Treatment of the vertebral column

1 . A method of treating a vertebral column comprising:

introducing a biological treatment into at least one area of a vertebral column selected from a facet joint, a disc space, a vertebral body and an endplate; and

at least partially mechanically unloading the treated area by applying a load-bearing device to at least a posterior region of the vertebral column.

2 . The method of claim 1 wherein the biological treatment comprises a biologically active component.

3 . The method of claim 2 wherein the biological treatment further comprises a biological additive.

4 . The method of claim 3 wherein the biological additive comprises at least one of a biomaterial carrier, a therapeutic agent, a liquid and a lubricant.

5 . The method of claim 3 wherein the biological additive is selected from autogenic collagen, allogenic collagen, xenogenic collagen, human recombinant collagen, gelatin, hyaluronic acid, fibrin, albumin, keratin, silk, elastin, glycosaminoglycans (GAGs), polyethylene glycol (PEG), polyethylene oxide (PEO), polyvinyl alcohol (PVA) hydrogel, polyvinyl pyrrolidone (PVP), co-polymers of PVA and PVP, polysaccharides, platelet gel, peptides, carboxymethyl cellulose, modified starches and celluloses.

6 . The method of claim 3 wherein the biological additive is selected from nutrients, analgesics, antibiotics, anti-inflammatories, steroids, antiviricides, vitamins, amino acids and peptides.

7 . The method of claim 6 wherein the biological additive comprises at least one of:

an analgesic selected from codeine, prodrugs, morphine, hydromorphone, propoxyphene, hydrocodone, oxycodone, meperidine, methadone, and fentanyl; and

an antibiotic selected from erythromycin, bacitracin, neomycin, penicillin, polymyxin B, tetracyclines, viomycin, chloromycetin, streptomycins, cefazolin, ampicillin, azactam, tobramycin, clindamycin and gentamycin.

8 . The method of claim 3 wherein the biological additive is selected from water, saline, radio-contrast media, hyaluronic acid, a salt of hyaluronic acid, sodium hyaluronate, glucosaminoglycan, dermatan sulfate, heparin sulfate, chondroitin sulfate, keratin sulfate, synovial fluid, a component of synovial fluid, vitronectin and rooster comb hyaluronate.

9 . The method of claim 1 wherein the biological treatment comprises a biologically active component selected from anti-cytokines; cytokines; anti-interleukin-1 components (anti-IL-1); anti-TNF alpha; growth factors; LIM mineralization proteins; stem cell material, autogenic chondrocytes; allogenic chondrocytes; autogenic chondrocytes with one of a retroviral viral vector or a plasmid viral vector; allogenic chondrocytes with one of a retroviral viral vector or a plasmid viral vector; and fibroblasts.

10 . The method of claim 1 wherein the biological treatment comprises a biologically active component selected from transforming growth factors, bone morphogenetic proteins, fibroblast growth factors, platelet derived growth factor (PDGF), insulin-like growth factor (ILGF); human endothelial cell growth factor (ECGF); epidermal growth factor (EGF); nerve growth factor (NGF); and vascular endothelial growth factor (VEGF).

11 . The method of claim 10 wherein the biologically active component comprises at least one of a transforming growth factor selected from TGF-beta 1, TGF-beta 2, and TGF-beta 3, and a bone morphogenetic protein selected from BMP-2, BMP-3, BMP-4, BMP-6, BMP-7, and BMP-9.

12 . The method of claim 1 wherein the biological treatment comprises stem cell material selected from dedifferentiated stem cells, undifferentiated stem cells, mesenchymal stem cells, marrow-extracted stem cell material and adipose-derived stem cell material.

13 . The method of claim 1 wherein the biological treatment comprises a biologically active component selected from cartilage derived morphogenetic protein (CDMP);

cartilage inducing factor (CIP); proteoglycans; hormones; and matrix metalloproteinases (MMP) inhibitors.

14 . The method of claim 1 wherein the biological treatment comprises a biologically active component selected from allogenic disc annulus material, xenogenic disc annulus material, biologic tissues, activated tissue grafts, engineered cells comprising a nucleic acid for encoding a protein or variant thereof, and a recombinant human bone morphogenetic protein.

15 . The method of claim 1 wherein the load-bearing device is formed from a material selected from polyaryletherketone (PAEK), polyetheretherketone (PEEK), polyetherketoneketone (PEKK), PEEK-carbon composite, polyetherimide, polyimide, polysulfone, polyethylene, polyester, polylactide, copolymers of poly L-lactide and poly D-lactide, polyorthoester, tyrosine polycarbonate, polyurethane, silicone and polyolefin rubber, and combinations thereof.

16 . The method of claim 1 wherein the load-bearing device is bioresorbable or partially resorbable.

17 . The method of claim 1 wherein the load-bearing device comprises at least one of a fixation system, a dampener system, an annulus repair system, and an annulus replacement system.

18 . The method of claim 17 wherein the load-bearing device comprises a fixation system comprising at least one of hooks, rods and screws.

19 . The method of claim 1 wherein the load-bearing device comprises at least one of plates, sheets and rods.

20 . The method of claim 1 wherein the load-bearing device is formed from a biocompatible material selected from metals, polymers, ceramics, and tissue, and combinations thereof.

21 . The method of claim 1 wherein:

the area of the vertebral column receiving the biological treatment comprises a facet joint.

22 . The method of claim 1 wherein:

the area of the vertebral column receiving the biological treatment comprises a facet joint;

the biological treatment comprises collagen, stem cells and BMP-6; and

the load-bearing device is applied to the posterior region adjacent to the facet joint receiving the biological treatment.

23 . The method of claim 1 wherein:

the area of the vertebral column receiving the biological treatment comprises a facet joint;

the biological treatment comprises a polyvinyl alcohol hydrogel containing chondrocytes and TGF-beta 2; and

the load-bearing device comprises a fixation system comprising at least one rod and at least one screw applied to the posterior region adjacent to the facet joint receiving the biological treatment.

24 . The method of claim 1 wherein:

the area of the vertebral column receiving the biological treatment comprises a facet joint;

the biological treatment comprises a polyethylene glycol gel containing fibroblasts and TGF-beta; and

the load-bearing device is applied to the posterior region adjacent to the facet joint receiving the biological treatment.

25 . The method of claim 1 wherein:

the area of the vertebral column receiving the biological treatment comprises a facet joint;

the biological treatment comprises a porcine-based collagen containing anti-TNF alpha and ILGF; and

the load-bearing device is applied to the posterior region adjacent to the facet joint receiving the biological treatment.

26 . The method of claim 1 wherein the biological treatment is non load-bearing.

27 . A method for treating a motion segment of a spinal column comprising:

accessing a portion of a patient's spinal column;

implanting a load-bearing device to at least partially mechanically unload an intact motion segment in the patient's spinal column, wherein the intact motion segment comprises a facet joint; and

injecting a biological treatment into the facet joint.

28 . The method of claim 27 wherein the load-bearing device is implanted at a location in the spine that is spaced from the motion segment receiving the biological treatment.

29 . The method of claim 27 wherein the load-bearing device is implanted at a location in the spine that is adjacent to the motion segment receiving the biological treatment.

30 . The method of claim 27 wherein the biological treatment is non-load-bearing.