# US 2019/0167314 A1 · Method and apparatus for inhibiting proximal junctional failure > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2019/0167314 A1 - Document ID: US20190167314A1 - Status: Published application - Kind: A1 - Application number: 16/206,590 - Filed: 2018-11-30 - Published: 2019-06-06 - Earliest claimed: 2017-12-01 - Assignees: Medicrea International - Applicants: Medicrea International - Inventors: Thomas Mosnier; David Nicholas Ryan - Web page: https://patentgrep.com/patent/US20190167314A1 ## CPC - A61B 17/7053: {with parts attached to bones or to each other by flexible wires, straps, sutures or cables} - A61B 17/1606: {of forceps type, i.e. having two jaw elements moving relative to each other} - A61B 17/7001: {Screws or hooks combined with longitudinal elements which do not contact vertebrae (A61B17/7058 takes precedence)} - A61B 17/7049: {Connectors, not bearing on the vertebrae, for linking longitudinal elements together (A61B17/7055, A61B17/7053, A61B17/7019 take precedence)} - A61B 17/7062: {Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs (rib fixation devices A61B17/8076); Tools for such devices} - A61B 17/707: {Devices acting on, or attached to, a transverse process or rib; Tools therefor} - A61B 17/7076: {for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation} - A61B 17/82: for bone cerclage {(apparatus for manipulating wires or straps A61B17/8861; wires, bands or straps other than cerclage A61B17/842)} - A61B 17/842: {Flexible wires, bands or straps (A61B17/72, A61B17/82, A61B17/86 take precedence)} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract Methods and devices are disclosed for inhibiting proximal junctional failure in a patient having posterior spinal instrumentation. One or more tension bands can be threaded through transverse bores in a spinous process of a vertebral body of a spine, superior and adjacent an uppermost instrumented vertebral body. Tension is applied to bias the spinous processes together and also in an inferior direction. The tension band is locked with respect to the spine, to maintain tension. ## Claims ### Claim 1 A method of inhibiting proximal junctional failure in a patient having posterior spinal instrumentation, comprising the steps of: creating a first transverse bore through a spinous process of a vertebral body of a spine, superior and adjacent an uppermost instrumented vertebral body, a second transverse bore through a spinous process of the uppermost instrumented vertebral body, and a third transverse bore through a spinous process of a vertebral body inferior and adjacent the uppermost instrumented vertebral body; threading a tension band having a first end and a second end through the first, second and third bores; extending the tension band inferiorly of the third transverse bore, under tension; and locking the tension band with respect to the spine. ### Claim 2 (depends on 1) The method of claim 1, wherein the locking comprises attaching a connector to the posterior spinal instrumentation and locking the tension band to the connector. ### Claim 3 (depends on 1) The method of claim 1, wherein the locking comprises attaching a connector to the spine and locking the tension band to the connector. ### Claim 4 (depends on 1) The method of claim 1, wherein the tension band has first and second ends, and both the first and second ends exit the first transverse bore and are locked under tension to a connector secured with respect to the spine. ### Claim 5 (depends on 4) The method of claim 4, wherein the posterior spinal instrumentation includes a left rod and a right rod, and the tension band is secured to the connector at a point that is medial to the left and right rods. ### Claim 6 (depends on 1) The method of claim 1, wherein the creating a first transverse bore step comprises locating opposing jaws of a bone punch on opposing sides of the spinous process, and punching the first transverse bore. ### Claim 7 (depends on 1) The method of claim 1, further comprising inserting a liner into at least the first transverse bore, prior to the threading a tension band step. ### Claim 8 (depends on 7) The method of claim 7, wherein the inserting the liner comprises inserting a grommet into at least the first transverse bore. ### Claim 9 (depends on 1) The method of claim 1, wherein the tension band extends through the first bore in a first direction, the second bore in a second direction generally opposite the first direction, and the third bore in the first direction, wherein the first end of the tension band is located one a first side of the spinous process and where the second end of the tension band is located on a second side of the spinous process. ### Claim 10 (depends on 9) The method of claim 9, wherein the second end of the tension band extends through the first bore in the first direction. ### Claim 11 (depends on 10) The method of claim 10, wherein the method further comprises extending a second tension band having a first end and a second end through the first bore, the second bore, and the third bore. ### Claim 12 (depends on 11) The method of claim 11, wherein the second tension band extends through the first bore in the second direction, the second bore in the first direction, and the third bore in the second direction, wherein the first end of the second tension band is located on the second side of the spinous process and the first end of the second tension band is located on the first side of the spinous process. ### Claim 13 (depends on 12) The method of claim 12, wherein the second end of the second tension bands extends through the first bore in the second direction. ### Claim 14 A system of inhibiting proximal junctional failure in a patient having posterior spinal instrumentation, the system comprising: at least one tension band having a first end and a second end; at least one connector configured to be attached to the patient's spine or the posterior spinal instrumentation; and wherein the at least one tension band is configured to pass through a plurality of transverse bores in at least two vertebrae of the patient's spine; wherein the first end of the at least one tension band and the second end of the at least one tension band are locked under tension in the at least one connector. ### Claim 15 (depends on 14) The system of claim 14, wherein the system further comprises a bone punch configured to create the plurality of transverse bores. ### Claim 16 (depends on 14) The system of claim 14, wherein the system comprises a plurality of connectors and wherein the first end of the at least one tension band is locked under tension in a first of the plurality of connectors and the second end of the at least one tension band is locked under tension in a second of the plurality of connectors. ### Claim 17 (depends on 16) The system of claim 16, wherein the first of the plurality of connectors and the second of the plurality of connectors are configured to be located on opposite transverse sides of the patient's spine. ### Claim 18 (depends on 14) The system of claim 14, wherein the at least one tension band comprises a first tension band and a second tension band each having a first end and a second end, and wherein the at least one connector comprises a first connector and a second connector, wherein the first end and the second end of the first tension band are locked under tension in the first connector, and wherein the first end and the second end of the second tension band are locked under tension in the second connector. ### Claim 19 (depends on 18) The system of claim 18, wherein the first connector and the second connector are configured to be located on opposite transverse sides of the patient's spine. ### Claim 20 (depends on 15) A kit containing the system of claim 15.