193 results about "Lumbar vertebral canal" patented technology

Surgical implants are configured for placement posteriorly to a spinal canal between vertebral bodies to distract the spine and enlarge the spinal canal. In the preferred embodiments the device permits spinal flexion while limiting spinal extension, thereby providing an effective treatment for treating spinal stenosis without the need for laminectomy. The invention may be used in the cervical, thoracic, or lumbar spine. Numerous embodiments are disclosed, including elongated, length-adjustable components coupled to adjacent vertebral bodies using pedicle screws. The preferred embodiments, however, teach a device configured for placement between adjacent vertebral bodies and adapted to fuse to the lamina, facet, spinous process or other posterior elements of a single vertebra. Various mechanisms, including shape, porosity, tethers, and bone-growth promoting substances may be used to enhance fusion. The tether may be a wire, cable, suture, or other single or multi-filament member. Preferably, the device forms a pseudo-joint in conjunction with the non-fused vertebra. Alternatively, the device could be fused to the caudal vertebra or both the cranial and caudal vertebrae.

The present invention expands a spinal canal by drilling a cylindrical passage in each pedicle of a vertebra, making a circumferential pedicle cut (osteotomy) through each pedicle from within the passage, separating each pedicle cut by inserting an implant into the passage which distracts the pedicle cut to expand the spinal canal, and securing each pedicle cut, allowing the vertebra to heal with the spinal canal expanded. The implant includes an outer sleeve, an inner bolt, and expandable flanges. The outer sleeve includes an upper portion and a lower portion, with the expandable flanges connected to the lower portion and housed within the upper portion. Rotation of the inner bolt causes the upper and lower portions of the outer sleeve to separate, causing the pedicle cut to widen and the expandable flanges to radially extend into and stabilize the widened pedicle cut to effectuate expansion of the spinal canal.

Disclosed is a lead for percutaneous insertion into an epidural space of a spinal canal, which includes an elongated lead body having opposed proximal and distal end portions. At least one electrode for stimulating a patient is operatively associated with the distal end portion of the lead body. Structure for conducting signals extends through the lead body to connect the electrode to a connecting structure operatively associated with the proximal end portion of the lead body. The connecting structure is capable of engaging a signal generator such that signals can be conducted from a signal generator to the electrode. The distal end portion of the lead body is adapted for movement between a first state, in which the distal end portion has a generally linear configuration, and a second state, in which the distal end portion has an undulating configuration.

Methods and devices are provided for replacing a spinal disc. In an exemplary embodiment, artificial disc replacements and methods are provided wherein at least a portion of a disc replacement can be implanted using a posterolateral approach. With a posterolateral approach, the spine is accessed more from the side of the spinal canal through an incision formed in the patient's back. A pathway is created from the incision to the disc space between adjacent vertebrae. Portions of the posterolateral annulus, and posterior lip of the vertebral body may be removed to access the disc space, leaving the remaining annulus and the anterior and posterior longitudinal ligaments in tact. The disc implant can be at least partially introduced using a posterolateral approach, yet it has a size that is sufficient to restore height to the adjacent vertebrae, and that is sufficient to maximize contact with the endplates of the adjacent vertebrae.

Methods and apparatus are provided for selective surgical removal of tissue, e.g., for enlargement of diseased spinal structures, such as impinged lateral recesses and pathologically narrowed neural foramen. In one variation, tissue may be ablated, resected, removed, or otherwise remodeled by standard small endoscopic tools delivered into the epidural space through an epidural needle. Once the sharp tip of the needle is in the epidural space, it is converted to a blunt tipped instrument for further safe advancement. A specially designed epidural catheter that is used to cover the previously sharp needle tip may also contain a fiberoptic cable. Further embodiments of the current invention include a double barreled epidural needle or other means for placement of a working channel for the placement of tools within the epidural space, beside the epidural instrument. The current invention includes specific tools that enable safe tissue modification in the epidural space, including a barrier that separates the area where tissue modification will take place from adjacent vulnerable neural and vascular structures. In one variation, a tissue removal device is provided including a thin belt or ribbon with an abrasive cutting surface. The device may be placed through the neural foramina of the spine and around the anterior border of a facet joint. Once properly positioned, a medical practitioner may enlarge the lateral recess and neural foramina via frictional abrasion, i.e., by sliding the tissue removal surface of the ribbon across impinging tissues. A nerve stimulator optionally may be provided to reduce a risk of inadvertent neural abrasion. Additionally, safe epidural placement of the working barrier and epidural tissue modification tools may be further improved with the use of electrical nerve stimulation capabilities within the invention that, when combined with neural stimulation monitors, provide neural localization capabilities to the surgeon. The device optionally may be placed within a protective sheath that exposes the abrasive surface of the ribbon only in the area where tissue removal is desired. Furthermore, an endoscope may be incorporated into the device in order to monitor safe tissue removal. Finally, tissue remodeling within the epidural space may be ensured through the placement of compression dressings against remodeled tissue surfaces, or through the placement of tissue retention straps, belts or cables that are wrapped around and pull under tension aspects of the impinging soft tissue and bone in the posterior spinal canal.

Barriers are used to hold prosthetic components, including intradiscal devices, in position while allowing natural movement within a “safe zone.” In the preferred embodiments, the barrier is in the form of a “buttress” plate coupled to a controlled linkage that prevents the device from moving into a dangerous position. The movable member(s) allow an intradiscal device to move through a safe zone while permitting mobile artificial disc replacements (ADRs) or other intradiscal devices to self-center with movement of the vertebrae. The link member(s) broadly serve as a “tether” to prevent extrusion of the intradiscal device into the spinal canal, or outside of the disc space. The intradiscal device may be mobile, or attached to one or both of the vertebral endplates. Other mechanisms to accommodate the movable link members are also disclosed. The plates are preferably constructed of metal, but the invention is not limited in terms of the biocompatible material(s) used for the plate or link members.

Apparatus and methods for performing spinal disc lesioning procedures while monitoring the temperature near the spinal nerve roots. A needle containing a thermocouple and an injection bore may be placed between the disc and a nerve root. Temperature near the nerve root may be monitored during the lesioning procedure and if raised to a point where damage to the nerve could occur, the procedure may be stopped before damage is done. Coolant may be injected through the injection bore to lower the temperature near the nerve root. Additional dual purpose needles may be placed on the disc adjacent the opposite nerve root or in the spinal canal at the level of the disc for additional control. A hollow, flexible tip electrode needle may be used to repair and lesion the disc tissue. Prior to lesioning, the electrode may be stimulated to assess motor nerve response and avoid motor nerve damage.

A surgical spine implant comprises a solid wedge shape device body is such that said polygonal shape with decreased height posterior and several surfaces that contours to the anatomy of the spine intervertebral space without complex machining across radiuses. The diminished height posteriorly provides for the angulations necessary to accommodate and ensure maintenance of the normal spinal alignment resulting in posterior extension angulations. The device provides ease of application of bone grafts. Such as for impaction of cancellous bone grafts after placement of the device and narrow posterior aspect easily directs grafts. This minimizes the problem of bone grafts hanging up behind the device either to the right or the left of the medial or lateral, which prevents the displacement of the device or prominence of the bone grafts near the spinal canal. The recess hole in the device accommodates a holding insertion tool and ease of bone graft packing “fill” to ensure a tight fit and immobile the attachment of the disc to the lower vertebrae.

A method for correcting spinal stenosis involves cannulating a passage in a vertebra, and placing a distal portion of an implant therein. Then, a circumferential vertebral cut is performed from within the passage, using a proximal end of the distal portion of the implant to align the vertebral cut. Then, a proximal portion of the implant is placed into the passage, positioned against the distal portion at the vertebral cut. Operation of the distal and the proximal portions of the implant relative to one another widens the vertebral cut and expands the spinal canal. The proximal portion can then be secured to the distal portion to stabilize the vertebral cut, allowing vertebral healing with the spinal canal expanded. Flanges may exist that radially extend outward from the implant and into the vertebral cut, or into the passage walls, to assist vertebral cut widening and stabilization.

A method for treating stenosis in a spine of a patient having a median plane, wherein the spine includes a spinal canal having a posterior surface, a dural sac and an epidural space between the posterior surface and dural sac, the location of the stenosis determining a region of interest in the spine. In an embodiment the method comprises the steps of a) generating at least one view of a portion of the spinal canal in the region of interest; b) compressing the dural sac in the region of interest by injecting a fluid to form a safety zone and establish a working zone in the region of interest, the safety zone lying between the working zone and the dural sac; c) percutaneously accessing the epidural space in the region of interest on a first side of the median plane; d) inserting a tissue removal tool into tissue in the working zone on the first side of the median plane; e) using the tissue removal tool to percutaneously reduce the stenosis on the first side of the median plane; and f utilizing the at least one view to position the tissue removal too during at least a part of step d) and at least part of step e)

Methods and devices are provided for replacing a spinal disc. In an exemplary embodiment, artificial disc replacements and methods are provided wherein at least a portion of a disc replacement can be implanted using a posterolateral approach. With a posterolateral approach, the spine is accessed more from the side of the spinal canal through an incision formed in the patient's back. A pathway is created from the incision to the disc space between adjacent vertebrae. Portions of the posterolateral annulus, and posterior lip of the vertebral body may be removed to access the disc space, leaving the remaining annulus and the anterior and posterior longitudinal ligaments in tact. The disc implant can be at least partially introduced using a posterolateral approach, yet it has a size that is sufficient to restore height to the adjacent vertebrae, and that is sufficient to maximize contact with the endplates of the adjacent vertebrae.

Devices and methods are disclosed for expanding a spinal canal. An implantable device having a shaft with a first cross-sectional dimension distinct from a second cross-sectional dimension can be inserted into an opening in a lamina and rotated 90 degrees to hinge the lamina away from the spinal canal. The implant can have one or more radiused edges, a bulleted tip, one or more lateral extensions for fastening the implantable device to bone, one or more hinged lateral extensions, one or more arcuate protrusions for biting into adjacent bone, an enlarged proximal head to prevent over-insertion, and/or a sleeve disposed therearound to reduce friction. Various embodiments of an insertion apparatus that can be selectively coupled to the implantable device are also disclosed, along with methods of expanding a spinal canal in minimally-invasive procedures using an implantable device and/or an insertion apparatus.

In various aspects, systems and methods involve catheters having infusion sections with permeable membranes that develop significant back pressure to enhance uniform delivery of the drug over an infusion section; catheters that have two or more infusion sections spaced apart along the length of the same catheter, catheters that include two or more infusion sections serviced by independent lumens (such that, e.g., different drug solutions can be delivered to the different infusion sections); implantable drug delivery systems with pumps and multiple reservoirs from which drugs can be delivered; systems that are capable of delivering drug solutions with selected densities; etc. Methods for delivering a drug to a brain through a spinal canal include delivering hypobaric solutions containing the drug.

Methods and devices for detecting positioning of a probe in a tissue of a patient. A method can include providing a detection device; advancing a device coupled probe through the tissue of the patient and toward the patient's spinal canal; detecting a change in pressure about the distal portion of the coupled probe during advancing, where the detected pressure change indicates probe positioning in the patient's spinal canal; outputting the detected pressure change or indication of probe positioning to a visual display.

Spinal canal expansion through pedicle lengthening in combination with spinal column stabilization, to treat spinal stenosis, spondylolisthesis, kyphosis, scoliosis or a major spinal rotational deformity, with or without a spinal fusion. A device or implant that includes a pedicle lengthening implant to decompress (expand) the spinal canal, and a bridge to connect two or more pedicle lengthening implants and/or pedicle screws or bone anchors to achieve simultaneous spinal stabilization across one or more vertebral segments. The bridge across the vertebral segments can include a longitudinal member, such as a plate or rod. The pedicle lengthening implant is originally made, or can be modified to, connect to the longitudinal member. Spinal deformity can be manipulated, through operation of one or more pedicle lengthening implants in respective vertebral segments, to improve a relative relationship between the respective vertebra segments, the longitudinal member then fixating the vertebral segments into a multi-level spinal construct.

This invention provides a new technology for management of back pain by stimulating the spinal cord in a manner that renders it refractory to transmission of deleterious or undesirable sensory input. The electrical stimulus comprises high frequency pulses in a regular or complex pattern or that are stochastically produced under microprocessor control. The stimulus is applied directly to the surface of the spinal cord from within the spinal canal, which provides important benefits over previous technology. The stimulus alleviates symptoms and signs of back pain, while minimizing the risk of side effects such as paresthesia, and potentially minimizing the effects on motor neuron transmission and proprioception.

An implant for expanding a spinal canal having an upper portion, a lower portion, and an inner member. The inner member communicates with a swivelable coupling located at each end of the inner member within the implant. Each swivelable coupling also interacts with a respective one of the upper and lower portion, within an inner bore thereof. Accordingly, movement of the inner member relative to one or both of the upper and the lower portions, via one or both swivelable couplings, translates the upper portion away from the lower portion, about a vertebral cut, to widen the vertebral cut and expand the spinal canal. The swivelable action of the couplings during translation allows angulation of the inner member, relative to a longitudinal axis of the implant, to accommodate a natural lateral shift occurring during a widening of a vertebral cut.

A catheter apparatus includes a hollow needle having an open, sharpened tip at its distal end. A cannula is telescopically disposed within the needle. The cannula has a closed, blunt tip at its distal end, a hollow lumen, and an open proximal end. The cannula is made of a flexible metal material and has an insulating material covering except at its distal portion defining the distal end. A metallic wire capable of transmitting radio frequency (RF) energy is telescopically disposed within the cannula. The cannula lumen has a seating surface for accommodating the distal end of the wire. The cannula distal end is capable of extending beyond the needle so that the blunt tip may be seated in a critical treatment region in a patient's spinal canal without damaging any nerves. A method of treating a patient's pain includes a step of inserting the catheter apparatus into a critical treatment region in the spinal canal of the patient. Once the needle is located near the treatment region, the cannula is advanced until the blunt tip extends beyond the needle's distal end. RF energy is then transmitted through the wire, the cannula's blunt tip, and to the treatment region.