1735 results about "Intervertebral disc" patented technology

Apparatus and a method of inserting spinal implants is disclosed in which an intervertebral space is first distracted, a hollow sleeve having teeth at one end is then driven into the vertebrae adjacent that disc space. A drill is then passed through the hollow sleeve removing disc and bone in preparation for receiving the spinal implant which is then inserted through the sleeve.

Devices and methods for treating a damaged intervertebral disc to reduce or eliminate associated back pain. Dynamic bias devices and reinforcement devices are disclosed, which may be used individually or in combination, to eliminate nerve impingement associated with the damaged disc, and / or to reinforce the damaged disc, while permitting relative movement of the vertebrae adjacent the damaged disc.

An implant for forming an intervertebral disc nucleus pulposus prosthesis includes a conformable material adapted to fill cavities within the disc and to at least partially polymerize in-situ to form a shaped, resiliently deformable prosthesis.

The invention relates to a surgical implant that provides an artificial diarthroidal-like joint, suitable for use in replacing any joint, but particularly suitable for use as an intervertebral disc endoprosthesis. The invention contains two rigid opposing shells, each having an outer surface adapted to engage the surfaces of the bones of a joint in such a way that the shells are immobilized by friction between their outer surfaces and the surfaces of the bone. These outer surfaces are sufficiently rough that large frictional forces strongly resist any slippage between the outer surface and the bone surfaces in the joint. They may be convex, and when inserted into a milled concavity, are immediately mechanically stable. Desirably, the outer surfaces of the shells are adapted to allow for bony ingrowth, which further stabilizes the shells in place. The inner surfaces of the shells are relatively smooth, and adapted to slide easily across a portion of the outer surface of a central body disposed between the shells. The central body has a shape that cooperates with the shape of the inner surface of the shell so as to provide a range of motion similar to that provided by a healthy joint. A flexible sheath extends between edges of the opposing shells. The inner surface of this sheath, together with the inner surfaces of the rigid shells, defines a cavity encasing the central body. At least a portion of this cavity is filled with a fluid lubricant, further decreasing the frictional force between inner surfaces of the shell and the surface of the central body.

Apparatus and methods for treating an intervertebral disc by ablation of disc tissue. A method of the invention includes positioning at least one active electrode within the intervertebral disc, and applying at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s), wherein the volume of the nucleus pulposus is decreased, pressure exerted by the nucleus pulposus on the annulus fibrosus is reduced, and discogenic pain of a patient is alleviated. In other embodiments, a curved or steerable probe is guided to a specific target site within a disc to be treated, and the disc tissue at the target site is ablated by application of at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s). A method of making an electrosurgical probe is also disclosed.

The present invention provides an expandable intervertebral implant that is selectively disposed in the intervertebral space and deployed, thereby in-situ distracting, realigning, and / or stabilizing or fusing a portion of the spine of a patient in the treatment of injury, disease, and / or degenerative condition. The expandable intervertebral implant includes a superior member and an inferior member, each of which has a partially or substantially wedge or prismatic shape and a partially or substantially convex or other-shaped surface that is suitable for engaging the substantially concave surfaces of the associated bony superior and inferior intervertebral endplates. Once disposed in the intervertebral space, the expandable intervertebral implant is actuated and deployed, with the superior member and the inferior member moving apart from one another, seating against the associated intervertebral endplates, and distracting, realigning, and / or stabilizing them to a desired degree. The external surface of each of the superior member and the inferior member is provided with a plurality of ridges or other friction structures, providing purchase with the associated intervertebral endplates.

An artificial intervertebral disc and disc nucleus are described herein having chambers and dampening members. The dampening members may be within or outside of the main body of the device. The chambers may be filled with a suitable liquid, gas, or both, and separated by valves to regulate flow of fluid between chambers, within a dampening member, between the main body and dampening member, or all of the above. Chambers may be filled with responsive hydrogels, EPAM, or other suitable materials, and the device may have activation plates or members, a strain gauge, a pressure sensor, or other means for detecting changes in the materials and / or triggering desired changes in the materials in order to mimic the behavior of a healthy native disc or disc nucleus. A control system may be in communication with the device for receiving feedback and delivering stimuli to initiate desired changes in the fluids or other materials. Membranes may be of variable permeability and may be metallized to ensure as low permeability as possible. Dampening members may be filled during manufacture with carbon dioxide or other suitable gas which may be in a supercritical state and allowed to return to ambient temperature and gaseous state or by other means. Methods of manufacture, delivery of the artificial disc and related structures, and methods of treatment are also described.

The present invention provides a method for intervertebral disc surgery. The method includes creating a passage in a vertebral body adjacent to the intervertebral disc. The passage extends from a side surface of the vertebral body to a nucleus pulposus of the intervertebral disc. Annulus fibrosis tissue of the intervertebral disc is not incised during the surgery.

Apparatus and methods for treating an intervertebral disc by ablation of disc tissue. A method of the invention includes positioning at least one active electrode within the intervertebral disc, and applying at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s), wherein the volume of the nucleus pulposus is decreased, pressure exerted by the nucleus pulposus on the annulus fibrosus is reduced, and discogenic pain of a patient is alleviated. In other embodiments, a curved or steerable probe is guided to a specific target site within a disc to be treated, and the disc tissue at the target site is ablated by application of at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s). A method of making an electrosurgical probe is also disclosed.

A system for repairing an intervertebral disc by delivering and curing a biomaterial in situ within the disc. The system includes both a device, having an insertable balloon and related lumen, controls and adapters, as well as an in situ curable biomaterial (and related biomaterial delivery means). The system can allow the doctor to determine a suitable endpoint for biomaterial delivery, by controlling distraction and / or biomaterial delivery pressure, and in turn, to deliver a desired quantity of biomaterial to the balloon in order to achieve improved polymer cure and implant characteristics. Also provided is a related method for repairing an intervertebral disc by using such a system to deliver and cure the biomaterial in situ. The system can be used to implant a prosthetic total disc, or a prosthetic disc nucleus in a manner that leaves the surrounding disc tissue substantially intact.

The invention relates to a surgical implant that provides an artificial diarthroidal-like joint, suitable for use in replacing any joint, but particularly suitable for use as an intervertebral disc endoprosthesis. The invention contains two rigid opposing shells, each having an outer surface adapted to engage the surfaces of the bones of a joint in such a way that the shells are immobilized by friction between their outer surfaces and the surfaces of the bone. These outer surfaces are sufficiently rough that large frictional forces strongly resist any slippage between the outer surface and the bone surfaces in the joint. They may be convex, and when inserted into a milled concavity, are immediately mechanically stable. Desirably, the outer surfaces of the shells are adapted to allow for bony ingrowth, which further stabilizes the shells in place. The inner surfaces of the shells are relatively smooth, and adapted to slide easily across a portion of the outer surface of a central body disposed between the shells. The central body has a shape that cooperates with the shape of the inner surface of the shell so as to provide a range of motion similar to that provided by a healthy joint. A flexible sheath extends between edges of the opposing shells. The inner surface of this sheath, together with the inner surfaces of the rigid shells, defines a cavity encasing the central body. At least a portion of this cavity is filled with a fluid lubricant, further decreasing the frictional force between inner surfaces of the shell and the surface of the central body.

A method of treating spine disease including the steps of removing at least a portion of a natural facet joint from a vertebral body; implanting an intervertebral disc prosthesis and replacing the portion of the natural facet joint with a facet joint prosthesis. The removed facet portion may be a cephalad or a caudal facet or both. The replacing step may include the step of attaching the facet joint prosthesis to the vertebral body, such as at or near a pedicle and / or spinous process. The invention also provides spinal prostheses to treat spine disease. The spinal prostheses include an intervertebral disc prosthesis and a facet joint prosthesis having artificial facet joint structure adapted and configured to replace a removed portion of the natural facet joint (cephalad, caudal or both).

Instruments of an instrumentation set may be used to prepare a disc space and to insert an implant into the prepared disc space. The instruments may include fixed tip distractors and / or modular tip distractors. The instruments may include a chisel. The chisel may allow simultaneous removal of a desired amount of bone from each of a pair of vertebrae. The instruments may include an implant inserter. The implant inserter may grip sides of an implant. A portion of the implant inserter may fit within grooves of the implant to minimize or eliminate portions of the implant that extend beyond side surfaces of the implant.

Disclosed are devices and methods for emplacement of an expandable device in a body part of interest in human and animal subjects. In one embodiment, the expandable device comprises a cage that may be emplaced in the intervertebral disc for use in spine fusion techniques. The device is fashioned so that it may be delivered to the intervertebral disc by percutaneous means, such as via a cannula. Additionally disclosed are systems and kits employing the devices of the invention as well as methods of manufacturing the devices of the invention.

Methods and devices are provided for the explantation of spinal implants. A cutting tool may be extended into the spinal implant. The spinal implant may be cut into pieces and the pieces removed.

Apparatus and methods for treating a target tissue by delivering a fluid at a defined temperature to a patient's body. An apparatus of the invention includes a fluid delivery unit for delivering fluid in at least close proximity to the target tissue, an aspiration unit for withdrawing the fluid, and a fluid source unit for providing the fluid at the defined temperature. A method of the invention includes forming a void in at least close proximity to the target tissue, and circulating a preheated fluid through the void, wherein the target tissue undergoes adjustment from body temperature to a treatment temperature due to heat exchange between the fluid and the target tissue.

Prosthetic intervertebral discs and methods for using the same are described. The subject prosthetic discs include upper and lower endplates separated by a compressible core member. The prosthetic discs described herein include one-piece, two-piece, three-piece, and four-piece structures. The subject prosthetic discs exhibit stiffness in the vertical direction, torsional stiffness, bending stiffness in the saggital plane, and bending stiffness in the front plane, where the degree of these features can be controlled independently by adjusting the components of the discs. The interface mechanism between the endplates and the core members of several embodiments of the described prosthetic discs enables a very easy surgical operation for implantation.

A device for providing support for biological tissue is disclosed. The device can expand and be implanted in lieu of removed or otherwise missing bone, such as a vertebra, and / or soft tissue, such as a intervertebral disc. The device can be configured to radially expand in a single plane when the device is longitudinally contracted. Methods for using the device are also disclosed.

A trial intervertebral disk implant includes a first plate, a second plate, adjacent to the first plate, a conformable layer between the first and the second plates, and a pressure sensor within the conformable layer. The pressure sensor measures a distribution of compression force exerted by the first and the second plates on the conformable layer. The trial implant includes indicating means for indicating a position of the first and the second plates relative to each other, and locating means, for locating a position of the trial implant relative to the vertebrae between which said trial implant has been placed. The trial implant further includes at least one retractable member, connected to at least one of the first and the second plates. The retractable member can be extended or retracted through an aperture defined by a surface of the plate that is proximal to an abutting vertebra.

Methods and apparatus for selectively applying electrical energy to a target location within a patient's body, particularly including tissue in the spine. In a method of the invention high frequency (RF) electrical energy is applied to one or more active electrodes on an electrosurgical probe in the presence of an electrically conductive fluid to remove, contract or otherwise modify the structure of tissue targeted for treatment. In one aspect, a dura mater and spinal cord are insulated from the electrical energy by an insulator positioned on a non-active side of the probe. In another aspect, a plasma is aggressively formed in the electrically conductive fluid by delivering a conductive fluid to a distal end portion of the probe and aspirating the fluid from a location proximal of the return electrode. In another aspect, a distal end of an electrosurgical probe having at least one electrode on a biased, curved, bent, or steerable shaft is guided or steered to a target site within an intervertebral disc having a disc defect for treatment of tissue to be treated at the target site by the selective application of electrical energy thereto.

A prosthesis for the replacement of the cartilaginous structures of a spine motion segment is described. The prosthesis comprises an intervertebral disc prosthesis in combination with a facet joint prosthesis.

Prosthetic intervertebral discs, systems including such prosthetic intervertebral discs, and methods for using the same are described. The subject prosthetic discs include upper and lower endplates separated by a compressible core member. The subject prosthetic discs exhibit stiffness in the vertical direction, torsional stiffness, bending stiffness in the saggital plane, and bending stiffness in the front plane, where the degree of these features can be controlled independently by adjusting the components, construction, and other features of the discs.

An intervertebral disc having a first end plate, a second end plate and a core. The first end plate including a top surface and a bottom spherical surface. The second end plate having a lower surface and an upper surface, the upper surface including at least one protrusion having a length and a width extending upward from said upper surface. The core having a concave surface and a second surface. The core adapted for being disposed between the first end plate and the second end plate.

A device and method are used in fortifying an intervertebral disc having an annulus fibrosis with an inner wall. According to the method, a hole is formed through the annulus fibrosis, and a collapsed bag is inserted into the disc through the hole. The bag is inflated, or allowed to expand within the disc space, then filling with one or more biocompatible materials. The hole in the annulus fibrosis is then closed. In one preferred embodiment, the bag includes an inflatable bladder or balloon which is filled with a gas or liquid to expand the bag. In an alternative preferred embodiment, the bag includes a self-expanding frame that assumes a collapsed state for introduction into the disc space and an expanded state once inserted through the hole in the annulus. The self-expanding frame is composed of a shape-memory material, for example. The bag preferably features a wall which is porous to allow for the diffusion of body fluids therethrough, and the bag and / or frame may be fastened to the inner wall of the annulus at one or more points. The biocompatible material may include autograft nucleus pulposis, allograft nucleus pulposis or xenograft nucleus pulposis. In the preferred embodiment, the biocompatible material includes morselized nucleus or annulus from the same disc.

Apparatus and methods for treating an intervertebral disc by ablation of disc tissue. A method of the invention includes positioning at least one active electrode within the intervertebral disc, and applying at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s), wherein the volume of the nucleus pulposus is decreased, pressure exerted by the nucleus pulposus on the annulus fibrosus is reduced, and discogenic pain of a patient is alleviated. In other embodiments, a curved or steerable probe is guided to a specific target site within a disc to be treated, and the disc tissue at the target site is ablated by application of at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s). A method of making an electrosurgical probe is also disclosed.

A long-term implantable ultrasound therapy system and method is provided that provides directional, focused ultrasound to localized regions of tissue within body joints, such as spinal joints. An ultrasound emitter or transducer is delivered to a location within the body associated with the joint and heats the target region of tissue associated with the joint from the location. Such locations for ultrasound transducer placement may include for example in or around the intervertebral discs, or the bony structures such as vertebral bodies or posterior vertebral elements such as facet joints. Various modes of operation provide for selective, controlled heating at different temperature ranges to provide different intended results in the target tissue, which ranges are significantly effected by pre-stressed tissues such as in-vivo intervertebral discs. In particular, treatments above 70 degrees C., and in particular 75 degrees C., are used for structural remodeling, whereas lower temperatures achieves other responses without appreciable remodeling.

An expandable interbody fusion device for implantation into the intradiscal space between two opposing vertebral bodies of a spine comprises a superior endplate member having an upper surface for engaging a superior vertebral body in a spine, and an inferior endplate member having a lower surface for engaging an inferior vertebral body in the spine. The superior endplate member and the inferior endplate member are releasably coupled and define a cavity therebetween. At least one expansion member is configured to be introduced into the cavity to move the superior endplate and the inferior endplate members relatively apart upon introduction and to thereby decouple the superior endplate member and the inferior endplate member. An inserter may be releasably coupled to the device to facilitate insertion of the device as well as to provide a track for insertion of the expansion members.

A device and method for repairing spinal discs in which the nucleus has been damaged. A central section of the nucleus is cored out using a device which ablates the tissue using RF energy. A nucleus implant comprising a shape memory material is placed in the central section of the disc through a cannula, which implant is activated by body heat to expand and fill the central section, such that the implant emulates the functions and strength of the disc's natural nucleus.

Various methods and devices are provided for stabilizing the posterior elements of the spine, and more preferably methods and devices are provided for sharing the load with the intervertebral disc, the facet joints, the ligaments, and the muscles of the spinal column. In certain exemplary embodiments, methods and devices are provided for substantially controlling or providing resistance to movement, e.g., flexion, extension, lateral bending, and / or axial rotation, of the adjacent vertebrae.