Method for remediation of intervertebral disks
A method for the implantation of a device made of bioresorbable materials between interspinous processes is described. The implant has a spacer that can be placed between adjacent spinous processes to limit the movement of the vertebrae. Once inserted between interspinous processes, the implant acts to limit extension (backward bending) of the spine without inhibiting the flexion (forward bending) of the spinal column. The device is used as an adjunct to remediation of an intervertebral disk.
1 . A method for remediation of a damaged intervertebral disk, comprising the steps of:
accessing an intervertebral space;
restoring the damaged disk;
inserting a bioresorbable device between spinous processes of the spinal column; and
wherein the steps of restoring and inserting are done in any order.
2 . The method of claim 1 further comprising the step of tethering the spinous processes with a bioresorbable tether.
3 . The method of claim 2 wherein the tethering step further comprises threading the tether around the spinous processes and fastening the ends together.
4 . The method of claim 1 , where the step of inserting the device further comprises:
accessing adjacent first and second spinal processes of the vertebrae;
distracting the first and second spinous processes;
implanting the device between said spinous processes, said device comprising a spacer; and
where the distracting and implanting steps are done in any order or simultaneously.
5 . The method of claim 4 , wherein the step of implanting the spacer between the spinous processes further comprises;
assembling the spacer on an insertion tool with a distal end and proximal end, the tool comprising;
a distraction guide at the distal end of the insertion tool, a handle at the proximal end of the insertion tool, a central body proximal to the distraction guide, and a stop between the central body and the handle; and
wherein the spacer fits over the distraction guide and is disposed between the stop and the distraction guide;
separating tissues and ligaments with the distraction guide of the insertion tool;
urging the spacer into the space between the spinous processes;
removing the insertion tool, while leaving the spacer in place; and
where the distracting and implanting steps are done in any order or simultaneously.
6 . The method of claim 1 , where the step of inserting the device further comprises:
accessing adjacent first and second spinal processes of the vertebrae;
distracting the first and second spinous processes;
inserting a device between the spinous processes of the spinal column using the steps of:
a central body with a distal end and a proximal end, said central body having a longitudinal axis;
a spacer associated with the central body, wherein said spacer is adapted to be placed between spinous processes;
a tissue expander extending from the distal end of the body; and
where the distracting and inserting steps are done in any order or simultaneously.
7 . The method of claim 1 , where the step of inserting the device further comprises:
accessing adjacent first and second spinal processes of the vertebrae;
distracting the first and second spinous processes;
inserting a device between the spinous processes of the spinal column, the device comprising:
a central body with a distal end and a proximal end, said central body having a longitudinal axis;
a stop located at the proximal end of the central body;
a spacer associated with the central body, wherein said spacer is adapted to be placed between spinous processes;
a tissue expander extending from the distal end of the body; and
where the distracting and inserting steps are done in any order or simultaneously.
8 . The method of claim 7 , wherein the stop is a first wing.
9 . The method of claim 8 further comprising tethering the spinous processes and the device wherein the device already is inserted between the spinous processes, and wherein the device has a bioresorbable tether anchored at a first end to the device.
10 . The method of claim 9 wherein the tethering step further comprises using a tool to guide a second end of the tether over an upper spinous process, through a bore through the tissue expander, under a lower spinous process, and through a lower bore in the first wing; and anchoring the second end of the tether to the lower bore in the first wing, the first end of the tether anchored to an upper bore in the first wing.
11 . The method of claim 9 wherein the tethering step further comprises using a tool to guide a second end of the tether under a lower spinous process, through a bore through the tissue expander, over an upper spinous process, and through an upper bore in the first wing; and anchoring the second end of the tether to the upper bore in the first wing, the first end of the tether anchored to a lower bore in the first wing.
12 . The method of claim 8 , further comprising a second wing located at the distal end of the central body, wherein the spacer is between the stop and the second wing.
13 . The method of claim 12 further comprising tethering the spinous processes and the device wherein the device already is inserted between the spinous processes, and wherein the device has a bioresorbable tether anchored at a first end to the device.
14 . The method of claim 13 wherein the tethering step further comprises using a tool to guide a second end of the tether over an upper spinous process, through a bore through the tissue expander, under a lower spinous process, and through a lower bore in the first wing; and anchoring the second end of the tether to the lower bore in the first wing, the first end of the tether anchored to an upper bore in the first wing.
15 . The method of claim 13 wherein the tethering step further comprises using a tool to guide a second end of the tether under a lower spinous process, through a bore through the tissue expander, over an upper spinous process, and through an upper bore in the first wing; and anchoring the second end of the tether to the upper bore in the first wing, the first end of the tether anchored to a lower bore in the first wing.
16 . A method for remediation of a damaged intervertebral disk, comprising:
accessing the intervertebral space;
inserting a device between the spinous processes of the spinal column using the steps of:
accessing adjacent first and second spinal processes of the vertebrae;
distracting the first and second spinous processes;
implanting the device between the spinous processes; and
where the distracting and implanting steps are done in any order or simultaneously; and
replacing the intervertebral disk; and
wherein the steps of inserting and replacing are done in any order.
17 . A method for remediation of a damaged intervertebral disk, comprising:
accessing the intervertebral space;
inserting a device between the spinous processes of the spinal column using the steps of:
accessing adjacent first and second spinal processes of the vertebrae;
distracting the first and second spinous processes;
implanting the device between the spinous processes; and
where the distracting and implanting steps are done in any order or simultaneously; and
repairing the intervertebral disk; and
wherein the steps of inserting and repairing are done in any order.
18 . In a method for remediation of an intervertebral disk, the improvement including the step of temporarily distracting spinous processes with the implantation of a bioresorbable spacer between the spinous processes.
19 . In a method for remediation of an intervertebral disk, the improvement including the step of temporarily maintaining a minimum spacing between the spinous processes with the implantation of a bioresorbable spacer between the spinous processes.
20 . The method of claim 16 wherein the inserting step includes inserting a bioresorbable device.
21 . The method of claim 17 wherein the inserting step includes inserting a bioresorbable device.
22 . A method for remediation of a damaged intervertebral disk, comprising the steps of:
accessing an intervertebral space;
restoring the damaged disk;
inserting a device between spinous processes of the spinal column; and
wherein the steps of restoring and inserting are done in any order.
23 . The method as in claim 22 further comprising the step of tethering the spinous processes with a bioresorbable suture after the inserting step.
24 . The method as in claim 22 further comprising the step of tethering the spinous processes and the device with a bioresorbable suture after the inserting step.
25 . In a method for remediation of an intervertebral disk, the improvement including the step of temporarily distracting spinous processes with the implantation of a spacer between the spinous processes.
26 . In a method for remediation of an intervertebral disk, the improvement including the step of temporarily maintaining a minimum spacing between the spinous processes with the implantation of a spacer between the spinous processes.