Spinal disc annulus reconstruction method and spinal disc annulus stent
A surgical method of repair and reconstruction of the spinal disc wall (annulus) after surgical invasion or pathologic rupture, incorporating suture closure, or stent insertion and fixation, designed to reduce the failure rate of conventional surgical procedures on the spinal discs. The design of the spinal disc annulus stent allows ingrowth of normal cells of healing in an enhanced fashion strengthening the normal reparative process.
1. A method for treating an intervertebral disc having an aperture in the annulus fibrosus, wherein the aperture provides a pathway for the migration of intradiscal material from the subannular space, the method comprising the steps of:
providing a device having a first folded configuration and second unfolded configuration, wherein said unfolded configuration has a width dimension, a depth dimension, and a height dimension, wherein, in use, said height dimension lies substantially parallel to the axis of a patient's spine, the depth dimension lies substantially perpendicular to the axis of the spine, and the width dimension lies substantially parallel to the circumference of the patient's disc annulus, and wherein said width dimension is greater than said height dimension and said height dimension is greater than said depth dimension;
wherein the first folded configuration comprises dimensions permitting said device to pass through the aperture and the second unfolded configuration comprises at least one dimension larger than a dimension of the aperture;
inserting the device through the aperture in the first configuration; and
causing or allowing the device to obtain said second configuration whereby said width or height dimension at least partially spans said aperture, thereby providing a barrier restricting the migration of intradiscal material through the aperture.
2. The method of claim 1 wherein the device is comprised at least in part of a shape memory material.
3. The method of claim 1 , wherein the device is comprised at least in part of biocompatible fabric.
4. The method of claim 1 , wherein the device is at least in part bioabsorbable.
5. The method of claim 1 , further comprising the step of treating the annulus tissue surrounding the aperture to reduce the relative motion thereof.
6. The method of claim 5 , further comprising the step of reapproximating the aperture.
7. The method of claim 1 , wherein the device further comprises at least one fixation element for attaching the device to the annulus.
8. The method of claim 6 wherein the device further comprises at least one element for reapproximating the aperture.
9. The method of claim 1 , wherein the aperture is pathologic.
10. The method of claim 1 , wherein the aperture is formed at least in part by a surgical incision.
11. A method for treating an intervertebral disc having an aperture in the annulus fibrosus, wherein the method of claim 1 is performed following discectomy.
12. The method of claim 1 , further comprising the step of applying sutures to acutely stabilize said device.
13. The method of claim 1 , wherein said device is comprised at least in part from autograft.
14. The method of claim 13 , wherein said autograft is muscle fascia.
15. The method of claim 1 , wherein said device is comprised at least in part from allograft.
16. The method of claim 1 , wherein said device is comprised at least in part from a biocompatible membrane.
17. The method of claim 16 , wherein said biocompatible membrane is a medical grade biocompatible fabric.
18. The method of claim 16 , wherein said biocompatible membrane is a medical grade polymeric sheet.
19. The method of claim 1 , wherein said device is applied at least in part in said aperture.
20. The method of claim 19 , wherein said device comprises a filler material.
21. The method of claim 20 , wherein said filler is at least in part form-fitting.
22. The method of claim 20 , wherein said filler is at least in part non-form-fitting.
23. The method of claim 1 , further comprising the step of placing sutures at about equal distances along the sides of the aperture.
24. The method of claim 1 , wherein at least a portion of the device comprises a biodegradable or bioresorbable material.
25. The method of claim 24 , wherein the biodegradable or bioresorbable material comprises a fibrous mesh.
26. The method of claim 24 , wherein the biodegradable material comprises a medical grade polymeric sheet.
27. The method of claim 1 , wherein the device is comprised at least in part of biocompatible fibrous mesh.
28. The method of claim 1 , wherein the device is comprised of a material selected from the group consisting of expandable polytetrafluoroethylene (ePTFE), a material to facilitate regeneration of disc tissue, and a hygroscopic material.
29. The method of claim 28 , wherein the material to facilitate tissue growth comprises a bioactive silica based material.
30. The method of claim 28 , wherein the material to facilitate tissue growth comprises a tissue growth factor.
31. The method of claim 1 , wherein the device is comprised at least in part of polymer fibers.
32. The method of claim 1 , wherein at least a portion of the device is porous.
33. The method of claim 1 , wherein at least a portion of the device is non-porous.
34. The device of claim 1 , wherein at least a portion of the device is formed at least in part of xenograft.