Laminoplasty implants and methods of use

Abstract

An implant is provided for connecting the vertebral arch plate with the epiphysis that has been separated from the lateral mass of the vertebra during the laminoplasty procedure. [Solution] The implant (10) has a first portion (20) configured to engage with the lateral mass (120). The first portion has a lateral opening (34) for receiving a fastener (36) for fixing it to the lateral mass. The implant has a second portion (60) configured to engage with the epiphysis (160). The second portion is connected to the first portion such that the second portion is rotatable relative to the first portion about a rotational axis. The second portion has a lateral opening for receiving a fastener. The implant is configured so that the first portion can be fixed to the lateral mass prior to the separation of the arch from the lateral mass.

Description

Technical Field

[0001] The present invention generally relates to surgical implants. In particular, the present invention relates to implants for vertebroplasty.

Background Art

[0002] In some pathological findings, the spinal canal passing through the patient's vertebrae is too narrow or is becoming too narrow, constricting the spinal cord passing through it. The narrowing can be congenital and potentially affect patients at any age. The narrowing can also be due to other causes, such as aging, trauma or excision of the lamellar tissue of the vertebra.

[0003] Age-related conditions are, for example, spondylosis in which the water content of the intervertebral disc decreases and its density becomes smaller. These degenerative changes occurring near the intervertebral disc can sometimes cause bone overgrowth and the formation of bone spurs, called "bone spurs", which can compress the spinal cord. Narrowing of the spinal cord in the spine often causes, for example, pain, weakness, or loss of sensation in the hands and feet. Other causes of spinal cord narrowing include atrophy of the intervertebral disc, which causes the intervertebral disc cavity to narrow and its rim to bulge and spread like a mushroom, resulting in pressure being applied to the spinal cord. Due to degenerative arthritis of the facet joints, the joints may expand or the vertebrae may slide against each other, which can also compress the spinal cord. For example, instability between vertebrae caused by stretching or thickening of ligaments can also cause pressure on the spinal cord or nerve roots.

[0004] Myelopathy, that is, dysfunction of the spinal cord, occurs due to compression of the spinal cord. The rubbing of the spinous process against the spinal cord can also contribute to this symptom, and spinal cord compression can ultimately damage the blood vessels supplying blood to the spinal cord, worsening the myelopathy.

[0005] Traditional procedures to relieve compression of the spinal cord include laminectomy, which involves removing the vertebral arch and vertebral processes to expose the dura mater covering the spinal cord. Another known procedure is laminoplasty, which involves lifting the vertebral arch away from the dura mater, but not completely removing it. Typically, one side of the vertebral arch is cut, while a partial incision is made on the other side, allowing the arch to hinge and move away from the spinal cord, thereby increasing the size of the spinal canal. Next, a laminoplasty plate is screwed to the articular surface and to the hinged vertebral arch. A plate of the appropriate size is selected and bent to the desired shape, preferably having multiple screw holes. Bone supports are placed in the vertebral arch and within the opening in the articular surface to help maintain the opening of the vertebral arch. Prior to surgery, the surgeon needs to measure the vertebra to determine the size of the plate required for implantation. At that point, it is best to select a plate with appropriate dimensions and shape, which can then be implanted in the relevant area. [Overview of the project] [Problems that the invention aims to solve]

[0006] There is a need for laminoplasty implants that preferably have a uniform size and allow the degree of opening of the laminoplasty disc to the lateral vertebral mass to be varied as needed to suit the patient's anatomical structure, cutting location, and other factors.

[0007] There is a need for a laminoplasty implant that is foldable, preferably to allow introduction into the surgical site via a cannula or the like.

[0008] Another request is for a laminoplasty implant that can be surgically implanted using minimally invasive techniques. [Means for solving the problem]

[0009] The requests described herein, as well as further requests and other requests, and further advantages and other advantages, are satisfied or provided by the teachings of the present invention which describe the solutions and advantages described below.

[0010] In one aspect, the gist of the present invention is an implant for connecting a vertebral arch with an epiphysis separated from the lateral mass of a vertebra during a laminoplasty procedure. The implant has a first portion configured to engage with the lateral mass. The first portion has a surface that interfaces with the lateral mass. The first portion has a lateral opening for receiving fasteners for fixing the first portion to the lateral mass. The implant has a second portion configured to engage with the epiphysis of the vertebral arch separated from the lateral mass during a laminoplasty procedure. The second portion extends between a proximal and distal end. The proximal end of the second portion is connected to the first portion such that the second portion is rotatable about a rotational axis relative to the first portion. The second portion has a lateral opening for receiving fasteners for fixing the second portion to the vertebral arch.

[0011] In yet another embodiment of an implant for connecting a vertebral arch with an epiphysis separated from the lateral mass of the vertebra during a laminoplasty procedure, the second portion has a receiving portion configured to receive the epiphysis of the separated vertebral arch.

[0012] In yet another embodiment of an implant for connecting the arch plate with the epiphysis separated from the lateral mass of the vertebra during a laminoplasty procedure, the receiving portion is located at the distal end of the second portion.

[0013] In yet another embodiment of an implant for connecting a vertebral arch with an epiphysis separated from the lateral mass of the vertebra during a laminoplasty procedure, the receiving portion has an outer member extending distally from a second portion. The receiving portion further has an inner member extending distally from the second portion. The receiving portion forms a space between the outer member and the inner member.

[0014] In yet another embodiment of an implant for connecting a vertebral arch plate with an epiphysis separated from the lateral mass of the vertebra during a laminoplasty procedure, the receiving portion is configured to receive the epiphysis of the lateral mass between an outer member and an inner member.

[0015] In yet another embodiment of an implant for connecting a vertebral arch with an epiphysis separated from the lateral mass of the vertebra during a laminoplasty procedure, a lateral opening for receiving a fastener for fixing a second portion to the vertebral arch penetrates the outer member.

[0016] In yet another embodiment of an implant for connecting an epiphyseal arch plate separated from the lateral mass of a vertebra during a laminoplasty procedure, the receiving portion comprises a transition portion located between an outer member and an inner member, the transition portion extending along an axis parallel to the spine once the first portion is fixed to the lateral mass.

[0017] In yet another embodiment of an implant for connecting a vertebral arch with an epiphysis separated from the lateral mass of the vertebra during a laminoplasty procedure, the distance between the outer and inner members is greater than the width of the vertebral arch measured at the epiphysis of the arch.

[0018] In yet another embodiment of an implant for connecting a vertebral arch with an epiphysis separated from the lateral mass of the vertebra during a laminoplasty procedure, the inner member is configured to abut against the inner surface of the vertebral arch and the outer member abuts against the outer surface of the vertebral arch once the epiphysis of the vertebral arch is received into the receiving portion.

[0019] In yet another embodiment of an implant for connecting a vertebral arch with an epiphysis separated from the lateral mass of the vertebra during a laminoplasty procedure, the outer and inner members are U-shaped to receive the epiphysis of the vertebral arch.

[0020] In yet another embodiment of an implant for connecting the arch plate with the epiphysis separated from the lateral mass of the vertebra during a laminoplasty procedure, the outer member extends further from the second portion than the inner member.

[0021] In yet another embodiment of an implant for connecting a vertebral arch with an epiphysis separated from the lateral mass of the vertebra during a laminoplasty procedure, the lateral opening is positioned on the outer member such that the fastener, inserted through the lateral opening and received in the vertebral arch, does not strike the first projection.

[0022] In yet another embodiment of an implant for connecting a vertebral arch with an epiphysis separated from the lateral mass of the vertebra during a laminoplasty procedure, the outer member has a flexible portion extending in the direction of the spine. The flexible portion is located between the lateral opening of the second portion and the proximal end of the second portion.

[0023] In yet another embodiment of an implant for connecting a vertebral arch with an epiphysis separated from the lateral mass of the vertebra during a laminoplasty procedure, the implant further comprises an osteofusion material provided on one or more surfaces of the implant that interface with the bone. The osteofusion material is selected to promote ossinolysis between the bone and the osteofusion material.

[0024] In yet another embodiment of an implant for connecting a vertebral arch with an epiphysis separated from the lateral mass of the vertebra during a laminoplasty procedure, the first portion has a plurality of positioning pins extending from the interface surface. The positioning pins are configured to engage with the bone to prevent movement of the first portion relative to the lateral mass while the fastener is attached.

[0025] In yet another embodiment of an implant for connecting an epiphyseal arch plate separated from the lateral mass of a vertebra during a laminoplasty procedure, the first portion and rotational axis are configured such that the first portion can be fixed to the lateral mass before the arch plate is cut adjacent to the lateral mass.

[0026] In yet another embodiment of an implant for connecting the vertebral arch with the epiphysis separated from the lateral mass of the vertebra during a laminoplasty procedure, the rotational axis extends along an axis parallel to the spine once the first portion is fixed to the lateral mass.

[0027] In yet another embodiment of an implant for connecting a vertebral lamina having an osteotomy end separated from the lateral mass of a vertebra during a vertebroplasty procedure, the implant has a hinge provided between a first portion and a second portion. The hinge facilitates rotation of the first portion and the second portion.

[0028] In yet another embodiment of an implant for connecting a vertebral lamina having an osteotomy end separated from the lateral mass of a vertebra during a vertebroplasty procedure, the receiving portion is U-shaped.

[0029] These and other aspects of the present invention will become apparent in light of the following brief description of the drawings and detailed description.

Brief Description of the Drawings

[0030] [Figure 1] A perspective view of the front side of an implant as one embodiment of the present invention. [Figure 2] A perspective view of the back side of the implant shown in FIG. 1. [Figure 3] A perspective view of the bottom side of the implant shown in FIG. 1. [Figure 4] A perspective view of the bottom side of the implant shown in FIG. 1. [Figure 5] A perspective view of the implant shown in FIG. 1, further showing a fastener for fixing the implant. [Figure 6A] A view showing a cross-section of a vertebra. [Figure 6B] A view showing a cross-section of a vertebra, showing a state in which a vertebral lamina having an osteotomy end is separated from the vertebra during a vertebroplasty procedure. [Figure 6C] A view showing a cross-section of a vertebra, showing a state in which a vertebral lamina having an osteotomy end is separated from the vertebra during a vertebroplasty procedure, and a state in which a first portion of the implant is fixed to the lateral mass. [Figure 6D] A view of the implant shown in FIGS. 6A and 6B. [Figure 6E]Figures 6A and 6B show the implant, with the second portion fixed to the vertebral arch and the bone ends of the vertebral arch receptacle received within the receiving portion. [Modes for carrying out the invention]

[0031] This disclosure describes aspects of the present invention with reference to the exemplary embodiments shown in the drawings, but the aspects of the present invention are not limited to the exemplary embodiments shown in the drawings. As will be apparent to those skilled in the art, the aspects of the present invention include many more embodiments. Therefore, the aspects of the present invention should not be limited in light of the exemplary embodiments shown in the drawings. Also, as will be apparent to those skilled in the art, modifications and alterations can be made without departing from the true scope of the invention. For example, in some cases, one or more features disclosed in connection with one embodiment can be used alone or in combination with one or more features of one or more other embodiments.

[0032] Referring to Figures 1 to 4, an implant 10 is shown for connecting the lamina plate 130 with the epiphysis 160 separated from the lateral mass 120 of the vertebra 140 during a laminoplasty procedure. The implant 10 has a first portion 20 configured to engage with the lateral mass 120 (not shown in Figures 1 to 4). The implant 10 has a second portion 60 configured to engage with the epiphysis 160 of the lamina plate separated from the lateral mass 120 during a laminoplasty procedure.

[0033] In the embodiment disclosed in Figure 1, the first portion 20 extends in a plane between the first end 30 and the second end 40. The first portion 20 has a top surface 32 and a bottom surface 42. The bottom surface 42 is configured to interface with the outer mass 120 when the implant 10, in particular the first portion 20, is positioned relative to the outer mass 120. The first portion 20 has a rim 22 that extends along the periphery of the first portion 20 between the top surface 32 and the bottom surface 42. In the embodiments disclosed in Figures 1 to 4, the rim 22 of the first portion 20 defines a quadrilateral, however, the present invention is not limited in this respect. Those skilled in the art will understand that the shape of the first portion may vary. Preferably, the bottom surface 42 of the first portion is configured to interface with the outer mass 120.

[0034] The first portion 20 has a hole 34 extending between the top surface 32 and the bottom surface 42. The hole 34 is configured to receive a fixation device, such as a bone screw 36 (shown in Figure 5). The illustrated embodiment has one hole 34 in the first portion 20, but the present invention is not limited in this respect. Those skilled in the art will understand that the first portion 20 may have two or more through holes for receiving bone fixation devices. In the illustrated embodiment, the first portion 20 has a second hole 44 extending between the top surface 32 and the bottom surface 42. The second hole 44 is configured to receive surgical instruments for manipulating the implant 10 during surgical introduction of the implant 10. It should be understood that the second hole 44 is not necessary for carrying out the present invention. For example, the second hole 44 may be omitted from the implant 10.

[0035] The implant 10 has a second portion 60 extending from a proximal end 70 and a distal end 80. The second portion 60 has a top surface 72 and a bottom surface 82. The second portion 60 has a rim 62 extending along the periphery of the second portion 60 between the top surface 72 and the bottom surface 82. In the embodiments disclosed in Figures 1 to 4, the rim 22 of the second portion 60 defines a quadrilateral; however, the present invention is not limited in this respect. Those skilled in the art will understand that the shape of the second portion 60 may vary.

[0036] The first portion 20 is connected to the second portion 60 such that the first portion 20 is rotatable relative to the second portion 60 about a rotation axis 59. In the embodiment shown in Figure 1, the first end 30 of the first portion 20 is connected to the proximal end 70 of the second portion 60. Thus, the first portion 20 can rotate relative to the second portion 60 about a rotation axis 59. In the illustrated embodiment, the first portion 20 is connected to the second portion 60 via a hinge 50. In the disclosed embodiment, a portion of the hinge 50 is integral with the first portion 20, and a portion of the hinge is integral with the second portion 60. The first portion 20 has a knuckle 52 with a bore 54. The knuckle 52 extends from the first end 22 of the first portion 20. The second portion 60 has two pins 56. The pins 56 are configured to be received in opposite openings 58 provided in the bore 54 of the knuckle 52. Thus, the hinge 50 facilitates the rotation of the first part 20 relative to the second part 60 around the axis of rotation 59. In this embodiment, the pin 56 and the bore 58 are coaxial with the axis of rotation 59 when the hinge 50 is assembled. In this embodiment, the hinge 50 is preferably assembled by a surgical team by snapping the pin 56 into the bore 56. In a variation, the hinge may be assembled by the manufacturer.

[0037] It should be understood that while one embodiment of the hinge is illustrated, the present invention is not limited in this respect, and rotation of the first part 20 relative to the second part 60 can be achieved using many different techniques. For example, in one embodiment of the present invention, the first part 20 and the second part are preferably connected by a flexible material extending between the first end 30 of the first part 20 and the proximal end 70 of the second part 60. Thus, the material provided between the first part 20 and the second part 60 allows rotation of the first part 20 relative to the second part 60. Similarly, rotation can be achieved using many different forms of hinges.

[0038] The second portion 60 has a hole 74 extending between the top surface 72 and the bottom surface 82. The hole 74 is configured to receive a fixation device, such as a bone screw 76 (shown in Figure 5). The illustrated embodiment includes one hole 74 provided in the second portion 60, but the present invention is not limited in this respect. Those skilled in the art will understand that the second portion 60 may have two or more through holes for receiving bone fixation devices.

[0039] In one embodiment of the present invention, the second portion 60 has a receiving portion 90 configured to receive the epiphysis 160 of a separated vertebral arch. Referring to the embodiments disclosed in Figures 1 to 4, the receiving portion 90 is located at the distal end 80 of the second portion 60, forming part of the second portion 60. In the illustrated embodiment, the receiving portion 90 has an inner member 100 and an outer member 110. The inner member 100 extends distally from the second portion 60 to its distal end 102. The outer member extends distally from the second portion to its distal end 112. As shown in the illustration, the receiving portion 60 forms a space 92 between the inner member 100 and the outer member 110.

[0040] The receiving portion 90 is configured to receive the epiphysis 160 of the vertebral arch plate separated from the outer mass. This is shown, for example, in Figure 6E. The epiphysis 160 is received in the space 92 between the inner member 100 and the outer member 110. In this way, the implant 10 of the present invention facilitates the performance of laminoplasty procedures.

[0041] In the disclosed embodiment, the hole 74 in the second portion 60 for receiving the bone screw 76 extends laterally through the outer member 110. In this way, the screw 76 can be fixed to the bone end 160 of the arch plate, which separates the outer member 110 and the second portion 60 from the outer mass.

[0042] The receiving portion 90 includes a transition portion 94 between the outer member 110 and the inner member 100. In the illustrated embodiment, the transition portion is perpendicular to the second portion 60 and is U-shaped in plane, extending from the proximal end 70 to the distal end 80. Thus, the transition portion 94 extends along an axis parallel to the spine when the first portion 20 is fixed to the outer mass 120. As will be understood by those skilled in the art familiar with the present disclosure in the art, the present invention is not limited in this respect and various forms of transition portions can be used in accordance with the present invention. In some embodiments of the present invention, it can be said that the present invention can be carried out without a receiving portion. In such embodiments, the first portion 60 is held adjacent to the outer surface of the vertebral arch located near the epiphysis 160. Using a surgical implant, a resistive force can be applied to the lower surface of the vertebral arch while the screw 76 is fixed to the vertebral arch.

[0043] The inventors have discovered that by using the receiving portion 90 according to the illustrated embodiment of the implant 10, a stopping force can be provided to the epiphysis of the vertebral arch, thereby facilitating the fixation of the second portion to the vertebral arch via a bone screw. The inventors have found that this embodiment is particularly advantageous when performing laminoplasty using minimally invasive techniques or limited instruments. The implant 10 of the present invention does not require adjustment at the surgical site to match the degree of opening of the vertebral arch. The implant 10 is configured to have a range of use for such degree of opening. A further technical advance of the implant of the present invention is that it can be easily fixed to the lateral mass and the separated epiphysis.

[0044] The distance between the outer member 110 and the inner member 100 is selected to be greater than the width of the vertebral arch measured at the end of the vertebral arch. In this way, the end of the vertebral arch 160 can be received within the receiving portion 90. When the end of the vertebral arch is received within the receiving portion 90, the inner member 100 is configured to abut against the inner surface 162 of the vertebral arch, and the outer member 110 is configured to abut against the outer surface 164 of the end of the vertebral arch 160. In some embodiments of the present invention, the inner member 100, the transition portion 94, and the outer member 110 define a U-shape for receiving the end of the vertebral arch.

[0045] Referring to the illustrated embodiment, the outer member 110 extends further distally from the inner member 100. Thus, the fixation device that is received through the outer member 110 does not come into contact with the inner member 100 until the screw penetrates the arch. Those skilled in the art will understand that the distal extensions of the inner member 100 and the outer member 110 may vary, and the present invention is not limited in this respect. For example, the distal extension of the inner member and the distal extension of the outer member may be the same. In another embodiment, the distal extension of the inner member is greater than the distal extension of the outer member.

[0046] In one embodiment of the present invention, the outer member 110 has a flexible portion 114 extending in the direction of the spine. The flexible portion 144 is positioned between the lateral opening 74 of the second portion 60 and the proximal end 70 of the second portion. In some embodiments, the flexible portion 114 is provided between the receiving portion 90 and the proximal end 70 of the second portion 60. In this way, the flexible portion 114 provides flexibility in addition to the rotational axis, thereby allowing the receiving portion to interface appropriately with the arch so that the desired fixation of the arch can be achieved.

[0047] In one embodiment, the implant is made of titanium. In another embodiment, the implant is made of a biocompatible polymer. In a modified embodiment, the implant 10 is made of any suitable material known to those skilled in the art. The implant 10 may further have an osteofusion material provided on one or more surfaces of the implant that interface with the bone. The osteofusion material is selected to promote ossinolysis between the bone and the osteofusion material.

[0048] In some embodiments of the present invention as shown in the figures, the first part 20 has a plurality of positioning pins 24 extending from the interface surface (bottom surface) 42 of the first part. The positioning pins 24 are configured to engage with bone to prevent movement of the first part 20 relative to the outer mass 120 while the fastener 36 is attached. In yet another embodiment of the present invention, the positioning pins are provided on the second part. As will be understood by those skilled in the art, the present invention is not limited in this respect and can be carried out without positioning pins.

[0049] The first portion 20 and the axis of rotation 59 are configured to allow the first portion 20 to be fixed to the lateral mass 120 before cutting the laminoplasty adjacent to the lateral mass 120. As will be understood by those skilled in the art familiar with the present disclosure in the art, the present invention is not limited in this respect, and the laminoplasty may be cut and separated from the lateral mass before the first portion is fixed. However, the inventors have found that several advantages can be obtained by providing an implant configured to allow the fixation of the first portion 20 prior to the separation of the laminoplasty. First, the implant can simplify the laminoplasty procedure. Second, the implant can provide optical or physical guidance to allow cutting of the laminoplasty in such a manner that the epiphysis 160 can be received into the receiving portion.

[0050] Referring to Figure 5, bone screws 36,76 used in the implant 10 of the present invention are disclosed. As will be understood by those skilled in the art, a wide variety of bone fixation devices can be used in the present invention. The present invention is not limited to the fixation device type or bone screw type shown in Figure 5.

[0051] Referring to Figures 6A to 6E, a method for attaching the implant 10 according to the present invention is shown. Figure 6A shows a cross-section of the laminoplasty disc 130. During the laminoplasty procedure, the laminoplasty disc 130 is repositioned to enlarge the cervical cavity of the spine, thereby reducing the pressure and stress on the spinal nerves located within this cavity. The first lateral portion 132 of the laminoplasty disc is completely cut using surgical tools. It is preferable to partially cut the opposite lateral portion of the laminoplasty disc, thereby facilitating the opening of the laminoplasty disc 130 as shown in Figure 6B.

[0052] Referring to Figure 6C, the first portion 20 of the implant is fixed to the outer mass 120. The bottom surface 42 of the first portion 20 interfaces with the outer surface of the outer mass. A screw 76 is inserted through the first portion 20 so that the first portion is fixed to the outer mass 120. In the illustrated embodiment, the laminolam is separated and spread at the first lateral portion 132, thereby forming the epiphysis 160 of the laminolam. This is the position after rotation. The first lateral portion 132 of the laminolam 130 can be cut before or after the fixation of the first portion 20.

[0053] Referring to Figure 6D, the second portion 60 is rotated around the axis of rotation 59 so that the receiving portion 90 moves in close contact with the epiphysis 160 of the vertebral arch. Both the epiphysis 160 and the receiving portion are rotated so that the epiphysis is received within the receiving portion 90 between the inner member 100 and the outer member 110. The receiving portion 90, and the inner member 100 and the outer member 110 located on opposite sides of each other, help to hold the position of the epiphysis 160 within them while the fixation device 76 is inserted into the vertebral arch, thereby fixing the second portion 60 to the epiphysis of the vertebral arch. Thus, the inventors have found that laminoplasty can be performed more easily and efficiently compared to other known methods and systems.

[0054] As will be understood by those skilled in the art, specific embodiments of implant 10 are illustrated, but the present invention is not limited to the specific or relative dimensions of the individual components disclosed herein. Those skilled in the art will understand that the dimensions of the implant may vary based on the anatomical structure and the form of the procedure. Furthermore, the figures provided herein are intended to illustrate the present invention.

[0055] The inventors have further discovered that, as another advantage of the invention, the first part can be rotated relative to the second part, and as a result, the implant can be completely folded. In this way, the implant is compact and can be inserted into the surgical site with minimally invasive surgical instruments.

[0056] Certain terminology is used herein for reference purposes only, and thus this terminology does not limit the invention. For example, terms such as “top,” “bottom,” “upper,” and “downward” refer to directions in the referenced drawings. For example, terms such as “front,” “back,” “bottom,” and “side” refer to the orientation of parts of a component within a consistent but arbitrary reference frame, which is made clear by referring to the text and the relevant drawings describing the component under description. Such terminology may include the words specifically mentioned above, their derivatives, and words with similar meanings. Similarly, “first,” “second,” and other such numerical terms referring to structures do not imply order or sequence unless explicitly specified in the context.

[0057] When introducing components or features of the present invention and exemplary embodiments in this description, the articles “a,” “an,” “the,” and “said” in the original specification (translated as “the foregoing”) mean that one or more such components or features exist. The terms “comprising,” “including,” and “having” are comprehensive terms and mean that there may be additional components or features other than those specifically mentioned. Furthermore, it should be understood that the method steps, processes, and operations described herein should not be considered as necessarily requiring these actions in a specific order as described or illustrated, unless otherwise specified. It should also be understood that additional or alternative steps may be employed.

[0058] The present invention is not limited to the embodiments or examples contained herein, and the claims should be understood to include modifications of such embodiments, including parts of the embodiments, and combinations of various constituent elements of the embodiments that fall within the scope of the invention described in the following claims. All prior art documents (including patent and non-patent documents) described herein are incorporated herein by reference and their entire contents are incorporated herein by reference. [Explanation of Symbols]

[0059] 10 Implants 20 Part 1 32 Top surface 60 Part 2 80 Distal end 90 Reception Department 100 Internal material 110 Exterior components 120 Outer mass 130 Lamina 140 vertebrae 160 Epiphysis

Claims

1. An implant for connecting the vertebral arch plate with the epiphysis separated from the lateral mass of the vertebra during laminoplasty, wherein the implant is Having a first portion configured to engage with the outer mass, the first portion having a surface that interfaces with the outer mass, and the first portion having a lateral opening for receiving fasteners for fixing the first portion to the outer mass, It has a second portion configured to engage with the bone ends of the vertebral plate separated from the lateral mass during the laminoplasty procedure, the second portion extending between a proximal end and a distal end, the proximal end of the second portion being connected to the first portion such that the second portion is rotatable about a rotational axis relative to the first portion, The implant comprises a second portion having a lateral opening for receiving fasteners for fixing the second portion to the vertebral arch.

2. The implant according to claim 1, wherein the second portion has a receiving portion configured to receive the bone end of the separated vertebral arch plate.

3. The implant according to claim 2, wherein the receiving portion is located at the distal end of the second portion.

4. The receiving section is, An outer member extending distally from the second portion, It has an inner member extending distally from the second portion, The implant according to claim 3, wherein the receiving portion forms a space between the outer member and the inner member.

5. The implant according to claim 4, wherein the receiving portion is configured to receive the bone end of the outer mass between the outer member and the inner member.

6. The implant according to claim 4, wherein the lateral opening for receiving a fastener for fixing the second portion to the vertebral arch penetrates the outer member.

7. The implant according to claim 6, wherein the receiving portion comprises a transition portion located between the outer member and the inner member, and the transition portion extends along an axis parallel to the spine when the first portion is fixed to the outer mass.

8. The implant according to claim 6, wherein the distance between the outer member and the inner member is greater than the width of the vertebral arch measured at the bone end of the vertebral arch.

9. The implant according to claim 8, wherein when the bone end of the vertebral arch is received within the receiving portion, the inner member is configured to abut against the inner surface of the vertebral arch, and the outer member is configured to abut against the outer surface of the vertebral arch.

10. The implant according to claim 9, wherein the outer member and the inner member are U-shaped to receive the bone ends of the vertebral arch.

11. The implant according to claim 9, wherein the outer member extends further from the second portion than the inner member.

12. The implant according to claim 11, wherein the lateral opening is positioned on the outer member such that the fastener, which is inserted through the lateral opening and received in the arch plate, does not come into contact with the first projection.

13. The implant according to claim 6, wherein the outer member has a flexible portion extending in the direction of the spine, and the flexible portion is located between the lateral opening of the second portion and the proximal end of the second portion.

14. The implant according to claim 6, further comprising a bone fusion material provided on one or more surfaces of the implant that interface with bone, wherein the bone fusion material is selected to promote bone assimilation between the bone and the bone fusion material.

15. The implant according to claim 6, wherein the first portion has a plurality of positioning pins extending from the interface surface, the positioning pins being configured to engage with the bone to prevent the movement of the first portion relative to the outer mass while the fastener is attached.

16. The implant according to claim 6, wherein the first portion and the axis of rotation are configured to allow the first portion to be fixed to the outer mass before the arch plate is cut adjacent to the outer mass.

17. The implant according to claim 6, wherein the rotational axis extends along an axis parallel to the spine when the first portion is fixed to the outer mass.

18. The implant according to claim 6, wherein the implant is provided between the first portion and the second portion and has a hinge that facilitates rotation between the first portion and the second portion.

19. The implant according to claim 6, wherein the receiving portion is U-shaped.

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