# US 9,867,721 B2 · Method and apparatus for post-operative tuning of a spinal implant

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- Number: US 9,867,721 B2
- Document ID: US9867721B2
- Status: Granted
- Kind: B2
- Application number: 10/423,515
- Filed: 2003-04-25
- Published: 2004-08-05
- Granted: 2018-01-16
- Earliest claimed: 2003-01-30
- Assignees: Medtronic Navigation, Inc.
- Applicants: Mark Hunter
- Inventors: Mark Hunter
- Web page: https://patentgrep.com/patent/US9867721B2

## CPC

- A61F 2/4657: {Measuring instruments used for implanting artificial joints (for surgical instruments A61B90/06)}
- A61B 17/025: {Joint distractors}
- A61B 17/15: Guides therefor
- A61B 17/1703: {using imaging means, e.g. by X-rays}
- A61B 17/175: {for preparing the femur for hip prosthesis insertion}
- A61B 17/1757: {for the spine}
- A61B 34/20: Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B 90/10: for stereotaxic surgery, e.g. frame-based stereotaxis
- A61F 2/4425: {made of articulated components}
- G16Z 99/00: Subject matter not provided for in other main groups of this subclass
- A61B 17/00234: {for minimally invasive surgery (A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)}
- A61B 34/25: {User interfaces for surgical systems}
- A61B 34/30: Surgical robots
- A61B 2017/00199: {with a console, e.g. a control panel with a display}
- A61B 2017/0256: {for the spine}
- A61B 2034/102: {Modelling of surgical devices, implants or prosthesis}
- A61B 2034/105: {Modelling of the patient, e.g. for ligaments or bones}
- A61B 2034/107: {Visualisation of planned trajectories or target regions}
- A61B 2034/108: {Computer aided selection or customisation of medical implants or cutting guides}
- A61B 2034/2051: {Electromagnetic tracking systems}
- A61B 2034/2072: {Reference field transducer attached to an instrument or patient}
- A61B 2034/252: {indicating steps of a surgical procedure}
- A61B 2034/254: {being adapted depending on the stage of the surgical procedure}
- A61B 2034/256: {having a database of accessory information, e.g. including context sensitive help or scientific articles}
- A61B 2090/363: {Use of fiducial points}
- A61B 2090/365: {augmented reality, i.e. correlating a live optical image with another image}
- A61B 2090/374: {NMR or MRI}
- A61B 2090/376: {using X-rays, e.g. fluoroscopy}
- A61B 2090/3983: {Reference marker arrangements for use with image guided surgery}
- A61F 2/32: for the hip
- A61F 2/34: Acetabular cups
- A61F 2/36: Femoral heads {; Femoral endoprostheses}
- A61F 2/441: {made of inflatable pockets or chambers filled with fluid, e.g. with hydrogel}
- A61F 2/4607: {of hip femoral endoprostheses}
- A61F 2/4609: {of acetabular cups}
- A61F 2/48: Operating or control means, e.g. from outside the body or control of sphincters
- A61F 2002/30471: {connected by a hinged linkage mechanism, e.g. of the single-bar or multi-bar linkage type}
- A61F 2002/30476: {locked by an additional locking mechanism}
- A61F 2002/305: {Snap connection}
- A61F 2002/30517: {using a locking plate}
- A61F 2002/30538: {for adjusting angular orientation}
- A61F 2002/30548: {for adjusting fluid pressure}
- A61F 2002/30565: {having spring elements}
- A61F 2002/30578: {having apertures, e.g. for receiving fixation screws}
- A61F 2002/30579: {with mechanically expandable devices, e.g. fixation devices}
- A61F 2002/30586: {having two or more inflatable pockets or chambers}
- A61F 2002/30624: {Hinged joint, e.g. with transverse axle restricting the movement}
- A61F 2002/30649: {Ball-and-socket joints}
- A61F 2002/30668: {Means for transferring electromagnetic energy to implants}
- A61F 2002/3067: {for data transfer}
- A61F 2002/30677: {Means for introducing or releasing pharmaceutical products, e.g. antibiotics, into the body}
- A61F 2002/3069: {Revision endoprostheses}
- A61F 2002/449: {comprising multiple spinal implants located in different intervertebral spaces or in different vertebrae}
- A61F 2002/4632: {using computer-controlled surgery, e.g. robotic surgery}
- A61F 2002/4635: {using minimally invasive surgery}
- A61F 2002/4666: {for measuring force, pressure or mechanical tension}
- A61F 2002/4668: {for measuring angles}
- A61F 2002/467: {for measuring fluid pressure}
- A61F 2002/4681: {by applying mechanical shocks, e.g. by hammering}
- A61F 2220/0025: Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F 2220/0091: connected by a hinged linkage mechanism, e.g. of the single-bar or multi-bar linkage type
- A61F 2250/0001: Means for transferring electromagnetic energy to implants
- A61F 2250/0002: for data transfer
- A61F 2250/0006: for adjusting angular orientation
- A61F 2250/0013: for adjusting fluid pressure
- Y02A 90/10: Information and communication technologies [ICT] supporting adaptation to climate change, e.g. for weather forecasting or climate simulation
- 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)
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- G16Z: INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS, NOT OTHERWISE PROVIDED FOR
- Y02A: TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE

## Abstract

A tunable implant, system, and method enables a tunable implant to be adjusted within a patient. The tunable implant includes a securing mechanism to secure the implant in the patient, a actuation portion that enables the implant to move and an adjustment portion that permits adjustment of the implant after the implant has been positioned within the patient. The method of adjusting the tunable implant includes analyzing the operation of the implant, determining if any adjustments are necessary and adjusting the implant to improve implant performance. The implant system includes both the tunable implant and a telemetric system that is operable to telemetrically receive data from the tunable implant where the data is used to determine if adjustment of the tunable implant is necessary. The system also includes an instrument assembly that is used for performing spinal surgery where the instrument assembly includes a mounting platform and a jig.

## Claims

### Claim 1

A tunable implant configured to be positioned within a patient, said tunable implant comprising:
a pair of support plates, each support plate having a flange extending at a non-zero angle relative to each support plate, wherein each flange is operable to engage a side of a vertebra of the patient;
a bladder mechanism including a plurality of bladders between said pair of support plates, wherein each bladder includes a sensor to sense a parameter; and
a bladder control system positioned within said bladder mechanism operable to receive said parameter from each sensor and to adjust a pressure in each bladder of the plurality of bladders in a real time manner;
wherein each support plate includes a first segment and a second segment connected with a hinge and configured to enable the tunable implant to be folded in a manner to make said tunable implant substantially smaller than in an unfolded state, wherein said first segment is folded towards said second segment via said hinge, and unfolded for fixation to the vertebra during implantation.

### Claim 2 (depends on 1)

The tunable implant as defined in claim 1 wherein each flange defines a passageway operable to receive a bone screw to secure the tunable implant to the vertebra.

### Claim 3

A tunable implant configured to be positioned within a patient, said tunable implant comprising:
a pair of support plates, each support plate having a flange extending at a non-zero angle relative each support plate and configured to engage a vertebra;
an adjustable portion having a plurality of regions, each region having a sensor and at least one force control beam configured to apply a force to a spring in each region, wherein upon adjusting said adjustable portion to effect at least one of a range of motion or a stiffness of said adjustable portion, said tunable implant provides a changed performance;
wherein each sensor is operable to sense at least one of a force parameter or a temperature parameter; and
a force control system positioned within said implant operable to receive said force parameter or temperature parameter from each sensor and is operable to adjust said adjustable portion by adjusting a tension on said spring in each region with each force control beam in a real-time manner.

### Claim 4 (depends on 3)

The tunable implant as defined in claim 3 wherein said force parameter is selected from a group comprising pressure, stress, strain, loading force, torsional force, and frictional force.

### Claim 5 (depends on 1)

The tunable implant as defined in claim 1 wherein said bladder control system is operable to be actuated telemetrically in a non-surgical procedure.

### Claim 6 (depends on 1)

The tunable implant as defined in claim 1 wherein said bladder control system includes a resonant circuit.

### Claim 7

A tunable implant system comprising: a tunable implant configured to be positioned within a patient, said tunable implant comprising:
a pair of support plates, each support plate having a flange extending at a non- zero angle relative to each support plate, wherein each flange is operable to engage a side of a vertebra of the patient;
a bladder mechanism including a plurality of bladders between said pair of support plates, wherein each bladder includes a sensor to sense a parameter; and
a bladder control system positioned within said bladder mechanism operable to receive said parameter from each sensor and to adjust a pressure in each bladder of the plurality of bladders in a real time manner;
wherein each support plate includes a first segment and a second segment connected with at least one hinge and configured to enable said tunable implant to be folded in a manner to make said tunable implant substantially smaller than in an unfolded state, wherein said tunable implant is configured to be folded during insertion for implantation, wherein said first segment is folded towards said second segment via said at least one hinge, and unfolded for fixation to the vertebra during implantation; and
a patient sensor operable to be attached to the patient during a motion analysis; wherein said bladder control system positioned within said bladder mechanism is operable to receive sensed parameters from said patient sensor.

### Claim 8 (depends on 4)

The tunable implant as defined in claim 4 wherein said at least one hinge comprises a first hinge and a second hinge.

### Claim 9 (depends on 7)

The tunable implant system as defined in claim 7 wherein said tunable implant comprises a plurality of said tunable implants.

### Claim 10 (depends on 9)

The tunable implant system as defined in claim 9 wherein each said bladder control system is operable to be controlled telemetrically.