Method and apparatus for closing a fissure in the annulus of an intervertebral disc, and/or for effecting other anatomical repairs and/or fixations

Abstract

Apparatus for attaching a first object to a second object, said apparatus comprising:a distal anchor comprising a generally cylindrical body, a distal end and a proximal end, wherein said distal end comprises an inclined distal end surface, and a vertical bore extending through said generally cylindrical body, perpendicular to the longitudinal axis of said generally cylindrical body;a proximal anchor comprising a generally cylindrical body, a distal end and a proximal end, a top surface and a bottom surface, a first vertical bore extending through said generally cylindrical body from said top surface to said bottom surface, perpendicular to the longitudinal axis of the generally cylindrical body, a second vertical bore spaced distally from said first vertical bore and extending from said top surface to said bottom surface parallel to said first vertical bore, a third vertical bore spaced distally from said second vertical bore and extending from said top surface to said bottom surface parallel to said first vertical bore, and a fourth vertical bore spaced distally from said third vertical bore and extending from said top surface to said bottom surface parallel to said first vertical bore; anda suture having a proximal end and a distal end, with an enlargement formed at said distal end, wherein said suture extends through said vertical bore of said distal anchor, through said fourth vertical bore of said proximal anchor, through said third vertical bore of said proximal anchor, through said second vertical bore of said proximal anchor and through said first vertical bore of said proximal anchor.

Description

REFERENCE TO PENDING PRIOR PATENT APPLICATIONS[0001]This patent application claims benefit of:[0002](i) pending prior U.S. Provisional Patent Application Ser. No. 61 / 866,955, filed Aug. 16, 2013 by Suture Concepts Inc. and Peter Sorensen et al. for METHOD AND APPARATUS FOR CLOSING A FISSURE IN THE ANNULUS OF AN INTERVERTEBRAL DISC, AND / OR FOR EFFECTING OTHER ANATOMICAL REPAIRS AND / OR FIXATIONS (Attorney's Docket No. SUTURECONCEPTS-1 PROV);[0003](ii) pending prior U.S. Provisional Patent Application Ser. No. 61 / 915,433, filed Dec. 12, 2013 by Suture Concepts Inc. and Peter Sorensen et al. for METHOD AND APPARATUS FOR CLOSING A FISSURE IN THE ANNULUS OF AN INTERVERTEBRAL DISC, AND / OR FOR EFFECTING OTHER ANATOMICAL REPAIRS AND / OR FIXATIONS (Attorney's Docket No. SUTURECONCEPTS-2 PROV); and[0004](iii) pending prior U.S. Provisional Patent Application Ser. No. 61 / 984,431, filed Apr. 25, 2014 by Suture Concepts Inc. and Peter Sorensen et al. for METHOD AND APPARATUS FOR CLOSING A FISSURE ...

AI Technical Summary

Benefits of technology

This approach effectively prevents recurrent herniation and allows for the treatment of herniated discs and annular tears while preserving the nucleus, providing stable closure of fissures and reducing the risk of further disc degeneration.

Problems solved by technology

The nucleus becomes thinner and less able to handle compressive loads.

The redundant annular fibers are less effective in controlling vertebral motion.

Degenerative disc disease is frequently the cause of substantial pain for a patient.

Current surgical treatments for disc degeneration are generally “destructive”, in the sense that they generally involve the removal or destruction of disc tissue.

The foregoing two groups of procedures compromise the nucleus of the treated disc, and may exacerbate fissures in the annulus while accessing the nucleus.

However, such spinal fusion procedures transmit additional stress to the adjacent discs, which typically results in premature degeneration of the adjacent discs over time.

In general, the “destructive” nature of current surgical treatments for disc degeneration can provide substantial pain relief for the patient, but it can also lead to further disc degeneration over time, which can result in new pain for the patient.

By way of example but not limitation, procedures to remove the nucleus or a portion of the nucleus, and procedures to destroy nuclear material, compromise nucleus function and may exacerbate fissures in the annulus while accessing the nucleus, thereby leading to further disc degeneration.

However, in practice, this is difficult to achieve.

By way of example but not limitation, it is difficult to close fissures in the annulus by conventional suturing.

For one thing, the annulus is tough and thick and does not lend itself to manual suturing, particularly given the limited access corridors often imposed on the surgeon.

For another thing, the loads imposed on the nucleus are large, so that inadequate closure of the fissures can lead to subsequent recurrence of the fissures.

Furthermore, the area surrounding the intervertebral disc is crowded with delicate structures (e.g., nerves), so that the use of knots to secure suture can be problematic.

By way of further example but not limitation, it is difficult to close fissures in the annulus using conventional toggle anchors.

However, this system suffers from significant drawbacks.

First, it is difficult to reliably toggle conventional toggle anchors within the nucleus, which can result in poor setting of the conventional toggle anchors within the intervertebral disc and hence inadequate closure of the fissure.

Second, it is difficult to set the cinch knot close to the surface of the annulus, particularly given the limited access corridors often imposed on the surgeon, which can result in inadequate closure of the fissure and interference with the delicate structures around the intervertebral disc, e.g., nerves, etc.

Third, the cinch knot can easily slip, thereby undermining the closure of the fissure.

For this reason, systems using conventional toggle anchors have achieved limited success in closing fissures within the annulus.

However, this knotless ratchet securement is limited to preset tension levels (i.e., it is not continuously adjustable) and has limited holding power, among other things.

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