Spinal fixation systems
The present disclosure includes fixation devices that comprise one or more porous elements or fenestrations to aid in osteo-integration of the fixation device. These fixation devices may be additively manufactured using biocompatible materials such that the solid and porous aspects of the screw are fused together into a single construct. Spinal stabilization systems are also disclosed having spanning portions extending between and securable to pedicle screw assemblies, the spanning portions have stiffness characteristics that may be variable or selectively adjustable, and/or have non-linear behavior with respect to force versus distortion. Additionally, the systems may utilize a plurality of spanning portions in which two or more of the spanning portions have different stiffness characteristics. Methods for fabricating and using the foregoing devices are also described herein.
1. A spinal stabilization system securable with a plurality of vertebrae, the system comprising:
at least one anchor configured for attachment to at least two vertebrae;
a plurality of spanning structures extending between and securable with the at least one anchor, each spanning structure having an adjustable bending stiffness;
wherein the plurality of spanning structures are arranged in layers extending substantially the distance between the at least two vertebrae;
wherein each of the spanning structures is adjusted to impart a different bending stiffness between its respective anchors;
wherein the bending stiffness of each of the spanning structures is adjustable after being secured with the anchors;
wherein the layers comprise an outer member of a first cross-sectional area and an inner portion of a second cross-sectional area that is larger than the first cross-sectional area; and
wherein the outer member cross-sectional area is smaller than the inner portion cross-sectional area, the outer member and inner portion being configured to be positioned substantially within another structural member, the combined members being retained with a first end securable with a first vertebral body and a second end operatively fixable with a second vertebral body.
2. The system of claim 1 , wherein the bending stiffness of each of the spanning structures is adjustable in an orientation corresponding to the orientation of the at least two vertebrae.
3. The system of claim 1 , wherein the bending stiffness of each of the spanning structures is adjustable in anterior, posterior, lateral, and torsional modes.
4. The system of claim 1 , wherein the bending stiffness of each of the spanning structures is variable in both longitudinal and transverse planes relative to the at least two vertebrae.
5. The system of claim 1 , wherein the bending stiffness of each of the spanning structures is adjustable by selection of the material of the inner portion, and wherein the material of the inner portion is introducable after securing the outer member to the at least one anchor.
6. The system of claim 1 , wherein the inner portion is comprised of a plurality of components, and wherein the bending stiffness of each of the spanning structures may also be adjusted by selecting a number of inner portion components disposed within the outer member.
7. The system of claim 6 , wherein the bending stiffness of each of the spanning structures is adjustable by removal or addition of inner portion components.
8. The system of claim 1 , wherein the bending stiffness of each of the spanning structures is adjustable by orientation of the inner portion relative to the outer member.
9. The system of claim 8 , wherein at least one of the outer member and the inner portion has eccentrically positioned regions of reduced cross-sectional area,. wherein rotation of the regions provides a direction of decreased bending stiffness.
10. The system of claim 1 , wherein the inner portion is at least one helical coil spring concentrically located inside the outer member comprised of at least one other helical coil spring.
11. The system of claim 10 , wherein the bending stiffness of each of the spanning structures is also adjustable by adjusting at least one physical characteristic of the one or more helical coil springs.
12. The system of claim 11 , wherein the at least one physical characteristic of the one or more helical coil springs includes at least one of the number of coils, the diameter of the coils, and the length of the spring.
13. The system of claim 10 , wherein the one or more helical coil springs provide adjustable compression/expansion stiffness to the plurality of spanning structures.
14. The system of claim 10 , wherein one of the helical coil springs provides a compression stiffness and the other helical coil spring provides an expansion stiffness to the plurality of spanning structures.
15. The system of claim 1 , wherein the compression/expansion stiffness of the each spanning structure is selectively adjustable.
16. The system of claim 1 , wherein the bending stiffness of each spanning structure is adjustable via a percutaneous incision in a patient's skin.
17. The system of claim 1 , wherein at least one spanning structure of the plurality thereof is adjustable via an end thereof.
18. The system of claim 1 , wherein at least one spanning structure of the plurality thereof is adjustable via an implanted key or tool without an incision.