SPINAL IMPLANTS WITH COOPERATING ANCHORING SUTURES
Spinal implant devices include: (a) a spinal implant; and (b) at least on suture extending through a bone tunnel and attached to the spinal implant to fixate the spinal implant in the body.
1 . A spinal implant with at least one cooperating suture, comprising:
a spinal implant; and
at least one suture, wherein, in position, the at least one suture extends through a bone tunnel in a vertebral body and attaches to the spinal implant.
2 . An implant according to claim 1 , wherein the spinal implant is a total disc replacement spinal implant with attachment material attached thereto, the spinal implant having a primary implant body with a boundary substantially coextensive with a target natural spinal disc replacement location, wherein the attachment material extends in at least one of a superior or inferior direction beyond the bounds of the primary implant body with opposing end portions of the at least one suture extending through the attachment material while a medial portion of the suture resides in the bone tunnel in the vertebral body.
3 . An implant according to claim 1 , wherein, during implantation, the suture includes at least one needle, wherein the needle is curved with a substantially blunt tip.
4 . An implant according to claim 1 , wherein the spinal implant comprises attachment material, wherein the at least one suture is configured so that a length of suture forms two outwardly extending legs with a medial portion therebetween, and wherein, in position, the two legs of the suture define a suture knot that reside tightly against an outer surface of the attachment material with the medial portion in the bone tunnel in the vertebral body.
5 . An implant according to claim 4 , wherein the at least one suture is a plurality of sutures for multi-point attachment to the attachment material of the spinal implant.
6 . An implant according to claim 1 , wherein the at least one suture extends through a bone tunnel formed in vertebral cancellous bone.
7 . An implant according to claim 1 , wherein the at least one suture is resorbable.
8 . An implant according to claim 2 , wherein the primary body is a non-articulating unitary elastomeric body.
9 . An implant according to claim 2 , wherein the attachment material comprises a porous material.
10 . An implant according to claim 2 , wherein the attachment material comprises a mesh skirt extending over at least a major portion of an annulus outer surface of the primary implant body with upwardly and downwardly extending pliant segments, and wherein the at least one suture is at least two spaced apart sutures that are secured to the mesh skirt via tied suture knots, wherein the tied suture knots snugly abut an outer surface of the pliant segments forcing the attachment material against the vertebral body.
11 . An implant according to claim 1 , further comprising at least one threaded bone anchor with an associated suture attached to the bone attachment material in a location that is spaced apart from the at least one suture.
12 . An implant according to claim 2 , wherein the primary body comprises a crystalline polyvinylalcohol hydrogel, wherein the bone attachment material comprises a mesh skirt with attachment segments that extend above and below a superior and inferior surface of the primary body, and wherein the at least one suture is at least four sutures, a respective one attached to spaced apart portions of the attachment segments of the mesh skirt with the suture sets from the bone anchors tied in knots tightly against an outer surface of the mesh skirt.
13 . A medical spinal implant kit, comprising;
a total disc replacement (TDR) spinal implant comprising a bone attachment material; and
a plurality of sutures configured to reside against an outer surface of the bone attachment material with the respective sutures configured and sized to reside in at least one bone tunnel in a vertebral body above and/or below the TDR implant to secure the TDR implant in position.
14 . A medical kit according to claim 13 , wherein each of the plurality of sutures comprise a needle or a substantially rigid sharp leading edge portion configured to be able to penetrate the bone attachment material, and wherein, in position the edges of the sutures define suture knots that reside against the outer surface of the bone attachment material.
15 . A medical kit according to claim 13 , wherein the bone attachment material comprises at least one of needle, suture or bone tunnel alignment indicia to allow a clinician to visually identify target suture positions.
16 . A medical kit according to claim 13 , further comprising a bone tunneling drill configured to form a bone tunnel in a vertebral body.
17 . A medical kit according to claim 13 , further comprising at least one suture anchor with a threaded bone anchor body and an associated at least one suture.
18 . A medical kit according to claim 13 , wherein the bone attachment material comprises mesh.
19 . A medical kit according to claim 13 , further comprising a bone tunnel template for defining target bone tunnel ingress and egress positions in a vertebral body.
20 . A method of attaching a total disc replacement (TDR) implant to at least one vertebral body, comprising;
implanting a TDR;
forming at least one bone tunnel in at least one vertebral body proximate the TDR;
inserting at least one suture through the at least one bone tunnel; and
affixing the inserted at least one suture to the TDR to thereby secure the TDR in position in the body.
21 . A method according to claim 20 , wherein the forming step is carried out after the implanting step.
22 . A method according to claim 20 , wherein the implanting step is carried out before the inserting step.
23 . A method according to claim 20 , wherein the implanting step is carried out after the forming and inserting steps.
24 . A method according to claim 20 , wherein the affixing step comprises tying the at least one suture to form a knot.
25 . A method according to claim 20 , wherein the TDR comprises a porous bone attachment material extending upwardly and/or downwardly beyond the bounds of a primary implant body, wherein the method further comprises:
pushing or pulling the porous bone attachment material away from the proximate vertebral body during the inserting step; and
pushing or pulling at least one needle attached to the at least one suture through the porous bone attachment material before the affixing step.
26 . A method according to claim 20 , wherein the TDR implant comprises an elastomeric primary body with mesh bone attachment material integrally attached thereto, wherein the affixing step comprises tying a plurality of spaced apart sutures tightly against mesh material extending from the TDR implant to hold the implant in position in a patient's body.
27 . A method according to claim 20 , wherein the affixing step comprises anchoring the TDR to a vertebral body using the at least one suture extending through a bone tunnel that extends into cancellous bone.
28 . A method according to claim 20 , wherein the at least one suture is a plurality of sutures, and wherein the at least one bone tunnel is a plurality of bone tunnels, the inserting step comprises inserting at least one suture into at least two spaced apart bone tunnels in an upper vertebral body and inserting at least one suture into at least two spaced apart bone tunnels in a lower vertebral body with the TDR therebetween, and wherein the affixing step comprises tying the at least four sutures, to the TDR to thereby secure the TDR in position in the body.
29 . A method according to claim 20 , further comprising placing a template of target ingress and egress locations of a bone tunnel over a selected vertebral body, then marking the target ingress and egress locations of a bone tunnel on vertebral bone using the template.