# US 9,433,442 B2 · Spinal correction system and method > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 9,433,442 B2 - Document ID: US9433442B2 - Status: Granted - Kind: B2 - Application number: 14/162,378 - Filed: 2014-01-23 - Published: 2015-07-23 - Granted: 2016-09-06 - Earliest claimed: 2014-01-23 - Assignees: Warsaw Orthopedic, Inc. - Applicants: Warsaw Orthopedic, Inc. - Inventors: Gary S. Lindemann; Alison G. Powers; Keith E. Miller; Jeremy J. Rawlinson - Web page: https://patentgrep.com/patent/US9433442B2 ## CPC - A61B 17/7053: {with parts attached to bones or to each other by flexible wires, straps, sutures or cables} - A61B 17/7022: {Tethers, i.e. longitudinal elements capable of transmitting tension only, e.g. straps, sutures or cables (A61B17/702 takes precedence)} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract A spinal construct includes at least one tether extending between a first end connectable with a first fastener connected with spinal tissue and a second end connectable with a second fastener connected with spinal tissue. The at least one tether has a tension between the fasteners. A ratchet is engagable with the at least one tether to adjust the tension. Systems and methods are disclosed. ## Claims ### Claim 1 A spinal construct comprising: at least one tether extending between a first end connectable with a first fastener connected with spinal tissue and a second end connectable with a second fastener connected with spinal tissue, the at least one tether having a tension between the fasteners; and a ratchet engageable with the at least one tether to adjust the tension, the ratchet includes a rotatable reel configured for rotation in two directions to adjust the tension, the rotatable reel being axially movable between a first configuration in which the reel is rotatable relative to the ratchet and a second configuration in which rotation of the reel is resisted. ### Claim 2 (depends on 1) A spinal construct as recited in claim 1, wherein the at least one tether includes a first tether connected to the first fastener and the ratchet and a second tether connected to the second fastener and the ratchet. ### Claim 3 (depends on 1) A spinal construct as recited in claim 1, further comprising a third fastener including the ratchet and being configured for penetrating spinal tissue between the first fastener and the second fastener. ### Claim 4 (depends on 3) A spinal construct as recited in claim 3, wherein the at least one tether includes a first tether having an adjustable tension and being connected with the first fastener and the ratchet, and a second tether having a fixed tension and being connected with the second fastener and the third fastener. ### Claim 5 (depends on 1) A spinal construct as recited in claim 1, wherein the rotatable reel includes a male mating part engageable with the ratchet. ### Claim 6 (depends on 1) A spinal construct as recited in claim 1, further comprising a third fastener configured for penetrating spinal tissue and including the ratchet, the ratchet comprising a rotatable reel engagable with the tether to selectively adjust the tension. ### Claim 7 (depends on 6) A spinal construct as recited in claim 6, wherein the reel is lockable to prevent rotation thereof. ### Claim 8 (depends on 7) A spinal construct as recited in claim 7, wherein the reel is biased to a locked configuration. ### Claim 9 (depends on 1) A spinal construct as recited in claim 1, wherein the ratchet is configured for magnetic actuation to adjust the tension. ### Claim 10 (depends on 1) A spinal construct as recited in claim 1, wherein the ratchet is configured to dynamically adjust the tension. ### Claim 11 (depends on 1) A spinal construct as recited in claim 1, wherein at least one of the fasteners comprises a C-shaped clamp having a coupling member engagable with the tether. ### Claim 12 (depends on 1) A spinal construct as recited in claim 1, wherein at least one of the fasteners comprises a clamp having an inner surface defining ribs. ### Claim 13 A spinal construct comprising: a fastener including a ratchet having a reel engageable with an intermediate portion of a tether having a tension between ends thereof, wherein the reel is rotatable in two directions relative to the ratchet to adjust the tension, and wherein the reel is axially movable between a first configuration such that the reel is rotatable relative to the ratchet and a second configuration such that the rotation of the reel is resisted. ### Claim 14 (depends on 13) A spinal construct as recited in claim 13, wherein the ratchet extends between a first end defining a first cavity configured for disposal of a first end of the reel in the second configuration and a second end defining a second cavity configured for disposal of a second end of the reel. ### Claim 15 (depends on 14) A spinal construct as recited in claim 14, wherein the ratchet includes a biasing member disposed in the second cavity between the second end of the ratchet and the second end of the reel to resiliently bias the reel to the second configuration. ### Claim 16 (depends on 13) A spinal construct as recited in claim 13, wherein the reel includes an inner surface defining a bore configured for disposal of the at least one tether. ### Claim 17 A method of treating a spine disorder, the method comprising the steps of: providing at least one tether extending between a first end connected with a first fastener and a second end connected with a second fastener, the at least one tether having a tension between the fasteners; providing a ratchet for connection with an intermediate portion of the at least one tether; engaging the first fastener with a first costo-vertebral surface and engaging the second fastener with a second costo-vertebral surface; and engaging the ratchet and a reel to rotate the reel in two directions to selectively adjust the tension, wherein the step of engaging the ratchet comprises axially translating the reel between a first configuration such that the reel is rotatable relative to the ratchet and a second configuration such that rotation of the reel is resisted.