Intervertebral Disc Annulus Repair With Knotless Adjustable Tension
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Solution Overview
Problem
Current surgical treatments for degenerative disc disease, such as microlumbar discectomy, Chymopapin injection, laser discectomy, and spinal fusion, compromise the nucleus and annulus, leading to further disc degeneration and inadequate closure of fissures in the annulus, while conventional toggle anchors and knotless systems face difficulties in reliable anchoring and maintaining tension.
Innovation Solution
A novel method and apparatus using flexible longitudinal fixation components with transverse bar anchors that can be easily inserted through the annulus and nucleus, allowing adjustable tension without knots, and are anchored to vertebral bodies to securely close fissures in the annulus, preventing nucleus extrusion and nerve compression.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If conventional toggle anchors are used to close fissures in the annulus, then fissure closure is attempted, but reliable anchoring and maintaining tension is difficult
Solution Approach 1:
The system divides the anchoring function into two separate components: a distal anchor for reliable anchoring in the nucleus/annulus and a proximal anchor for tension maintenance outside the disc. This segmentation allows each component to be optimized for its specific function, resolving the contradiction between reliable anchoring and ease of tension maintenance.
Solution Approach 2:
A suture acts as an intermediary element connecting the distal and proximal anchors. This intermediary allows the tensioning and anchoring functions to be separated in space and operation, enabling reliable anchoring at the distal end while maintaining ease of tension control at the proximal end.
2Reliability
If surgical treatments like microlumbar discectomy, Chymopapin injection, laser discectomy, or spinal fusion are performed, then degenerative disc disease is treated, but the nucleus and annulus are compromised leading to further disc degeneration
Solution Approach 1:
The invention extracts and removes the harmful surgical interventions (discectomy, injection, fusion) that compromise the nucleus and annulus. Instead, it introduces a minimally invasive suture-based system that closes fissures without removing or damaging disc tissue, thereby treating degenerative disc disease while preventing further degeneration.
Solution Approach 2:
Rather than removing damaged tissue, the invention converts the harmful effect of fissures into a benefit by using the suture system to close and reinforce the annulus, transforming the weakened structure into a strengthened one that prevents further degeneration.
3Reliability
If knots are used to maintain tension in anchor systems, then tension can be secured, but the system becomes more complex and may interfere with surrounding structures
Solution Approach 1:
The invention extracts and removes the knotting element from the anchor system. Instead of using knots to maintain tension, the proximal anchor provides a knotless mechanism for tension maintenance, simplifying the device and reducing interference with surrounding structures while maintaining reliable tension.
4Reliability
If the annulus is repaired by closing fissures, then disc structure is preserved, but adequate closure is difficult to achieve with conventional methods
Solution Approach 1:
The repair system segments the closure function into distal anchoring (distal anchor in nucleus/annulus) and proximal tensioning (proximal anchor outside disc). This segmentation enables adequate fissure closure by providing stable anchoring points on both sides of the fissure, making the closure process more achievable and reliable.
Data Source
AI summary
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 distal suture having a proximal end and a distal end, with an enlargement formed at said distal end and an eyelet formed at said proximal end, wherein said suture extends through said vertical bore of said distal anchor; a proximal anchor comprising a generally cylindrical body, a distal end and a proximal end, a vertical bore extending through said generally cylindrical body, perpendicular to the longitudinal axis of said generally cylindrical body, a recess formed on one side of said generally cylindrical body and a U-shaped slot formed on the opposing side of said generally cylindrical body, whereby to form a flexible finger extending distally within said generally cylindrical body, and further wherein said distal end of said finger is spaced from an opposing portion of said generally cylindrical body; and a proximal suture having a proximal end and a distal end, with an enlargement formed at said distal end, wherein said proximal suture extends through said vertical bore of said proximal anchor, through said eyelet of said distal suture, back through said vertical bore of said proximal anchor, through said recess of said proximal bore and through said U-shaped slot of said proximal anchor, with a loop of proximal suture extending through said eyelet of said distal suture.