USRE43434E1 - Method and apparatus for treating intervertebral disks - Google Patents
Method and apparatus for treating intervertebral disks Download PDFInfo
- Publication number
- USRE43434E1 USRE43434E1 US10/923,564 US92356404A USRE43434E US RE43434 E1 USRE43434 E1 US RE43434E1 US 92356404 A US92356404 A US 92356404A US RE43434 E USRE43434 E US RE43434E
- Authority
- US
- United States
- Prior art keywords
- thermoplastic material
- needle
- injection
- expandable member
- annulus
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Fee Related
Links
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7097—Stabilisers comprising fluid filler in an implant, e.g. balloon; devices for inserting or filling such implants
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8802—Equipment for handling bone cement or other fluid fillers
- A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
- A61B17/8822—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it characterised by means facilitating expulsion of fluid from the introducer, e.g. a screw pump plunger, hydraulic force transmissions, application of vibrations or a vacuum
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8802—Equipment for handling bone cement or other fluid fillers
- A61B17/8833—Osteosynthesis tools specially adapted for handling bone cement or fluid fillers; Means for supplying bone cement or fluid fillers to introducing tools, e.g. cartridge handling means
- A61B17/8836—Osteosynthesis tools specially adapted for handling bone cement or fluid fillers; Means for supplying bone cement or fluid fillers to introducing tools, e.g. cartridge handling means for heating, cooling or curing of bone cement or fluid fillers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/885—Tools for expanding or compacting bones or discs or cavities therein
- A61B17/8852—Tools for expanding or compacting bones or discs or cavities therein capable of being assembled or enlarged, or changing shape, inside the bone or disc
- A61B17/8855—Tools for expanding or compacting bones or discs or cavities therein capable of being assembled or enlarged, or changing shape, inside the bone or disc inflatable, e.g. kyphoplasty balloons
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/441—Joints for the spine, e.g. vertebrae, spinal discs made of inflatable pockets or chambers filled with fluid, e.g. with hydrogel
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/442—Intervertebral or spinal discs, e.g. resilient
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4601—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for introducing bone substitute, for implanting bone graft implants or for compacting them in the bone cavity
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00491—Surgical glue applicators
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3472—Trocars; Puncturing needles for bones, e.g. intraosseus injections
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8802—Equipment for handling bone cement or other fluid fillers
- A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
- A61B2017/00539—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated hydraulically
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
- A61B2017/00557—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated inflatable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/025—Joint distractors
- A61B2017/0256—Joint distractors for the spine
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2/4611—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
- A61F2002/3006—Properties of materials and coating materials
- A61F2002/30065—Properties of materials and coating materials thermoplastic, i.e. softening or fusing when heated, and hardening and becoming rigid again when cooled
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30563—Special structural features of bone or joint prostheses not otherwise provided for having elastic means or damping means, different from springs, e.g. including an elastomeric core or shock absorbers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30581—Special structural features of bone or joint prostheses not otherwise provided for having a pocket filled with fluid, e.g. liquid
- A61F2002/30583—Special structural features of bone or joint prostheses not otherwise provided for having a pocket filled with fluid, e.g. liquid filled with hardenable fluid, e.g. curable in-situ
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/442—Intervertebral or spinal discs, e.g. resilient
- A61F2002/444—Intervertebral or spinal discs, e.g. resilient for replacing the nucleus pulposus
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2002/4635—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2002/465—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using heating means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2002/4688—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor having operating or control means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2210/0071—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof thermoplastic
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2210/0085—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof hardenable in situ, e.g. epoxy resins
Definitions
- This invention relates to surgical methods generally, and is more specifically related to a method and apparatus for treating intervertebral disks of mammals.
- the intervertebral disk is a disk with fibrosus bands occupying the space between two vertebrae.
- the anatomy of the disk provides a cushion to allow motion, limit motion and provide space, distancing the vertebra off the nerves and compressible tissue.
- Part of the vertebrae are bony blocks, which, when stacked one upon the other, form the anterior portion of the spine.
- the fibrosus band includes an outer annulus fibrosus which surrounds an inner nucleus pulposus.
- Annulus fibrosus as referred to herein, is the marginal or peripheral portion of an intervertebral disk. Intervertebral disks are prone to injury. Due to the low blood supply to this area, intervertebral disks are slow to heal, and may not materially heal.
- the nucleus pulposus When the annulus fibrosus is torn, or punctured, the nucleus pulposus can leak or migrate from the annulus fibrosus.
- the nucleus pulposus is a substance of jelly like consistency found in the center of an intervertebral disk and flows from the associated annulus fibrosus when the annulus fibrosus is ruptured or prolapsed.
- the effect of a ruptured or prolapsed annulus fibrosus may result in spasm, and neurological compromise, such as the compressed nerve and other compressible soft tissues, i.e. arteries, veins.
- Degeneration of the condition may increase over time, resulting in chronic and debilitating pain.
- the condition is usually disabling.
- Suppressive measures include steroidal injection, removal of the nucleus pulposus, and fusion either by donor bone, coral or by metal bracing. If disk removal is performed, a healthy part of the disk is often taken, eradicating the function of the joint, and accelerating the degeneration of adjacent segments of the body, as the body attempts to stabilize. This approach frequently leaves the patient immunologically and structurally compromised if not permanently disabled.
- Isolated treatment to only the damaged structures employing the most non-invasive procedure possible is preferred.
- This approach allows as much of the healthy tissue as possible to remain, and to retain normal neurological function.
- the offending material can be removed, the material must be replaced with a material which will perform the function formerly performed by the material removed.
- the thermoplastic material must be pliable in its application, and non-flowing after replacement.
- the present invention is particularly directed to a process for treating the spine including the injection of a thermoplastic material heated to a predetermined temperature for injection into the nucleus pulposus in a flowing state where it cools and sets at body temperature into a non-flowing state.
- Inorganic materials have been shown to penetrate the endplates of the associated vertebrae.
- a thermoplastic or thermoplastic polymer material is any plastic or organic material that softens when heated and hardens when cooled.
- the thermoplastic material prior to injection is heated to a temperature sufficient for the material to flow under pressure into the nucleus pulposus and, after it sets into a non-flowing state at body temperature, the material retains sufficient resilience to provide desired cushioning of the spine.
- gutta percha which is normally combined with other elements or ingredients in a suitable gutta percha compound.
- Gutta percha is a linear crystalline polymer which melts at a predetermined temperature a random but distinct change in structure results. Normal body temperature is 37 C and a suitable thermoplastic material hardens into a non-flowing state at a temperature range between about 35 C and 42 C (the degree symbol for temperature is omitted in all references herein to a specific temperature).
- a crystalline phase appears in two forms; an alpha phase and a beta phase.
- the alpha form is the material that comes from the natural tree product.
- the processed form is the beta form.
- gutta percha When there is a temperature increase, there is a transition from beta phase to alpha phase at about 46 C.
- the gutta percha changes to an amorphous phase about 54 C to 60 C.
- the gutta percha Crystallizes to the alpha phase. Normal cooling returns the gutta percha to the beta phase.
- Gutta percha softens at a temperature above about 64 C.
- a suitable gutta percha compound is dental gutta percha which contains by weight only about 20% gutta percha with zinc oxide comprising about 60% to 75% of the material. The remaining 5% to 10% consists of various resins, waxes, and metal sulfates. The percentages listed are directed to an optimum gutta percha compound.
- the preferred percentage of gutta percha is in the range of 15% to 40%.
- Zinc oxide and metals in the gutta percha compound are desirable for imaging such as X-rays while resins and waxes are desirable for obtaining an adequate flow of the thermoplastic material.
- Gutta percha provides the desired resiliency at body temperature and is at least about 15% of the compound.
- Zinc oxide also provides an anti-inflammatory property.
- a mineral trioxide aggregate may be added to the gutta percha compound.
- An injection device such as an injection gun, is utilized for heating and injecting the thermoplastic material under a predetermined pressure within the spine.
- the injection device may utilize a silver needle, encased in ceramics, of about 20 to 30 centimeters in length with a diameter as high as 1 centimeter.
- the size of the needle may depend on such factors as the amount of thermoplastic material to be injected, the temperature of the thermoplastic being injected, and the axial pressure applied by the injection device, such as a piston or plunger, to the thermoplastic material to force the heated material from the end of the needle into the spine.
- the thermoplastic material is physiologically acceptable to the human body.
- thermoplastic material When the thermoplastic material is utilized to treat a ruptured annulus fibrosus, the nucleus pulposus is removed and the material removed is replaced by the heated thermoplastic material which sets at body temperature and provides sufficient resilience after setting to permit adequate motion and cushioning of the vertebrae.
- the cushioning effect of the gutta percha compound provides a semimobile disk as a buffer to a fusion to reduce the possibility of sequential iatrogenic disk degeneration.
- the thermoplastic material is injected within the potential nucleus pulposus space bordered by the annulus fibrosus to replace the removed nucleus pulposus by a needle of the injection device.
- thermoplastic material When the thermoplastic material is injected within the spine to reduce a scoliosis, the material is sequentially injected by a needle of the injection device into the annulus fibrosus or interannular at the apex and adjacent joints of the concavity of the scoliosis. Such an injection tends to straighten the curvature of the spine is a wedge-like action.
- FIGS. 8-10 An embodiment illustrated in FIGS. 8-10 includes an injection system in which an expandable member is first expanded into the annulus fibrosus of a disk and then a thermoplastic material is injected into the annulus fibrosus to collapse the expandable member and occupy the space formerly occupied by the expandable member.
- the expandable member is mounted in concentric relation about the needle.
- a further object of the present invention is to provide such a method in which the thermoplastic material is heated to a predetermined temperature for flow into the annulus fibrosus and hardens when it cools from body temperature into a non-flowing state to form a resilient support for cushioning between vertebrae.
- Another object of the invention is to provide a method to treat a ruptured annulus fibrosus of a spine by removal of the nucleus pulposus and injection of a thermoplastic material into the annulus fibrosus to replace the nucleus pulposus.
- An additional object is to provide an apparatus to treat an annulus fibrosus of a spine in which an injection device heats the thermoplastic material for flow into the annulus fibrosus and another injection member is effective for expanding an expandable member in the annulus fibrosus.
- FIG. 1 is a diagrammatic view of a ruptured/prolapsed annulus fibrosus and the resulting migrated nucleus pulposus of an intervertebral disk;
- FIG. 2 is a sectional view of the ruptured annulus fibrosus showing leakage of the nucleus pulposus
- FIG. 3 is a diagrammatic view illustrating injection of a thermoplastic material by an injecting device into the annulus fibrosus for replacement of the nucleus pulposus;
- FIG. 4 shows the intervertebral disk after setting of the thermoplastic material
- FIG. 5 illustrates the abnormal curvature of the lower spine for the injection of a thermoplastic material into the curved concave portion of the spine
- FIG. 6 is a perspective view of a modified injecting device for injecting a thermoplastic material within the spine
- FIG. 7 is a perspective view of a disk dilator
- FIG. 8 is a generally schematic view of a separate embodiment of the invention in which a disk dilator is intentionally provided to force adjacent disks apart and then a thermoplastic material is injected in the space occupied by the expandable dilator member;
- FIG. 9 is a section taken generally along line 9 - 9 of FIG. 8 ;
- FIG. 10 is a sectional view of an annulus fibrosus showing the expandable member expanded and the injection of the thermoplastic material adjacent the expandable member.
- FIG. 1 a portion of a spine is shown generally pictorially in FIG. 1 including an intervertebral disk 10 adjacent a vertebra 11 .
- Disk 10 has an annulus fibrosus 12 which has ruptured at 14 resulting in a leakage or migration of nucleus pulposus 16 from the annulus fibrosus 12 .
- a sacral nerve is shown at 18 extending from the cauda eqina 19 and the migrating or flowing nucleus pulposus 16 may result in a compression of nerve 18 with recognition that the techniques will be adapted specific to facilitate delivery to different levels of the spine.
- FIGS. 1-4 illustrate the removal of the nucleus pulposus 16 and replacement with a thermoplastic material.
- the rupture or prolapse of the annulus fibrosus 12 is first identified and isolated. This identification and isolation is by means such as X-ray, MRI or other diagnostic imaging procedures which are diagnostically acceptable. After the area of rupture or prolapse is identified and isolated the site is surgically accessed.
- the nucleus pulposus 16 removed is replaced with a thermoplastic material which is physiologically acceptable to the human body and flows when injected but hardens at body temperature into a non-flowing resilient material.
- the thermoplastic material is first heated by a suitable injection device having an injection needle to a predetermined temperature for flow under pressure from the needle into the annulus fibrosus 12 wherein the nucleus pulposus 16 has been removed.
- a thermoplastic material which has been found to be highly satisfactory is gutta percha or a gutta percha compound.
- Gutta percha is a geometric isomer of natural rubber.
- a substance such as mineral trioxide aggregate and other anti-inflammatory elements may be added to the gutta percha to facilitate the binding properties and to facilitate healing of the affected area.
- Dental gutta percha which may be utilized contains approximately 20% gutta percha, with zinc oxide comprising 60% to 75% of the material. The remaining 5% to 10% consists of various resins, waxes, metal sulfates for radioopacity, and coloration.
- gutta percha When cold, gutta percha is relatively inelastic, but as it warms it becomes moldable. At a high temperature gutta percha will flow under pressure to permit injection from an injection needle into the annulus fibrosus 12 .
- thermoplastic material 20 within the annulus fibrosus 12 by an injection device or gun illustrated schematically at 22 is shown.
- Injection gun 22 has a body 24 with a removable plunger 26 adapted to receive a cylindrical plug of the thermoplastic material 20 .
- a heater 28 is provided to heat the thermoplastic material 20 and a heater control unit 30 having an adjustable temperature control knob 32 is provided with a temperature readout at 34 .
- Electrical leads 36 extend to heater 28 .
- An injection needle 38 preferably formed of silver extends from body 24 and has a ceramic sheath 40 about a portion of needle 38 .
- a hand operated trigger 42 may be activated for forcing thermoplastic material 20 from the end of needle 38 upon heating of the thermoplastic material 20 to a predetermined temperature.
- a foot operated hydraulic pump may be provided at 44 to supply fluid through lines 46 , 48 to a hydraulic cylinder 45 .
- a pressure readout is provided at 49 .
- a suitable piston 51 may exert an axial force against the thermoplastic material 20 .
- a hydraulic system is effective in providing an axial injection force that may be easily regulated and controlled by personnel performing the procedure.
- a suitable injection device designated as a Obtura II Heated Gutta Percha System may be purchased from Obtura of Fenton, Mo.
- Needle 38 preferably formed of silver may be of various diameters but will not exceed a diameter of about 1 centimeter. Needle 38 may have a length of between 20 centimeters and 30 centimeters.
- a plug or stick of the thermoplastic material 20 may have a total volume of about 21 cubic centimeters with a diameter of about 16 millimeters and a length of about 101 ⁇ 2 centimeters.
- the thermoplastic material 20 is required to be heated prior to injection to permit flow of the thermoplastic material. The higher the temperature of the thermoplastic material, the lower the viscosity and the faster flow. A lower temperature heating increases the viscosity and retards the flow rate.
- the degree to which the thermoplastic material 20 is heated may vary substantially dependent primarily on the diameter of needle 38 and the axial force applied to the heated thermoplastic material for injection. Generally the lowest temperature to which the thermoplastic material is heated while utilizing a large diameter needle such as 1 centimeter in diameter with a relatively high axial force may be 50 C while the highest temperature will be less than about 250 C.
- the optimum temperature is about 185 C within an optimum range between about 150 C and 200 C.
- thermoplastic material it is desirable for the thermoplastic material to have a viscosity and temperature suitable for injection and flow into the space previously occupied by the annulus fibrosus 12 .
- the material flows to fill the entire void area of the annulus fibrosus possibly including the ruptured area 14 .
- the thermoplastic material 20 cools relatively rapidly and, for example, reaches body temperature about its outer surface very quickly if injected at a temperature of about 185 C and then cools internally to body temperature in several minutes depending primarily on the thickness and surface area of the thermoplastic material.
- the thermoplastic material 20 tends to set at about 42 C and is not in a flowing state lower than about 42 C.
- thermoplastic material 20 Upon reaching the body temperature of 37 C, the thermoplastic material is set. At normal human body temperature the thermoplastic material is no longer moldable and is not flowing or migrating. Thus, the thermoplastic material 20 remains within the annulus fibrosus 16 and repairs the rupture 14 of the annulus fibrosus. It is, however, necessary that the thermoplastic material retain sufficient resilience in order to provide in a satisfactory manner the functions of allowing motion and adequately cushioning of the joint between associated vertebrae. If necessary, the thermoplastic material 20 may be subsequently removed from the annulus fibrosus 12 by surgical, physical, enzymatic, and/or chemical means.
- FIG. 5 a spinal column is shown generally at 50 having vertebrae 52 with intervertebral disks 54 positioned therebetween.
- FIG. 5 shows spine 50 with scoliosis or abnormal curvature of the spine.
- the abnormal curvature of spine 50 provides a concave curvature as shown in FIG. 5 at which disks 34 are positioned.
- a thermoplastic material 20 may be injected at intervertebral disks 54 progressively to reduce the concavity for flow into the associated annulus fibrosus as in the procedure set forth in FIGS. 1-4 .
- the amount of the injected material will vary with the greatest amount of injected material at the greatest deflection and the least amount at the disks closest to the terminal ends of the abnormal curvature. However, the nucleus pulposus is not removed from the spine 50 .
- the injected material provides a force acting as a wedge to reduce the concavity of the scoliosis.
- Gutta percha as set forth in the embodiment of FIGS. 1-4 is the preferred material for the thermoplastic material to be injected due to the characteristics that allow gutta percha to be used in other joints of the body.
- a modified injection device is shown generally at 60 including an injection needle 62 , a heater 64 receiving an inner end portion of needle 62 , and an electrical heater control element 66 having leads 68 extending to heater 64 .
- a suitable control knob 70 controls the temperature and a readout panel indicates the temperature which, for example, may be about 185 C.
- a generally cylindrical chamber or housing 72 adjacent heater 64 is provided to receive a cylindrical plug 74 of the thermoplastic material.
- Housing 72 has open ends to receive removable threaded end plugs 73 for maintaining plug 74 in a sealed relation.
- One plug 73 is shown removed from housing 72 in FIG. 6 .
- Plug 74 may also be covered with a suitable cover which may be manually removed for use, either in combination with or without end plugs 73 .
- Housing 72 upon removal of plugs 73 may be connected to heater 64 at one end and connected to a fluid pressure chamber 76 at an opposed end.
- a suitable fluid from a reservoir 78 having a foot operated pedal 80 and a vent 82 is supplied through line 84 to pressure chamber 76 .
- Concentric pistons 86 and 88 responsive to pressurized fluid in chamber 76 are provided to engage the end of thermoplastic plug 74 to urge plug 74 into heater 64 for injection from needle 62 under a predetermined pressure.
- a pressure gauge 90 is provided to indicate the fluid pressure applied against thermoplastic plug 74 .
- housing 72 may be disposable with heater 64 being of an increased length to receive the entire length of plug 74 .
- Needle 62 is preferably about 6 mm in diameter, and between about 20 cm and 30 cm in length for maneuverability.
- the volume of thermoplastic material to purge needle 62 may be between about 5.65 cc and 8.48 cc dependent on the size of the needle. Approximately 15 cc of thermoplastic material may be utilized for injection within the spine.
- Cylindrical plug 74 may have a total volume of 21 cc with a diameter of 16 mm and a length of 10.45 cm to provide a compact unit.
- Needle 62 may be formed of a ceramic material and preferably includes an inner silver liner for receiving heater tape 63 which may be formed of a suitable material to provide an electrical resistance, for example.
- Needle 62 , heater 64 and housing 72 may comprise separate injection subassemblies removably connected to pressure chamber 76 by a suitable threaded connection thereby to provide disposable units if desired with leads 68 detached from heater 64 .
- the fluid for the hydraulic system for fluid cylinder 76 may be water or another innocuous fluid.
- Disk dilator assembly 100 having a cylindrical chamber 102 with an inert fluid such as saline therein and a piston 108 for pressurizing the fluid.
- Disk dilator assembly 100 is designed for detachable connection to pressure chamber 76 of the injector device of FIG. 6 for the supply of hydraulic fluid for acting against piston 108 .
- a detachable balloon dilator sleeve 106 extends about the extending end of needle 104 having lateral openings 107 .
- Piston 108 is effective to pressurize the fluid for flow through openings 107 for expansion of sleeve 106 as shown in broken lines in FIG. 7 .
- Dilator sleeve 106 upon injection of needle 104 in a disk of the spine is expanded for exerting an expanding force against the disk.
- FIGS. 8-10 are partially schematic, a further modification of an injection device and injection system is illustrated utilizing certain features shown in the embodiments of FIGS. 6 and 7 .
- the injection system shown generally in FIG. 8 includes an injection device generally indicated at 200 having an inner needle 202 and an outer concentric sheath or housing 204 forming an annulus 206 therebetween.
- An outer dilator sleeve 208 is mounted about sheath 204 . Openings 210 in the wall of sheath 204 permit fluid flow from annulus 206 through openings 210 for expansion of dilator sleeve 208 .
- Dilator sleeve 208 may be formed of an inert elastomeric material.
- annulus fibrosus 12 has a rupture 14 therein.
- Fluid such as a saline solution is first injected through annulus 206 and openings 210 to expand sleeve 208 in the void area of the annulus fibrosus 12 for forcing adjacent vertebrae apart.
- a gutta percha compound is injected through needle 202 to fill the area occupied by expandable sleeve 208 .
- the pressure at which the gutta percha is injected is greater than the pressure of the saline solution to force the saline solution from sleeve 208 to collapse sleeve 208 . If desired, the pressure of the saline solution may also be decreased.
- injection device 200 may be withdrawn from the annulus fibrosus 12 .
- Gutta percha is injected at pressures generally between about 10 psi and 150 psi dependent primarily on the size of the patient, such as infants requiring a very low psi and a relatively large person requiring a relatively high psi.
- the system for injection of the saline solution and gutta percha as shown in FIG. 8 includes a branch connection 212 extending from sheath 204 and connected to a flexible hose 214 .
- a cylindrical chamber 216 for saline or other suitable sanitary liquid fills chamber 216 , hose 112 , and annulus 206 .
- a piston 218 is mounted in chamber 216 .
- Hydraulic fluid in reservoir 220 of tank 222 is dispensed by operation of suitable foot pedals 223 and other suitable controls.
- the hydraulic fluid through hose 224 acts against piston 218 for pressurizing chamber 216 and forcing saline through openings 210 for expanding sleeve 208 against the surface defining the void area in annulus fibrosus 12 .
- Hollow needle 202 is connected to a flexible hose 228 extending to a gutta percha injection device 230 generally similar to injection device 60 shown in FIG. 6 .
- Gutta percha device 230 includes a cylindrical chamber or housing 232 having a plug 234 of gutta percha therein.
- a heater 236 is controlled by electrical control panel 238 having suitable electrical controls thereon.
- a hydraulic cap 240 mounted within the end of cylinder 232 has a pair of telescoping pistons 242 , 244 for engaging gutta percha plug 234 and forcing the heated gutta percha through the end of needle 202 into the annulus fibrosus 12 as shown in FIG.
- Expanding sleeve 208 is effective in defining the void area upon the expansion of sleeve 208 . Then, the gutta percha easily flows into the area formed by expanding sleeve 208 . Expanding sleeve 208 is also effective in forcing adjacent disks apart and the increased area or volume is also filled with gutta percha thereby making the gutta percha more effective in filling the void area of the annulus fibrosus 12 .
- the injection system shown in FIGS. 8-10 is generally a combination of the embodiments shown in FIGS. 6 and 7 .
- the housing and expandable sleeve shown in FIG. 7 may befitted about the hollow needle of FIG. 6 and saline for expanding the sleeve may be provided through a “y” adapter to the annulus between the needle and the housing.
- the system shown in FIGS. 8-10 comprises a combination of the features shown in the embodiment of FIGS. 6 and 7 .
- gutta percha or a gutta percha compound including at least about 15% of the compound by weight is the preferred thermoplastic material
- other types of thermoplastic material may be suitable if in a non-flowing state at body temperature (37 C) and in a flowing state when heated over at least about 50 C for injection from a needle of an injection device.
- Various other ingredients or elements may be added to the gutta percha compound in various percentages.
- specific injection devices have been illustrated for injection of the thermoplastic material, other types of injection devices for heating the thermoplastic material and for applying an axial force against the thermoplastic material for injection may be provided.
- thermoplastic material for example, various devices may be provided for heating the thermoplastic material prior to injection and for pressurizing the thermoplastic material for controlled flow of the thermoplastic material through an injection needle for injection.
Abstract
The method and apparatus as shown in FIGS. 8-10 in which a fluid expandable member (208) is positioned in concentric relation about a needle (202). The fluid expandable member (208) is expanded into the nucleus pulposus potential space bordered by the annulus fibrosus of an intervertebral disk. Then, thermoplastic material in a flowing state is injected by a needle (202) within the annulus fibrosus to collapse the fluid expandable member (208) and occupy the space formerly occupied by the fluid expandable member (208).
Description
This is a continuation-in-part of pending application Ser. No. 09/456,375 filed Dec. 8, 1999; which is a continuation-in-part of application Ser. No. 09/274,217 filed Mar. 23, 1999; which is a continuation-in-part of application Ser. No. 09/255,372 filed Feb. 22, 1999.
This invention relates to surgical methods generally, and is more specifically related to a method and apparatus for treating intervertebral disks of mammals.
The intervertebral disk is a disk with fibrosus bands occupying the space between two vertebrae. The anatomy of the disk provides a cushion to allow motion, limit motion and provide space, distancing the vertebra off the nerves and compressible tissue. Part of the vertebrae are bony blocks, which, when stacked one upon the other, form the anterior portion of the spine. The fibrosus band includes an outer annulus fibrosus which surrounds an inner nucleus pulposus. Annulus fibrosus, as referred to herein, is the marginal or peripheral portion of an intervertebral disk. Intervertebral disks are prone to injury. Due to the low blood supply to this area, intervertebral disks are slow to heal, and may not materially heal. When the annulus fibrosus is torn, or punctured, the nucleus pulposus can leak or migrate from the annulus fibrosus. The nucleus pulposus is a substance of jelly like consistency found in the center of an intervertebral disk and flows from the associated annulus fibrosus when the annulus fibrosus is ruptured or prolapsed.
The effect of a ruptured or prolapsed annulus fibrosus may result in spasm, and neurological compromise, such as the compressed nerve and other compressible soft tissues, i.e. arteries, veins. Degeneration of the condition may increase over time, resulting in chronic and debilitating pain. The condition is usually disabling.
Suppressive measures include steroidal injection, removal of the nucleus pulposus, and fusion either by donor bone, coral or by metal bracing. If disk removal is performed, a healthy part of the disk is often taken, eradicating the function of the joint, and accelerating the degeneration of adjacent segments of the body, as the body attempts to stabilize. This approach frequently leaves the patient immunologically and structurally compromised if not permanently disabled.
Isolated treatment to only the damaged structures employing the most non-invasive procedure possible is preferred. This approach allows as much of the healthy tissue as possible to remain, and to retain normal neurological function. While the offending material can be removed, the material must be replaced with a material which will perform the function formerly performed by the material removed. A need exists for a process which limits the material removed from the intervertebral disk, and which replaces the material so removed with a composition that is physiologically acceptable to the human body, and which allows the intervertebral disk to retain motion and characteristics of normal joint function, including cushioning the joint as compression is introduced from the stacking of the vertebrae. The thermoplastic material must be pliable in its application, and non-flowing after replacement.
In addition, many patients suffer from scoliosis or lateral curvature of the spine. The most common remedy at the present time is the fusion normally by donor bone or metal bracing which oftentimes is not successful or only partially successful. Pain normally accompanies scoliosis and pain suppressants may result in an undesirable chemical dependency in some instances. A need exists to correct the abnormal curvature of the spine without utilizing fusion techniques applied to the spine.
The present invention is particularly directed to a process for treating the spine including the injection of a thermoplastic material heated to a predetermined temperature for injection into the nucleus pulposus in a flowing state where it cools and sets at body temperature into a non-flowing state. Inorganic materials have been shown to penetrate the endplates of the associated vertebrae. A thermoplastic or thermoplastic polymer material is any plastic or organic material that softens when heated and hardens when cooled. The thermoplastic material prior to injection is heated to a temperature sufficient for the material to flow under pressure into the nucleus pulposus and, after it sets into a non-flowing state at body temperature, the material retains sufficient resilience to provide desired cushioning of the spine.
A thermoplastic material which has been found to be highly satisfactory is gutta percha which is normally combined with other elements or ingredients in a suitable gutta percha compound. Gutta percha is a linear crystalline polymer which melts at a predetermined temperature a random but distinct change in structure results. Normal body temperature is 37 C and a suitable thermoplastic material hardens into a non-flowing state at a temperature range between about 35 C and 42 C (the degree symbol for temperature is omitted in all references herein to a specific temperature). A crystalline phase appears in two forms; an alpha phase and a beta phase. The alpha form is the material that comes from the natural tree product. The processed form is the beta form. When heated, gutta percha undergoes phase transitions. When there is a temperature increase, there is a transition from beta phase to alpha phase at about 46 C. The gutta percha changes to an amorphous phase about 54 C to 60 C. When cooled very slowly, about 1 C per hour, the gutta percha crystallizes to the alpha phase. Normal cooling returns the gutta percha to the beta phase. Gutta percha softens at a temperature above about 64 C. A suitable gutta percha compound is dental gutta percha which contains by weight only about 20% gutta percha with zinc oxide comprising about 60% to 75% of the material. The remaining 5% to 10% consists of various resins, waxes, and metal sulfates. The percentages listed are directed to an optimum gutta percha compound. The preferred percentage of gutta percha is in the range of 15% to 40%. Zinc oxide and metals in the gutta percha compound are desirable for imaging such as X-rays while resins and waxes are desirable for obtaining an adequate flow of the thermoplastic material. Gutta percha provides the desired resiliency at body temperature and is at least about 15% of the compound. Zinc oxide also provides an anti-inflammatory property. In some instances, a mineral trioxide aggregate may be added to the gutta percha compound.
An injection device, such as an injection gun, is utilized for heating and injecting the thermoplastic material under a predetermined pressure within the spine. The injection device may utilize a silver needle, encased in ceramics, of about 20 to 30 centimeters in length with a diameter as high as 1 centimeter. The size of the needle may depend on such factors as the amount of thermoplastic material to be injected, the temperature of the thermoplastic being injected, and the axial pressure applied by the injection device, such as a piston or plunger, to the thermoplastic material to force the heated material from the end of the needle into the spine. The thermoplastic material is physiologically acceptable to the human body.
When the thermoplastic material is utilized to treat a ruptured annulus fibrosus, the nucleus pulposus is removed and the material removed is replaced by the heated thermoplastic material which sets at body temperature and provides sufficient resilience after setting to permit adequate motion and cushioning of the vertebrae. The cushioning effect of the gutta percha compound provides a semimobile disk as a buffer to a fusion to reduce the possibility of sequential iatrogenic disk degeneration. The thermoplastic material is injected within the potential nucleus pulposus space bordered by the annulus fibrosus to replace the removed nucleus pulposus by a needle of the injection device.
When the thermoplastic material is injected within the spine to reduce a scoliosis, the material is sequentially injected by a needle of the injection device into the annulus fibrosus or interannular at the apex and adjacent joints of the concavity of the scoliosis. Such an injection tends to straighten the curvature of the spine is a wedge-like action.
An embodiment illustrated in FIGS. 8-10 includes an injection system in which an expandable member is first expanded into the annulus fibrosus of a disk and then a thermoplastic material is injected into the annulus fibrosus to collapse the expandable member and occupy the space formerly occupied by the expandable member. The expandable member is mounted in concentric relation about the needle.
It is an object of the present invention to provide a method of injecting a thermoplastic material into the annulus fibrosus of a spine.
A further object of the present invention is to provide such a method in which the thermoplastic material is heated to a predetermined temperature for flow into the annulus fibrosus and hardens when it cools from body temperature into a non-flowing state to form a resilient support for cushioning between vertebrae.
Another object of the invention is to provide a method to treat a ruptured annulus fibrosus of a spine by removal of the nucleus pulposus and injection of a thermoplastic material into the annulus fibrosus to replace the nucleus pulposus.
An additional object is to provide an apparatus to treat an annulus fibrosus of a spine in which an injection device heats the thermoplastic material for flow into the annulus fibrosus and another injection member is effective for expanding an expandable member in the annulus fibrosus.
Other objects, features, and advantages of the invention will be apparent from the following specification and drawings.
Referring now to the drawings for a better understanding of the invention, and more particularly to the embodiment shown in FIGS. 1-4 , a portion of a spine is shown generally pictorially in FIG. 1 including an intervertebral disk 10 adjacent a vertebra 11. Disk 10 has an annulus fibrosus 12 which has ruptured at 14 resulting in a leakage or migration of nucleus pulposus 16 from the annulus fibrosus 12. In this example a sacral nerve is shown at 18 extending from the cauda eqina 19 and the migrating or flowing nucleus pulposus 16 may result in a compression of nerve 18 with recognition that the techniques will be adapted specific to facilitate delivery to different levels of the spine.
It is desired to remove nucleus pulposus 16 which flows at body temperature and replace it with a thermoplastic material which does not flow at body temperature (37 C). FIGS. 1-4 illustrate the removal of the nucleus pulposus 16 and replacement with a thermoplastic material. For this purpose the rupture or prolapse of the annulus fibrosus 12 is first identified and isolated. This identification and isolation is by means such as X-ray, MRI or other diagnostic imaging procedures which are diagnostically acceptable. After the area of rupture or prolapse is identified and isolated the site is surgically accessed. Since it is a goal of the invention to minimize trauma associated with the procedure, it is preferred to access the site through an arthroscopic procedure, or technology that involves minimal invasion and offense to healthy areas of the annulus fibrosus 12, while damaged parts of the intervertebral disk are removed. Current technology allows for surgical removal of nucleus pulposus 16 by irrigation and suction.
The nucleus pulposus 16 removed is replaced with a thermoplastic material which is physiologically acceptable to the human body and flows when injected but hardens at body temperature into a non-flowing resilient material. The thermoplastic material is first heated by a suitable injection device having an injection needle to a predetermined temperature for flow under pressure from the needle into the annulus fibrosus 12 wherein the nucleus pulposus 16 has been removed. A thermoplastic material which has been found to be highly satisfactory is gutta percha or a gutta percha compound. Gutta percha is a geometric isomer of natural rubber. A substance such as mineral trioxide aggregate and other anti-inflammatory elements may be added to the gutta percha to facilitate the binding properties and to facilitate healing of the affected area. Dental gutta percha which may be utilized contains approximately 20% gutta percha, with zinc oxide comprising 60% to 75% of the material. The remaining 5% to 10% consists of various resins, waxes, metal sulfates for radioopacity, and coloration. When cold, gutta percha is relatively inelastic, but as it warms it becomes moldable. At a high temperature gutta percha will flow under pressure to permit injection from an injection needle into the annulus fibrosus 12.
Referring particularly to FIG. 3 , injection of thermoplastic material 20 within the annulus fibrosus 12 by an injection device or gun illustrated schematically at 22 is shown. Injection gun 22 has a body 24 with a removable plunger 26 adapted to receive a cylindrical plug of the thermoplastic material 20. A heater 28 is provided to heat the thermoplastic material 20 and a heater control unit 30 having an adjustable temperature control knob 32 is provided with a temperature readout at 34. Electrical leads 36 extend to heater 28. An injection needle 38 preferably formed of silver extends from body 24 and has a ceramic sheath 40 about a portion of needle 38. A hand operated trigger 42 may be activated for forcing thermoplastic material 20 from the end of needle 38 upon heating of the thermoplastic material 20 to a predetermined temperature. To assist trigger 42 in exerting an axial force against the plug of thermoplastic material 20 in gun 22, a foot operated hydraulic pump may be provided at 44 to supply fluid through lines 46, 48 to a hydraulic cylinder 45. A pressure readout is provided at 49. A suitable piston 51 may exert an axial force against the thermoplastic material 20. A hydraulic system is effective in providing an axial injection force that may be easily regulated and controlled by personnel performing the procedure. A suitable injection device designated as a Obtura II Heated Gutta Percha System may be purchased from Obtura of Fenton, Mo.
The optimum temperature is about 185 C within an optimum range between about 150 C and 200 C.
It is desirable for the thermoplastic material to have a viscosity and temperature suitable for injection and flow into the space previously occupied by the annulus fibrosus 12. After injection of the thermoplastic material 20 into the annulus fibrosus 12, the material flows to fill the entire void area of the annulus fibrosus possibly including the ruptured area 14. The thermoplastic material 20 cools relatively rapidly and, for example, reaches body temperature about its outer surface very quickly if injected at a temperature of about 185 C and then cools internally to body temperature in several minutes depending primarily on the thickness and surface area of the thermoplastic material. The thermoplastic material 20 tends to set at about 42 C and is not in a flowing state lower than about 42 C. Upon reaching the body temperature of 37 C, the thermoplastic material is set. At normal human body temperature the thermoplastic material is no longer moldable and is not flowing or migrating. Thus, the thermoplastic material 20 remains within the annulus fibrosus 16 and repairs the rupture 14 of the annulus fibrosus. It is, however, necessary that the thermoplastic material retain sufficient resilience in order to provide in a satisfactory manner the functions of allowing motion and adequately cushioning of the joint between associated vertebrae. If necessary, the thermoplastic material 20 may be subsequently removed from the annulus fibrosus 12 by surgical, physical, enzymatic, and/or chemical means.
Referring now to FIG. 5 , a spinal column is shown generally at 50 having vertebrae 52 with intervertebral disks 54 positioned therebetween. FIG. 5 shows spine 50 with scoliosis or abnormal curvature of the spine. The abnormal curvature of spine 50 provides a concave curvature as shown in FIG. 5 at which disks 34 are positioned. To correct or remedy the abnormal curvature of spine 50, a thermoplastic material 20 may be injected at intervertebral disks 54 progressively to reduce the concavity for flow into the associated annulus fibrosus as in the procedure set forth in FIGS. 1-4 . The amount of the injected material will vary with the greatest amount of injected material at the greatest deflection and the least amount at the disks closest to the terminal ends of the abnormal curvature. However, the nucleus pulposus is not removed from the spine 50. The injected material provides a force acting as a wedge to reduce the concavity of the scoliosis. Gutta percha as set forth in the embodiment of FIGS. 1-4 is the preferred material for the thermoplastic material to be injected due to the characteristics that allow gutta percha to be used in other joints of the body.
Embodiment of FIG. 6
Referring to FIG. 6 , a modified injection device is shown generally at 60 including an injection needle 62, a heater 64 receiving an inner end portion of needle 62, and an electrical heater control element 66 having leads 68 extending to heater 64. A suitable control knob 70 controls the temperature and a readout panel indicates the temperature which, for example, may be about 185 C.
A generally cylindrical chamber or housing 72 adjacent heater 64 is provided to receive a cylindrical plug 74 of the thermoplastic material. Housing 72 has open ends to receive removable threaded end plugs 73 for maintaining plug 74 in a sealed relation. One plug 73 is shown removed from housing 72 in FIG. 6 . Plug 74 may also be covered with a suitable cover which may be manually removed for use, either in combination with or without end plugs 73. Housing 72 upon removal of plugs 73 may be connected to heater 64 at one end and connected to a fluid pressure chamber 76 at an opposed end. A suitable fluid from a reservoir 78 having a foot operated pedal 80 and a vent 82 is supplied through line 84 to pressure chamber 76. Concentric pistons 86 and 88 responsive to pressurized fluid in chamber 76 are provided to engage the end of thermoplastic plug 74 to urge plug 74 into heater 64 for injection from needle 62 under a predetermined pressure. A pressure gauge 90 is provided to indicate the fluid pressure applied against thermoplastic plug 74. In some instances, housing 72 may be disposable with heater 64 being of an increased length to receive the entire length of plug 74.
It may be desirable in some instances to provide a heater tape 63 in needle 62 for heating of the projecting needle 62. Needle 62 may be formed of a ceramic material and preferably includes an inner silver liner for receiving heater tape 63 which may be formed of a suitable material to provide an electrical resistance, for example. Needle 62, heater 64 and housing 72 may comprise separate injection subassemblies removably connected to pressure chamber 76 by a suitable threaded connection thereby to provide disposable units if desired with leads 68 detached from heater 64. The fluid for the hydraulic system for fluid cylinder 76 may be water or another innocuous fluid.
Embodiment of FIG. 7
Also shown in FIG. 7 as an attachment is a disk dilator assembly generally indicated at 100 having a cylindrical chamber 102 with an inert fluid such as saline therein and a piston 108 for pressurizing the fluid. Disk dilator assembly 100 is designed for detachable connection to pressure chamber 76 of the injector device of FIG. 6 for the supply of hydraulic fluid for acting against piston 108. A detachable balloon dilator sleeve 106 extends about the extending end of needle 104 having lateral openings 107. Piston 108 is effective to pressurize the fluid for flow through openings 107 for expansion of sleeve 106 as shown in broken lines in FIG. 7 . Dilator sleeve 106 upon injection of needle 104 in a disk of the spine is expanded for exerting an expanding force against the disk.
Embodiment of FIGS. 8-10
Referring now to FIGS. 8-10 which are partially schematic, a further modification of an injection device and injection system is illustrated utilizing certain features shown in the embodiments of FIGS. 6 and 7 . The injection system shown generally in FIG. 8 includes an injection device generally indicated at 200 having an inner needle 202 and an outer concentric sheath or housing 204 forming an annulus 206 therebetween. An outer dilator sleeve 208 is mounted about sheath 204. Openings 210 in the wall of sheath 204 permit fluid flow from annulus 206 through openings 210 for expansion of dilator sleeve 208. Dilator sleeve 208 may be formed of an inert elastomeric material.
As shown in FIG. 10 , annulus fibrosus 12 has a rupture 14 therein. Fluid such as a saline solution is first injected through annulus 206 and openings 210 to expand sleeve 208 in the void area of the annulus fibrosus 12 for forcing adjacent vertebrae apart. After the vertebrae have been forced apart and expandable sleeve 208 fits tightly against the surface defining the void area, a gutta percha compound is injected through needle 202 to fill the area occupied by expandable sleeve 208. The pressure at which the gutta percha is injected is greater than the pressure of the saline solution to force the saline solution from sleeve 208 to collapse sleeve 208. If desired, the pressure of the saline solution may also be decreased.
After insertion of the gutta percha compound, injection device 200 may be withdrawn from the annulus fibrosus 12. Gutta percha is injected at pressures generally between about 10 psi and 150 psi dependent primarily on the size of the patient, such as infants requiring a very low psi and a relatively large person requiring a relatively high psi.
The system for injection of the saline solution and gutta percha as shown in FIG. 8 includes a branch connection 212 extending from sheath 204 and connected to a flexible hose 214. A cylindrical chamber 216 for saline or other suitable sanitary liquid fills chamber 216, hose 112, and annulus 206. A piston 218 is mounted in chamber 216. Hydraulic fluid in reservoir 220 of tank 222 is dispensed by operation of suitable foot pedals 223 and other suitable controls. The hydraulic fluid through hose 224 acts against piston 218 for pressurizing chamber 216 and forcing saline through openings 210 for expanding sleeve 208 against the surface defining the void area in annulus fibrosus 12.
The injection system shown in FIGS. 8-10 is generally a combination of the embodiments shown in FIGS. 6 and 7 . The housing and expandable sleeve shown in FIG. 7 may befitted about the hollow needle of FIG. 6 and saline for expanding the sleeve may be provided through a “y” adapter to the annulus between the needle and the housing. Thus, the system shown in FIGS. 8-10 comprises a combination of the features shown in the embodiment of FIGS. 6 and 7 .
While gutta percha or a gutta percha compound including at least about 15% of the compound by weight is the preferred thermoplastic material, it is understood that other types of thermoplastic material may be suitable if in a non-flowing state at body temperature (37 C) and in a flowing state when heated over at least about 50 C for injection from a needle of an injection device. Various other ingredients or elements may be added to the gutta percha compound in various percentages. Further, while specific injection devices have been illustrated for injection of the thermoplastic material, other types of injection devices for heating the thermoplastic material and for applying an axial force against the thermoplastic material for injection may be provided. For example, various devices may be provided for heating the thermoplastic material prior to injection and for pressurizing the thermoplastic material for controlled flow of the thermoplastic material through an injection needle for injection. Thus, while preferred embodiments of the present invention have been illustrated in detail, it is apparent that modifications and adaptations of the preferred embodiments will occur to those skilled in the art. However, it is to be expressly understood that such modifications and adaptations are within the spirit and scope of the present invention as set forth in the following claims.
Claims (31)
1. A method for treating an intervertebral disk of the spine, comprising:
selecting an intervertebral disk of the spine;
providing an injection device having an expandable member about an injection needle for a thermoplastic material;
injecting said expandable member and said needle into the annulus fibrosus of said selected disk;
expanding said expandable member into the annulus fibrosus of said selected disk; and
then injecting a thermoplastic material from said needle into said annulus fibrosus of said selected disk to occupy the space defined by said expandable member.
2. The A method defined in claim 1 , further for treating an intervertebral disk of the spine, comprising:
selecting an intervertebral disk of the spine;
obtaining an injection device having an expandable member about an injection needle for injecting a thermoplastic material;
heating the thermoplastic material to a flowable state;
inserting said expandable member and said needle into the annulus fibrosus of said intervertebral disk;
expanding said expandable member into the annulus fibrosus of said intervertebral disk to occupy a space; and
injecting a thermoplastic material from said needle into said annulus fibrosus of said selected disk to occupy the space defined by said expandable member;
injectingwherein said thermoplastic material is injected from said needle under a pressure greater than the pressure for expanding said expandable member to effect collapsing of said expandable member with said thermoplastic material occupying the space formerly occupied by said expandable member.
3. The method defined in for treating an intervertebral disk of the spine of claim 1 2, further comprising:
removing nucleus pulposus from said annulus fibrosus prior to insertion of said expandable member and said needle into said annulus fibrosus.
4. An injection device fortreating an intervertebral disk of the spine of a patient, comprising:
a hollow needle for the injection of a thermoplastic material into the annulus fibrosus of a disk from the projecting end of the needle;
an expandable member about said hollow needle for expanding into the annulus fibrosus of the disk prior to injection of the thermoplastic material in the annulus fibrosus; and
a heater for heating said thermoplastic material to effect flowing thereof prior to injection into the annulus fibrosus.
5. An injection system for treating an intervertebral disk of a spines comprising:
an injection device including a hollow needle for injecting a thermoplastic material within the annulus fibrosus of a disk, and an expandable member about said hollow needle to form an annulus between said needle and said expandable member;
a fluid pressure device to provide pressurized fluid in said annulus for expanding said expandable member into said annulus fibrosus;
a heating device for heating the thermoplastic material; and
a force applying device for forcing said thermoplastic material from said needle in a flowing state.
6. The An injection system as defined in claim 5 for treating an intervertebral disk of a spine, further comprising:
an injection device including a hollow needle having a purgeable volume of at least 5 cubic centimeters for injecting a thermoplastic material within the annulus fibrosus of a disk, and an expandable member about said hollow needle to form an annulus between said needle and said expandable member;
a heating device for heating the thermoplastic material;
a force applying device for forcing said thermoplastic material from said needle in a flowing state; and
a concentric sleeve about said needle for forming said an annulus between said sleeve and said needle, said expandable member mounted about said sleeve.
7. The injection system as defined in of claim 6 , wherein said sleeve has a plurality of openings therein for communicating fluid to said expandable member for expanding said expandable member within said annulus fibrosus.
8. The injection system as defined in of claim 5 wherein said fluid pressure device includes a pressurized liquid, and a hydraulically actuated piston for pressurizing said liquid 6, further comprising:
a fluid pressure device to provide pressurized fluid in said annulus for expanding said expandable member into said annulus fibrosus.
9. An injection gun for injecting a thermoplastic material between a joint of a patient, comprising:
a chamber for receiving said thermoplastic material in a non-flowing state;
a heater adjacent said chamber for heating said thermoplastic material to a flowing state;
a hollow injection needle operatively connected to said heater to receive the flowing thermoplastic material from said heater for injection between the joint of the patient; and
a hydraulic force applying assembly to apply hydraulic force against said thermoplastic material to force the thermoplastic material when heated to a flowing state from said needle.
10. The injection gun as defined in device of claim 9 30, further comprising:
a plug of said thermoplastic material within said chamber, said hydraulic force applying assembly including a hydraulically actuated piston adjacent said plug for forcing said thermoplastic material from said needle after said thermoplastic material is heated to a flowing state.
11. The injection gun as defined in device of claim 10 28, further comprising:
a fluid pressure source for said hydraulically actuated piston; and
a foot operated pedal associated with said fluid pressure source to provide a selected fluid pressure to said piston and heated thermoplastic material.
12. The injection gun as defined in device of claim 9 31, further comprising:
an expandable member about said hollow needle to form an annulus between said needle and said expandable member; and
a fluid pressure device to provide pressurized fluid in said annulus for expanding said expandable member a distraction element for insertion into the annulus fibrosus to create a void.
13. The injection gun as defined in device of claim 12 , further comprising:
a substantially rigid concentric sleeve about said hollow needle for forming an annulus between said sleeve and said needle;
an expandable member mounted about said sleeve; and
a fluid pressurization device to provide pressurization fluid in said annulus for expanding said expandable member, said expandable member being in fluid communication with said annulus wherein said distraction element comprises an expandable member about said hollow needle to form an annulus between said needle and said expandable member.
14. The injection gun as defined in device of claim 9 30, wherein said thermoplastic material comprises gutta percha.
15. The injection gun as defined in device of claim 9 30, wherein said thermoplastic material comprises a gutta percha compound in which gutta percha is between 15% and 40% by weight of the compound.
16. The injection gun as defined in device of claim 9 30, wherein said heater heating element heats said thermoplastic material compound for flowing at a temperature between about 150 C and 200 C.
17. The injection gun as defined in claim 9 , further comprising:
a generally cylindrical housing forming the chamber to receive a plug of thermoplastic material and having opposed open ends, said cylindrical housing being removable from said injection needle; and
a threaded end plug for each of said open ends when said housing is removed from said injection needle for sealing of said thermoplastic material therein.
18. The injection device as defined in of claim 17 31, wherein said heater heating element is removably mounted adjacent one of said open ends upon removal of an associated end plug.
19. The method for treating an intervertebral disk of the spine of claim 3, wherein injecting a thermoplastic material from said needle into said annulus fibrosus of said selected disk to occupy a space comprises injecting a thermoplastic material from said needle into said annulus fibrosus of said selected disk to occupy a space defined by the removal of said nucleus pulposus.
20. The injection system of claim 8, wherein said fluid pressure device includes a pressurized liquid and a hydraulically actuated piston for pressurizing said liquid.
21. The injection device of claim 30, wherein said injection device comprises an injection gun.
22. The injection device of claim 30, wherein said heating element comprises a heater.
23. The injection device of claim 30, wherein said heating element is situated adjacent said chamber.
24. The injection device of claim 30, wherein said hollow injection needle is operatively connected to said heating element to receive said thermoplastic material from said heating element.
25. The injection device of claim 30, wherein said force applying assembly comprises a hydraulic force applying assembly.
26. The injection device of claim 30, wherein said force applying assembly comprises a mechanical force applying assembly.
27. The injection device of claim 26, wherein said mechanical force applying assembly comprises a hand operated trigger.
28. The injection device of claim 10, wherein said force applying assembly comprises a hydraulic force applying assembly for hydraulically actuating said piston.
29. The injection device of claim 13, further comprising:
a fluid pressure device to provide pressurized fluid in said annulus for expanding said expandable member.
30. An injection device for injecting a thermoplastic material into a joint of a patient, comprising:
a chamber for receiving said thermoplastic material in a non-flowing state;
a heating element for heating said thermoplastic material to a flowing state;
a hollow injection needle having a purgeable volume of at least 5 cubic centimeters to receive the flowing thermoplastic material for injection into said joint; and
a force applying assembly to apply force against said thermoplastic material to force the thermoplastic material from said needle when heated to a flowing state; and
a distraction element for insertion into the annulus fibrosus to create a void, wherein the distraction element comprises:
a substantially rigid concentric sleeve about said hollow needle for forming an annulus between said sleeve and said needle;
an expandable member mounted about said sleeve; and
a fluid pressurization device to provide pressurization fluid in said annulus for expanding said expandable member, said expandable member being in fluid communication with said annulus.
31. An injection device for injecting a thermoplastic material into a joint of a patient, comprising:
a chamber for receiving said thermoplastic material in a non-flowing state;
a heating element for heating said thermoplastic material to a flowing state;
a hollow injection needle having a purgeable volume of at least 5 cubic centimeters to receive the flowing thermoplastic material for injection into said joint; and
a force applying assembly to apply force against said thermoplastic material to force the thermoplastic material from said needle when heated to a flowing state; and
wherein said chamber for receiving said thermoplastic material comprises:
a generally cylindrical housing forming the chamber to receive a plug of thermoplastic material and having opposed open ends, said cylindrical housing being removable from said injection needle; and
a threaded end plug for each of said open ends when said housing is removed from said injection needle for sealing of said thermoplastic material therein.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/923,564 USRE43434E1 (en) | 1999-02-22 | 2004-08-20 | Method and apparatus for treating intervertebral disks |
Applications Claiming Priority (5)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US09/255,372 US6206921B1 (en) | 1999-02-22 | 1999-02-22 | Method of replacing nucleus pulposus and repairing the intervertebral disk |
US09/274,217 US6183518B1 (en) | 1999-02-22 | 1999-03-23 | Method of replacing nucleus pulposus and repairing the intervertebral disk |
US09/456,375 US6264659B1 (en) | 1999-02-22 | 1999-12-08 | Method of treating an intervertebral disk |
US09/569,807 US6436143B1 (en) | 1999-02-22 | 2000-05-12 | Method and apparatus for treating intervertebral disks |
US10/923,564 USRE43434E1 (en) | 1999-02-22 | 2004-08-20 | Method and apparatus for treating intervertebral disks |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US09/569,807 Reissue US6436143B1 (en) | 1999-02-22 | 2000-05-12 | Method and apparatus for treating intervertebral disks |
Publications (1)
Publication Number | Publication Date |
---|---|
USRE43434E1 true USRE43434E1 (en) | 2012-05-29 |
Family
ID=24276937
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US09/569,807 Ceased US6436143B1 (en) | 1999-02-22 | 2000-05-12 | Method and apparatus for treating intervertebral disks |
US10/923,564 Expired - Fee Related USRE43434E1 (en) | 1999-02-22 | 2004-08-20 | Method and apparatus for treating intervertebral disks |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US09/569,807 Ceased US6436143B1 (en) | 1999-02-22 | 2000-05-12 | Method and apparatus for treating intervertebral disks |
Country Status (5)
Country | Link |
---|---|
US (2) | US6436143B1 (en) |
EP (1) | EP1289454A1 (en) |
AU (2) | AU2001259523B2 (en) |
CA (1) | CA2412605A1 (en) |
WO (1) | WO2001087195A1 (en) |
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20150335369A1 (en) * | 2005-08-22 | 2015-11-26 | Dfine, Inc. | Bone treatment systems and methods |
Families Citing this family (216)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6436143B1 (en) | 1999-02-22 | 2002-08-20 | Anthony C. Ross | Method and apparatus for treating intervertebral disks |
US20060247665A1 (en) * | 1999-05-28 | 2006-11-02 | Ferree Bret A | Methods and apparatus for treating disc herniation and preventing the extrusion of interbody bone graft |
US20070038231A1 (en) | 1999-05-28 | 2007-02-15 | Ferree Bret A | Methods and apparatus for treating disc herniation and preventing the extrusion of interbody bone graft |
US7273497B2 (en) | 1999-05-28 | 2007-09-25 | Anova Corp. | Methods for treating a defect in the annulus fibrosis |
WO2009033100A1 (en) | 2007-09-07 | 2009-03-12 | Intrinsic Therapeutics, Inc. | Bone anchoring systems |
US6821276B2 (en) * | 1999-08-18 | 2004-11-23 | Intrinsic Therapeutics, Inc. | Intervertebral diagnostic and manipulation device |
US7553329B2 (en) | 1999-08-18 | 2009-06-30 | Intrinsic Therapeutics, Inc. | Stabilized intervertebral disc barrier |
US8323341B2 (en) | 2007-09-07 | 2012-12-04 | Intrinsic Therapeutics, Inc. | Impaction grafting for vertebral fusion |
CA2425951C (en) | 1999-08-18 | 2008-09-16 | Intrinsic Therapeutics, Inc. | Devices and method for nucleus pulposus augmentation and retention |
US7998213B2 (en) | 1999-08-18 | 2011-08-16 | Intrinsic Therapeutics, Inc. | Intervertebral disc herniation repair |
US7972337B2 (en) | 2005-12-28 | 2011-07-05 | Intrinsic Therapeutics, Inc. | Devices and methods for bone anchoring |
WO2004100841A1 (en) | 1999-08-18 | 2004-11-25 | Intrinsic Therapeutics, Inc. | Devices and method for augmenting a vertebral disc nucleus |
US7220281B2 (en) | 1999-08-18 | 2007-05-22 | Intrinsic Therapeutics, Inc. | Implant for reinforcing and annulus fibrosis |
US7717961B2 (en) | 1999-08-18 | 2010-05-18 | Intrinsic Therapeutics, Inc. | Apparatus delivery in an intervertebral disc |
US7935147B2 (en) | 1999-10-20 | 2011-05-03 | Anulex Technologies, Inc. | Method and apparatus for enhanced delivery of treatment device to the intervertebral disc annulus |
US7052516B2 (en) | 1999-10-20 | 2006-05-30 | Anulex Technologies, Inc. | Spinal disc annulus reconstruction method and deformable spinal disc annulus stent |
US7951201B2 (en) | 1999-10-20 | 2011-05-31 | Anulex Technologies, Inc. | Method and apparatus for the treatment of the intervertebral disc annulus |
US8632590B2 (en) | 1999-10-20 | 2014-01-21 | Anulex Technologies, Inc. | Apparatus and methods for the treatment of the intervertebral disc |
US7004970B2 (en) | 1999-10-20 | 2006-02-28 | Anulex Technologies, Inc. | Methods and devices for spinal disc annulus reconstruction and repair |
US6592625B2 (en) | 1999-10-20 | 2003-07-15 | Anulex Technologies, Inc. | Spinal disc annulus reconstruction method and spinal disc annulus stent |
US8128698B2 (en) | 1999-10-20 | 2012-03-06 | Anulex Technologies, Inc. | Method and apparatus for the treatment of the intervertebral disc annulus |
US7615076B2 (en) | 1999-10-20 | 2009-11-10 | Anulex Technologies, Inc. | Method and apparatus for the treatment of the intervertebral disc annulus |
CA2685349C (en) | 1999-11-15 | 2013-09-17 | Bio Syntech Canada Inc. | Temperature-controlled and ph-dependant self-gelling biopolymeric aqueous solution |
US7641657B2 (en) | 2003-06-10 | 2010-01-05 | Trans1, Inc. | Method and apparatus for providing posterior or anterior trans-sacral access to spinal vertebrae |
US6790210B1 (en) | 2000-02-16 | 2004-09-14 | Trans1, Inc. | Methods and apparatus for forming curved axial bores through spinal vertebrae |
US6899716B2 (en) * | 2000-02-16 | 2005-05-31 | Trans1, Inc. | Method and apparatus for spinal augmentation |
ES2308014T5 (en) | 2000-02-16 | 2012-03-16 | Trans1, Inc. | Apparatus for distraction and spinal fusion |
US7547324B2 (en) | 2000-02-16 | 2009-06-16 | Trans1, Inc. | Spinal mobility preservation apparatus having an expandable membrane |
US6575979B1 (en) * | 2000-02-16 | 2003-06-10 | Axiamed, Inc. | Method and apparatus for providing posterior or anterior trans-sacral access to spinal vertebrae |
US6558390B2 (en) | 2000-02-16 | 2003-05-06 | Axiamed, Inc. | Methods and apparatus for performing therapeutic procedures in the spine |
US7727263B2 (en) | 2000-02-16 | 2010-06-01 | Trans1, Inc. | Articulating spinal implant |
US6740093B2 (en) | 2000-02-28 | 2004-05-25 | Stephen Hochschuler | Method and apparatus for treating a vertebral body |
US6805695B2 (en) | 2000-04-04 | 2004-10-19 | Spinalabs, Llc | Devices and methods for annular repair of intervertebral discs |
WO2001076514A2 (en) * | 2000-04-05 | 2001-10-18 | Kyphon Inc. | Methods and devices for treating fractured and/or diseased bone |
IL153490A0 (en) | 2000-06-29 | 2003-07-06 | Biosyntech Canada Inc | Composition and method for the repair and regeneration of cartilage and other tissues |
DE10032220A1 (en) * | 2000-07-03 | 2002-01-24 | Sanatis Gmbh | Magnesium ammonium phosphate cements, their manufacture and use |
AU1538702A (en) * | 2000-10-24 | 2002-05-06 | Cryolife Inc | In situ bioprosthetic filler and methods, particularly for the in situ formationof vertebral disc bioprosthetics |
DE60207902T2 (en) * | 2001-01-30 | 2006-06-14 | Nissan Chemical Ind Ltd | Isocyanurate compound and process for its preparation |
US8002775B2 (en) * | 2001-10-24 | 2011-08-23 | Warsaw Orthopedic, Inc. | Methods and instruments for treating pseudoarthrosis |
EP1448089A4 (en) * | 2001-11-01 | 2008-06-04 | Spine Wave Inc | Devices and methods for the restoration of a spinal disc |
US20030195630A1 (en) * | 2002-04-10 | 2003-10-16 | Ferree Bret A. | Disc augmentation using materials that expand in situ |
US7273523B2 (en) | 2002-06-07 | 2007-09-25 | Kyphon Inc. | Strontium-apatite-cement-preparations, cements formed therefrom, and uses thereof |
US6793678B2 (en) | 2002-06-27 | 2004-09-21 | Depuy Acromed, Inc. | Prosthetic intervertebral motion disc having dampening |
US6932843B2 (en) | 2002-09-25 | 2005-08-23 | Medicinelodge, Inc. | Apparatus and method for the in-situ formation of a structural prosthesis |
NZ539779A (en) * | 2002-11-05 | 2009-01-31 | Spineology Inc | A semi-biological intervertebral disc replacement system created by inserting tissue promoting material into a cavity in the disc |
US20040186471A1 (en) * | 2002-12-07 | 2004-09-23 | Sdgi Holdings, Inc. | Method and apparatus for intervertebral disc expansion |
US20040122438A1 (en) * | 2002-12-23 | 2004-06-24 | Boston Scientific Corporation | Flex-tight interlocking connection tubing for delivery of bone cements/biomaterials for vertebroplasty |
CA2513680A1 (en) * | 2003-01-17 | 2004-08-05 | Psinergi Corporation | Artificial nucleus pulposus and method of injecting same |
KR20050092795A (en) * | 2003-01-31 | 2005-09-22 | 짐머 오르쏘바이올로직스 인코포레이티드 | Hydrogel compositions comprisign nucleus pulposus tissue |
WO2004080357A1 (en) | 2003-03-14 | 2004-09-23 | Ferreyro Irigoyen Roque Humber | Hydraulic device for the injection of bone cement in percutaneous vertebroplasty |
US8066713B2 (en) | 2003-03-31 | 2011-11-29 | Depuy Spine, Inc. | Remotely-activated vertebroplasty injection device |
US8415407B2 (en) | 2004-03-21 | 2013-04-09 | Depuy Spine, Inc. | Methods, materials, and apparatus for treating bone and other tissue |
DE602004031612D1 (en) | 2003-06-20 | 2011-04-14 | Intrinsic Therapeutics Inc | DEVICE FOR DISTRIBUTING AN IMPLANT THROUGH A RINGED DEFECT IN A RIBBON DISC |
US20040260300A1 (en) * | 2003-06-20 | 2004-12-23 | Bogomir Gorensek | Method of delivering an implant through an annular defect in an intervertebral disc |
US20050043796A1 (en) * | 2003-07-01 | 2005-02-24 | Grant Richard L. | Spinal disc nucleus implant |
US8579908B2 (en) | 2003-09-26 | 2013-11-12 | DePuy Synthes Products, LLC. | Device for delivering viscous material |
AU2004283727A1 (en) | 2003-10-23 | 2005-05-06 | Trans1 Inc. | Tools and tool kits for performing minimally invasive procedures on the spine |
ES2404682T3 (en) | 2003-12-11 | 2013-05-28 | Isto Technologies Inc. | Particle Cartilage System |
EP1729672A2 (en) | 2004-01-08 | 2006-12-13 | Spine Wave, Inc. | Apparatus and method for injecting fluent material at a distracted tissue site |
ES2396133T3 (en) * | 2004-04-27 | 2013-02-19 | Kyphon SÀRl | Bone replacement compositions and method of use |
US20050245938A1 (en) * | 2004-04-28 | 2005-11-03 | Kochan Jeffrey P | Method and apparatus for minimally invasive repair of intervertebral discs and articular joints |
US20080132899A1 (en) * | 2004-05-17 | 2008-06-05 | Shadduck John H | Composite implant and method for treating bone abnormalities |
JP2008504895A (en) * | 2004-06-29 | 2008-02-21 | スパイン・ウェイブ・インコーポレーテッド | Method for treating disc defects and injuries |
CA2575699C (en) | 2004-07-30 | 2014-07-08 | Disc-O-Tech Medical Technologies Ltd. | Methods, materials and apparatus for treating bone and other tissue |
US8048083B2 (en) * | 2004-11-05 | 2011-11-01 | Dfine, Inc. | Bone treatment systems and methods |
US7678116B2 (en) * | 2004-12-06 | 2010-03-16 | Dfine, Inc. | Bone treatment systems and methods |
US7559932B2 (en) * | 2004-12-06 | 2009-07-14 | Dfine, Inc. | Bone treatment systems and methods |
US7682378B2 (en) * | 2004-11-10 | 2010-03-23 | Dfine, Inc. | Bone treatment systems and methods for introducing an abrading structure to abrade bone |
US7717918B2 (en) | 2004-12-06 | 2010-05-18 | Dfine, Inc. | Bone treatment systems and methods |
US8070753B2 (en) | 2004-12-06 | 2011-12-06 | Dfine, Inc. | Bone treatment systems and methods |
US7722620B2 (en) | 2004-12-06 | 2010-05-25 | Dfine, Inc. | Bone treatment systems and methods |
US20060122614A1 (en) * | 2004-12-06 | 2006-06-08 | Csaba Truckai | Bone treatment systems and methods |
US7267690B2 (en) | 2005-03-09 | 2007-09-11 | Vertebral Technologies, Inc. | Interlocked modular disc nucleus prosthesis |
BRPI0609542A2 (en) | 2005-03-29 | 2011-10-18 | Synthes Gmbh | instrument for inserting a hydrogel prosthesis into an intervertebral disc, instrument kit for inserting an elongated hydrogel prosthesis into an intervertebral disc, and instrument for determining the volume within an intervertebral disc |
US7674296B2 (en) | 2005-04-21 | 2010-03-09 | Globus Medical, Inc. | Expandable vertebral prosthesis |
FR2885512B1 (en) * | 2005-05-10 | 2007-08-10 | Biocoral Inc | SYRINGE FOR BIO-MATERIAL |
US20060276902A1 (en) * | 2005-06-03 | 2006-12-07 | Zipnick Richard I | Minimally invasive apparatus to manipulate and revitalize spinal column disc |
US7988735B2 (en) * | 2005-06-15 | 2011-08-02 | Matthew Yurek | Mechanical apparatus and method for delivering materials into the inter-vertebral body space for nucleus replacement |
US9381024B2 (en) | 2005-07-31 | 2016-07-05 | DePuy Synthes Products, Inc. | Marked tools |
US9918767B2 (en) | 2005-08-01 | 2018-03-20 | DePuy Synthes Products, Inc. | Temperature control system |
US20070060887A1 (en) * | 2005-08-22 | 2007-03-15 | Marsh David A | Ophthalmic injector |
US8777479B2 (en) | 2008-10-13 | 2014-07-15 | Dfine, Inc. | System for use in bone cement preparation and delivery |
US8540723B2 (en) | 2009-04-14 | 2013-09-24 | Dfine, Inc. | Medical system and method of use |
WO2007025290A2 (en) * | 2005-08-26 | 2007-03-01 | Isto Technologies, Inc. | Implants and methods for repair, replacement and treatment of joint disease |
US7651701B2 (en) | 2005-08-29 | 2010-01-26 | Sanatis Gmbh | Bone cement composition and method of making the same |
US20070118144A1 (en) | 2005-09-01 | 2007-05-24 | Csaba Truckai | Systems for sensing retrograde flows of bone fill material |
EP1957012A4 (en) * | 2005-11-22 | 2012-05-02 | Bonwrx | Method and composition for repair and reconstruction of intervertebral discs and other reconstructive surgery |
US8360629B2 (en) | 2005-11-22 | 2013-01-29 | Depuy Spine, Inc. | Mixing apparatus having central and planetary mixing elements |
US7699894B2 (en) * | 2005-12-22 | 2010-04-20 | Depuy Spine, Inc. | Nucleus pulposus trial device and technique |
US20070191861A1 (en) * | 2006-01-30 | 2007-08-16 | Sdgi Holdings, Inc. | Instruments and methods for implanting nucleus replacement material in an intervertebral disc nucleus space |
US20070213822A1 (en) * | 2006-02-14 | 2007-09-13 | Sdgi Holdings, Inc. | Treatment of the vertebral column |
US7754005B2 (en) * | 2006-05-02 | 2010-07-13 | Kyphon Sarl | Bone cement compositions comprising an indicator agent and related methods thereof |
US7674243B2 (en) * | 2006-05-17 | 2010-03-09 | Alcon Inc. | Ophthalmic injection device using piezoelectric array |
US7862540B2 (en) * | 2006-05-17 | 2011-01-04 | Alcon Research, Ltd. | Ophthalmic injection device using shape memory alloy |
US20070268340A1 (en) * | 2006-05-17 | 2007-11-22 | Bruno Dacquay | Ophthalmic Injection System and Method Using Piezoelectric Array |
US20070270768A1 (en) * | 2006-05-17 | 2007-11-22 | Bruno Dacquay | Mechanical Linkage Mechanism For Ophthalmic Injection Device |
US7887521B2 (en) * | 2006-05-17 | 2011-02-15 | Alcon Research, Ltd. | Ophthalmic injection system |
US7811252B2 (en) * | 2006-05-17 | 2010-10-12 | Alcon Research, Ltd. | Dosage control device |
US7871399B2 (en) * | 2006-05-17 | 2011-01-18 | Alcon Research, Ltd. | Disposable ophthalmic injection device |
US20070270750A1 (en) * | 2006-05-17 | 2007-11-22 | Alcon, Inc. | Drug delivery device |
WO2010062971A1 (en) | 2008-11-26 | 2010-06-03 | Anova Corporation | Methods and apparatus for anulus repair |
US7507286B2 (en) * | 2006-06-08 | 2009-03-24 | Sanatis Gmbh | Self-foaming cement for void filling and/or delivery systems |
US8764835B2 (en) | 2006-06-13 | 2014-07-01 | Bret A. Ferree | Intervertebral disc treatment methods and apparatus |
US9232938B2 (en) | 2006-06-13 | 2016-01-12 | Anova Corp. | Method and apparatus for closing fissures in the annulus fibrosus |
US8834496B2 (en) | 2006-06-13 | 2014-09-16 | Bret A. Ferree | Soft tissue repair methods and apparatus |
WO2008001385A2 (en) * | 2006-06-29 | 2008-01-03 | Depuy Spine, Inc. | Integrated bone biopsy and therapy apparatus |
US20080027456A1 (en) * | 2006-07-19 | 2008-01-31 | Csaba Truckai | Bone treatment systems and methods |
US8357168B2 (en) * | 2006-09-08 | 2013-01-22 | Spine Wave, Inc. | Modular injection needle and seal assembly |
WO2008032322A2 (en) | 2006-09-14 | 2008-03-20 | Depuy Spine, Inc. | Bone cement and methods of use thereof |
US20080075788A1 (en) * | 2006-09-21 | 2008-03-27 | Samuel Lee | Diammonium phosphate and other ammonium salts and their use in preventing clotting |
US20080125712A1 (en) * | 2006-09-26 | 2008-05-29 | Alcon Manufacturing, Ltd. | Ophthalmic injection system |
US20080097390A1 (en) * | 2006-09-27 | 2008-04-24 | Alcon Manufacturing, Ltd. | Spring actuated delivery system |
US20080281292A1 (en) * | 2006-10-16 | 2008-11-13 | Hickingbotham Dyson W | Retractable Injection Port |
US10426578B2 (en) | 2006-10-16 | 2019-10-01 | Natural Dental Implants, Ag | Customized dental prosthesis for periodontal or osseointegration and related systems |
US9539062B2 (en) | 2006-10-16 | 2017-01-10 | Natural Dental Implants, Ag | Methods of designing and manufacturing customized dental prosthesis for periodontal or osseointegration and related systems |
WO2008105951A2 (en) * | 2006-10-16 | 2008-09-04 | Alcon Research, Ltd. | Universal rechargeable limited reuse assembly for ophthalmic hand piece |
US9022970B2 (en) * | 2006-10-16 | 2015-05-05 | Alcon Research, Ltd. | Ophthalmic injection device including dosage control device |
US20100106083A1 (en) * | 2006-10-16 | 2010-04-29 | Alcon Research, Ltd. | Method of Operating Ophthalmic Hand Piece with Disposable End |
US8454362B2 (en) * | 2006-10-16 | 2013-06-04 | Natural Dental Implants Ag | Customized dental prosthesis for periodontal- or osseointegration, and related systems and methods |
US20080234625A1 (en) * | 2006-10-16 | 2008-09-25 | Bruno Dacquay | Fuse Assembly For Single Use Medical Device |
US8602780B2 (en) * | 2006-10-16 | 2013-12-10 | Natural Dental Implants, Ag | Customized dental prosthesis for periodontal or osseointegration and related systems and methods |
CA2747850C (en) * | 2006-10-19 | 2013-05-14 | Depuy Spine, Inc. | Fluid delivery system |
WO2008073190A2 (en) * | 2006-11-03 | 2008-06-19 | Kyphon Sarl | Materials and methods and systems for delivering localized medical treatments |
US9737414B2 (en) | 2006-11-21 | 2017-08-22 | Vertebral Technologies, Inc. | Methods and apparatus for minimally invasive modular interbody fusion devices |
WO2008070863A2 (en) * | 2006-12-07 | 2008-06-12 | Interventional Spine, Inc. | Intervertebral implant |
US11395626B2 (en) | 2006-12-07 | 2022-07-26 | DePuy Synthes Products, Inc. | Sensor for intervertebral fusion indicia |
US8696679B2 (en) * | 2006-12-08 | 2014-04-15 | Dfine, Inc. | Bone treatment systems and methods |
US8979931B2 (en) | 2006-12-08 | 2015-03-17 | DePuy Synthes Products, LLC | Nucleus replacement device and method |
US8197491B2 (en) | 2006-12-19 | 2012-06-12 | Synthes Usa, Llc | Injectable fastener system and method |
US8163549B2 (en) | 2006-12-20 | 2012-04-24 | Zimmer Orthobiologics, Inc. | Method of obtaining viable small tissue particles and use for tissue repair |
US8870871B2 (en) * | 2007-01-17 | 2014-10-28 | University Of Massachusetts Lowell | Biodegradable bone plates and bonding systems |
US8556910B2 (en) * | 2007-04-03 | 2013-10-15 | Dfine, Inc. | Bone treatment systems and methods |
CA2684040C (en) | 2007-04-12 | 2016-12-06 | Isto Technologies, Inc. | Method of forming an implant using a mold that mimics the shape of the tissue defect site and implant formed therefrom |
WO2008137428A2 (en) * | 2007-04-30 | 2008-11-13 | Dfine, Inc. | Bone treatment systems and methods |
US8864801B2 (en) | 2007-04-30 | 2014-10-21 | Warsaw Orthopedic, Inc. | Method of deformity correction in a spine using injectable materials |
US8900307B2 (en) | 2007-06-26 | 2014-12-02 | DePuy Synthes Products, LLC | Highly lordosed fusion cage |
US20090018512A1 (en) * | 2007-07-13 | 2009-01-15 | Charles Steven T | Pneumatically-Powered Ophthalmic Injector |
US20090018548A1 (en) * | 2007-07-13 | 2009-01-15 | Charles Steven T | Pneumatically-Powered Intraocular Lens Injection Device with Removable Cartridge |
US9597118B2 (en) * | 2007-07-20 | 2017-03-21 | Dfine, Inc. | Bone anchor apparatus and method |
US7740619B2 (en) * | 2007-08-01 | 2010-06-22 | Alcon Research, Ltd. | Spring driven ophthalmic injection device with safety actuator lockout feature |
US20090036842A1 (en) * | 2007-08-03 | 2009-02-05 | Raffi Pinedjian | Consumable Activation Lever For Injection Device |
US7629768B2 (en) * | 2007-08-03 | 2009-12-08 | Alcon Research, Ltd. | Easy cleaning C-shaped charging base |
JP5441922B2 (en) | 2008-01-17 | 2014-03-12 | ジンテス ゲゼルシャフト ミット ベシュレンクテル ハフツング | Inflatable intervertebral implant and related manufacturing method |
US9445854B2 (en) | 2008-02-01 | 2016-09-20 | Dfine, Inc. | Bone treatment systems and methods |
US20100030220A1 (en) * | 2008-07-31 | 2010-02-04 | Dfine, Inc. | Bone treatment systems and methods |
US9161798B2 (en) | 2008-02-01 | 2015-10-20 | Dfine, Inc. | Bone treatment systems and methods |
EP2252336B1 (en) | 2008-02-28 | 2014-06-25 | Dfine, Inc. | Bone treatment systems and methods |
EP2262449B1 (en) | 2008-04-05 | 2020-03-11 | Synthes GmbH | Expandable intervertebral implant |
US9180416B2 (en) | 2008-04-21 | 2015-11-10 | Dfine, Inc. | System for use in bone cement preparation and delivery |
US7968616B2 (en) * | 2008-04-22 | 2011-06-28 | Kyphon Sarl | Bone cement composition and method |
ES2361099B1 (en) * | 2008-05-26 | 2012-05-08 | Rudolf Morgenstern Lopez | "INTERVERTEBRAL PROSTHESIS" |
US20100097879A1 (en) * | 2008-06-24 | 2010-04-22 | John Krueger | Apparatus and method for optimizing reaction time for curable material |
WO2010042049A1 (en) | 2008-10-10 | 2010-04-15 | Milux Holding S.A. | Composition, method and device for stabilizing implanted hydraulic devices |
US8163022B2 (en) | 2008-10-14 | 2012-04-24 | Anulex Technologies, Inc. | Method and apparatus for the treatment of the intervertebral disc annulus |
US20100114067A1 (en) * | 2008-10-31 | 2010-05-06 | Warsaw Orthopedic, Inc. | Multi-Chamber Mixing System |
US8128591B2 (en) * | 2008-11-10 | 2012-03-06 | Warsaw Orthopedic, Inc. | Multiple component mixing and delivery system |
US8721723B2 (en) | 2009-01-12 | 2014-05-13 | Globus Medical, Inc. | Expandable vertebral prosthesis |
AU2010213585A1 (en) * | 2009-02-13 | 2011-09-22 | Warsaw Orthopedic, Inc. | Heated tip implant delivery system |
US9526620B2 (en) | 2009-03-30 | 2016-12-27 | DePuy Synthes Products, Inc. | Zero profile spinal fusion cage |
US8636803B2 (en) | 2009-04-07 | 2014-01-28 | Spinal Stabilization Technologies, Llc | Percutaneous implantable nuclear prosthesis |
US8372036B2 (en) | 2009-05-06 | 2013-02-12 | Alcon Research, Ltd. | Multi-layer heat assembly for a drug delivery device |
WO2011005199A1 (en) * | 2009-07-10 | 2011-01-13 | Milux Holding S.A. | Apparatus and methods for treatment of arthrosis or osteoarthritis in a joint of a mammal or human patient |
US9393129B2 (en) | 2009-12-10 | 2016-07-19 | DePuy Synthes Products, Inc. | Bellows-like expandable interbody fusion cage |
US8177747B2 (en) | 2009-12-22 | 2012-05-15 | Alcon Research, Ltd. | Method and apparatus for drug delivery |
US8652153B2 (en) | 2010-01-11 | 2014-02-18 | Anulex Technologies, Inc. | Intervertebral disc annulus repair system and bone anchor delivery tool |
US8870880B2 (en) | 2010-04-12 | 2014-10-28 | Globus Medical, Inc. | Angling inserter tool for expandable vertebral implant |
US8282683B2 (en) | 2010-04-12 | 2012-10-09 | Globus Medical, Inc. | Expandable vertebral implant |
US9301850B2 (en) | 2010-04-12 | 2016-04-05 | Globus Medical, Inc. | Expandable vertebral implant |
US8591585B2 (en) | 2010-04-12 | 2013-11-26 | Globus Medical, Inc. | Expandable vertebral implant |
US8979860B2 (en) | 2010-06-24 | 2015-03-17 | DePuy Synthes Products. LLC | Enhanced cage insertion device |
US8845733B2 (en) | 2010-06-24 | 2014-09-30 | DePuy Synthes Products, LLC | Lateral spondylolisthesis reduction cage |
TW201215379A (en) | 2010-06-29 | 2012-04-16 | Synthes Gmbh | Distractible intervertebral implant |
US9402732B2 (en) | 2010-10-11 | 2016-08-02 | DePuy Synthes Products, Inc. | Expandable interspinous process spacer implant |
US8353964B2 (en) | 2010-11-04 | 2013-01-15 | Carpenter Clyde T | Anatomic total disc replacement |
WO2012151253A1 (en) * | 2011-05-02 | 2012-11-08 | Insight Surgical Instruments Llc | Minimally invasive surgical applicator |
US9510953B2 (en) | 2012-03-16 | 2016-12-06 | Vertebral Technologies, Inc. | Modular segmented disc nucleus implant |
EP2877127B1 (en) | 2012-07-26 | 2019-08-21 | Synthes GmbH | Expandable implant |
US20140067069A1 (en) | 2012-08-30 | 2014-03-06 | Interventional Spine, Inc. | Artificial disc |
TW201422268A (en) | 2012-12-07 | 2014-06-16 | Ind Tech Res Inst | Injection device and heting device thereof |
US20140178343A1 (en) | 2012-12-21 | 2014-06-26 | Jian Q. Yao | Supports and methods for promoting integration of cartilage tissue explants |
US9737294B2 (en) | 2013-01-28 | 2017-08-22 | Cartiva, Inc. | Method and system for orthopedic repair |
WO2014117107A1 (en) | 2013-01-28 | 2014-07-31 | Cartiva, Inc. | Systems and methods for orthopedic repair |
US9522070B2 (en) | 2013-03-07 | 2016-12-20 | Interventional Spine, Inc. | Intervertebral implant |
US20140277467A1 (en) | 2013-03-14 | 2014-09-18 | Spinal Stabilization Technologies, Llc | Prosthetic Spinal Disk Nucleus |
WO2014159225A2 (en) | 2013-03-14 | 2014-10-02 | Baxano Surgical, Inc. | Spinal implants and implantation system |
US9295479B2 (en) | 2013-03-14 | 2016-03-29 | Spinal Stabilization Technologies, Llc | Surgical device |
US10478097B2 (en) | 2013-08-13 | 2019-11-19 | Innovative Surgical Solutions | Neural event detection |
US10478096B2 (en) | 2013-08-13 | 2019-11-19 | Innovative Surgical Solutions. | Neural event detection |
US10449002B2 (en) | 2013-09-20 | 2019-10-22 | Innovative Surgical Solutions, Llc | Method of mapping a nerve |
US10376209B2 (en) | 2013-09-20 | 2019-08-13 | Innovative Surgical Solutions, Llc | Neural locating method |
US10376208B2 (en) | 2013-09-20 | 2019-08-13 | Innovative Surgical Solutions, Llc | Nerve mapping system |
WO2016073587A1 (en) | 2014-11-04 | 2016-05-12 | Spinal Stabilization Technologies Llc | Percutaneous implantable nuclear prosthesis |
PL3215067T3 (en) | 2014-11-04 | 2020-11-02 | Spinal Stabilization Technologies Llc | Percutaneous implantable nuclear prosthesis |
US11426290B2 (en) | 2015-03-06 | 2022-08-30 | DePuy Synthes Products, Inc. | Expandable intervertebral implant, system, kit and method |
US9913727B2 (en) | 2015-07-02 | 2018-03-13 | Medos International Sarl | Expandable implant |
CA2997117A1 (en) | 2015-09-01 | 2017-03-09 | Spinal Stabilization Technologies Llc | Implantable nuclear prosthesis |
US10182939B2 (en) | 2015-09-16 | 2019-01-22 | Novartis Ag | Hydraulic injector and methods for intra-ocular lens insertion |
US9486323B1 (en) | 2015-11-06 | 2016-11-08 | Spinal Stabilization Technologies Llc | Nuclear implant apparatus and method following partial nuclectomy |
WO2018002715A2 (en) | 2016-06-28 | 2018-01-04 | Eit Emerging Implant Technologies Gmbh | Expandable and angularly adjustable articulating intervertebral cages |
WO2018002711A2 (en) | 2016-06-28 | 2018-01-04 | Eit Emerging Implant Technologies Gmbh | Expandable, angularly adjustable intervertebral cages |
US10231846B2 (en) | 2016-08-19 | 2019-03-19 | Stryker European Holdings I, Llc | Bone graft delivery loading assembly |
US10321833B2 (en) | 2016-10-05 | 2019-06-18 | Innovative Surgical Solutions. | Neural locating method |
US10537436B2 (en) | 2016-11-01 | 2020-01-21 | DePuy Synthes Products, Inc. | Curved expandable cage |
US10888433B2 (en) | 2016-12-14 | 2021-01-12 | DePuy Synthes Products, Inc. | Intervertebral implant inserter and related methods |
US10398563B2 (en) | 2017-05-08 | 2019-09-03 | Medos International Sarl | Expandable cage |
US11344424B2 (en) | 2017-06-14 | 2022-05-31 | Medos International Sarl | Expandable intervertebral implant and related methods |
US10940016B2 (en) | 2017-07-05 | 2021-03-09 | Medos International Sarl | Expandable intervertebral fusion cage |
US10869616B2 (en) | 2018-06-01 | 2020-12-22 | DePuy Synthes Products, Inc. | Neural event detection |
JP7457712B2 (en) | 2018-09-04 | 2024-03-28 | スパイナル スタビライゼーション テクノロジーズ リミテッド ライアビリティ カンパニー | Implantable nucleus pulposus prostheses, kits, and related methods |
US10870002B2 (en) | 2018-10-12 | 2020-12-22 | DePuy Synthes Products, Inc. | Neuromuscular sensing device with multi-sensor array |
US11446156B2 (en) | 2018-10-25 | 2022-09-20 | Medos International Sarl | Expandable intervertebral implant, inserter instrument, and related methods |
US11399777B2 (en) | 2019-09-27 | 2022-08-02 | DePuy Synthes Products, Inc. | Intraoperative neural monitoring system and method |
US11426286B2 (en) | 2020-03-06 | 2022-08-30 | Eit Emerging Implant Technologies Gmbh | Expandable intervertebral implant |
WO2022101524A1 (en) * | 2020-11-12 | 2022-05-19 | Burgos Flores Jesus | Implant for the intervertebral disc space for treating scoliosis, kyphosis, stenosis and fractures of the spinal column |
US11850160B2 (en) | 2021-03-26 | 2023-12-26 | Medos International Sarl | Expandable lordotic intervertebral fusion cage |
US11752009B2 (en) | 2021-04-06 | 2023-09-12 | Medos International Sarl | Expandable intervertebral fusion cage |
Citations (50)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US2995159A (en) | 1957-12-23 | 1961-08-08 | United Shoe Machinery Corp | Portable plastic injection devices |
US3890970A (en) | 1974-01-21 | 1975-06-24 | Robert L Gullen | Retention cannula or catheter and applicator |
US4000741A (en) | 1975-11-03 | 1977-01-04 | The Kendall Company | Syringe assembly |
US4265618A (en) * | 1977-09-09 | 1981-05-05 | Solar Energy Technology, Inc. | Electrically heated endodontic syringe for injecting thermoplastic material into a root canal cavity |
US4357136A (en) | 1977-09-09 | 1982-11-02 | Solar Energy Technology, Inc. | Method for filling a root canal |
US4517326A (en) | 1981-06-15 | 1985-05-14 | Freeman Chemical Corporation | Aqueous liquid filled polyurethane gels and method of making the same |
US4531916A (en) | 1983-07-08 | 1985-07-30 | W. L. Gore & Associates, Inc. | Dental implant with expanded PTFE gingival interface |
US4569736A (en) | 1981-09-19 | 1986-02-11 | Terumo Kabushiki Kaisha | Medical instruments made from a polyolefin composition which has been sterilized with gamma irradiation |
US4648880A (en) | 1984-08-30 | 1987-03-10 | Daniel Brauman | Implantable prosthetic devices |
US4651717A (en) | 1985-04-04 | 1987-03-24 | Dow Corning Corporation | Multiple envelope tissue expander device |
US4684344A (en) | 1986-04-11 | 1987-08-04 | Nalge Company | Electrically powered and heated endodontic syringe |
US4723547A (en) | 1985-05-07 | 1988-02-09 | C. R. Bard, Inc. | Anti-obesity balloon placement system |
US4740245A (en) | 1985-09-12 | 1988-04-26 | G-C Dental Industrial Corp. | Thermoplastic dental filling composition |
US4820303A (en) | 1984-08-30 | 1989-04-11 | Daniel Brauman | Implantable prosthetic devices |
US4944749A (en) | 1985-01-23 | 1990-07-31 | Hilton Becker | Implant and inflating construction |
US4966583A (en) | 1989-02-03 | 1990-10-30 | Elie Debbas | Apparatus for locating a breast mass |
US5047055A (en) | 1990-12-21 | 1991-09-10 | Pfizer Hospital Products Group, Inc. | Hydrogel intervertebral disc nucleus |
US5182151A (en) | 1989-07-10 | 1993-01-26 | Sumitomo Chemical Company, Limited | Thermoplastic resin composition |
US5183463A (en) | 1989-02-03 | 1993-02-02 | Elie Debbas | Apparatus for locating a breast mass |
US5272184A (en) | 1992-09-28 | 1993-12-21 | Itzhak Shoher | Metal composite and method for filling a dental cavity in the preparation of a dental restoration |
US5431654A (en) | 1991-09-30 | 1995-07-11 | Stryker Corporation | Bone cement injector |
US5445645A (en) | 1989-02-03 | 1995-08-29 | Debbas; Elie | Apparatus for locating a breast mass |
US5462542A (en) | 1994-01-24 | 1995-10-31 | United States Surgical Corporation | Sternum buckle with serrated strap |
US5515229A (en) | 1993-07-05 | 1996-05-07 | Texas Instruments Incorporated | Overcurrent protector with overheat prevention means |
US5545229A (en) | 1988-08-18 | 1996-08-13 | University Of Medicine And Dentistry Of Nj | Functional and biocompatible intervertebral disc spacer containing elastomeric material of varying hardness |
US5549679A (en) | 1994-05-20 | 1996-08-27 | Kuslich; Stephen D. | Expandable fabric implant for stabilizing the spinal motion segment |
US5632777A (en) | 1994-03-04 | 1997-05-27 | Petrick; Timothy B. | Method of inflating a prosthesis |
US5656013A (en) | 1988-07-22 | 1997-08-12 | Yoon; Inbae | Method of using an expandable multifunctional manipulating instrument for various medical procedures |
US5662674A (en) | 1989-02-03 | 1997-09-02 | Debbas; Elie | Apparatus for locating a breast mass |
US5800549A (en) | 1997-04-30 | 1998-09-01 | Howmedica Inc. | Method and apparatus for injecting an elastic spinal implant |
US5849014A (en) | 1997-03-20 | 1998-12-15 | Johnson & Johnson Professional, Inc. | Cement restrictor system and method of forming a cement plug within the medullary canal of a bone |
US5865802A (en) | 1988-07-22 | 1999-02-02 | Yoon; Inbae | Expandable multifunctional instruments for creating spaces at obstructed sites endoscopically |
US5888220A (en) * | 1994-05-06 | 1999-03-30 | Advanced Bio Surfaces, Inc. | Articulating joint repair |
US5925051A (en) | 1997-01-22 | 1999-07-20 | Mikhail; W.E. Michael | Method and apparatus for positioning and compacting bone graft |
US5934903A (en) | 1997-11-24 | 1999-08-10 | Marlin; Jay | Needle and method for injecting heated thermoplastic material into a dental cavity |
US6127597A (en) | 1997-03-07 | 2000-10-03 | Discotech N.V. | Systems for percutaneous bone and spinal stabilization, fixation and repair |
US6126446A (en) | 1998-04-22 | 2000-10-03 | Roeko Gmbh & Co., Dentalerzeugnisse | Composition for filling tooth root canals |
US6183518B1 (en) | 1999-02-22 | 2001-02-06 | Anthony C. Ross | Method of replacing nucleus pulposus and repairing the intervertebral disk |
US6187048B1 (en) | 1994-05-24 | 2001-02-13 | Surgical Dynamics, Inc. | Intervertebral disc implant |
US6206921B1 (en) | 1999-02-22 | 2001-03-27 | Peter A. Guagliano | Method of replacing nucleus pulposus and repairing the intervertebral disk |
US6241734B1 (en) | 1998-08-14 | 2001-06-05 | Kyphon, Inc. | Systems and methods for placing materials into bone |
US6264659B1 (en) | 1999-02-22 | 2001-07-24 | Anthony C. Ross | Method of treating an intervertebral disk |
US6290982B1 (en) | 1996-12-17 | 2001-09-18 | Jvs-Polymers Oy | Plasticizable implant material and method for producing the same |
US6395029B1 (en) | 1999-01-19 | 2002-05-28 | The Children's Hospital Of Philadelphia | Sustained delivery of polyionic bioactive agents |
US6436143B1 (en) | 1999-02-22 | 2002-08-20 | Anthony C. Ross | Method and apparatus for treating intervertebral disks |
US6506333B1 (en) | 1996-05-03 | 2003-01-14 | Baxter International Inc. | Method of surface modifying a medical tubing |
US6554830B1 (en) | 2000-04-10 | 2003-04-29 | Sdgi Holdings, Inc. | Fenestrated surgical anchor and method |
US6565572B2 (en) | 2000-04-10 | 2003-05-20 | Sdgi Holdings, Inc. | Fenestrated surgical screw and method |
WO2003045274A2 (en) | 2001-11-21 | 2003-06-05 | Nuvasive, Inc. | Thermopolymer composition and related methods |
US20050049707A1 (en) | 2003-08-29 | 2005-03-03 | Ferree Bret A. | Cemented artificial disc replacements |
Family Cites Families (9)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3875595A (en) * | 1974-04-15 | 1975-04-08 | Edward C Froning | Intervertebral disc prosthesis and instruments for locating same |
DE3609672A1 (en) * | 1986-03-21 | 1987-09-24 | Klaus Draenert | EVACUABLE BONE CEMENT SYRINGE |
US4772287A (en) * | 1987-08-20 | 1988-09-20 | Cedar Surgical, Inc. | Prosthetic disc and method of implanting |
US5324305A (en) * | 1992-12-15 | 1994-06-28 | Ryder International Corporation | Bioadhesive applicator |
US5514137A (en) * | 1993-12-06 | 1996-05-07 | Coutts; Richard D. | Fixation of orthopedic devices |
US6022376A (en) * | 1997-06-06 | 2000-02-08 | Raymedica, Inc. | Percutaneous prosthetic spinal disc nucleus and method of manufacture |
US6375672B1 (en) * | 1999-03-22 | 2002-04-23 | Board Of Trustees Of Michigan State University | Method for controlling the chemical and heat induced responses of collagenous materials |
US6428576B1 (en) * | 1999-04-16 | 2002-08-06 | Endospine, Ltd. | System for repairing inter-vertebral discs |
CA2458821C (en) * | 2001-08-31 | 2012-01-10 | University Of Southern California | Use of non-toxic crosslinking agents to inhibit mechanical degradation of collagenous tissues |
-
2000
- 2000-05-12 US US09/569,807 patent/US6436143B1/en not_active Ceased
-
2001
- 2001-05-07 AU AU2001259523A patent/AU2001259523B2/en not_active Ceased
- 2001-05-07 WO PCT/US2001/014555 patent/WO2001087195A1/en active IP Right Grant
- 2001-05-07 AU AU5952301A patent/AU5952301A/en active Pending
- 2001-05-07 CA CA002412605A patent/CA2412605A1/en not_active Abandoned
- 2001-05-07 EP EP01933068A patent/EP1289454A1/en not_active Withdrawn
-
2004
- 2004-08-20 US US10/923,564 patent/USRE43434E1/en not_active Expired - Fee Related
Patent Citations (53)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US2995159A (en) | 1957-12-23 | 1961-08-08 | United Shoe Machinery Corp | Portable plastic injection devices |
US3890970A (en) | 1974-01-21 | 1975-06-24 | Robert L Gullen | Retention cannula or catheter and applicator |
US4000741A (en) | 1975-11-03 | 1977-01-04 | The Kendall Company | Syringe assembly |
US4265618A (en) * | 1977-09-09 | 1981-05-05 | Solar Energy Technology, Inc. | Electrically heated endodontic syringe for injecting thermoplastic material into a root canal cavity |
US4357136A (en) | 1977-09-09 | 1982-11-02 | Solar Energy Technology, Inc. | Method for filling a root canal |
US4517326A (en) | 1981-06-15 | 1985-05-14 | Freeman Chemical Corporation | Aqueous liquid filled polyurethane gels and method of making the same |
US4569736A (en) | 1981-09-19 | 1986-02-11 | Terumo Kabushiki Kaisha | Medical instruments made from a polyolefin composition which has been sterilized with gamma irradiation |
US4531916A (en) | 1983-07-08 | 1985-07-30 | W. L. Gore & Associates, Inc. | Dental implant with expanded PTFE gingival interface |
US4820303A (en) | 1984-08-30 | 1989-04-11 | Daniel Brauman | Implantable prosthetic devices |
US4648880A (en) | 1984-08-30 | 1987-03-10 | Daniel Brauman | Implantable prosthetic devices |
USRE35391E (en) | 1984-08-30 | 1996-12-03 | Brauman; Daniel | Implantable prosthetic devices |
US4944749A (en) | 1985-01-23 | 1990-07-31 | Hilton Becker | Implant and inflating construction |
US4651717A (en) | 1985-04-04 | 1987-03-24 | Dow Corning Corporation | Multiple envelope tissue expander device |
US4723547A (en) | 1985-05-07 | 1988-02-09 | C. R. Bard, Inc. | Anti-obesity balloon placement system |
US4740245A (en) | 1985-09-12 | 1988-04-26 | G-C Dental Industrial Corp. | Thermoplastic dental filling composition |
US4684344A (en) | 1986-04-11 | 1987-08-04 | Nalge Company | Electrically powered and heated endodontic syringe |
US5656013A (en) | 1988-07-22 | 1997-08-12 | Yoon; Inbae | Method of using an expandable multifunctional manipulating instrument for various medical procedures |
US5865802A (en) | 1988-07-22 | 1999-02-02 | Yoon; Inbae | Expandable multifunctional instruments for creating spaces at obstructed sites endoscopically |
US5545229A (en) | 1988-08-18 | 1996-08-13 | University Of Medicine And Dentistry Of Nj | Functional and biocompatible intervertebral disc spacer containing elastomeric material of varying hardness |
US5662674A (en) | 1989-02-03 | 1997-09-02 | Debbas; Elie | Apparatus for locating a breast mass |
US4966583A (en) | 1989-02-03 | 1990-10-30 | Elie Debbas | Apparatus for locating a breast mass |
US5183463A (en) | 1989-02-03 | 1993-02-02 | Elie Debbas | Apparatus for locating a breast mass |
US5445645A (en) | 1989-02-03 | 1995-08-29 | Debbas; Elie | Apparatus for locating a breast mass |
US5182151A (en) | 1989-07-10 | 1993-01-26 | Sumitomo Chemical Company, Limited | Thermoplastic resin composition |
US5047055A (en) | 1990-12-21 | 1991-09-10 | Pfizer Hospital Products Group, Inc. | Hydrogel intervertebral disc nucleus |
US5431654A (en) | 1991-09-30 | 1995-07-11 | Stryker Corporation | Bone cement injector |
US5272184A (en) | 1992-09-28 | 1993-12-21 | Itzhak Shoher | Metal composite and method for filling a dental cavity in the preparation of a dental restoration |
US5515229A (en) | 1993-07-05 | 1996-05-07 | Texas Instruments Incorporated | Overcurrent protector with overheat prevention means |
US5462542A (en) | 1994-01-24 | 1995-10-31 | United States Surgical Corporation | Sternum buckle with serrated strap |
US5632777A (en) | 1994-03-04 | 1997-05-27 | Petrick; Timothy B. | Method of inflating a prosthesis |
US5888220A (en) * | 1994-05-06 | 1999-03-30 | Advanced Bio Surfaces, Inc. | Articulating joint repair |
US5549679A (en) | 1994-05-20 | 1996-08-27 | Kuslich; Stephen D. | Expandable fabric implant for stabilizing the spinal motion segment |
US6187048B1 (en) | 1994-05-24 | 2001-02-13 | Surgical Dynamics, Inc. | Intervertebral disc implant |
US6506333B1 (en) | 1996-05-03 | 2003-01-14 | Baxter International Inc. | Method of surface modifying a medical tubing |
US6290982B1 (en) | 1996-12-17 | 2001-09-18 | Jvs-Polymers Oy | Plasticizable implant material and method for producing the same |
US5925051A (en) | 1997-01-22 | 1999-07-20 | Mikhail; W.E. Michael | Method and apparatus for positioning and compacting bone graft |
US6127597A (en) | 1997-03-07 | 2000-10-03 | Discotech N.V. | Systems for percutaneous bone and spinal stabilization, fixation and repair |
US5849014A (en) | 1997-03-20 | 1998-12-15 | Johnson & Johnson Professional, Inc. | Cement restrictor system and method of forming a cement plug within the medullary canal of a bone |
US5800549A (en) | 1997-04-30 | 1998-09-01 | Howmedica Inc. | Method and apparatus for injecting an elastic spinal implant |
US5934903A (en) | 1997-11-24 | 1999-08-10 | Marlin; Jay | Needle and method for injecting heated thermoplastic material into a dental cavity |
US6168432B1 (en) | 1997-11-24 | 2001-01-02 | Jay Marlin | Needle and method for injecting heated thermoplastic material into a dental cavity |
US6126446A (en) | 1998-04-22 | 2000-10-03 | Roeko Gmbh & Co., Dentalerzeugnisse | Composition for filling tooth root canals |
US6241734B1 (en) | 1998-08-14 | 2001-06-05 | Kyphon, Inc. | Systems and methods for placing materials into bone |
US6395029B1 (en) | 1999-01-19 | 2002-05-28 | The Children's Hospital Of Philadelphia | Sustained delivery of polyionic bioactive agents |
US6436143B1 (en) | 1999-02-22 | 2002-08-20 | Anthony C. Ross | Method and apparatus for treating intervertebral disks |
US6264659B1 (en) | 1999-02-22 | 2001-07-24 | Anthony C. Ross | Method of treating an intervertebral disk |
US6183518B1 (en) | 1999-02-22 | 2001-02-06 | Anthony C. Ross | Method of replacing nucleus pulposus and repairing the intervertebral disk |
US6206921B1 (en) | 1999-02-22 | 2001-03-27 | Peter A. Guagliano | Method of replacing nucleus pulposus and repairing the intervertebral disk |
US6554830B1 (en) | 2000-04-10 | 2003-04-29 | Sdgi Holdings, Inc. | Fenestrated surgical anchor and method |
US6565572B2 (en) | 2000-04-10 | 2003-05-20 | Sdgi Holdings, Inc. | Fenestrated surgical screw and method |
WO2003045274A2 (en) | 2001-11-21 | 2003-06-05 | Nuvasive, Inc. | Thermopolymer composition and related methods |
US20040228898A1 (en) | 2001-11-21 | 2004-11-18 | Ross Anthony C. | Thermopolymer composition and related methods |
US20050049707A1 (en) | 2003-08-29 | 2005-03-03 | Ferree Bret A. | Cemented artificial disc replacements |
Non-Patent Citations (1)
Title |
---|
Indian Plastic Portal, TPU Thermoplastic Polyurethane, {http://www.indianplasticportal.com/tpu.html}, accessed May 19, 2008. * |
Cited By (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20150335369A1 (en) * | 2005-08-22 | 2015-11-26 | Dfine, Inc. | Bone treatment systems and methods |
US10136934B2 (en) * | 2005-08-22 | 2018-11-27 | Dfine, Inc. | Bone treatment systems and methods |
US11672579B2 (en) | 2005-08-22 | 2023-06-13 | Dfine Inc. | Bone treatment systems and methods |
Also Published As
Publication number | Publication date |
---|---|
AU5952301A (en) | 2001-11-26 |
CA2412605A1 (en) | 2001-11-22 |
EP1289454A1 (en) | 2003-03-12 |
AU2001259523B2 (en) | 2005-04-14 |
US6436143B1 (en) | 2002-08-20 |
WO2001087195A1 (en) | 2001-11-22 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
USRE43434E1 (en) | Method and apparatus for treating intervertebral disks | |
US6264659B1 (en) | Method of treating an intervertebral disk | |
AU2001259523A1 (en) | Method and apparatus for treating intervertebral disks | |
WO2000049978A1 (en) | Method of treating an intervertebral disk | |
US6206921B1 (en) | Method of replacing nucleus pulposus and repairing the intervertebral disk | |
US6183518B1 (en) | Method of replacing nucleus pulposus and repairing the intervertebral disk | |
US8372115B2 (en) | Bone support device, system and method | |
US7559932B2 (en) | Bone treatment systems and methods | |
JP4584526B2 (en) | Devices and methods for treating fractured and / or diseased bones | |
CA2328229C (en) | Interbody device and method for treatment of osteoporotic vertebral collapse | |
US6852095B1 (en) | Interbody device and method for treatment of osteoporotic vertebral collapse | |
US20030050644A1 (en) | Systems and methods for accessing and treating diseased or fractured bone employing a guide wire | |
US20070021835A1 (en) | Systems and methods for providing prostheses | |
US8696679B2 (en) | Bone treatment systems and methods | |
US20050015148A1 (en) | Biocompatible wires and methods of using same to fill bone void | |
US7128746B2 (en) | Device for treating intervertebral disc herniations | |
KR20030029621A (en) | Systems and methods for treating vertebral bodies | |
CN107320173B (en) | Vertebral body expansion shaping systems and methods | |
EP1594421A2 (en) | Artificial nucleus pulposus and method of injecting same | |
US20100174243A1 (en) | Apparatus for Delivery of Therapeutic Material to an Intervertebral Disc and Method of Use | |
US20060293561A1 (en) | System and methods for intervertebral disc surgery |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
AS | Assignment |
Owner name: NUVASIVE, INC., CALIFORNIA Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:ROSS, ANTHONY C.;GUAGLIANO, PETER A.;REEL/FRAME:016083/0714 Effective date: 20040819 |
|
REMI | Maintenance fee reminder mailed | ||
LAPS | Lapse for failure to pay maintenance fees | ||
AS | Assignment |
Owner name: BANK OF AMERICA, N.A., AS ADMINISTRATIVE AGENT, NORTH CAROLINA Free format text: SECURITY INTEREST;ASSIGNORS:NUVASIVE, INC.;NUVASIVE CLINICAL SERVICES MONITORING, INC.;NUVASIVE CLINICAL SERVICES, INC.;AND OTHERS;REEL/FRAME:052918/0595 Effective date: 20200224 |