# US 2014/0194933 A1 · Devices and methods for stabilizing tissue and implants > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2014/0194933 A1 - Document ID: US20140194933A1 - Status: Published application - Kind: A1 - Application number: 14/205,592 - Filed: 2014-03-12 - Published: 2014-07-10 - Earliest claimed: 2004-10-26 - Assignees: P Tech, LLC - Applicants: P Tech, LLC - Inventors: Peter M. BONUTTI - Web page: https://patentgrep.com/patent/US20140194933A1 ## CPC - A61B 17/7064: {Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor} - A61B 17/0401: {Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors (A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811)} - A61B 17/7067: {Devices bearing against one or more spinous processes and also attached to another part of the spine; Tools therefor} - A61F 2/08: Muscles; Tendons; Ligaments - A61F 2/0811: {Fixation devices for tendons or ligaments} - A61F 2/30749: {Fixation appliances for connecting prostheses to the body} - A61F 2/4405: {for apophyseal or facet joints, i.e. between adjacent spinous or transverse processes (devices implanted between spinous or transverse processes A61B17/7062)} - A61F 2/441: {made of inflatable pockets or chambers filled with fluid, e.g. with hydrogel} - A61F 2/442: {Intervertebral or spinal discs, e.g. resilient (non-disc-shaped intervertebral inflatable pockets A61F2/441; non-disc-shaped intervertebral fusion implants A61F2/4455)} - A61L 27/58: Materials at least partially resorbable by the body - A61B 17/842: {Flexible wires, bands or straps (A61B17/72, A61B17/82, A61B17/86 take precedence)} - A61B 2017/00398: {using powered actuators, e.g. stepper motors, solenoids} - A61B 2017/00951: {adhesive} - A61B 2017/0404: {Buttons} - A61B 2017/0496: {for tensioning sutures} - A61B 2090/064: {for measuring force, pressure or mechanical tension} - A61F 2/0063: {Implantable repair or support meshes, e.g. hernia meshes} - A61F 2002/30462: {retained or tied with a rope, string, thread, wire or cable} - A61F 2002/4435: {Support means or repair of the natural disc wall, i.e. annulus, e.g. using plates, membranes or meshes} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C) - A61L: METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES (preservation of bodies or disinfecting characterised by the agents employed A01N; preserving, e.g. sterilising, food or foodstuffs A23; preparations for medical, dental or toiletry purposes A61K) ## Abstract An implant for repairing a joint between a first bone and a second bone includes a first section constructed of a substantially rigid material and a graft constructed of soft tissue having a first end and a second end. The first section has a first end surface configured for positioning against the first bone. The graft is configured for stabilizing the first section relative to the first bone. A first fastener is configured for mounting to the graft and the first section to anchor the graft to the first section. A second fastener is configured for mounting to the graft and the first bone to anchor the graft to the first bone. ## Claims ### Claim 1 A method for stabilizing a patient's spine, the method comprising: a) performing a surgical procedure on the spine; b) securing a first fastener to a first spinous process of a first vertebra; c) securing a second fastener to a first inferior facet portion and a second superior facet portion of a second vertebra; d) securing a tensioning member to the first and second fasteners; and e) tightening the tensioning member to draw the first fastener toward the second fastener. ### Claim 2 (depends on 1) The method of claim 1, further comprising: f) securing a third fastener to a second spinous process of the second vertebra; g) securing the tensioning member to the third fastener, the tensioning member comprised of a suture; and h) tightening the suture to draw the third fastener toward the second fastener, the second fastener extending through a facet joint between the first inferior facet portion and the second superior facet portion. ### Claim 3 (depends on 1) The method of claim 1, further comprising: f) securing a fourth fastener to a second inferior facet portion of the second vertebra; g) securing the tensioning member to the fourth fastener; and h) tightening the tensioning member to draw the second fastener toward the fourth fastener, the fourth fastener extending through a facet joint between the second inferior facet portion and a third superior facet portion of a third vertebra. ### Claim 4 (depends on 1) The method of claim 1, further comprising: f) securing a fifth fastener to a first superior facet portion of the first vertebra; g) securing the suture to the fifth fastener; and h) tightening the tensioning member to draw the second fastener toward the fifth fastener, the fifth fastener extending through a facet joint between the first superior facet portion and a fourth inferior facet portion of a fourth vertebra. ### Claim 5 (depends on 1) The method of claim 1, further comprising: f) placing a plate adjacent the first spinous process and a second spinous process; g) securing the plate to the first and second spinous processes with sixth and seventh fasteners, respectively; h) securing the tensioning member to the sixth and seventh fasteners; and i) tightening the tensioning member to draw the sixth and seventh fasteners toward the spinous processes, respectively. ### Claim 6 (depends on 5) The method of claim 5, further comprising: f) securing an eighth fastener to a third spinous process of a third vertebra; g) securing the plate to the third spinous process with a ninth fastener; h) securing a second tensioning member to the eighth and ninth fasteners; and i) tightening the second tensioning member to bias the ninth fastener and the plate toward the eighth fastener. ### Claim 7 (depends on 5) The method of claim 5, further comprising: f) securing a tenth fastener to a fourth spinous process of a fourth vertebra; g) securing the plate to the fourth spinous process with an eleventh fastener; h) securing a third tensioning member to the tenth and eleventh fasteners; and i) tightening the third tensioning member to bias the eleventh fastener and the plate toward the tenth fastener. ### Claim 8 (depends on 1) The method of claim 1, further comprising: f) securing a fourth tensioning member to an anterior longitudinal ligament of the spine, the anterior longitudinal ligament having a weakened portion that is weakened as a result of the surgical procedure of step (a), the anterior longitudinal ligament including an upper end at a first side of the weakened portion and a lower end at a second side of the weakened portion, the fourth tensioning member secured to the upper end; g) securing the fourth tensioning member to the lower end; and h) tightening the fourth tensioning member to draw the upper end toward the lower end. ### Claim 9 A method for stabilizing a patient's spine, the method comprising: a) performing a surgical procedure on the spine; b) securing a second fastener to a first inferior facet portion of a first vertebra of the spine; c) securing a fourth fastener to a second inferior facet portion of a second vertebra of the spine; d) securing a tensioning member to the second and fourth fasteners; and e) tightening the tensioning member to draw the second fastener toward the fourth fastener. ### Claim 10 (depends on 9) The method of claim 9, further comprising: f) securing a third fastener to a second spinous process of the second vertebra; g) securing a first fastener to a first spinous process of the first vertebra; h) securing the tensioning member to the first fastener extending from the second fastener; i) securing the tensioning member to the third fastener extending from the second fastener; and j) tightening the tensioning member to draw the first fastener toward the second fastener and the third fastener toward the second fastener; respectively. ### Claim 11 (depends on 9) The method of claim 9, further comprising: f) securing a fifth fastener to a first upper facet portion of the first vertebra; g) securing the tensioning member to the fifth fastener; and h) tightening the tensioning member to draw the fifth fastener toward the second fastener. ### Claim 12 (depends on 9) The method of claim 9, further comprising: f) placing a plate adjacent to first and second spinous processes of the first and second vertebrae; g) securing the plate to the first and second spinous processes with sixth and seventh fasteners, respectively; h) securing the tensioning member to the sixth and seventh fasteners; and i) tightening the tensioning member to draw the sixth and seventh fasteners toward the first and second spinous processes, respectively. ### Claim 13 (depends on 12) The method of claim 12, further comprising: f) securing an eighth fastener to a third spinous process of a third vertebra; g) securing the plate to the third spinous process with a ninth fastener; h) securing a second tensioning member to the eighth and ninth fasteners; and i) tightening the second tensioning member to bias the ninth fastener and the plate toward the third spinous process. ### Claim 14 (depends on 13) The method of claim 13, further comprising: j) securing a tenth fastener to a fourth spinous process of a fourth vertebra; k) securing the plate to the fourth spinous process with an eleventh fastener; l) securing a third tensioning member to the tenth and eleventh fasteners; and m) tightening the third tensioning member to bias the eleventh fastener and the plate toward the fourth spinous process. ### Claim 15 A method for stabilizing a patient's spine, the method comprising: a) performing a surgical procedure on the spine; b) securing a first fastener to a first spinous process of a first vertebra; c) securing a second fastener to a third spinous process of a third vertebra; d) securing a tensioning member to the first and second fasteners such that the tensioning member extends past and proximate a second spinous process of a second vertebra; and e) tightening the tensioning member to draw the first fastener toward the second fastener and the first spinous process toward the third spinous process. ### Claim 16 (depends on 15) The method of claim 15, further comprising: f) securing a third fastener to a fourth spinous process of a fourth vertebra; g) securing a fourth fastener to a first inferior facet portion of the first vertebra and a second superior facet portion of the second vertebra; h) securing a second tensioning member to the third fastener; i) securing the second tensioning member to the fourth fastener; and j) tightening the second tensioning member to draw the third fastener toward the fourth fastener. ### Claim 17 (depends on 15) The method of claim 15, further comprising: f) securing a fifth fastener to a second inferior facet portion of the second vertebra; g) securing a sixth fastener to a third superior facet portion of the third vertebra; h) securing a third tensioning member to the fifth fastener; i) securing the third tensioning member to the sixth fastener such that the third tensioning member extends through a facet joint between the second inferior facet portion and the third superior facet portion; and j) tightening the third tensioning member to draw the fifth fastener toward the sixth fastener. ### Claim 18 (depends on 15) The method of claim 15, further comprising: f) securing a ligament graft to a first vertebral body of the first vertebra with a seventh fastener; and g) securing the ligament graft to a second vertebral body of the second vertebra with an eighth fastener. ### Claim 19 (depends on 15) The method of claim 15, further comprising: f) securing a ninth fastener to an anterior longitudinal ligament of the spine proximate a first vertebral body of the first vertebra; g) securing a tenth fastener to the anterior longitudinal ligament proximate a second vertebral body of the second vertebra; h) securing a fourth tensioning member to the ninth and tenth fasteners; and i) tightening the fourth tensioning member to draw the ninth fastener toward the tenth fastener. ### Claim 20 (depends on 19) The method of claim 19, wherein the anterior longitudinal ligament includes a weakened portion between the ninth and tenth fasteners and further comprising: j) securing a second ligament graft to the anterior longitudinal ligament across the weakened portion with one of the ninth and tenth fasteners and the fourth tensioning member. ### Claim 21 (depends on 19) The method of claim 19, wherein the anterior longitudinal ligament includes a weakened portion between the ninth and tenth fasteners, the fourth tensioning member extending from the ninth fastener through the anterior longitudinal ligament, through a first vertebral body of the first vertebra, through a first intervertebral disc between the first and second vertebrae, through a second vertebral body of the second vertebra and through the anterior longitudinal ligament proximate the tenth fastener such that the fourth tensioning member has a generally curved shape when mounted between the ninth and tenth fasteners, the tensioning member and the fourth tensioning member comprised of sutures.