Dynamic implanted spinal orthosis and operative procedure for fitting

Claim 2

An implanted dynamic vertebral orthosis for adjusting the relative positions of spinal vertebrae with respect to a vertical axis comprising anchoring members for securing to the vertebrae and holding means connected to the anchoring members, said holding means including at least one curved holding rod which is flexible and elastic in bending and connected to said anchoring members for anchoring at least two different vertebrae, and coupling means for connecting said holding rod to said anchoring members, wherein said coupling means comprises a first coupling member preventing all relative horizontal translational sliding movement of the vertebrae, while permitting relative longitudinal translational sliding movement along said vertical axis and relative rotational movement about said vertical axis of said holding means having elastic return means capable of exerting elastic return forces having predetermined orientation and magnitude between said anchoring members, for holding the vertebrae in a predetermined corrected position against natural deforming forces for reducing the overall forces exerted on the vertebrae.

Claim 3

An orthosis as in claim 1, wherein said coupling means further includes a second coupling member for rigidly connecting said holding rod to said anchoring members and preventing all relative lateral movements of the vertebrae with respect to said vertical axis while permitting said relative longitudinal translational sliding movement and said relative rotational movement about said vertical axis.

Claim 4

An orthosis as in claim 1, and wherein said coupling means permits relative rotation of said holding rod about an axis perpendicular to a frontal plane of said orthosis.

Claim 5

An orthosis as in claim 3, and wherein said coupling means permits relative rotation of said holding rod about an axis perpendicular to a sagittal plane of said orthosis.

Claim 6

An orthosis as in claim 1, and wherein said holding rods have a shape when connected to said anchoring members which is elastically different from their shape when not so connected, so as to exert elastic return forces when the vertebrae are in the corrected position.

Claim 7

An orthosis as in claim 5, and wherein said coupling means permits rotation of said holding rod about the longitudinal axis of said holding rod.

Claim 8

An orthosis as in claim 1, and wherein said coupling means includes a cylindrical bore, said holding rod passing slidably through said bore.

Claim 9

An orthosis as in claim 7, and wherein said bore is formed in one of said coupling members, said one of said coupling members being rotatably mounted with respect to said anchoring members about an axis perpendicular to the frontal plane of of said orthosis.

Claim 10

An orthosis as in claim 8, and wherein said coupling member is mounted so as to be rotatable about an axis perpendicular to the sagittal plane of said orthosis.

Claim 11

An orthosis as in claim 8, and wherein said coupling member is a sphere having a cylindrical bore and a spherical housing on said anchoring member.

Claim 12

An orthosis as in claim 1, and wherein said elastic return means includes at least one spring.

Claim 13

An orthosis as in claim 1, and including on one side of said vertical axis a holding rod and at least one compression spring surrounding said holding rod.

Claim 14

An orthosis as in claim 1, and wherein said elastic return means comprises at least one torsion spring having coils surrounding said holding rod and locked to said anchoring member for imparting a torsional force to said holding rod.

Claim 15

An orthosis as in claim 1, and including means for adjusting the magnitude of said elastic return forces exerted by said elastic return means.

Claim 16

An orthosis as in claim 14, and wherein said adjusting means includes means for varying the elastic elongation of the elastic return means.

Claim 17

An orthosis as in claim 14, and wherein said adjusting means includes a stop for the elastic return means and at least one device for adjusting the position of said stop.

Claim 18

An orthosis as in claim 14, and including means for percutaneous control of said adjusting means after implantation of the orthosis.

Claim 19

An orthosis as in claim 14, and wherein said elastic return means is formed from a shape-memory metal alloy.

Claim 20

A process for effecting and maintaining a correction of the relative positions of spinal vertebrae while preserving at least in part the natural physiological mobility of the vertebrae, and implanting a dynamic spinal orthosis by fixing anchoring members to the vertebrae, and connecting holding means to the anchoring members, and including the steps of exposing the vertebrae to be corrected, fitting and securing the anchoring members to the vertebrae to be corrected, connecting an operative instrumentation to the anchoring members, applying holding forces along three orthogonal axes to the anchoring members for each vertebra for placing the vertebrae in a corrected position, and measuring the holding forces necessary along said axes for each vertebra for maintaining the vertebra in the corrected position, determining the characteristics of the holding means required for generating elastic return forces as a function of the measured holding forces, adjusting the orthosis as a function of the characteristics determined, connecting the holding means to the anchoring members, and thereby imparting the elastic return forces to each vertebra, removing the operative instrumentation and dosing the surgical site.

Claim 21

A process for effecting and maintaining a correction of the relative positions of spinal vertebrae while preserving at least in part the natural physiological mobility of the vertebrae, and implanting a dynamic spinal orthosis by fixing anchoring members to the vertebrae, and connecting holding means to the anchoring members, and including the steps of exposing the vertebrae to be corrected, fitting and securing the anchoring members to the vertebrae to be corrected, connecting an operative instrumentation to the anchoring members, applying holding forces along three orthogonal axes to the anchoring members for each vertebra for placing the vertebrae in a corrected position, and measuring the holding forces necessary along said axes for each vertebra for maintaining the vertebra in the corrected position, determining the characteristics of the holding means required for generating elastic return forces as a function of the measured holding forces, adjusting the orthosis as a function of the characteristics determined, connecting the holding means to the anchoring members, and thereby imparting the elastic return forces to each vertebra, removing the operative instrumentation and dosing the surgical site.

Claim 22

A process as in claim 19, and including determining said characteristics by means of dynamometric sensors on the operative instrumentation.

Claim 23

A process as in claim 19, and including adjusting the holding means for generating elastic return forces for maintaining the corrected position of the vertebrae.

Claim 24

Implanted dynamic vertebral orthosis comprising anchoring members for securing to the vertebrae and holding means associated with the anchoring components, wherein the holding means include at least one curved holding rod which is flexible and elastic in bending connected with components for anchoring at least two different vertebrae, wherein each holding rod is connected to the anchoring components by first coupling means preventing all relative sliding movement in horizontal translation with respect to the vertebrae, wherein each holding rod is connected with the anchoring components for at least one vertebra by second coupling means allowing sliding in relative longitudinal translation along a vertical axis, wherein each holding rod is connected with the anchoring components for at least one vertebra by third coupling means allowing relative rotation about a vertical axis, wherein each holding rod is connected with the anchoring components for at least one vertebra by fourth coupling means allowing relative rotation about an horizontal axis, and wherein the holding means is capable of exerting elastic return forces having orientation and magnitude for holding the vertebrae in the corrected position against the natural deforming forces.

Claim 25

Implanted dynamic vertebral orthosis comprising anchoring members for securing to the vertebrae and holding means associated with the anchoring components, wherein the holding means include at least one curved holding rod which is flexible and elastic in bending connected with components for anchoring at least two different vertebrae, wherein each holding rod is connected to the anchoring components by first coupling means preventing all relative sliding movement in horizontal translation with respect to the vertebrae, wherein each holding rod is connected with the anchoring components for at least one vertebra by second coupling means allowing sliding in relative longitudinal translation along a vertical axis, wherein each holding rod is connected with the anchoring components for at least one vertebra by third coupling means allowing relative rotation about a vertical axis, wherein each holding rod is connected with the anchoring components for at least one vertebra by fourth coupling means allowing relative rotation about an horizontal axis, and wherein the holding means is capable of exerting elastic return forces having orientation and magnitude for holding the vertebrae in the corrected position against the natural deforming forces.

Claim 26

A dynamic, implantable vertebral orthosis for adjusting the relative positions of spinal vertebrae comprising anchoring members securable to the vertebrae and holding means associated with the anchoring members, said holding means including at least one curved holding rod which is flexible and elastic upon bending and connected to said anchoring members for attachment to at least two different vertebrae, and coupling means for connecting said holding rod to said anchoring members, said coupling means preventing all relative horizontal translational sliding movement of the vertebrae, said coupling means further permitting relative longitudinal translational sliding movement along a vertical axis and relative rotational movement of the vertebrae about a vertical axis, said holding means having elastic return means capable of exerting elastic return forces having adjustable orientation and magnitude for maintaining the vertebrae in a corrected position against natural deforming forces, or so as to reduce the overall forces exerted on the vertebrae while preserving the mobility and allowing physiological movements of the vertebrae.

Claim 27

A dynamic, implantable vertebral orthosis for adjusting the relative positions of spinal vertebrae comprising anchoring members securable to the vertebrae and holding means associated with the anchoring members, said holding means including at least one curved holding rod which is flexible and elastic upon bending and connected to said anchoring members for attachment to at least two different vertebrae, and coupling means for connecting said holding rod to said anchoring members, said coupling means preventing all relative horizontal translational sliding movement of the vertebrae, said coupling means further permitting relative longitudinal translational sliding movement along a vertical axis and relative rotational movement of the vertebrae about a vertical axis, said holding means having elastic return means capable of exerting elastic return forces having adjustable orientation and magnitude for maintaining the vertebrae in a corrected position against natural deforming forces, or so as to reduce the overall forces exerted on the vertebrae while preserving the mobility and allowing physiological movements of the vertebrae.

Claim 28

A vertebral orthosis as in claim 23 and wherein said coupling means comprises a spherical member having a cylindrical bore therethrough, said holding rod being slidable in and passing through said bore.

Claim 29

A vertebral orthosis as in claim 24 and including a spherical housing for said spherical member whereby said spherical member is rotatable in said spherical housing.

Claim 30

A vertebral orthosis as in claim 25 and including means for adjusting the position of said rod in said spherical member.