# US 8,784,450 B2 · Interarticulating spinous and transverse process staples for spinal fusion

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- Number: US 8,784,450 B2
- Document ID: US8784450B2
- Status: Granted
- Kind: B2
- Application number: 13/101,129
- Filed: 2011-05-04
- Published: 2011-12-29
- Granted: 2014-07-22
- Earliest claimed: 2005-04-12
- Applicants: Mosheh T. Moskowitz; Ahmnon D. Moskowitz; Nathan C. Moskowitz
- Inventors: Mosheh T. Moskowitz; Ahmnon D. Moskowitz; Nathan C. Moskowitz
- Web page: https://patentgrep.com/patent/US8784450B2

## CPC

- A61B 17/0642: {for bones, e.g. for osteosynthesis or connecting tendon to bone}
- A61B 17/0643: {with separate closing member, e.g. for interlocking with staple}
- A61B 17/068: Surgical staplers {, e.g. containing multiple staples or clamps}({staplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105;} for performing anastomosis A61B17/115; {staplers in general B25C5/00})
- A61B 17/7065: {Devices with changeable shape, e.g. collapsible or having retractable arms to aid implantation; Tools therefor}
- A61B 17/707: {Devices acting on, or attached to, a transverse process or rib; Tools therefor}
- A61B 17/809: {with bone-penetrating elements, e.g. blades or prongs (bone staples A61B17/0642; intramedullary nails with a plate at an end A61B17/7233)}
- A61F 2/447: {substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section}
- A61F 2/4637: {for connecting or disconnecting two parts of a prosthesis}
- A61B 17/7064: {Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor}
- A61B 17/8042: {the additional component being a cover over the screw head}
- A61B 17/86: Pins or screws {or threaded wires; nuts therefor (A61B17/72 take precedence)}
- A61B 2017/0641: {having at least three legs as part of one single body}
- A61B 2017/0647: {having one single leg, e.g. tacks}
- A61B 2017/0648: {threaded, e.g. tacks with a screw thread}
- A61B 2017/922: {Devices for impaction, impact element}
- A61F 2002/2835: {Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material}
- A61F 2002/30331: {made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit}
- A61F 2002/30383: {made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove}
- A61F 2002/30476: {locked by an additional locking mechanism}
- A61F 2002/305: {Snap connection}
- A61F 2002/30772: {Apertures or holes, e.g. of circular cross section}
- A61F 2002/30787: {inclined obliquely with respect to each other}
- A61F 2002/30879: {Ribs}
- A61F 2002/448: {comprising multiple adjacent spinal implants within the same intervertebral space or within the same vertebra, e.g. comprising two adjacent spinal implants}
- A61F 2002/4622: {having the shape of a forceps or a clamp}
- A61F 2002/4641: {for disconnecting}
- A61F 2220/0025: Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F 2220/0033: made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
- 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)

## Abstract

Thoracic/lumbar and cervical spinous process staples which staple/fuse adjacent spinous processes are disclosed. Thoracic/lumbar transverse process staples which staple/fuse adjacent transverse processes are also disclosed. Each embodiment has upper and lower claws connected by a ratchet spring mechanism, along with a multiplicity of bone fastener prongs attached to the upper and lower claws. Two sets of prongs on each staple claw are spaced by a distance approximately equal to the distance separating adjacent spinous or transverse processes so as to facilitate stapling/fusion of two adjacent processes. Also disclosed are staple prongs with multiple perforations which enable incorporation of bone fusion material thereby facilitating stapling/fusion of spinal elements.

## Claims

### Claim 1

An interarticulating staple for clamping one of a thoracic/lumbar Spinous Process (SP), a thoracic/lumbar Transverse Process (TP), and cervical Spinous Process (SP), the interarticulating staple comprising:
a first claw;
a second claw;
a staple pin pivotally connecting the first claw and the second claw; and
a ratchet mechanism that limits an opening force of the first claw with respect to the second claw at a fully open position, a fully closed position, and an intermediate position between the fully open position and the fully closed position.

### Claim 2 (depends on 1)

The staple according to claim 1, wherein the ratchet mechanism comprises:
a ratchet pin pivotably mounted to the first claw,
wherein the second claw includes a plurality of ratchet teeth,
wherein the ratchet pin includes a flexure spring configured to sequentially engage individual teeth of the plurality of ratchet teeth as the first claw pivots about the staple pin with respect to the second claw in a closing direction, the flexure spring cooperating with each of the plurality of ratchet teeth to prevent an opening movement of the first claw with respect to the second claw in the opening direction at a plurality of positions including the fully open position, the fully closed position, and the intermediate position.

### Claim 3 (depends on 1)

The staple according to claim 1, wherein the ratchet mechanism comprises:
a ratchet pin pivotably mounted to the second claw,
wherein the first claw includes a plurality of ratchet teeth,
wherein the ratchet pin includes a flexure spring configured to sequentially engage individual teeth of the plurality of ratchet teeth as the first claw pivots about the staple pin with respect to the second claw in a closing direction,
wherein, at each location where the flexure spring engages the individual teeth of the plurality of ratchet teeth, the flexure spring prevents the first claw from moving in an opening direction with respect to the second claw and permits the first claw to continue to move in the closing direction with respect to the second claw, and
wherein the flexure spring engages the individual teeth of the plurality of ratchet teeth at a plurality of positions including at least the fully open position, the fully closed position, and the intermediate position.

### Claim 4 (depends on 1)

The staple according to claim 1, wherein the first claw includes a clamping surface and the second claw includes a clamping surface.

### Claim 5 (depends on 1)

The staple according to claim 1, wherein the first claw includes a clamping surface having a plurality of ridges, and
wherein the second claw includes a clamping surface having a plurality of ridges.

### Claim 6 (depends on 1)

The staple according to claim 1, wherein the first claw includes a clamping surface having a plurality of prongs.

### Claim 7 (depends on 6)

The staple according to claim 6, wherein the second claw includes a clamping surface having a plurality of prongs.

### Claim 8 (depends on 6)

The staple according to claim 6, wherein one of the plurality of prongs includes a perforation.

### Claim 9 (depends on 6)

The staple according to claim 6, wherein one of the plurality of prongs includes a plurality of perforations.

### Claim 10 (depends on 6)

The staple according to claim 6, wherein each of the plurality of prongs includes a perforation.

### Claim 11 (depends on 1)

The staple according to claim 1, wherein the first claw and the second claw each include a portion having a staple pin opening,
wherein the portion having the staple pin opening of the first claw overlaps the portion having the staple pin opening of the second claw, and
wherein the staple pin engages the staple pin opening of the first claw and the second claw to pivotally connect the first claw to the second claw.

### Claim 12 (depends on 11)

The staple according to claim 11, wherein the portion having the staple pin opening of each of the first claw and the second claw includes claw teeth, and
wherein the claw teeth of the first claw interdigitate with the claw teeth of the second claw.

### Claim 13 (depends on 4)

The staple according to claim 4, wherein the clamping surface of the first claw opposes the clamping surface of the second claw.

### Claim 14 (depends on 2)

The staple according to claim 2, wherein the ratchet pin is pivotably mounted to the first claw by a ratchet bolt.

### Claim 15 (depends on 1)

The staple according to claim 1, wherein the ratchet mechanism comprises:
a ratchet pawl pivotably mounted to the first claw,
wherein the second claw includes a plurality of ratchet teeth, and
wherein a portion of the ratchet pawl is configured to sequentially engage individual teeth of the plurality of ratchet teeth to fix a position of the first claw with respect to the second claw at least at a fully open position, a fully closed position, and an intermediate position between the fully open position and the fully closed position.

### Claim 16 (depends on 15)

The staple of claim 15, wherein of the ratchet pawl is configured to sequentially engage of the individual teeth of the plurality of ratchet teeth as the first claw pivots with respect to the second claw in a closing direction, and
wherein, at each location where the ratchet pawl engages the individual teeth of the plurality of ratchet teeth, the ratchet pawl prevents the first claw from moving in an opening direction with respect to the second claw and permits the first claw to continue to move in the closing direction with respect to the second claw.

### Claim 17 (depends on 2)

The staple according to claim 2, wherein the ratchet pawl is pivotably mounted to the first claw by a ratchet bolt.

### Claim 18 (depends on 1)

The staple according to claim 1, wherein the first claw includes a first clamping surface and the second claw includes a second clamping surface,
wherein the first clamping surface is opposed to the second clamping surface.

### Claim 19 (depends on 18)

The staple according to claim 18, wherein each of the first clamping surface and the second clamping surface has a convex surface.

### Claim 20 (depends on 18)

The staple according to claim 18, wherein each of the first clamping surface and the second clamping surface has a concave surface.

### Claim 21 (depends on 18)

The staple according to claim 18, wherein the staple is a thoracic/lumbar Spinous Process (SP) staple configured to clamp a thoracic/lumbar Spinous Process (SP), and
wherein each of the first clamping surface and the second clamping surface has a concave surface.

### Claim 22 (depends on 6)

The staple according to claim 6, wherein the staple is a thoracic/lumbar Spinous Process (SP) staple configured to clamp a thoracic/lumbar Spinous Process (SP),
wherein the plurality of prongs on the first claw are separated into a first group of prongs and a second group of prongs, and
wherein the first group of prongs on the first claw is separated from the second group of prongs on the first claw by a first distance that is substantially equal to an inter-lumbar Spinous Process (SP) distance.

### Claim 23 (depends on 7)

The staple according to claim 7, wherein the staple is a thoracic/lumbar Spinous Process (SP) staple configured to clamp a thoracic/lumbar Spinous Process (SP),
wherein the plurality of prongs on the second claw are separated into a first group of prongs and a second group of prongs, and
wherein the first group of prongs on the second claw is separated from the second group of prongs on the second claw by a second distance that is substantially equal to an inter-lumbar Spinous Process (SP) distance.

### Claim 24 (depends on 7)

The staple according to claim 7, wherein the staple is a thoracic/lumbar Spinous Process (SP) staple configured to clamp a thoracic/lumbar Spinous Process (SP),
wherein the plurality of prongs on the first claw are separated into a first group of prongs and a second group of prongs,
wherein the first group of prongs on the first claw is separated from the second group of prongs on the first claw by a first distance that is substantially equal to an inter-lumbar Spinous Process (SP) distance,
wherein the plurality of prongs on the second claw are separated into a first group of prongs and a second group of prongs, and
wherein the first group of prongs on the second claw is separated from the second group of prongs on the second claw by a second distance that is substantially equal to the inter-lumbar Spinous Process (SP) distance.

### Claim 25 (depends on 24)

The staple according to claim 24, wherein the first distance is equal to the second distance.

### Claim 26 (depends on 24)

The staple according to claim 24, wherein the first distance is not equal to from the second distance.

### Claim 27 (depends on 18)

The staple according to claim 18, wherein the staple is a thoracic/lumbar Transverse Process (TP) staple, and
wherein each of the first clamping surface and the second clamping surface has a concave surface portion.

### Claim 28 (depends on 18)

The staple according to claim 18, wherein the staple is a thoracic/lumbar Transverse Process (TP) staple, and
wherein each of the first clamping surface and the second clamping surface has a convex surface portion and a concave surface portion.

### Claim 29 (depends on 18)

The staple according to claim 18, wherein the staple is a thoracic/lumbar Transverse Process (TP) staple, and
wherein each of the first clamping surface and the second clamping surface has a convex surface portion and a concave surface portion,
wherein the convex surface portion of the first clamping surface of the first claw is opposed to the convex surface portion of the second clamping surface of the second claw, and
wherein the concave surface portion of the first clamping surface of the first claw is opposed to the concave surface portion of the second clamping surface of the second claw.

### Claim 30 (depends on 6)

The staple according to claim 6, wherein the staple is a thoracic/lumbar Transverse Process (TP) staple configured to clamp a thoracic/lumbar Transverse Process (TP),
wherein the plurality of prongs on the first claw are separated into a first group of prongs and a second group of prongs, and
wherein the first group of prongs on the first claw is separated from the second group of prongs on the first claw by a first distance that is substantially equal to an inter-lumbar Transverse Process (TP) distance.

### Claim 31 (depends on 7)

The staple according to claim 7, wherein the staple is a thoracic/lumbar Transverse Process (TP) staple configured to clamp a thoracic/lumbar Transverse Process (TP),
wherein the plurality of prongs on the second claw are separated into a first group of prongs and a second group of prongs, and
wherein the first group of prongs on the second claw is separated from the second group of prongs on the second claw by a second distance that is substantially equal to an inter-lumbar Transverse Process (TP) distance.

### Claim 32 (depends on 7)

The staple according to claim 7, wherein the staple is a thoracic/lumbar Transverse Process (TP) staple configured to clamp a thoracic/lumbar Transverse Process (TP),
wherein the plurality of prongs on the first claw are separated into a first group of prongs and a second group of prongs,
wherein the first group of prongs on the first claw is separated from the second group of prongs on the first claw by a first distance that is substantially equal to an inter-lumbar Transverse Process (TP) distance,
wherein the plurality of prongs on the second claw are separated into a first group of prongs and a second group of prongs, and
wherein the first group of prongs on the second claw is separated from the second group of prongs on the second claw by a second distance that is substantially equal to the inter-lumbar Transverse Process (TP) distance.

### Claim 33 (depends on 32)

The staple according to claim 32, wherein the first distance is equal to the second distance.

### Claim 34 (depends on 32)

The staple according to claim 32, wherein the first distance is not equal to from the second distance.

### Claim 35 (depends on 18)

The staple according to claim 18, wherein the staple is a cervical Spinous Process (SP) staple, and
wherein each of the first clamping surface and the second clamping surface has a concave surface portion.

### Claim 36 (depends on 18)

The staple according to claim 18, wherein the staple is a cervical Spinous Process (SP) staple, and
wherein each of the first clamping surface and the second clamping surface has a convex surface portion and a concave surface portion.

### Claim 37 (depends on 18)

The staple according to claim 18, wherein the staple is a cervical Spinous Process (SP) staple, and
wherein each of the first clamping surface and the second clamping surface has a convex surface portion and a concave surface portion,
wherein the convex surface portion of the first clamping surface of the first claw is opposed to the convex surface portion of the second clamping surface of the second claw, and
wherein the concave surface portion of the first clamping surface of the first claw is opposed to the concave surface portion of the second clamping surface of the second claw.

### Claim 38 (depends on 6)

The staple according to claim 6, wherein the staple is a cervical Spinous Process (SP) staple configured to clamp a cervical Spinous Process (SP),
wherein the plurality of prongs on the first claw are separated into a first group of prongs and a second group of prongs, and
wherein the first group of prongs on the first claw is separated from the second group of prongs on the first claw by a first distance that is substantially equal to an inter-lumbar cervical Spinous Process (SP) distance.

### Claim 39 (depends on 7)

The staple according to claim 7, wherein the staple is a cervical Spinous Process (SP) staple configured to clamp a cervical Spinous Process (SP),
wherein the plurality of prongs on the second claw are separated into a first group of prongs and a second group of prongs, and
wherein the first group of prongs on the second claw is separated from the second group of prongs on the second claw by a second distance that is substantially equal to an inter-lumbar cervical Spinous Process (SP) distance.

### Claim 40 (depends on 7)

The staple according to claim 7, wherein the staple is a cervical Spinous Process (SP) staple configured to clamp a cervical Spinous Process (SP),
wherein the plurality of prongs on the first claw are separated into a first group of prongs and a second group of prongs,
wherein the first group of prongs on the first claw is separated from the second group of prongs on the first claw by a first distance that is substantially equal to an inter-lumbar cervical Spinous Process (SP) distance,
wherein the plurality of prongs on the second claw are separated into a first group of prongs and a second group of prongs, and
wherein the first group of prongs on the second claw is separated from the second group of prongs on the second claw by a second distance that is substantially equal to the inter-lumbar cervical Spinous Process (SP) distance.

### Claim 41 (depends on 40)

The staple according to claim 40, wherein the first distance is equal to the second distance.

### Claim 42 (depends on 40)

The staple according to claim 40, wherein the first distance is not equal to the second distance.

### Claim 43 (depends on 6)

The staple according to claim 6, wherein one of the plurality of prongs is a solid, straight prong.

### Claim 44 (depends on 6)

The staple according to claim 6, wherein one of the plurality of prongs is a solid, curved prong.

### Claim 45 (depends on 6)

The staple according to claim 6, wherein one of the plurality of prongs is a perforated, straight prong.

### Claim 46 (depends on 6)

The staple according to claim 6, wherein one of the plurality of prongs is a perforated, curved prong.

### Claim 47 (depends on 8)

The staple according to claim 8, wherein the perforation is configured to hold bone/biological fusion promoters to facilitate fusion.

### Claim 48

An interarticulating staple for clamping one of a thoracic/lumbar Spinous Process (SP), a thoracic/lumbar Transverse Process (TP), and cervical Spinous Process (SP), the interarticulating staple comprising:
first means for clawing bone;
second means for clawing bone;
a staple pin pivotally connecting the first means and the second means; and
ratchet means for limiting an opening force of the first means with respect to the second means at a fully open position, a fully closed position, and an intermediate position between the fully open position and the fully closed position.

### Claim 49

An interarticulating staple for clamping one of a thoracic/lumbar Spinous Process (SP), a thoracic/lumbar Transverse Process (TP), and cervical Spinous Process (SP), the interarticulating staple comprising:
first means for clawing bone and second means for clawing bone, the first means pivotally connected to the second means; and
ratchet means for limiting an opening force of the first means with respect to the second means and fixing a position of the first means with respect the second means at a fully open position, a fully closed position, and an intermediate position between the fully open position and the fully closed position.

### Claim 50

An interarticulating staple for clamping one of a thoracic/lumbar Spinous Process (SP), a thoracic/lumbar Transverse Process (TP), and cervical Spinous Process (SP), the interarticulating staple comprising:
a first claw having a first clamping surface and a second claw having a second clamping surface, wherein the first clamping surface and the second clamping surface cooperate to clamp a pair of adjacent spinous processes when the first claw and the second claw are in a closed position;
a staple pin pivotally connecting the first claw and the second claw; and
a ratchet mechanism that limits an opening force of the first claw with respect to the second claw at a fully open position, a fully closed position, and an intermediate position between the fully open position and the fully closed position.

### Claim 51

A method of providing an interarticulating staple for positioning on a pair of adjacent spinous processes to clamp one of a thoracic/lumbar Spinous Process (SP), a thoracic/lumbar Transverse Process (TP), and cervical Spinous Process (SP), the method of providing the interarticulating staple comprising:
providing a first claw having a first clamping surface and a second claw having a second clamping surface, wherein the first clamping surface and the second clamping surface cooperate to clamp the pair of adjacent spinous processes when the first claw and the second claw are in a closed position;
providing a staple pin pivotally connecting the first claw and the second claw; and
providing a ratchet mechanism that limits an opening force of the first claw with respect to the second claw at a fully open position, a fully closed position, and an intermediate position between the fully open position and the fully closed position such that the interarticulating staple can be secured to a pair of adjacent spinous processes by clamping the first clamping surface and the second clamping surface to the pair of adjacent spinous processes in at least one of the intermediate position and the fully closed position.