The present disclosure generally relates to the field of prosthetic medical devices and methods. Specifically, the present disclosure includes a spinal implant that may be positioned along an individual's vertebrae to simulate the natural spinous process and lamina portions of the vertebral arch removed during a laminectomy procedure.
A laminectomy is a surgical procedure for removal of the vertebral arch, including the spinous process and portions of the lamina, located in the cervical, thoracic, lumbar, and sacral regions of the spine. This procedure may be performed on patients with back pain due to compression along the spinal cord or nerves, which may be caused from various spine diseases, including (but not limited to) degenerative, infectious, neoplastic, traumatic, and congenital pathologies. Removal of the vertebral arch allows for decompression of the spinal canal, and gives the surgeon access to the contents of the spinal canal as needed.
Despite its advantages, a laminectomy procedure may present various complications. For example, a laminectomy procedure inherently results in postoperative dead space around the surgical area. This dead space may lead to dangerous postoperative fluid collections, such as hematomas, and may lead to infection. Known methods to address these complications may involve rotating muscles in the patient's back to re-occupy the dead space. However, this generally requires a plastic surgeon, additional time, and may cause additional blood loss.
Further, some patients may require the application of a spinal fixation construct, which may include e.g., pedicle screws and rods, along a spinal segment for treatment of spinal instability, in addition to laminectomies for decompression of the neural elements. Any spinal fusion procedure carries the risk of causing adjacent segment disease or proximal junctional kyphosis. Moreover, such fixation constructs generally exacerbate the problem of postoperative dead space in the laminectomy defect because it is more difficult to bring the paraspinal muscles back towards the midline to fill this dead space after the pedicle screws and rods have been placed.
It is with these observations in mind, among others, that various aspects of the present disclosure were conceived and developed.
Corresponding reference characters indicate corresponding elements among the view of the drawings. The headings used in the figures do not limit the scope of the claims.
Aspects of the present disclosure relate to systems and methods for a spinal implant that are suitable for addressing various postoperative spine complications, among other advantages. The spinal implant may generally comprise a biocompatible body defining a first member resembling portions of the vertebral lamina, and a second member resembling a spinous process. The spinal implant may be configured for mounting directly to or proximate to bone tissue along a spinal segment subsequent to a laminectomy procedure, or may be engaged to the spinal segment together with a spinal fixation construct.
In some embodiments, the spinal implant may include one or more apertures or engagement members (e.g., hooks, or rings) for engaging with bodily tissue, as described herein. In addition, multiple spinal implants may be deployed along a human spine to accommodate the removal of more than one vertebral arch (multiple laminectomies), and the multiple spinal implants may be serially aligned along the spine, chained together or otherwise interconnected to increase spinal stability, among other features. Referring to the drawings, embodiments of a spinal implant are illustrated and generally indicated as 110, 210, 310, 410, and 510 in
Referring to
Referring to
Referring to
In addition, the body 112 of the spinal implant 110 may further include a second member 130 oriented in perpendicular relation relative to the first member 114. The second member 130 may be generally rectangular as shown and may define a first end 132 in communication with the first member 114 along a generally central area of the fourth side 122 of the first member 114, and a second (free) end 134 opposite the first end 132, as shown. In some embodiments, the first member 114 and the second member 130 collectively define a general t-shape configuration that is intended to simulate the removed portions of a vertebral arch (not shown) along the first vertebral segment 104 subsequent to a laminectomy procedure. It should be appreciated that the body 112 of the spinal implant 110 is not limited to certain shapes and may take on various forms and dimensions so long as the spinal implant 110 accommodates the occupation of postoperative dead space, and provides other features as described herein. As further shown, one or more screws 140, pins, or other such fastening members, or adhesive (not shown) may be employed along the first member 114 to mount the first member 114 to portions of the first vertebral segment 104. In other embodiments, however, the spinal implant 110 may simply be positioned along the spine 102 as shown without screws 140, and the spinal implant 110 may be engaged with bodily tissue or otherwise held in place relative to the spine 102 without being directly mounted to the second vertebral segment 106.
The body 112 may be formed of various materials suitable for engagement around a surgical area and the spine 102. In some embodiments, the body 112 of the spinal implant 110 may be formed using one or more biocompatible materials for forming synthetic bone tissue, such as bone graft substitutes, or bone cement, and may include calcium sulfate and/or calcium phosphate to form the body 112 with synthetic bone-like properties. Utilizing such materials in these embodiments, the body 112 as formed may provide an interconnected, porous scaffold (not shown) that may allow bone tissue to grow safely within, through, and around the body 112 of the spinal implant 110. The biocompatible materials of the body 112 may further include antibiotics which may be absorbed by bodily tissue around the surgical area over extended periods of time. To form the body 112 in these embodiments, the biocompatible materials may generally be in the form of a powder, which may be received within one or more molds (pre-configured to desired shapes for the spinal implant 110) by injection or otherwise and mixed with one or more solutions to ultimately create synthetic bone tissue of a predefined configuration defined by the molds. In other embodiments, the body 112 may include metals, combinations of metals and synthetic bone tissue, or may be formed entirely of a metal material (e.g., molded, cast, extruded, or otherwise formed into the desired shape).
Referring to
As further shown, the spinal implant 210 may be integrated with a spinal fixation construct 211 comprising one or more pedicle screws, rods, or other spinal fixation hardware that is coupled to the spine 202. In the embodiment shown, the spinal fixation construct 211 may include any cross link system for spinal fixation as would be understood by one skilled in the art. The spinal implant 210 may be engaged along the first vertebral segment 204 prior to application of the spinal fixation construct 211, together with application of the spinal fixation construct 211, or otherwise, as further described herein.
Referring to
In addition, the body 212 of the spinal implant 210 may further include a second member 230 oriented in substantially perpendicular relation relative to the first member 214. The second member 230 may be generally rectangular as shown and may define a first end 232 in communication with the first member 214 along a generally central area of the fourth side 222 of the first member 214, and a second (free) end 234 opposite the first end 232, as shown. In some embodiments, the first member 214 and the second member 230 collectively define a general t-shape configuration that is intended to simulate the removed portions of a vertebral arch (not shown) along the first vertebral segment 204 subsequent to a laminectomy procedure. It should be appreciated that the body 212 of the spinal implant 210 is not limited to certain shapes and may take on various forms and dimensions so long as the spinal implant 210 accommodates the occupation of postoperative dead space, and provides other features as described herein. One or more screws, pins, or other such fastening members, or adhesive (not shown) may be employed along the first member 214 to mount the first member 214 to portions of the first vertebral segment 204.
As further shown in
Similar to the spinal implant 110, the body 212 of the spinal implant 210 may be formed of various materials suitable for engagement around a surgical area and the spine 202. In some embodiments, the body 212 of the spinal implant 210 may be formed using one or more biocompatible materials for forming synthetic bone tissue, such as bone graft substitutes, or bone cement, and may include calcium sulfate and/or calcium phosphate to form the body 212 with synthetic bone-like properties. Utilizing such materials in these embodiments, the body 212 as formed may provide an interconnected, porous scaffold (not shown) that may allow bone tissue to grow safely within, through, and around the body 212 of the spinal implant 210. The biocompatible materials of the body 212 may further include antibiotics which may be absorbed by bodily tissue around the surgical area over extended periods of time. To form the body 212 in these embodiments, the biocompatible materials may generally be in the form of a powder, which may be received within one or more molds by injection or otherwise and mixed with one or more solutions to ultimately create synthetic bone tissue of a predefined configuration defined by the molds. In other embodiments, the body 212 may include metals, combinations of metals and synthetic bone tissue, or may be formed entirely of a metal material, to compliment metal-based embodiments of the spinal fixation construct 211.
Referring to
In addition, the body 312 of the spinal implant 310 may further include a second member 330 oriented in perpendicular relation relative to the first member 314. The second member 330 may be generally rectangular as shown and may define a first end 332 (shown in
Further, the spinal implant 310 may include one or more of an interconnecting arrangement 340, such as an interconnecting arrangement 340A, and an interconnecting arrangement 340B shown, for interconnecting the spinal implant 310 with one or more adjacent spinal implants similar to the spinal implant 310, such as a spinal implant 342 and a spinal implant 344. In this manner, a plurality of spinal implants such as the spinal implant 310, spinal implant 342, and the spinal implant 344, may be chained together or otherwise interconnected along a spine.
In some embodiments, the interconnecting arrangement 340A may include an arm 346A and an arm 346B defined along a first side 347 of the second member 330 to accommodate offset connections respectively with an arm 348A and an arm 348B defined along the spinal implant 342. The arm 346A and the arm 346B of the spinal implant 310 may be rotatably coupled to the arm 348A and the arm 348B of the spinal implant 342 using a pin 349 at least partially disposed through a portion of each of the arms 346A and 346B and the arms 348A and 348B. A first hinge, designated H1, may be defined along the connection of the arm 346A and the arm 346B of the spinal implant 310 and the arm 348A and the arm 348B of the spinal implant 342 via the pin 349, such that the spinal implant 310 and the spinal implant 342 may rotate relative to one another along a fixed axis of rotation.
Similarly, the interconnecting arrangement 340B may include an arm 350A and an arm 350B defined along a second side 351 (opposite the first side 347) of the second member 330 to accommodate offset connections respectively with an arm 352A and an arm 352B defined along the spinal implant 342. The arm 350A and the arm 350B of the spinal implant 310 may be rotatably coupled to the arm 352A and the arm 352B of the spinal implant 344 using a pin 353 at least partially disposed through a portion of each of the arms 350A and 350B and the arms 352A and 352B. A second hinge, designated H2, may be defined along the connection of the arm 350A and the arm 350B of the spinal implant 310 and the arm 352A and the arm 352B of the spinal implant 344 via the pin 353, such that the spinal implant 310 and the spinal implant 344 may rotate relative to one another along a fixed axis of rotation.
Referring back to
Referring to
In this non-limiting embodiment, the spinous process plate section 416 further includes at least one plate section opening 424 through which the paraspinal muscles may be attached or at least partially received. Furthermore, the first screw shelf 420A, and the second screw shelf 420B, may include at least one screw shelf opening 426 for receiving a screw (not shown) or other fastening member for engaging with bone tissue or a spinal fixation construct. It is contemplated that the screw shelf openings 426 can vary in diameter to accommodate different screw sizes such that the device may be substantially secured to the engaged muscle, tissue, or other material. In addition, the removable screw tabs 422 may include respective screw tab openings 428 through which screw tab screws (not shown) may be threaded such that the surgeon may substantially secure the spinal implant 410 to a patient's bone. It is contemplated that the spinal implant 410 may include an alternative fastening device without departing from the scope of the disclosure. For example, the spinal implant 410 may be surgically tethered, fused, fixed or any combination of those, to the patient.
In this non-limiting embodiment, the first lamina support 414A is separated from the second lamina support 414B by the support bridge 418. However, it is contemplated that they may also be separated by the spinous process plate section 416. In addition, it is also contemplated that the first lamina support 414A and the second lamina support 414B may be configured to attach to each other. For example, a support bar (not shown) may be installed within the space between the first lamina support 414A and the second lamina support 414B. This support bar may be substantially rigid, or it may be configured to allow relative motion between the first lamina support 414A and the second lamina support 414B. Additionally, the first lamina support 414A and the second lamina support 414B may include curved bottom surfaces that may be capable of closely engaging with portions of the cut lamina (not shown).
In one non-limiting embodiment, the removable screw tabs 422 are configured to be detached from the first screw shelf 420A or the second screw shelf 420B such that they may accommodate varying interpeduncular distance. To illustrate, in this non-limiting embodiment, the surgeon may cut off any excess or undesired screw tabs 422 in order to provide the patient with a better implant. If the patient's spine is particularly wide, the at least one removable screw tabs 422 may be used by the surgeon to connect the device to the patient; however, if the spine is too narrow for the removable screw tabs 422 than any or all of them may be removed by the surgeon so that the connection can be made directly with the first screw shelf 420A and the second screw shelf 420B. In addition, the removable screw tabs 422 may have a reduced thickness compared to the first screw shelf 420A or the second screw shelf 420B such that the surgeon may quickly and easily cut off the screw tab or tabs 422 that are not needed, while still sufficiently thick enough to substantially achieve a secure engagement of the muscle, tissue, or other material.
Furthermore, it is contemplated that the at least one of the removable screw tabs 422 may vary in number and in distance between each tab and perform substantially the same function without departing from the scope of the disclosure. In one non-limiting example, the body of the removable screw tabs 422 may further include another removable screw tab (not shown) extending outwardly therefrom from, with a profile that generally matches the dimensions of the screw tabs 422. In this case, another removable screw tab may be separated by a scored section (not shown) that has a substantially reduced material thickness in comparison to the screw tabs 422 such that a surgeon may quickly and easily separate one tab from another. It is also contemplated that the at least one removable screw tab 422 may comprise any known or suitable alternative to size and shape, location, configuration, etc. without departing from the scope of the disclosure. It is further appreciated that any known or suitable alternative configuration of the at least one removable screw tab 422 could be employed, such as multi-level removable screw tabs, wherein the one or both of the screw shelves may extend along a first vertical axis such that the screw shelf can be configured to attach to multiple screw tabs each stacked upon one another such that the screw tab screws may extend through multiple screw tab openings and can be threadably received by the screw tab openings. It is also contemplated that the at least one removable screw tab 422 may extend from the first screw shelf 420A and second screw shelf 420B from different angles. In addition, the at least one removable screw tab 422 may also be arranged in a shaft-loop configuration.
In another non-limiting embodiment, the spinal implant 410 may further include an anchor jaw assembly (not shown). The anchor jaw assembly may include a rectangular support component (not shown) that may extend outward from the anterior or posterior surface of the support bridge 418, first lamina support 414A, second lamina support 414B, first screw shelf 420A, second screw shelf 420B, or any combination of these components, with the support component being adjustably secured to an anchor jaw (not shown). The anchor jaw may include a dual-prong configuration that extends outward from the support component and may comprise a first elongated prong of the anchor jaw, a second elongated prong of the anchor jaw, and a plurality of jaw openings positioned on both the first prong, and the second prong. In this manner, a screw, rail, pin, or other suitable fastening device may extend through the first prong of the anchor jaw, the patients natural spinous process, and the second prong of the anchor jaw so that a surgeon may fix the spinal implant 410 to inferior and superior adjacent spinous processes, additional spinous process implants, or both, as a means to correct multilevel laminar defects or other relevant conditions. The anchor jaw may integrate with these features in other methods as well. For example, in one non-limiting embodiment, the anchor jaw may also be designed as a rotatable clamp structure (not shown) that may secure the assembly to a feature by compressing the prongs, against the feature, and wherein the rotatable clamp structure is rotatable about an anchor locking position disposed between the rectangular support component and the clamp structure so that the assembly may accommodate for variations in the curvature of the patient's spine.
In another non-limiting embodiment, shown in
As further shown in
In addition, in another non-limiting embodiment, the spinous process plate section 416 may include a plurality of engagement members 492 (shown in
It is further contemplated that a person with ordinary skill in the art would understand that the at least one of the screw tab openings 428, the plate section openings 424, and the screw shelf openings 426 may have different shapes depending on the surgeon's needs. For example, the plate section openings 424 may have a square shape or an oblong shape and serve substantially the same purpose without departing from the scope of the disclosure. In addition, although not depicted, any of the openings may have a textured or threaded surface such that they are configured to receive a suitable fastening device.
In some embodiments, the first lamina support 414A and the second lamina support 414B can generally be shaped into any substantially structurally compliant form. For example, the first lamina support 414A may comprise a straight rectangular portion, a straight rectangular portion and a portion angled outward from the support bridge 418, a straight cylindrical portion, or any combination of these or forms. In one non-limiting embodiment, the first lamina support 414A and the second lamina support 414B may have substantially different lengths than depicted. Alternatively, the first lamina support 414A. In one non-limiting embodiment, the spinal implant 410 may be designed without either of the first lamina support 414A and the second lamina support 414B. For example, the spinous process plate section 416 may be configured to attach directly to the first screw shelf 420A, second screw shelf 420B, and the support bridge 418.
Additionally, the spinous process plate section 416 is depicted having a pentagon-shaped dimension, but it should be understood by a person of ordinary skill in the art that the spinous process plate section 416 may be comprised in other shapes and forms without departing from the scope of the disclosure. For example, it is contemplated that the spinous process plate section 416 may have a substantially rounded dimension instead of the pentagonal dimension depicted in the figures. In addition, the spinous process plate section 416 could be designed to imitate the natural appearance of a person's spinous process.
Referring to
As further shown, the spinal implant 510 may be integrated with a spinal fixation construct 511 comprising one or more pedicle screws, rods, or other spinal fixation hardware that is coupled to the spine 502. In the embodiment shown, the spinal fixation construct 511 may include any cross link system for spinal fixation as would be understood by one skilled in the art. The spinal implant 510 may be engaged along the first vertebral segment 504 prior to application of the spinal fixation construct 511, together with application of the spinal fixation construct 511, or otherwise, as further described herein.
The spinal implant 510 may include a body 512 defining a first member 514. The first member 514 may be generally formed with dimensions suitable for engagement along portions of the first vertebral segment 504 such as the cut lamina portions 507A/507B and may be generally formed with dimensions suitable for connections to portions of the spinal fixation construct 511, as further described herein. In some embodiments, the first member 514 may further generally comprise a six-sided shape configuration, and may be substantially planar. In addition, the first member 514 of the body 512 may define a first lateral corner 516, and a second lateral corner 518 opposite the first lateral corner 516 as shown.
As further shown, the spinal implant 510 may be integrated with the spinal fixation construct 211. The spinal fixation construct 511 may include a first rod 520 and a second rod 522 oriented in parallel orientation relative to one another and positioned along the spine 502 as indicated. The spinal fixation construct 511 may further include one or more connection portions 524, illustrated as 524A (not shown in
In addition, the body 512 of the spinal implant 510 may further include a second member 530 oriented in substantially perpendicular relation relative to the first member 514. The second member 530 may be generally rectangular as shown and may extend from a generally central area of the first member 514, as shown. In some embodiments, the first member 514 and the second member 530 collectively define a general t-shape configuration (from a side view) that is intended to simulate the removed portions of a vertebral arch (not shown) along the first vertebral segment 504 subsequent to a laminectomy procedure.
In one embodiment, the spinal implant 510 is rigidly affixed to the spinal fixation construct 511 in the position shown in order to add rigidity to the entirety of the spinal fixation construct 511. In addition, the spinal implant 510 at least partially fills postoperative dead space along the cut lamina portions 507A/507B, and provides a suitable object for engagement to paraspinal muscles. As such, the spinal implant 510 provides a novel improvement to existing cross-link members, as the spinal implant 510 at least somewhat resembles the removed vertebral arch (not shown) while also providing additional functionality for spinal fixation and recovery.
It should be appreciated that the body 512 of the spinal implant 510 is not limited to certain shapes and may take on various forms and dimensions so long as the spinal implant 510 accommodates the occupation of postoperative dead space and the depicted connections to the spinal fixation construct 511, and provides other features as described herein. The body 512 may be manufactured or comprised of any number of suitable sterilizible and/or biocompatible materials, such as metal, polymer, alloy, biodegradable composite, bioactive material, resin, ceramic, or any combinations of the same. In addition, the surface of the spinal implant 510 may be coated with any number of suitable materials.
The embodiments of the spinal implants 110, 210, 310, 410, and 510 described herein may include various sub features or variations. For example, the spinal implants 110, 210, 310, 410, and 510 may include smooth surfaces, and/or may include surface features such as ridges, bumps, protrusions, channels or any combination of these elements without departing from the scope of the disclosure. These features may be advantageous for interacting or diverting the flow of liquid over the device during surgery. In addition, these features may be dispersed across the device in any known configuration to the preference of the user. Furthermore, the components of the spinal implants 110, 210, 310, 410, and 510 may be manufactured or comprised of any number of suitable sterilizible materials, such as metal, polymer, alloy, biodegradable composite, bioactive material, resin, ceramic, or any combination of these. In addition, the surface of the device may be coated with any number of suitable materials. Any of the spinal implants 110, 210, 310, 410, and 510 may be manufactured by connecting various discrete components, or by unitary construction.
Moreover, any of the spinal implants 110, 210, 310, 410, and 510 may be manufactured such that any interior part of the device, or the entire interior, is hollow. In this manner, any of the spinal implants 110, 210, 310, 410, and 510 can be partially or completely filled with antibiotic material, solutions, bioactive materials, or any combinations of the same. In addition, in a further implementation, any hollow interior of the spinal implants 110, 210, 310, 410, and 510 may comprise solid components as well. For example, in one non-limiting embodiment, the hollow interior may comprise at least one column shaped honeycomb structure. These columns may be arranged in such a manner that they cross-link with one another or alternatively, they may be arranged to be substantially parallel with one another along a face of the interior of the spinal implants 110, 210, 310, 410, and 510 both of which may provide the spinal implants 110, 210, 310, 410, and 510 with significant structural support. The honeycomb structures may be coated with any number of organic or inorganic substances, including catalysts, binders or any combination of these. Furthermore, the honeycomb structures could also comprise a plurality of pores dispersed along the length of the honeycomb structures.
For cases that require spinal fixation hardware, any of the spinal implants 110, 210, 310, 410, and 510 may include a bottom member or mounting rack (shown in
In some embodiments, the spinal implants 110, 210, 310, 410, and 510 may include one or more hooks (shown in
In addition, the spinal implants 110, 210, 310, 410, and 510 are depicted as one component. However, it is contemplated that the spinal implants 110, 210, 310, 410, and 510 can be constructed out of multiple components; for example, the plate section 416 of the spinal implant 410 could be comprised of two separable pieces. Further, any of the spinal implants 110, 210, 310, 410, and 510 may be printed at least partially using a three-dimensional printing device, using predetermined materials suitable for replicating bone tissue. The dimensions of the spinal implants 110, 210, 310, 410, and 510 may be determined based on a medical image of an actual patient or cadaver to generate the spinal implants 110, 210, 310, 410, and 510 with desired anatomical properties.
It should be understood from the foregoing that, while particular embodiments have been illustrated and described, various modifications can be made thereto without departing from the spirit and scope of the invention as will be apparent to those skilled in the art. Such changes and modifications are within the scope and teachings of this invention as defined in the claims appended hereto.
This is a continuation application that claims benefit to U.S. application Ser. No. 16/607,303 filed on Oct. 22, 2019, which claims the benefit of International Application No. PCT/US2018,029971 filed Apr. 27, 2018, which claims the benefit of U.S. Provisional Application Ser. No. 62/491,199 filed Apr. 27, 2017, all of which are herein incorporated by reference in their entireties.
Number | Date | Country | |
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62491199 | Apr 2017 | US |
Number | Date | Country | |
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Parent | 16607303 | Oct 2019 | US |
Child | 17931991 | US |