JP-2026514389-A - Intervertebral devices and associated systems and methods

Abstract

Spinal surgical procedures for implanting intervertebral devices and associated devices and systems are described herein. Representative spinal surgical procedures may include steps to obtain access to the affected intervertebral disc of the patient's spine via minimally invasive lateral, transpedicle, transfacet joint, or transforaminal access routes. Various instruments may be inserted through a trocar to (i) remove part or all of the affected intervertebral disc, (ii) expand the intervertebral space around the affected intervertebral disc, (iii) insert an intervertebral device into the intervertebral space, and/or (iv) fill the intervertebral device with filling material. Each of the aforementioned steps can be performed through a minimally invasive access route provided by a trocar. This can minimize damage to the patient's soft tissues and minimize patient pain and recovery time.

Inventors

• リアウ， ジェイソン
• フー， ニコラス
• マルシャン， フィリップ
• マルティネス， リリベス
• アイゼン， ジャック
• テイラー， ジェイコブ

Assignees

• ブルーム バイオメディカル， インコーポレイテッド

Dates

Publication Date

20260511

Application Date

20240327

Priority Date

20230328

Claims (20)

1. A method for treating a patient's spine, wherein the method is Inserting a trocar along a lateral, transpedicle, transface joint, or transforaminal access route so as to be close to the affected intervertebral disc within the intervertebral space of the vertebra, Inserting the discectomy device through the aforementioned trocar, Using the aforementioned discectomy device, destroy at least a portion of the affected intervertebral disc, Inserting the intervertebral device into the intervertebral space through the trocar, To expand the intervertebral device within the intervertebral space, A method comprising filling the intervertebral device with a filling material.
2. The method according to claim 1, wherein the intervertebral device comprises a braided filament.
3. The method according to claim 2, further comprising expanding the intervertebral device within the intervertebral space and then applying tension to the braided filaments.
4. The above method further, Inserting a balloon into the intervertebral space through the trocar, The method according to claim 1, comprising expanding the balloon in the intervertebral space and separating the intervertebral space.
5. The method according to claim 1, wherein the trocar is a first trocar, and the method further comprises inserting a second trocar through the first trocar, the second trocar having a curved distal portion configured to extend from the first trocar.
6. The method according to claim 5, wherein the insertion of the discectomy device includes inserting the discectomy device through the second trocar.
7. The above method further, Inserting a balloon into the intervertebral space through the second trocar, The method according to claim 5, comprising expanding the balloon in the intervertebral space and separating the intervertebral space.
8. The method according to claim 5, wherein the insertion of the intervertebral device includes inserting the intervertebral device through the second trocar.
9. The method according to claim 1, further comprising destroying at least a portion of the ligamentous structure located around the affected intervertebral disc.
10. The method according to claim 1, wherein the intervertebral space is the L4/L5 intervertebral space of the vertebra, and inserting the trocar so as to be close to the affected intervertebral disc within the L4/L5 intervertebral space includes inserting the trocar along a lateral approach extending through the iliac crest of the patient.
11. The method according to claim 1, wherein the intervertebral space is the L5/S1 intervertebral space of the spine, and inserting the trocar so as to be close to the affected intervertebral disc within the L5/S1 intervertebral space includes inserting the trocar along a lateral approach extending through the patient's iliac crest and the sacrum of the patient's spine.
12. A system for treating the patient's spine, A trocar, wherein the trocar is configured to be inserted laterally, transpedicle, transface joint, or transforaminal access pathway so as to be close to the affected intervertebral disc within the intervertebral space of the vertebra, A discectomy device, wherein the discectomy device is inserted through the trocar and is configured to operate to destroy at least a portion of the affected disc, An intervertebral device, wherein the intervertebral device is inserted through the trocar and configured to expand within the intervertebral space, A system comprising a filling material, the filling material being configured to be inserted into the expanded intervertebral device through the trocar.
13. The intervertebral device comprises a braided filament, according to claim 12.
14. The system according to claim 13, further comprising a tension-applying device inserted through the trocar and configured to actuate tension on the braided filaments within the intervertebral space.
15. The system according to claim 12, further comprising a balloon inserted through the trocar, expanded within the intervertebral space, and configured to separate the intervertebral space.
16. The system according to claim 12, wherein the trocar is a first trocar, further comprising a second trocar configured to be inserted through the first trocar, the second trocar having a curved distal portion configured to extend from the first trocar.
17. The system according to claim 16, wherein the discectomy device is configured to be inserted through the second trocar.
18. The intervertebral device is configured to be inserted through the second trocar, according to claim 16.
19. A method for treating a patient's spine, wherein the method is The first posterior fixing member is attached to the first vertebra of the spine, The second posterior fixing member is attached to the second vertebra of the spine adjacent to the first vertebra, and the intervertebral space is positioned between the first vertebra and the second vertebra. Inserting the trocar into the intervertebral space, Inserting a balloon into the intervertebral space through the trocar, The position and orientation of the first portion of the first rear fixing member are locked to the first portion of the second rear fixing member, The balloon in the intervertebral space is expanded, the intervertebral space is separated, and a lordosis is created between the first vertebra and the second vertebra. The position and orientation of the second portion of the first rear fixing member are locked to the position and orientation of the second portion of the second rear fixing member, thereby maintaining the generated lordosis. A method comprising deploying an intervertebral device within the intervertebral space.
20. The method according to claim 19, wherein locking the position and orientation of the second portion of the first rear fixing member with respect to the position and orientation of the second portion of the second rear fixing member includes tightening the first set screw of the first rear fixing member and tightening the second set screw of the second rear fixing member.

Description

(Cross-reference of related applications) This application is incorporated herein by reference in whole by (i) U.S. Provisional Patent Application No. 63/492,731, filed on 28 March 2023 and titled "INTERVERTEBRAL DEVICES, AND ASSOCIATED SYSTEMS AND METHODS", (ii) U.S. Provisional Patent Application No. 63/617,743, filed on 4 January 2024 and titled "INTERVERTEBRAL DEVICES, AND ASSOCIATED SYSTEMS AND METHODS", (iii) filed on 6 March 2024 and titled "INTERVERTEBRAL DEVICES, AND ASSOCIATED We claim the interests of U.S. Provisional Patent Application No. 63/562,033, titled "SYSTEMS AND METHODS." This technology focuses on intervertebral devices, such as intervertebral fixation devices, and associated systems and methods that can be deployed minimally invasively. Degenerative joint diseases in the spine typically involve the continuous degeneration of the intervertebral discs and the two posterior facet joints, which act as a tripod to provide stability between the vertebrae of the spine. The degeneration of these joints is referred to as degenerative disc disease (DDD) or intervertebral disc arthropathy and degenerative facet joint disease or facet joint arthropathy, respectively. As a result of DDD, the intervertebral discs often thin, leading to disc height collapse. Nerve foramina are openings through which spinal nerve roots pass when they are in the vertebral column, and the height of these nerve foramina directly corresponds to the height of the intervertebral disc. When disc height collapses, the original height of the nerve foramina also collapses, and therefore the exiting nerve roots are also compressed, which can induce neuralgia or radiculopathy extending down the leg. Disc height collapse can further cause ligament laxity and bulging in the spine. These ligaments, namely the posterior longitudinal ligament (PLL) and the ligamentum flavum, surround the spinal cord and can bulge into the spinal canal as the intervertebral disc height is compressed. As a result, compression of the entire spinal cord and/or meningeal sac occurs, centrally located within the spinal canal. This can cause nerve root pain extending to the legs, as well as weakness and fatigue in the legs (e.g., neurogenic claudication). Surgical treatment for lower back pain and sciatica all involve pain etiologies stemming from degenerative joint disease of the intervertebral discs in the spine. Surgical treatment includes, among other things, addressing mechanical instability of the spine, relieving nerve root compression, and restoring the spine's natural alignment. Mechanical instability is a result of degeneration of both the intervertebral discs and/or posterior facet joints. Mechanical instability causes painful arthritis or arthropathy. Treating mechanical instability of the spine may include spinal fusion. Many spinal fusion procedures aim to reduce mechanical instability, thereby reducing the movement of arthritis-affected joints that become inflamed with movement. Numerous methods of spinal fusion exist, including, for example, the surgical implantation of anterior and/or posterior fusion devices. Today, the most widely used method of spinal fusion involves posterior screws, used in combination with intervertebral cages for anterior support. As described above, nerve root compression can occur centrally around the spinal cord or meningeal sac, or laterally around the nerve root exiting the nerve foramen. Pain from nerve root compression often progresses along the nerve root cutaneous segments, causing nerve root or sciatica. Spinal surgical decompression is one method of treating nerve root compression, aiming to eliminate neuralgia by removing the compression from the nerve root. This can be achieved directly through the removal of bone/ligament/disc compressing the nerve. It can also be achieved indirectly by mechanically increasing intervertebral height using intervertebral spacers or intervertebral arch spacers, thereby restoring nerve foramen height and reducing the bulge of ligament/disc centrally into the spinal canal. One of the newer paradigms in spinal fusion and immobilization is restoring the spine's natural alignment. For example, sagittal balance can be restored using intervertebral spacers that restore the spine's natural lordotic curvature. Restoring neutral spinal alignment allows patients to walk or stand with good posture, rather than leaning forward. This reduces the strain on the paravertebral muscles in the spine. When spinal fusion is performed without restoring natural spinal alignment, "flat-back syndrome" often results, causing patients to suffer from chronic lower back pain due to muscle fatigue. In addition, inducing natural sagittal balance using lordotic spacers has become a primary means of preventing degeneration in the adjacent intervertebral spaces above and below spinal fusion. Intervertebral spacers are an important part of spinal fusion because they relate to the fundamental principles of tr