of the ratchet 262 and the gear rack 247 can be such that the distal end portion 248 can be moved in the first direction, thereby tightening the band 240, and the distal end portion 248 can be prevented from moving in a second direction, opposite the first direction, thereby preventing the band 240 from loosening.


The band 240 can be used in any suitable procedure to stabilize and/or fixate a first bone portion to a second bone portion. For example, in some embodiments, the band 240 can be disposed about an articular process of a first vertebra and an articular process of a second vertebra. In this manner, the distal end portion 248 and/or the body portion 245 can be positioned within the lumen 266 of the fastener mechanism 250 such that the band 240 forms a loop of suitable tightness about the first vertebra and the second vertebra. The band 240 can be used in conjunction with any suitable anchor configured to facilitate the stabilization and/or fixation of the first vertebra to the second vertebra and further configured to reduce potential slippage of the band 240 relative to the first vertebra and/or the second vertebra (as described in detail above with reference to FIG. 7).


In some embodiments, the band 240 can be used in any procedure described in or similar to those in U.S. patent application Ser. No. 12/859,009; filed Aug. 18, 2010, and titled “Vertebral Facet Joint Drill and Method of Use” (referred to as “the '009 application”), the disclosure of which is incorporated herein by reference in its entirety. In some embodiments, the band 240 can be used in conjunction with a spacer such as those described in the '009 application. For example, the spacer can be implanted and deployed to restore the space between facets of a superior articular process of a first vertebra and an inferior articular process of an adjacent vertebra. The spacer can be implanted and deployed to help stabilize adjacent vertebrae with adhesives and/or to deliver a medication. For example, in some embodiments, the spacer can be at least temporarily maintained in a desired position via an adhesive while the band 240 is positioned relative to the first vertebra and/or second vertebra. In some embodiments, an adhesive can be used in conjunction with the band 240 to stabilize and/or fixate the first vertebra to the second vertebra.


In some embodiments, the spacer can be, for example, substantially disc shaped. In other embodiments, the spacer can be other shapes, e.g., square, elliptical, or any other shape. The spacer can include a first side and a second side. The first side and/or the second side can be, for example, convex, concave, or flat. Said another way, the first side of the spacer can be concave, convex, or flat, and the second side of the spacer can be concave, convex, or flat, for example, the first side can be concave and the second side concave, the first side can be concave and the second side convex, etc. The spacer can include the same materials as band 140. In some embodiments, the spacer can include substances configured to release medication and/or increase the stability of a vertebra and/or band 140. As discussed above, the substances can include a medicine(s) and/or an adhesive(s).



FIGS. 9A-10B illustrate a flexible elongate body 340 (also referred to herein as “band”), an anchor 380, and a spacer 354 collectively used to stabilize adjacent vertebrae according to an embodiment. As shown in FIG. 9A, the band 340 can be used to stabilize a first vertebra 4A and a second vertebra 4B via the spinous articular process 16A (also referred to herein as “process 16A”) of the first vertebra 4A and the spinous articular process 16B (also referred to herein as “process 16B”) of the second vertebra 4B. The band 340 can be similar to band 140 described above with reference to FIG. 7 and can include similar components. By way of example, band 340 includes a fastener mechanism 350 (FIG. 9B), a body portion 345 (FIG. 9B), and a distal end portion 348 (FIG. 10B). As shown in FIGS. 9A-10B, the band 340 can be monolithically constructed in an elongate shape and can have a substantially rectangular cross-sectional shape. More specifically, the band 340 can have a substantially rectangular shape including rounded edges configured to reduce digging or grinding into the bone or portion thereof.


The fastener mechanism 350 defines a lumen 366 and includes a ratchet 362. The lumen 366 of the fastener mechanism 350 receives the distal end portion 348 of the band 340 such that the body portion 345 forms a loop that substantially encircles the process 16A of the first vertebra 4A and the process 16B of the second vertebra 4B. While not shown in FIGS. 9A-10B, the band 340 includes a gear rack that can be similar to or the same as the gear racks described above in the previous embodiments. In this manner, the ratchet 362 is configured to engage the gear rack of the band 340 to maintain the distal end portion 348 of the band 340 within the lumen 366 (as described in detail above).


The anchor 380 is configured to substantially surround a portion of the band 340 as shown in FIGS. 9A and 9B. More specifically, the anchor 380 can be a hook (e.g., a J-hook or the like) configured to substantially surround the band 340 on at least three sides (e.g., all of the sides of the band 340 except the side disposed adjacent the first vertebra 4A). The anchor 380 defines an aperture (not shown in FIGS. 9A-10B) configured to receive a fastener 385. In this manner, the fastener 385 can be advanced into the process 16A of the first vertebra 4A to affix the anchor 380 thereto. Moreover, with the anchor 380 disposed about the portion of the band 340, the anchor 380 can limit the movement of the band 340 relative to the first vertebra 4A and the second vertebra 4B (e.g., in the posterior or anterior direction).


The spacer 354 is disposed between the process 16A of the first vertebra 4A and the process 16B of the second vertebra 4B. The spacer 354 can be any suitable shape, size, or configuration. For example, as shown in FIGS. 10A and 10B, the spacer 354 can be substantially rectangular and can include a first indentation 351, configured to receive a portion of the process 16A, and a second indentation 352, configured to receive a portion of the process 16B. Thus, the first indentation 351 is disposed opposite the second indentation 352 and a desired distance is defined therebetween. For example, in some embodiments, the distance between the first indentation 351 and the second indentation 352 is associated with a desired distance between the process 16A of the first vertebra and the process 16B of the second vertebra 4B. Expanding further, when the band 340 is tightened (e.g., the distal end portion 348 is advanced through the fastener mechanism 350), the spacer 354 can be configured to limit the tightening of the band 340 such that the desired distance between the process 16A and the process 16B is retained. In this manner, the spacer 354 can substantially limit undue pressure on the disc 6 (FIGS. 9A and 10A), an artificial disk, or a cage disposed between the first vertebra 4A and the second vertebra 4B, otherwise induced by over tightening the band 340.


As shown in FIG. 10B, the spacer 354 further includes a first side wall 356 and a second side wall 358. The first side wall 356 and the second side wall 358 can be configured to each define a channel 359 (shown on the first side wall 356 in FIGS. 9A and 9B). The channel 359 can receive a portion of the band 340 such that the walls defining the channel 359 substantially limit a posterior and/or an anterior movement of the portion of the band 340 (e.g., the walls form a barrier that limit the movement of the band 340 relative to the spacer 354). In this manner, the spacer 354 can reduce slippage of the band 340 relative to the process 16A and/or process 16B that may otherwise occur during tightening of the band 340. While the anchor 380 is shown as being disposed at a posterior position relative to the band 340, in other embodiments, the anchor 380 can be disposed in an anterior configuration wherein the fastener 385 is disposed on an anterior portion of the process 16A relative to the band 340.


While the anchor 380 is shown as being independently formed from the band 340, in other embodiments, an anchor can be monolithically formed with a band. For example, FIGS. 11A-11C illustrate a flexible elongate body 440 (also referred to herein as “band”) according to an embodiment. The band 440 can be similar to band 140 described above with reference to FIG. 7 and can include similar components. By way of example, band 440 includes a fastener mechanism 450, a body portion 445, a distal end portion 448, and an anchor portion 480. As shown in FIGS. 11A-11C, the band 440 can be monolithically constructed in an elongate shape and can have a substantially rectangular cross-sectional shape. More specifically, the band 440 can have a substantially rectangular shape including rounded edges configured to reduce digging or grinding into the bone or portion thereof. The fastener mechanism 450 defines a lumen 466 and includes ratchet 462. The body portion 445 includes a gear rack 447 having a set of gears 464. In this manner, the distal end portion 448 can be inserted into the lumen 466 of the fastener member 450 such that the gear rack 447 engages the ratchet 462, as described in detail above. The anchor portion 480 is monolithically formed with the band 440. More specifically, the anchor portion 480 can be a substantially annular portion of the band 480 configured to define an aperture 482. The aperture 482 can receive a fastener 485 (FIGS. 12A and 12B), as further described herein.


As shown in FIGS. 12A and 12B, the band 440 can be used to stabilize a first vertebra 4A and a second vertebra 4B via the spinous articular process 16A (also referred to herein as “process 16A”) of the first vertebra 4A and the spinous articular process 16B (also referred to herein as “process 16B”) of the second vertebra 4B. More specifically, the lumen 466 of the fastener mechanism 450 can receive the distal end portion 448 of the band 440 such that the body portion 445 forms a loop that substantially encircles the process 16A of the first vertebra 4A and the process 16B of the second vertebra 4B (as described in detail above). The fastener 485 can be inserted into the aperture 482 (FIGS. 11A-11C) and advanced into the process 16A of the first vertebra 4A to affix the anchor portion 480 thereto. In some embodiments, the fastener 485 can be inserted into the aperture 482 and at least partially advanced into the process 16A of the first vertebra 4A prior to the distal end portion 448 of the band 440 being inserted into the lumen 466 of the fastener mechanism 450. In some embodiments, the fastener 485 can be advanced into the process 16A concurrently with the distal end portion 448 being advanced through the lumen 466.


With the anchor portion 480 affixed to the process 16A via the fastener 485, movement of the band 440 in the anterior and/or posterior direction, relative to the process 16A is substantially limited. In addition, a spacer 454 can be disposed between the process 16A of the first vertebra 4A and the process 16B of the second vertebra 4B prior to tightening the band 440 about the process 16A of the first vertebra 4A and the process 16B of the second vertebra 4B. For example, in some embodiments, the spacer 454 can be disposed between the process 16A of the first vertebra 4A and the process 16B of the second vertebra 4B after advancing the fastener 485 into the process 16A and prior to advancing the distal end portion 448 of the band 440 through the lumen 466. In other embodiments, the spacer 454 can be disposed between the process 16A of the first vertebra 4A and the process 16B of the second vertebra 4B prior to the insertion of the fastener 454 in the process 16A and prior to the insertion of the distal end portion 448 into the lumen 466. In still other embodiments, the spacer 454 can be disposed between the process 16A of the first vertebra 4A and the process 16B of the second vertebra 4B after the fastener 485 is advanced into the process 16A and after the band 440 is partially tightened. The spacer 454 can be similar to the spacer 354 described above with reference to FIGS. 9A-10B. Therefore, the form of spacer 454 is not described in detail herein. As described above, the spacer 454 can reduce slippage of the band 440 relative to the process 16A and/or process 16B that may occur during tightening of the band 440.


While the anchor portion 480 is shown in FIGS. 11A-12B as being substantially aligned with the body portion 445 of the band 440 (e.g., a center point of the annular shaped anchor portion 480 is positioned on a longitudinal axis or centerline of the band 440), in some embodiments, a flexible elongate body can include an anchor portion that is not positioned on a longitudinal axis or centerline. For example, FIGS. 13A-13C illustrate a flexible elongate body 540 (also referred to herein as “band”) according to an embodiment. The band 540 can be similar to band 140 described above with reference to FIG. 7 and can include similar components. By way of example, band 540 includes a fastener mechanism 550, a body portion 545, a distal end portion 548, and an anchor portion 580. As shown in FIGS. 13A-13C, the band 540 can be monolithically constructed in an elongate shape and can have a substantially rectangular cross-sectional shape. More specifically, the band 540 can have a substantially rectangular shape including rounded edges configured to reduce digging or grinding into the bone or portion thereof. The fastener mechanism 550 defines a lumen 566 and includes ratchet 562. The body portion 545 includes a gear rack 547 having of a set of gears 564. In this manner, the distal end portion 548 can be inserted into the lumen 566 of the fastener member 550 such that the gear rack 547 engages the ratchet 562, as described in detail above.


The anchor portion 580 is monolithically formed with the band 540. More specifically, the anchor portion 580 can be a lateral protrusion extending from a side of the band 540. For example, in some embodiments, the anchor portion 580 can extend substantially perpendicularly from a side of the band 540. In other embodiments, the anchor portion 580 can extend from the side of the band 540 at any suitable angular orientation (i.e., an angular orientation other than the perpendicular orientation (e.g., other than 90 degrees)). The anchor portion 580 can be substantially annular such that the anchor portion 580 defines an aperture 582. The aperture 582 can receive a fastener 585 (FIGS. 14A and 14B), as further described herein.


As shown in FIGS. 14A and 14B, the band 540 can be used to stabilize a first vertebra 4A and a second vertebra 4B via the spinous articular process 16A (also referred to herein as “process 16A”) of the first vertebra 4A and the spinous articular process 16B (also referred to herein as “process 16B”) of the second vertebra 4B. More specifically, the lumen 566 of the fastener mechanism 550 can receive the distal end portion 548 of the band 540 such that the body portion 545 forms a loop that substantially encircles the process 16A of the first vertebra 4A and the process 16B of the second vertebra 4B (as described in detail above). The fastener 585 can be inserted into the aperture 582 (FIGS. 13A-13C) and advanced into the process 16A of the first vertebra 4A to affix the anchor portion 580 thereto.


With the anchor portion 580 affixed to the process 16A via the fastener 585, movement of the band 540 in the anterior and/or posterior direction, relative to the process 16A is substantially limited. In addition, a spacer 554 can be disposed between the process 16A of the first vertebra 4A and the process 16B of the second vertebra 4B. The spacer 554 can be similar to the spacer 554 described above with reference to FIGS. 9A-10B. Therefore, the form of spacer 554 is not described in detail herein. As described above, the spacer 554 can reduce slippage of the band 540 relative to the process 16A and/or process 16B that may occur during tightening of the band 540.


While the anchor portion 580 is shown extending from a particular side of the band 540 in FIGS. 13A-14B, in other embodiments, an anchor portion can extend from either side of a band. Moreover, while the band 540 is shown in FIGS. 13A-14B as including a single anchor portion 580, in other embodiments, a band can include a first anchor portion extending from a first side of the band and a second anchor portion extending from a second side, opposite the first side, of the band. In such embodiments, the first anchor portion and the second anchor portion can be aligned along a length of a band or the first anchor portion and the second anchor portion can be offset along the length of the band.



FIG. 15 illustrates a flexible elongate body 640 (also referred to herein as “band”), and a spacer 654 collectively used to stabilize adjacent vertebrae according to an embodiment. While not shown in FIG. 15, flexible elongate body can be used with an anchor, such as, for example, an anchor 280, anchor 380 and/or anchor 480, as shown and described above. As shown in FIG. 15, the band 640 can be used to stabilize a first vertebra 4A and a second vertebra 4B via the spinous articular process 16A (also referred to herein as “process 16A”) of the first vertebra 4A and the spinous articular process 16B (also referred to herein as “process 16B”) of the second vertebra 4B. The band 640 can be similar to band 140 described above with reference to FIG. 7 and can include similar components. By way of example, band 640 includes a fastener mechanism 650, a body portion 645, and a distal end portion (not shown). Unlike FIGS. 9A-10B, which depict a spacer having indentations and channels, spacer 654 can be substantially cylindrical in shape, and can include a first lumen 659 to receive a portion of band 640, and a second lumen 659 to receive a second portion of band 640. Similar to the spacer 354, the spacer 654 is disposed between the process 16A of the first vertebra 4A and the process 16B of the second vertebra 4B. The spacer 654 can be any suitable shape, size, or configuration. In some embodiments, the diameter of the spacer 654 can be associated with a desired distance between the process 16A of the first vertebra and the process 16B of the second vertebra 4B. Similar to spacer 354, when the band 640 is tightened, the spacer 654 can be configured to limit the tightening of the band 640 such that the desired distance between the process 16A and the process 16B is retained.


Referring now to FIG. 16, a flowchart illustrates a method 790 for stabilizing a first bone portion and a second bone portion. The method 790 includes disposing a flexible band into contact with a first bone portion and into contact with a second bone portion, at 792. In some embodiments, the flexible band can be, for example, a flexible elongate body such as the flexible elongate body 340 described above with reference to FIGS. 9A-10B. The flexible band can define an aperture configured to receive a fastener that can secure the flexible band to the first bone. The fastener can be any suitable fastener such as, for example, a mechanical fastener (e.g., a pin, a nail, a screw, a bolt, a staple, or the like), a chemical fastener (e.g., an adhesive, tape, or the like), or any other suitable fastener or combination thereof.


The method 790 includes advancing a portion of the flexible band through an attachment connection until the first bone portion and the second bone portion are stabilized, at 794. The attachment portion can be substantially similar to the attachment portion (e.g., the fastener mechanism) 340 described herein. The advancing of the portion of the band through the attachment connection can be such that, for example, the band tightens about the first bone portion and about the second bone portion to move the first bone portion from a first orientation relative to the second bone portion to a second orientation relative to the second bone portion. Moreover, the second orientation of the first bone portion relative to the second bone portion can correspond to a stabilized orientation of the first bone portion and the second bone portion. In some embodiments, the first bone portion and the second bone portion can be a portion of a first vertebra and a portion of a second vertebra, respectively. For example, in some embodiments, the first bone portion and the second bone portion can be a spinous articular process of a first vertebra and a spinous articular process of a second vertebra, respectively. In other embodiments, the first bone portion and the second bone portion can be a transverse articular process of a first vertebra and a transverse articular process of a second vertebra, respectively.


In some embodiments, a spacer can be optionally disposed between the first bone portion and the second bone portion to facilitate the stabilization. For example, in some embodiments, the spacer can define a channel configured to receive a portion of the flexible band, thereby limiting or reducing slippage of the flexible band relative to the first bone portion and/or the second bone portion. In some embodiments, a spacer can define a desired distance between the first bone portion and the second bone portion.


The method further includes advancing a portion of the fastener through an aperture and into the first bone portion until the flexible band is secured to the first bone portion, at 796. In some embodiments, the fastener can be advanced through a pre-drilled hole in the first bone portion. In other embodiments, the fastener can be a self-taping fastener such as, for example, a self-taping screw. In this manner, the fastener can substantially limit slippage of the flexible band relative to the first bone portion and or the second bone portion.


Any of the embodiments, described above can be packaged independently or in any suitable combination. For example, in some embodiments, a kit can include at least flexible elongate body (e.g., a band) and a fastener. The band can include an interface portion configured to receive the fastener. For example, the band can be similar to or the same as the band 440 described above with reference to FIGS. 11A-12B. In this manner, the flexible band is configured to stabilize a first bone portion and a second bone portion. The fastener is configured to anchor the flexible band to the first bone portion such that the first bone portion, the second bone portion, and the flexible band are stabilized after being anchored. In some embodiments, the kit can include multiple fasteners of differing kinds. For example, in some embodiments, the kit can include a first fastener that is a bolt and include a second fastener that is a staple. In this manner, the kit can include multiple fasteners configured for use with varying bone structures. By way of example, in some embodiments, the relatively small size of a staple can be suitable for use on a cervical vertebra while the relatively large size of a bolt can be suitable for use on a lumbar vertebra.


In some embodiments, the kit can include a spacer and/or implant. For example, in some embodiments, the kit can include a spacer that is similar to or the same as the spacer 354 described above with reference to FIGS. 9A-10B. In some embodiments, the kit can include a set of spacers where each spacer has a size different than the other spacers included in the set. For example, in some embodiments, the kit can include (1) a first spacer, having a first size and that is configured to be disposed between a spinous articular process of a first cervical vertebra and a spinous articular process of a second cervical vertebra, and (2) a second spacer having a second size greater than the first size and that is configured to be disposed between a spinous articular process of a first lumbar vertebra and a spinous articular process of a second lumbar vertebra. In this manner, the appropriately sized spacer can be selected to stabilize a first and second vertebra.


While various embodiments have been described above, it should be understood that they have been presented by way of example only, not limitation, and various changes in form and details may be made. For example, while the embodiments are illustrated here as being disposed about a spinous articular process of a first vertebra and a spinous articular process of a second vertebra, in other embodiments, a flexible elongate body (e.g., a band) can be disposed about another portion of one or more vertebra. For example, in some embodiments, a flexible elongate body can be dispose about a transverse articular process of a first vertebra and a transverse articular process of a second vertebra. In such embodiments, the band can be tightened about the vertebrae to offset or correct misalignment of a portion of the spine (e.g., scoliosis, or the like).


While the descriptions given are with reference to stabilizing vertebra, another bone(s) such as for example, a sternum and/or a rib(s) could be stabilized using the flexible fastening bands described herein. In another example, a flexible fastening band can be used to stabilize and/or fixate an intramedullary (IM) rod or nail. For example, the flexible fastening band can be used at different longitudinal locations along an IM rod or nail, and used to couple adjacent bone portions to the IM rod or nail. In such situations, a given flexible fastening band can fix a first bone portion, the IM rod or nail, and a second bone portion, all of which are positioned between the distal portion and the attachment connection of the flexible fastening band. In yet another example, a flexible fastening band can be used to stabilize and/or fixate a bone fragment. While various embodiments have been described above with regard to natural bone spaces, (e.g., the space between an inferior articulate process and a superior articulate process), in other embodiments, the bone spacing can be man-made (e.g., sternum split during a heart procedure), and/or due to an injury (e.g., broken bone).


Where methods described above indicate certain events occurring in certain order, the ordering of certain events can be modified. Additionally, certain of the events can be performed concurrently in a parallel process when possible, as well as performed sequentially as described above. For example, while the method 790 described above includes advancing a portion of the band into the attachment connection prior to advancing the fastener, in some embodiments, the fastener can be at least partially advanced into a bone portion prior to the portion of the band being advanced through the attachment portion. In some embodiments, at least a portion of the advancing of the fastener into the bone portion and at least a portion of the advancing of the portion of the band into the attachment connection can be done concurrently (e.g., simultaneously or alternatively in relatively small increments).


By way of another example, in some embodiments, a spacer (e.g., the spacer 454 described above with reference to FIGS. 12A and 12B) can be disposed between a first bone portion and a second bone portion prior to tightening a band (e.g., the band 440 described above) about the first bone portion and the second bone portion. For example, in some embodiments, the spacer can be disposed between the first bone portion and the second bone portion after advancing a fastener (e.g., the fastener 485 described above) into the bone portion and prior to inserting a distal end portion of the band into an attachment connection. In other embodiments, the spacer can be disposed between the first bone portion and the second bone portion prior to the insertion of the fastener in the first bone portion and prior to the insertion of the distal end portion into the attachment connection. In still other embodiments, the spacer can be disposed between the first bone portion and the second bone portion after the fastener is completely advanced into the first bone portion and after the band is partially tightened about the first bone portion and the second bone portion.


Any portion of the apparatus and/or methods described herein may be combined in any combination, except mutually exclusive combinations. The embodiments described herein can include various combinations and/or sub-combinations of the functions, components and/or features of the different embodiments described.

Claims
  • 1. A method, comprising: disposing a flexible band into contact with a first bone portion and into contact with a second bone portion, the flexible band having an aperture configured to receive a fastener that is configured to secure the flexible band to the first bone portion;advancing a portion of the flexible band through an attachment connection of the flexible band until the first bone portion and the second bone portion are stabilized; andadvancing a portion of the fastener through the aperture and into the first bone portion until the flexible band is secured to the first bone portion, wherein the first bone portion is a spinous process of a first vertebra and the second bone portion is a spinous process of a second vertebra.
  • 2. The method of claim 1, further comprising: disposing an implant between the first bone portion and the second bone portion, the implant having a channel; anddisposing a portion of the flexible band into the channel of the implant.
  • 3. The method of claim 1, wherein the fastener is a screw, the portion of the fastener includes a threaded portion of the screw.
  • 4. The method of claim 1, wherein flexible band includes a flexible elongate body that is (1) monolithically formed with the attachment connection and (2) separately formed from an anchor of the flexible band that includes the aperture.
  • 5. The method of claim 4, wherein disposing the flexible band includes: disposing the anchor about the portion of the flexible elongate body and into contact with the first bone portion.
  • 6. The method of claim 1, further comprising advancing the portion of the flexible band through the attachment connection of the flexible band such that the first bone portion is moved from a first orientation relative to the second bone portion to a second orientation relative to the second bone portion.
  • 7. A method, comprising: disposing a flexible band into contact with a first bone portion and into contact with a second bone portion, the flexible band having an aperture configured to receive a fastener that is configured to secure the flexible band to the first bone portion, wherein the flexible band includes a flexible elongate body having a centerline between a proximal end of the flexible elongate body and a distal end of the flexible elongate body, the aperture is substantially centered along the centerline;advancing a portion of the flexible band through an attachment connection of the flexible band until the first bone portion and the second bone portion are stabilized; andadvancing a portion of the fastener through the aperture and into the first bone portion until the flexible band is secured to the first bone portion.
  • 8. A method, comprising: disposing a flexible band into contact with a first bone portion and into contact with a second bone portion, the flexible band having an aperture configured to receive a fastener that is configured to secure the flexible band to the first bone portion;advancing a portion of the flexible band through an attachment connection of the flexible band until the first bone portion and the second bone portion are stabilized; andadvancing a portion of the fastener through the aperture and into the first bone portion until the flexible band is secured to the first bone portion, wherein the first bone portion is a first transverse process of a first vertebra, the second bone portion is a second transverse process of a second vertebra.
  • 9. A method, comprising: disposing an implant between the first bone portion and a second bone portion;positioning a flexible band relative to a first bone portion and a second bone portion, wherein the flexible band comprises a distal end portion, a body portion located proximal to the distal end portion, and an attachment connection located proximal to the body portion;positioning an anchor portion comprising an aperture relative to the first bone portion;advancing the distal end of the flexible band through the attachment connection of the flexible band, wherein the flexible band is at least partially tightened about the first bone portion and the second bone portion; andadvancing a fastener through the aperture and into the first bone portion.
  • 10. The method of claim 9, wherein the implant comprises a surface having a barrier configured to prevent the body portion of the flexible band from sliding.
  • 11. The method of claim 9, wherein the aperture has a longitudinal axis that is generally perpendicular to a longitudinal axis of the flexible band when the flexible band is substantially flat.
  • 12. The method of claim 9, wherein the flexible band comprises a longitudinal axis, wherein the aperture is located along the longitudinal axis.
  • 13. The method of claim 9, wherein the flexible band comprises a longitudinal axis, wherein the aperture is offset from the longitudinal axis.
  • 14. The method of claim 9, wherein advancing the distal end of the flexible band through the attachment connection comprises advancing the distal end of the flexible band through the attachment connection in only one direction.
  • 15. The method of claim 9, wherein the anchor portion is movable along the flexible band.
  • 16. The method of claim 9, wherein the anchor portion is disposed about the distal end portion and/or the body portion prior to inserting the distal end portion through the attachment connection.
  • 17. The method of claim 9, wherein the anchor portion is fixed relative to the flexible band.
  • 18. The method of claim 9, wherein the first bone portion is a portion of a first vertebra and the second bone portion is a portion of a second vertebra.
CROSS-REFERENCE AND RELATED APPLICATIONS

This application is a divisional application of U.S. patent application Ser. No. 13/804,407, filed Mar. 14, 2013. This application is related to U.S. patent application Ser. No. 29/448,946 entitled “Flexible Elongate Member with a Portion to Receive a Bone Anchor,” filed on Mar. 14, 2013.

US Referenced Citations (509)
Number Name Date Kind
86016 Howell Jan 1869 A
1630239 Binkley et al. May 1927 A
1822280 Ervay Sep 1931 A
1822330 Anslie Sep 1931 A
2486303 Longfellow Oct 1949 A
2706023 Merritt Apr 1955 A
2967282 Schwartz et al. Jan 1961 A
3111945 Von Solbrig Nov 1963 A
3149808 Weckesser Sep 1964 A
3570497 Lemole Mar 1971 A
3867728 Stubstad et al. Feb 1975 A
3875595 Froning Apr 1975 A
3879767 Stubstad Apr 1975 A
4001896 Arkangel Jan 1977 A
4037603 Wendorff Jul 1977 A
4085466 Goodfellow et al. Apr 1978 A
4119091 Partridge Oct 1978 A
4156296 Johnson et al. May 1979 A
4164793 Swanson Aug 1979 A
4231121 Lewis Nov 1980 A
D261935 Halloran Nov 1981 S
4312337 Donohue Jan 1982 A
4323217 Dochterman Apr 1982 A
4349921 Kuntz Sep 1982 A
4502161 Wall Mar 1985 A
D279502 Halloran Jul 1985 S
D279503 Halloran Jul 1985 S
4535764 Ebert Aug 1985 A
4573458 Lower Mar 1986 A
4573459 Litton Mar 1986 A
4634445 Helal Jan 1987 A
4662371 Whipple et al. May 1987 A
4706659 Matthews et al. Nov 1987 A
4714469 Kenna Dec 1987 A
4722331 Fox Feb 1988 A
4730615 Sutherland et al. Mar 1988 A
4759766 Buettner-Janz et al. Jul 1988 A
4759769 Hedman et al. Jul 1988 A
4772287 Ray et al. Sep 1988 A
4773402 Asher et al. Sep 1988 A
4834757 Brantigan May 1989 A
4863477 Monson Sep 1989 A
4904260 Ray et al. Feb 1990 A
4907577 Wu Mar 1990 A
4911718 Lee et al. Mar 1990 A
4919667 Richmond Apr 1990 A
4923471 Morgan May 1990 A
4936848 Bagby Jun 1990 A
4941466 Romano Jul 1990 A
4959065 Arnett et al. Sep 1990 A
4969909 Barouk Nov 1990 A
5000165 Watanabe Mar 1991 A
5002546 Romano Mar 1991 A
5011484 Bréard Apr 1991 A
5015255 Kuslich May 1991 A
5047055 Bao et al. Sep 1991 A
5062845 Kuslich Nov 1991 A
5071437 Steffee Dec 1991 A
5092866 Breard et al. Mar 1992 A
5112013 Tolbert et al. May 1992 A
5112346 Hiltebrandt et al. May 1992 A
5127912 Ray et al. Jul 1992 A
5135188 Anderson et al. Aug 1992 A
5147404 Downey Sep 1992 A
5171280 Baumgartner Dec 1992 A
5192326 Bao et al. Mar 1993 A
5192327 Brantigan Mar 1993 A
5209755 Abrahan et al. May 1993 A
5258031 Salib et al. Nov 1993 A
5282861 Kaplan Feb 1994 A
5286249 Thibodaux Feb 1994 A
5300073 Ray et al. Apr 1994 A
5306275 Bryan Apr 1994 A
5306308 Gross et al. Apr 1994 A
5306309 Wagner et al. Apr 1994 A
5326364 Clift, Jr. et al. Jul 1994 A
5330479 Whitmore Jul 1994 A
5360431 Puno et al. Nov 1994 A
5368596 Burkhart Nov 1994 A
5370697 Baumgartner Dec 1994 A
5372598 Luhr et al. Dec 1994 A
5400784 Durand et al. Mar 1995 A
5401269 Buttner-Janz et al. Mar 1995 A
5413576 Rivard May 1995 A
5415661 Holmes May 1995 A
5425773 Boyd et al. Jun 1995 A
5437672 Alleyne Aug 1995 A
5445639 Kuslich et al. Aug 1995 A
5458642 Beer et al. Oct 1995 A
5458643 Oka et al. Oct 1995 A
5462542 Alesi, Jr. Oct 1995 A
5487756 Kallesoe et al. Jan 1996 A
5491882 Walston et al. Feb 1996 A
5496318 Howland et al. Mar 1996 A
5507823 Walston et al. Apr 1996 A
5509918 Romano Apr 1996 A
5514180 Heggeness et al. May 1996 A
5527312 Ray Jun 1996 A
5527314 Brumfield et al. Jun 1996 A
5534028 Bao et al. Jul 1996 A
5534030 Navarro et al. Jul 1996 A
5540706 Aust et al. Jul 1996 A
5545229 Parsons et al. Aug 1996 A
5549619 Peters et al. Aug 1996 A
5556431 Buttner-Janz Sep 1996 A
5562738 Boyd et al. Oct 1996 A
5571105 Gundolf Nov 1996 A
5571131 Ek et al. Nov 1996 A
5571189 Kuslich Nov 1996 A
5571191 Fitz Nov 1996 A
5577995 Walker et al. Nov 1996 A
5586989 Bray, Jr. Dec 1996 A
5591165 Jackson Jan 1997 A
5603713 Aust et al. Feb 1997 A
5638700 Shechter Jun 1997 A
5645597 Krapiva Jul 1997 A
5645599 Samani Jul 1997 A
5649947 Auerbach et al. Jul 1997 A
5653762 Pisharodi Aug 1997 A
5674295 Ray et al. Oct 1997 A
5674296 Bryan et al. Oct 1997 A
5676701 Yuan et al. Oct 1997 A
5683464 Wagner et al. Nov 1997 A
5683466 Vitale Nov 1997 A
5700265 Romano Dec 1997 A
5702450 Bisserie Dec 1997 A
5707373 Sevrain et al. Jan 1998 A
5713542 Benoit Feb 1998 A
5716415 Steffee Feb 1998 A
5725582 Bevan et al. Mar 1998 A
5741260 Songer et al. Apr 1998 A
5741261 Moskovitz et al. Apr 1998 A
D395138 Ohata Jun 1998 S
5766251 Koshino Jun 1998 A
5766253 Brosnahan Jun 1998 A
5772663 Whiteside et al. Jun 1998 A
5797916 McDowell Aug 1998 A
5824093 Ray et al. Oct 1998 A
5824094 Serhan et al. Oct 1998 A
5836948 Zucherman et al. Nov 1998 A
5851208 Trott Dec 1998 A
5860977 Zucherman et al. Jan 1999 A
5865846 Bryan et al. Feb 1999 A
5868745 Alleyne Feb 1999 A
5876404 Zucherman et al. Mar 1999 A
5879396 Walston et al. Mar 1999 A
5888203 Goldberg Mar 1999 A
5893889 Harrington Apr 1999 A
5895428 Berry Apr 1999 A
RE36221 Breard et al. Jun 1999 E
5918604 Whelan Jul 1999 A
5951555 Rehak et al. Sep 1999 A
5964765 Fenton et al. Oct 1999 A
5993452 Vandewalle Nov 1999 A
5997542 Burke Dec 1999 A
6001130 Bryan et al. Dec 1999 A
6014588 Fitz Jan 2000 A
6019763 Nakamura et al. Feb 2000 A
6019792 Cauthen Feb 2000 A
6039763 Shelokov Mar 2000 A
6048342 Zucherman et al. Apr 2000 A
6050998 Fletcher Apr 2000 A
6063121 Xavier et al. May 2000 A
6066325 Wallace et al. May 2000 A
6068630 Zucherman et al. May 2000 A
RE36758 Fitz Jun 2000 E
6080157 Cathro et al. Jun 2000 A
6099531 Bonutti Aug 2000 A
6102347 Benoit Aug 2000 A
6106558 Picha Aug 2000 A
6113637 Gill et al. Sep 2000 A
6132464 Martin Oct 2000 A
6132465 Ray et al. Oct 2000 A
6146422 Lawson Nov 2000 A
6156067 Bryan et al. Dec 2000 A
6179839 Weiss et al. Jan 2001 B1
D439340 Michelson Mar 2001 S
6200322 Branch et al. Mar 2001 B1
6293949 Justis et al. Sep 2001 B1
D450122 Michelson Nov 2001 S
6325803 Schumacher et al. Dec 2001 B1
D454953 Michelson Mar 2002 S
6368325 McKinley et al. Apr 2002 B1
6368350 Erickson et al. Apr 2002 B1
6371958 Overaker Apr 2002 B1
6375573 Romano Apr 2002 B2
6379386 Resch et al. Apr 2002 B1
D460188 Michelson Jul 2002 S
D460189 Michelson Jul 2002 S
6419678 Asfora Jul 2002 B1
6419703 Fallin et al. Jul 2002 B1
6436099 Drewry et al. Aug 2002 B1
6436101 Hamada et al. Aug 2002 B1
6436146 Hassler et al. Aug 2002 B1
D463560 Michelson Sep 2002 S
6447544 Michelson Sep 2002 B1
6470207 Simon et al. Oct 2002 B1
6565605 Goble et al. May 2003 B2
6572617 Senegas Jun 2003 B1
6579318 Varga et al. Jun 2003 B2
6579319 Goble et al. Jun 2003 B2
6589244 Sevrain et al. Jul 2003 B1
6600956 Maschino et al. Jul 2003 B2
6607530 Carl et al. Aug 2003 B1
6610091 Reiley Aug 2003 B1
D479331 Pike et al. Sep 2003 S
6626944 Taylor Sep 2003 B1
6641614 Wagner et al. Nov 2003 B1
6656195 Peters et al. Dec 2003 B2
6669697 Pisharodi Dec 2003 B1
6669729 Chin Dec 2003 B2
6706068 Ferree Mar 2004 B2
6743232 Overaker et al. Jun 2004 B2
6761720 Senegas Jul 2004 B1
6764491 Frey et al. Jul 2004 B2
6770095 Grinberg et al. Aug 2004 B2
6783527 Drewry et al. Aug 2004 B2
6790210 Cragg et al. Sep 2004 B1
6802863 Lawson et al. Oct 2004 B2
6811567 Reiley Nov 2004 B2
6902566 Zucherman et al. Jun 2005 B2
6908484 Zubok et al. Jun 2005 B2
6966930 Arnin et al. Nov 2005 B2
6974478 Reiley et al. Dec 2005 B2
6974479 Trieu Dec 2005 B2
D517404 Schluter Mar 2006 S
7008429 Golobek Mar 2006 B2
7013675 Marquez-Pickering Mar 2006 B2
7051451 Augostino et al. May 2006 B2
7074238 Stinson et al. Jul 2006 B2
7101375 Zucherman et al. Sep 2006 B2
7223269 Chappuis May 2007 B2
D565180 Liao Mar 2008 S
7371238 Sololeski et al. May 2008 B2
7458981 Fielding et al. Dec 2008 B2
7517358 Petersen Apr 2009 B2
7537611 Lee May 2009 B2
7559940 McGuire et al. Jul 2009 B2
7563286 Gerber et al. Jul 2009 B2
7585300 Cha Sep 2009 B2
7608104 Yuan et al. Oct 2009 B2
7695472 Young Apr 2010 B2
7799077 Lang et al. Sep 2010 B2
7806895 Weier et al. Oct 2010 B2
7846183 Blain Dec 2010 B2
7862590 Lim et al. Jan 2011 B2
7935136 Alamin et al. May 2011 B2
D643121 Milford et al. Aug 2011 S
7993370 Jahng Aug 2011 B2
7998172 Blain Aug 2011 B2
8052728 Hestad Nov 2011 B2
8109971 Hale Feb 2012 B2
8133225 Pieske Mar 2012 B2
8163016 Linares Apr 2012 B2
8177810 Ferree May 2012 B2
8192468 Biedermann et al. Jun 2012 B2
8216275 Fielding et al. Jul 2012 B2
8231661 Carls Jul 2012 B2
8246655 Jackson et al. Aug 2012 B2
8267966 McCormack et al. Sep 2012 B2
8292954 Robinson et al. Oct 2012 B2
8306307 Koike et al. Nov 2012 B2
8382801 Lamborne et al. Feb 2013 B2
8394125 Assell Mar 2013 B2
8460346 Ralph et al. Jun 2013 B2
8486078 Carl et al. Jul 2013 B2
8496691 Blain Jul 2013 B2
8579903 Carl Nov 2013 B2
8652137 Blain et al. Feb 2014 B2
8740942 Blain Jun 2014 B2
8740949 Blain Jun 2014 B2
8753345 McCormack et al. Jun 2014 B2
8784423 Kowarsch et al. Jul 2014 B2
8858597 Blain Oct 2014 B2
8882804 Blain Nov 2014 B2
8961613 Assell et al. Feb 2015 B2
D724733 Blain et al. Mar 2015 S
8974456 Allen et al. Mar 2015 B2
8979529 Marcus Mar 2015 B2
8992533 Blain et al. Mar 2015 B2
8998953 Blain Apr 2015 B2
9017389 Assell et al. Apr 2015 B2
9060787 Blain et al. Jun 2015 B2
9101410 Urrea Aug 2015 B1
D739935 Blain et al. Sep 2015 S
9149283 Assell et al. Oct 2015 B2
9161763 Assell et al. Oct 2015 B2
9179943 Blain Nov 2015 B2
9220547 Blain et al. Dec 2015 B2
D748262 Blain Jan 2016 S
9233006 Assell et al. Jan 2016 B2
D748793 Blain Feb 2016 S
9265546 Blain Feb 2016 B2
9271765 Blain Mar 2016 B2
9301786 Blain Apr 2016 B2
9314277 Assell et al. Apr 2016 B2
9345488 Assell et al. May 2016 B2
9421044 Blain et al. Aug 2016 B2
D765853 Blain et al. Sep 2016 S
D765854 Blain et al. Sep 2016 S
9456855 Blain et al. Oct 2016 B2
9517077 Blain et al. Dec 2016 B2
D777921 Blain et al. Jan 2017 S
D780315 Blain et al. Feb 2017 S
9572602 Blain et al. Feb 2017 B2
D790062 Blain et al. Jun 2017 S
9675387 Blain Jun 2017 B2
9743937 Blain et al. Aug 2017 B2
9808294 Blain Nov 2017 B2
9820784 Blain et al. Nov 2017 B2
9839450 Blain et al. Dec 2017 B2
D810942 Blain et al. Feb 2018 S
D812754 Blain et al. Mar 2018 S
9936984 Blain Apr 2018 B2
10022161 Blain Jul 2018 B2
10085776 Blain Oct 2018 B2
D834194 Blain et al. Nov 2018 S
10194955 Blain et al. Feb 2019 B2
10251679 Blain et al. Apr 2019 B2
20010018614 Bianchi Aug 2001 A1
20020018799 Spector et al. Feb 2002 A1
20020019637 Frey et al. Feb 2002 A1
20020029039 Zucherman et al. Mar 2002 A1
20020040227 Harari Apr 2002 A1
20020065557 Goble et al. May 2002 A1
20020072800 Goble et al. Jun 2002 A1
20020077700 Varga et al. Jun 2002 A1
20020086047 Mueller et al. Jul 2002 A1
20020120335 Angelucci et al. Aug 2002 A1
20020123806 Reiley Sep 2002 A1
20020151895 Soboleski et al. Oct 2002 A1
20020173800 Dreyfuss et al. Nov 2002 A1
20020173813 Peterson et al. Nov 2002 A1
20020198527 Muckter Dec 2002 A1
20030004572 Goble et al. Jan 2003 A1
20030028250 Reiley et al. Feb 2003 A1
20030040797 Fallin et al. Feb 2003 A1
20030120343 Whelan Jun 2003 A1
20030176919 Schmieding Sep 2003 A1
20030176922 Lawson et al. Sep 2003 A1
20030187454 Gill et al. Oct 2003 A1
20030191532 Goble et al. Oct 2003 A1
20030204259 Goble et al. Oct 2003 A1
20030216669 Lang et al. Nov 2003 A1
20030233146 Grinberg et al. Dec 2003 A1
20040006391 Reiley Jan 2004 A1
20040010318 Ferree Jan 2004 A1
20040024462 Ferree et al. Feb 2004 A1
20040049271 Biedermann et al. Mar 2004 A1
20040049272 Reiley Mar 2004 A1
20040049273 Reiley Mar 2004 A1
20040049274 Reiley Mar 2004 A1
20040049275 Reiley Mar 2004 A1
20040049276 Reiley Mar 2004 A1
20040049277 Reiley Mar 2004 A1
20040049278 Reiley Mar 2004 A1
20040049281 Reiley Mar 2004 A1
20040059429 Amin et al. Mar 2004 A1
20040087954 Allen et al. May 2004 A1
20040116927 Graf Jun 2004 A1
20040127989 Dooris et al. Jul 2004 A1
20040143264 McAfee Jul 2004 A1
20040176844 Zubok et al. Sep 2004 A1
20040199166 Schmieding et al. Oct 2004 A1
20040215341 Sybert et al. Oct 2004 A1
20040230201 Yuan et al. Nov 2004 A1
20040230304 Yuan et al. Nov 2004 A1
20050010291 Stinson et al. Jan 2005 A1
20050015146 Louis et al. Jan 2005 A1
20050043797 Lee Feb 2005 A1
20050043799 Reiley Feb 2005 A1
20050049705 Hale et al. Mar 2005 A1
20050055096 Serhan et al. Mar 2005 A1
20050059972 Biscup Mar 2005 A1
20050131409 Chervitz et al. Jun 2005 A1
20050131538 Chervitz et al. Jun 2005 A1
20050143818 Yuan et al. Jun 2005 A1
20050159746 Grab et al. Jul 2005 A1
20050177240 Blain Aug 2005 A1
20050197700 Boehem et al. Sep 2005 A1
20050216017 Fielding et al. Sep 2005 A1
20050240201 Yeung Oct 2005 A1
20050251256 Reiley Nov 2005 A1
20050256494 Datta Nov 2005 A1
20060004367 Alamin et al. Jan 2006 A1
20060036323 Carl et al. Feb 2006 A1
20060041311 McLeer Feb 2006 A1
20060084985 Kim Apr 2006 A1
20060085006 Ek et al. Apr 2006 A1
20060085072 Funk et al. Apr 2006 A1
20060111782 Petersen May 2006 A1
20060116684 Whelan Jun 2006 A1
20060149375 Yuan et al. Jul 2006 A1
20060200137 Soboleski et al. Sep 2006 A1
20060241601 Trautwein et al. Oct 2006 A1
20060241758 Peterman et al. Oct 2006 A1
20060293691 Mitra et al. Dec 2006 A1
20070055236 Hudgins et al. Mar 2007 A1
20070055252 Blain et al. Mar 2007 A1
20070055373 Hudgins et al. Mar 2007 A1
20070078464 Jones et al. Apr 2007 A1
20070100452 Prosser May 2007 A1
20070118218 Hooper May 2007 A1
20070123863 Winslow et al. May 2007 A1
20070135814 Farris Jun 2007 A1
20070149976 Hale et al. Jun 2007 A1
20070179619 Grab Aug 2007 A1
20070250166 McKay Oct 2007 A1
20070270812 Peckham Nov 2007 A1
20080009866 Alamin et al. Jan 2008 A1
20080058929 Whelan Mar 2008 A1
20080177264 Alamin et al. Jul 2008 A1
20080177326 Thompson Jul 2008 A1
20080183211 Lamborne et al. Jul 2008 A1
20080228225 Trautwein et al. Sep 2008 A1
20080262549 Bennett et al. Oct 2008 A1
20080287996 Soholeski et al. Nov 2008 A1
20090005818 Chin et al. Jan 2009 A1
20090005873 Slivka et al. Jan 2009 A1
20090018662 Pasquet et al. Jan 2009 A1
20090024166 Carl et al. Jan 2009 A1
20090076617 Ralph et al. Mar 2009 A1
20090105766 Thompson et al. Apr 2009 A1
20090125066 Kraus et al. May 2009 A1
20090138048 Baccelli et al. May 2009 A1
20090171360 Whelan Jul 2009 A1
20090198282 Fielding et al. Aug 2009 A1
20090264928 Blain Oct 2009 A1
20090264929 Alamin et al. Oct 2009 A1
20090270918 Attia et al. Oct 2009 A1
20090270929 Suddaby Oct 2009 A1
20090306716 Beger Dec 2009 A1
20090326589 Lemoine et al. Dec 2009 A1
20100010548 Hermida Ochoa Jan 2010 A1
20100076503 Beyar et al. Mar 2010 A1
20100131008 Overes et al. May 2010 A1
20100179553 Ralph et al. Jul 2010 A1
20100185241 Malandain et al. Jul 2010 A1
20100191286 Butler Jul 2010 A1
20100204700 Falahee Aug 2010 A1
20100204732 Aschmann Aug 2010 A1
20100234894 Alamin et al. Sep 2010 A1
20100274289 Carls Oct 2010 A1
20100298829 Schaller Nov 2010 A1
20100318133 Tornier Dec 2010 A1
20110022050 McClellan et al. Jan 2011 A1
20110022089 Assell et al. Jan 2011 A1
20110040301 Blain et al. Feb 2011 A1
20110082503 Blain Apr 2011 A1
20110098816 Jacob et al. Apr 2011 A1
20110160772 Arcenio Jun 2011 A1
20110172712 Chee et al. Jul 2011 A1
20110245875 Karim Oct 2011 A1
20110295318 Alamin et al. Dec 2011 A1
20110313456 Blain Dec 2011 A1
20120035658 Goble et al. Feb 2012 A1
20120041441 Bernstein et al. Feb 2012 A1
20120046749 Tatsumi Feb 2012 A1
20120101502 Kartalian Apr 2012 A1
20120150231 Alamin et al. Jun 2012 A1
20120221048 Blain Aug 2012 A1
20120221049 Blain Aug 2012 A1
20120221060 Blain Aug 2012 A1
20120245586 Lehenkari et al. Sep 2012 A1
20120271354 Baccelli et al. Oct 2012 A1
20120277801 Marik et al. Nov 2012 A1
20120310244 Blain et al. Dec 2012 A1
20130023878 Belliard et al. Jan 2013 A1
20130041410 Hestad et al. Feb 2013 A1
20130079778 Azuero et al. Mar 2013 A1
20130123923 Pavlov et al. May 2013 A1
20130245693 Blain Sep 2013 A1
20130253649 Davis Sep 2013 A1
20130261625 Koch et al. Oct 2013 A1
20130325065 Malandain et al. Dec 2013 A1
20140012318 Goel Jan 2014 A1
20140066758 Marik et al. Mar 2014 A1
20140228883 Blain Aug 2014 A1
20140257397 Akbarnia et al. Sep 2014 A1
20140277148 Blain et al. Sep 2014 A1
20140277149 Rooney et al. Sep 2014 A1
20140336653 Bromer Nov 2014 A1
20140378976 Garcia Dec 2014 A1
20150081023 Blain Mar 2015 A1
20150094766 Blain et al. Apr 2015 A1
20150094767 Blain et al. Apr 2015 A1
20150119988 Assell et al. Apr 2015 A1
20150164516 Blain et al. Jun 2015 A1
20150164652 Assell et al. Jun 2015 A1
20150190149 Assell et al. Jul 2015 A1
20150196330 Blain Jul 2015 A1
20150209096 Gephart Jul 2015 A1
20150257770 Assell et al. Sep 2015 A1
20150257773 Blain et al. Sep 2015 A1
20150327872 Assell et al. Nov 2015 A1
20150342648 McCormack et al. Dec 2015 A1
20160051294 Blain Feb 2016 A1
20160113692 Knoepfle Apr 2016 A1
20160128739 Blain et al. May 2016 A1
20160128838 Assell et al. May 2016 A1
20160213481 Blain Jul 2016 A1
20160324549 Blain Nov 2016 A1
20170000527 Blain et al. Jan 2017 A1
20170105767 Blain Apr 2017 A1
20170239060 Blain Aug 2017 A1
20170281232 Smith Oct 2017 A1
20180049780 Blain Feb 2018 A1
20180085148 Blain Mar 2018 A1
20190142478 Blain May 2019 A1
Foreign Referenced Citations (71)
Number Date Country
2 437 575 Apr 2009 CA
93 04 368 May 1993 DE
201 12 123 Sep 2001 DE
101 35 771 Feb 2003 DE
0 238 219 Sep 1987 EP
0 322 334 Jun 1989 EP
0 392 124 Oct 1990 EP
0 610 837 Aug 1994 EP
0 928 603 Jul 1999 EP
1 201 202 May 2002 EP
1 201 256 May 2002 EP
2 138 122 Dec 2009 EP
2 822 482 Jan 2015 EP
2 919 717 Sep 2015 EP
2 704 745 Nov 1994 FR
2 722 980 Feb 1996 FR
2 366 736 Mar 2002 GB
53-005889 Jan 1978 JP
62-270147 Nov 1987 JP
03-100154 Apr 1991 JP
03-240660 Oct 1991 JP
08-509918 Oct 1996 JP
10-179622 Jul 1998 JP
2000-201941 Jul 2000 JP
2000-210297 Aug 2000 JP
2003-079649 Mar 2003 JP
2004-508888 Mar 2004 JP
2004-181236 Jul 2004 JP
2006-230722 Sep 2006 JP
2006-528540 Dec 2006 JP
2007-503884 Mar 2007 JP
2007-517627 Jul 2007 JP
2007-190389 Aug 2007 JP
2008-510526 Apr 2008 JP
2009-533167 Sep 2009 JP
2010-173739 Aug 2010 JP
2012-509740 Apr 2012 JP
2012-521221 Sep 2012 JP
2013-534451 Sep 2013 JP
2014-513583 Jun 2014 JP
6012309 Jan 2007 MX
WO 93014721 Aug 1993 WO
WO 94004088 Mar 1994 WO
WO 97047246 Dec 1997 WO
WO 98048717 Nov 1998 WO
WO 99023963 May 1999 WO
WO 00038582 Jul 2000 WO
WO 00053126 Sep 2000 WO
WO 01030248 May 2001 WO
WO 02045765 Jun 2002 WO
WO 02065954 Aug 2002 WO
WO 02096300 Dec 2002 WO
WO 03101350 Dec 2003 WO
WO 2004071358 Aug 2004 WO
WO 2005020850 Mar 2005 WO
WO 2005072661 Aug 2005 WO
WO 2006023980 Mar 2006 WO
WO 2006096803 Sep 2006 WO
WO 2008008522 Jan 2008 WO
WO 2009013397 Jan 2009 WO
WO 2009021876 Feb 2009 WO
WO 2010060072 May 2010 WO
WO 2010122472 Oct 2010 WO
WO 2011011621 Jan 2011 WO
WO 2012007941 Jan 2012 WO
WO 2012116266 Aug 2012 WO
WO 2013022880 Feb 2013 WO
WO 2013138655 Sep 2013 WO
WO 2014078541 May 2014 WO
WO 2014158690 Oct 2014 WO
WO 2016044432 Mar 2016 WO
Non-Patent Literature Citations (124)
Entry
3rd Party Lab Notebook, “Facet Cartilage Repair,” dated May 20, 2003 in 2 pages.
ArthroTek, “CurvTek® Bone Tunneling System,” Surgical Technique, 2000, pp. 6.
ArthroTek, “CurvTek® Bone Tunneling System,” User's Manual, 2000, pp. 20.
Ash, H.E., “Proximal Interphalangeal Joint Dimensions for the Design of a Surface Replacement Prosthesis”, School of Engineering, University of Durham, Proceedings of the Institution of Mechanical Engineers Part H Journal of Engineering in Medicine Feb. 1996, vol. 210, No. 2, pp. 95-108.
Beaman, MD et al., “Substance P Innervation of Lumbar Spine Facet Joints”, Spine, 1993, vol. 18, No. 8, pp. 1044-1049.
Butterman, et al., “An Experimental Method for Measuring Force on the Spinal Facet Joint: Description and Application of the Method”, Journal of Biomechanical Engineering, Nov. 1991, vol. 113, pp. 375-386.
Cruess et al., “The Response of Articular Cartilage to Weight-Bearing Against Metal”, The Journal of Bone and Joint Surgery, Aug. 1984, vol. 66-B, No. 4, pp. 592-597.
Dalldorf et al., “Rate of Degeneration of Human Acetabular Cartilage after Hemiarthroplasty”, The Journal of Bone and Joint Surgery, Jun. 1995, vol. 77. No. 6, pp. 877-882.
E-mail from 3rd Party citing U.S. Appl. No. 60/721,909; U.S. Appl. No. 60/750,005 and U.S. Appl. No. 60/749,000, initial e-mail dated May 11, 2009, reply e-mail dated May 18, 2009.
Frost, Harold M., “From Wolff's Law to the Utah Paradigm: Insights About Bone Physiology and Its Clinical Applications”, The Anatomical Record, 2001, vol. 262, pp. 398-419.
King et al., “Mechanism of Spinal Injury Due to Caudocephalad Acceleration,” Symposium on the Lumbar Spine, Orthopedic Clinic of North America, Jan. 1975, vol. 6, pp. 19-31.
Kurtz, PhD et al., “Isoelastic Polyaryletheretherketone Implants for Total Joint Replacement”, Peek Biomaterials Handbook, Ch. 14, 2012, pp. 221-226.
Meisel et al., “Minimally Invasive Facet Restoration Implant for Chronic Lumbar Zygapophysial Pain: 1-Year Outcomes”, Annals of Surgical Innovation and Research (ASIR), 2014, vol. 8, No. 7, pp. 6.
Panjabi, PhD et al., “Articular Facets of the Human Spine: Quantitative Three-Dimensional Anatomy”, Spine, 1993, vol. 18, No. 10, pp. 1298-1310.
Parteq Innovations, “Facet Joint Implants & Resurfacing Devices,” Technology Opportunity Bulletin, Tech ID 1999-012, Queen's University, Ontario Canada, pp. 2.
Ravikumar et al., “Internal Fixation Versus Hemiarthroplasty Versus Total Hip Arthroplasty for Displaced Subcapital Fractures of Femur—13 year Results of a Prospective Randomised Study”, International Journal of the Care of the Injured (Injury), 2000, vol. 31, pp. 793-797.
Schendel et al., “Experimental Measurement of Ligament Force, Facet Force, and Segment Motion in the Human Lumbar Spine”, Journal of Biomechanics, 1993, vol. 26, No. 4/5, pp. 427-438.
Tanno et al., “Which Portion in a Facet is Specifically Affected by Articular Cartilage Degeneration with Aging in the Human Lumbar Zygapophysial Joint?”, Okajimas Folia Anatomica Japonica, May 2003, vol. 80, No. 1, pp. 29-34.
Official Communication in Australian Application No. 2005213459, dated Dec. 11, 2009.
Official Communication in Australian Application No. 2005213459, dated Dec. 15, 2010.
Official Communication in Australian Application No. 2011226832, dated Sep. 4, 2012.
Official Communication in Australian Application No. 2011226832, dated Oct. 31, 2012.
Official Communication in Australian Application No. AU2013237744, dated Sep. 2, 2014.
Notice of Acceptance in Australian Application No. AU2013237744, dated Apr. 23, 2015.
Official Communication in Australian Application No. AU2015205875, dated Apr. 2, 2016.
Official Communication in Australian Application No. AU2015205875, dated Jun. 15, 2016.
Official Communication in Canadian Application No. 2,555,355, dated Sep. 2, 2011.
Official Communication in Canadian Application No. 2,803,783, dated Sep. 29, 2014.
Official Communication in Canadian Application No. 2,803,783, dated Aug. 5, 2015.
Official Communication in Canadian Application No. 2,803,783, dated Jul. 7, 2016.
Official Communication in European Application No. 05712981.9, dated Jul. 24, 2007.
Official Communication in European Application No. 05712981.9, dated Mar. 10, 2008.
Official Communication in European Application No. 05712981.9, dated Apr. 6, 2009.
Official Communication in European Application No. 05712981.9, dated Jun. 15, 2010.
Official Communication in European Application No. 10178979.0, dated Mar. 14, 2011.
Official Communication in European Application No. 10178979.0, dated Nov. 13, 2012.
Official Communication in European Application No. 10178979.0, dated Aug. 5, 2013.
Official Communication in European Application No. 14175088.5, dated Sep. 8, 2014.
Official Communication in European Application No. 14175088.5, dated Nov. 18, 2015.
Official Communication in Japanese Application No. 2006-552309, dated May 25, 2010.
Official Communication in Japanese Application No. 2006-552309, dated Feb. 15, 2011.
Official Communication in Japanese Application No. 2010-221380, dated Feb. 15, 2011.
Official Communication in Japanese Application No. 2012-272106, dated Dec. 3, 2013.
Official Communication in Japanese Application No. 2012-272106, dated May 26, 2014.
Official Communication in Japanese Application No. 2012-272106, dated Feb. 23, 2015.
Official Communication in Japanese Application No. 2012-272106, dated Nov. 2, 2015.
International Search Report and Written Opinion in International Application No. PCT/US2005/003753, dated Dec. 5, 2006.
International Preliminary Report and Written Opinion in International App No. PCT/US2005/003753, dated Jan. 9, 2007.
Official Communication in European Application No. 08730413.5, dated Feb. 16, 2012.
Official Communication in European Application No. 14177951.2, dated Nov. 13, 2014.
International Search Report and Written Opinion in International Application No. PCT/US2008/054607, dated Jul. 10, 2008.
International Preliminary Report on Patentability in International Application No. PCT/US2008/054607, dated Sep. 3, 2009.
Official Communication in Australian Application No. 2011292297, dated Jul. 10, 2013.
Official Communication in Australian Application No. 2014277721, dated Sep. 8, 2016.
Official Communication in Australian Application No. 2014277721, dated Jan. 9, 2017.
Official Communication in European Application No. 11818586.7, dated Nov. 6, 2014.
Official Communication in European Application No. 11818586.7, dated Feb. 3, 2017.
Official Communication in Japanese Application No. 2013-524882, dated Mar. 2, 2015.
Official Communication in Japanese Application No. 2013-524882, dated Nov. 16, 2015.
Official Communication in Japanese Application No. 2015-242990, dated Dec. 12, 2016.
International Search Report and Written Opinion in International Application No. PCT/US2011/047432, dated Dec. 12, 2011.
International Preliminary Report on Patentability in International Application No. PCT/US2011/047432, dated Feb. 28, 2013.
Official Communication in Australian Application No. AU2012222229, dated Aug. 21, 2015.
Official Communication in Australian Application No. AU2012222229, dated May 11, 2016.
Official Communication in Australian Application No. AU2012222230, dated Aug. 21, 2015.
Official Communication in European Application No. EP12749447.4, dated Jan. 4, 2017.
Official Communication in European Application No. 12749251.0, dated Jan. 4, 2017.
Official Communication in Japanese Application No. JP 2013-555591, dated Jan. 4, 2016.
Official Communication in Japanese Application No. JP 2013-555592, dated Dec. 7, 2015.
Official Communication in Japanese Application No. JP 2013-555592, dated Aug. 8, 2016.
International Search Report in International Application No. PCT/US2012/026470, dated May 30, 2012.
International Preliminary Report on Patentability and Written Opinion in International Application No. PCT/US2012/026470, dated Sep. 6, 2013.
International Search Report and Written Opinion in International Application No. PCT/US2012/026472, dated Jun. 20, 2012.
International Preliminary Report on Patentability and Written Opinion in International Application No. PCT/US2012/026472, dated Mar. 12, 2014.
Official Communication in European Application No. 14774714.1, dated Oct. 21, 2016.
International Search Report and Written Opinion in International Application No. PCT/US2014/019302, dated May 18, 2015.
Official Communication in European Application No. 14776445.0, dated Nov. 7, 2016.
International Search Report and Written Opinion in International Application No. PCT/US2014/019325, dated Jun. 17, 2014.
International Preliminary Report on Patentability and Written Opinion in International Application No. PCT/US2014/019325, dated Sep. 24, 2015.
Official Communication in European Application No. 14850082.0, dated Aug. 31, 2016.
International Search Report and Written Opinion in International Application No. PCT/US2014/056598, dated Dec. 29, 2014.
International Preliminary Report on Patentability and Written Opinion in International Application No. PCT/US2014/056598, dated Apr. 7, 2016.
International Search Report and Written Opinion in International Application No. PCT/US2015/050441, dated Dec. 28, 2015.
International Preliminary Report on Patentability and Written Opinion in International Application No. PCT/US2015/050441, dated Mar. 30, 2017.
International Search Report and Written Opinion in International Application No. PCT/US2016/013062, dated Mar. 16, 2016.
International Search Report in International Application No. PCT/CA2002/000193 filed Feb. 15, 2002, dated Jun. 18, 2002.
International Search Report and Written Opinion in International Application No. PCT/US2004/028094, dated May 16, 2005.
International Preliminary Report on Patentability in International Application No. PCT/US2004/028094, dated Feb. 25, 2013.
International Search Report in International Application No. PCT/US2005/000987 filed Jan. 13, 2005, dated May 24, 2005.
International Preliminary Report on Patentability in International Application No. PCT/US2005/000987 filed Jan. 13, 2005, dated Jan. 17, 2006.
Official Communication in Australian Application No. AU2016231622, dated Nov. 22, 2018.
Official Communication in European Application No. 16180368.9, dated Jan. 11, 2018.
Official Communication in Canadian Application No. 2,804,223, dated Mar. 14, 2018.
Official Communication in European Application No. EP12749447.4, dated Nov. 14, 2018.
Official Communication in Japanese Application No. 2016-246368, dated Jul. 2, 2018.
Official Communication in Japanese Application No. JP 2013-555592, dated Jan. 5, 2018.
Official Communication in Japanese Application No. 2016-237460, dated Apr. 16, 2018.
Official Communication in Australian Application No. 2014241989, dated Jun. 20, 2018.
Official Communication in Australian Application No. 2014241989, dated Aug. 17, 2018.
Official Communication in Japanese Application No. JP 2016-500490, dated May 7, 2018.
Official Communication in Japanese Application No. JP 2016-500498, dated Jan. 5, 2018.
Official Communication in Japanese Application No. JP 2016-500498, dated Jul. 2, 2018.
Official Communication in Australian Application No. 2014327083, dated May 31, 2018.
Official Communication in Japanese Application No. JP 2016-517392, dated Jun. 4, 2018.
Official Communication in European Application No. 16743832.4, dated Jul. 24, 2018.
Sharpe Products, “Metal Round Disks”, https://web.archive.org/web/20170705214756/https://sharpeproducts.com/store/metal-round-disks, as archived Jul. 5, 2017 in 3 pages.
Official Communication in Australian Application No. AU2016231622, dated Dec. 5, 2017.
Official Communication in Canadian Application No. 2,803,783, dated Apr. 5, 2017.
Official Communication in European Application No. 16180368.9, dated Mar. 31, 2017.
Official Communication in Canadian Application No. 2,804,223, dated Jun. 5, 2017.
Official Communication in Japanese Application No. 2015-242990, dated May 8, 2017.
Official Communication in Japanese Application No. 2015-242990, dated Aug. 21, 2017.
Official Communication in European Application No. EP12749447.4, dated Apr. 4, 2017.
Official Communication in European Application No. 12749251.0, dated May 9, 2017.
Official Communication in Japanese Application No. 2016-246368, dated Oct. 30, 2017.
Official Communication in Japanese Application No. 2016-237460, dated Oct. 23, 2017.
Official Communication in Australian Application No. 2014241989, dated Aug. 31, 2017.
Official Communication in Japanese Application No. JP 2016-500490, dated Nov. 27, 2017.
Official Communication in Australian Application No. 2014241994, dated Oct. 30, 2017.
International Preliminary Report on Patentability and Written Opinion in International Application No. PCT/US2016/013062, dated Aug. 10, 2017.
Notice of Acceptance in Australian Application No. AU2016231622, dated Dec. 4, 2018.
Official Communication in Japanese Application No. JP 2016-500498, dated Mar. 4, 2019.
Notice of Acceptance in Australian Application No. 2014327083, dated Apr. 3, 2019.
Official Communication in Japanese Application No. JP 2016-517392, dated Apr. 22, 2019.
Related Publications (1)
Number Date Country
20180085149 A1 Mar 2018 US
Divisions (1)
Number Date Country
Parent 13804407 Mar 2013 US
Child 15784577 US