Posterior functionally dynamic stabilization system
View Patent ↗A functionally dynamic stabilization unit and system for treatment of spinal instability are provided. Each unit, and collectively, the system, is configured to control flexion, extension and translation of the affected unstable vertebral area, thereby stabilizing the vertebral segments by restoring normal function. This is achieved by providing a unit and system that allow for lateral bending, axial compression, rotation, anterior segmental height adjustment, and posterior segmental height adjustment. The unit and system provide sufficient segmental stiffness, while also limiting, or controlling, the range of motion (i.e., sufficient stiffness in the neutral or active zone, while limiting or preventing motion outside of the active zone) to stabilize the vertebral segments. In use, the system mimics the natural movement of the normal spine. Furthermore, the system includes a rigid, fusion-promoting coupler configured for use in an adjacent level, or as a substitute for the functionally dynamic unit. The modularity of the system allows adjustment over time and easier revision surgery, and is configured for minimally-invasive, delivery or implantation.
1. A spinal stabilization unit, comprising:
a flexible coupler having a body, a pair of arms, the arms being located at opposed ends of the coupler, and a range-of-motion limiting mechanism configured to control an amount of bending, an amount of compression, and an amount of extension of the coupler; and
an anchoring system including a plurality of bone anchors configured to cooperate with the arms of the flexible coupler to attach the coupler to bone;
wherein the range-of-motion limiting mechanism comprises a sleeve extending internally from a first end of the coupler towards a second end of the coupler and having a narrowed distal opening, and an elongated body extending internally from the second end of the coupler towards the first end of the coupler and having an enlarged end disposed within the sleeve and dimensioned such that the enlarged end abuts the wall of the narrowed opening when the coupler is elongated or bent, and the sleeve abuts the second end of the coupler when the coupler is compressed.
2. The unit of claim 1 , wherein at least one of the arms is connected to the body of the flexible coupler at a threaded connection.
3. The unit of claim 1 , wherein the body is flexible.
4. The unit of claim 1 , wherein the body is extendable and compressible along a longitudinal axis of the body.
5. The unit of claim 1 , wherein the body is bendable along its long axis.
6. The unit of claim 5 , wherein each arm includes a concave portion having an opening, and the anchoring system further includes a semispherical bell bearing for each bone anchor.
7. The unit of claim 6 , wherein the flexible coupler is movable relative to the plurality of bone anchors.
8. The unit of claim 1 , wherein the body is cylindrical and includes a plurality of elements forming slots within the body.
9. The unit of claim 1 , wherein a length of the flexible coupler is adjustable.
10. The unit of claim 9 , wherein one of the arms is attached to the coupler at a threaded connection, and the length of the coupler can be adjusted by rotation of the arm with respect to the threaded connection.
11. The unit of claim 1 , wherein the movement of the elongate body relative to the sleeve in a first direction defines a range of extension of the coupler, and movement of the elongate body relative to the sleeve in a second direction, opposite to the first direction, defines a range of compression of the coupler.
12. The unit of claim 1 , wherein the bone anchoring system further includes at least one ball bearing and at least one nut.
13. The unit of claim 1 , wherein the flexible coupler is configured to be movable relative to the anchoring system.
14. The unit of claim 1 , wherein the anchoring system further includes a plurality of nuts, each nut having a narrowed break-away portion configured to break when sufficient torque is applied to the nut.
15. The unit of claim 1 , wherein the range-of-motion limiting mechanism is located within the body.
16. A method of implanting a spinal stabilization unit, comprising:
providing at least one incision over at least two adjacent vertebrae to be treated;
positioning at least two wires into pedicles such that each wire separately contacts a pedicle of one of the at least two vertebrae;
securing a screw to each of the first and second adjacent vertebrae to be treated;
adjusting a length of a flexible coupler to fit between two of the screws; and
attaching the flexible coupler to the two screws of the first and second adjacent vertebrae.
17. The method of claim 16 , further including measuring the distance between the screws secured to the two adjacent vertebrae.
18. The method of claim 16 , wherein adjusting the length of the flexible coupler includes rotating an arm of flexible coupler to adjust an amount the arm extends from a body portion of the flexible coupler.
19. The method of claim 16 , further comprising:
providing at least one incision over a third vertebra to be treated;
positioning at least one wire into a pedicle of the third vertebra such that the wire separately contacts the pedicle of the third vertebra;
securing a screw to the third vertebra to be treated; and
attaching a rigid coupler to the screw of the third vertebra, and to one of the screws of the first and second vertebrae.
20. The method of claim 19 , further including measuring the distance between the screw of the third vertebra and to one of the screws of the first and second vertebrae.
21. The method of claim 20 , further adjusting a length of the rigid coupler to fit between the screw of the third vertebra and to one of the screws of the first and second vertebrae.
22. The method of claim 21 , wherein adjusting the length of the rigid coupler includes rotating an arm of the rigid coupler to adjust an amount the arm extends from the rigid coupler.