Methods and systems for laterally stabilized constraint of spinous processes
View Patent ↗A spinal implant for limiting flexion of the spine includes a tether structure for encircling adjacent spinal processes. Usually, a pair of compliance members will be provided as part of the tether structure for elastically limiting flexion while permitting an extension. A cross-member is provided between the compliance member or other portions of the tether structure to stabilize the tether structure and prevent misalignment after implantation.
1. A method for restricting flexion of a spinal segment having a spinal midline, said method comprising:
providing a first attachment element and a second attachment element, wherein the first attachment element is joined to the second attachment element with one connector extending therebetween and wherein the one connector has an elastic stiffness in tension that resists flexion of the spinal segment without resisting extension thereof, wherein the one connector provides the elastic stiffness in tension between the attachment elements in the range from 7.5 N/mm to 50 N/mm;
engaging the first attachment element to a first spinous process;
engaging the second attachment element to a second spinous process or a sacrum;
disposing the one connector beside one side of the spinal midline; and
providing a reinforcement member that limits deformation of the one connector under an axial load, wherein the reinforcement member is coupled to the one connector.
2. The method of claim 1 , wherein the elastic stiffness in tension is in the range from 10 N/mm to 25 N/mm.
3. The method of claim 2 , wherein the elastic stiffness in tension is in the range from 10 N/mm to 15 N/mm.
4. The method claim 1 , wherein the one connector provides an elastic stiffness in compression between the attachment elements below 3 N/mm.
5. The method of claim 4 , wherein the elastic stiffness in compression is below 0.5 N/mm.
6. The method of claim 1 , further comprising percutaneously introducing the attachment elements and the one connector.
7. The method of claim 6 , wherein percutaneously introducing the attachment elements and the connector comprises introducing the attachment elements and the connector from one side of the spinal midline.
8. The method of claim 6 , wherein percutaneously introducing the attachment elements and the connector comprises introducing the attachment elements and the connector from a posterior approach.
9. The method of claim 1 , wherein the first and second attachment elements comprise hooks for engaging the spinous processes or sacrum.
10. The method of claim 9 , wherein engaging the attachment elements to the spinous processes or sacrum comprises introducing the hooks in a retracted configuration and pivoting the hooks relative to the connector to capture the spinous processes or sacrum.
11. The method of claim 10 , wherein the first attachment element comprises a superior hook and the second attachment element comprises an inferior hook, and wherein engaging the first attachment element comprises engaging the superior hook to a superior surface of the first spinous process and engaging the second attachment element comprises engaging the inferior hook to an inferior surface of the second spinous process or sacrum.
12. The method of claim 1 , wherein providing the reinforcement member comprises providing a reinforcement sleeve disposed over the one connector.
13. The method of claim 1 , wherein the one connector comprises a superior segment and an inferior segment, and wherein the one connector further comprises a compliance member attached to the superior and inferior segments of the connector.
14. The method of claim 13 , wherein providing the reinforcement member comprises providing a slide assembly adjacent to the compliance member, and wherein the slide assembly aligns the superior and inferior segments of the connector.