US20110046672A1 - Vertebral pars interarticularis clamp a new spine fixation device, instrumentation, and methodology - Google Patents

Abstract

An improve spinal surgical implant used primarily in the posterior aspect of the spinal column for spinal reconstruction; revision surgery; deformity correction; and/or tumor surgery and/or trauma surgery of the cervical, thoracic and/or and lumbo-sacral spine.

Description

• The present invention is a divisional application of U.S. patent application Ser. No. 11/405,203 filed Apr. 17, 2006, which in claims priority on co-pending U.S. Provisional Application Ser. No. 60/674,426 filed Apr. 25, 2005, which is incorporated herein by reference.
• The present invention is directed to implants, more particularly to spinal implants, and even more particularly to a device and method for using a device that is designed to secure to the spinal column.
BACKGROUND OF THE INVENTION
• The human spine is made up of a column of thirty-three bones and their adjoining structures. The bodies of these vertebrae are connected by anterior and posterior ligaments and by discs of fibrocartilage generally known as intervertebral discs. These discs are positioned between opposite faces of adjacent vertebral bodies. This column of vertebrae and intervertebral discs forms a central axis that supports the head and torso. These vertebrae also enclose an opening through which the spinal cord passes.
• One of the most costly health problems in society involves back pain and pathology of the spine. These problems can affect individuals of all ages and can result in great suffering to victims. Back pain can be caused by several factors such as congenital deformities, traumatic injuries, degenerative changes to the spine, and the like. Such changes can cause painful excessive motion, or collapse of a motion segment resulting in the contraction of the spinal canal and compression of the neural structures, causing debilitating pain, paralysis or both, which in turn can result in nerve root compression or spinal stenosis.
• Nerve conduction disorders can also be associated with intervertebral discs or the vertebrae themselves. One such condition is herniation of the intervertebral disc, in which a small amount of tissue protrudes from the sides of the disc into the foramen to compress the spinal cord. A second common condition involves the development of small bone spurs, termed osteophytes, along the posterior surface of the vertebral body, again impinging on the spinal cord.
• Upon identification of these abnormalities, surgery may be required to correct the problem. For those problems associated with the formation of osteophytes or herniations of the intervertebral disc, one such surgical procedure is intervertebral discectomy. In this procedure, the involved vertebrae are exposed and the intervertebral disc is removed, thus removing the offending tissue or providing access for the removal of the bone osteophytes. A second procedure, termed a spinal fusion, may then be required to fix the vertebrae together to prevent movement and maintain a space originally occupied by the intervertebral disc. Although this procedure may result in some minor loss and flexibility in the spine due to the relatively large number of vertebrae, the minor loss of mobility is typically acceptable.
• For the replacement of a vertebra of the human spinal column, for the distraction of the spinal column, for the stabilization of the vertebrae and likewise, it is known to apply pedicle screws. The pedicle screw is screwed into the pedicle of the vertebra and the head of the pedicle screw is connected to suitable provisions, for example to a stabilizing system, to distraction rods, etc. During the treatment of the spine, the pedicle screw is generally first rotated into the pedicle. Subsequently, the insertion of the rod is effected.
• A standard pedicle screw assembly comprises a screw having an externally threaded stem having in turn a head provided with parts allowing it to be secured to one end of a distraction rod. Typically two such pedicle screws are inserted into respective vertebrae and are secured to a rod to distract and/or stabilize a spinal column after, for instance, a disk operation. One commonly used pedicle screw is disclosed in German Patent No. 4,107,480, which is incorporated herein by reference, and includes a head that has a pair of outwardly projecting parallel ridges with overhanging inner edges. A cap formed with a pair of complementary inwardly open slots fits with these ridges. The pedicle screw is threaded into the vertebrae, an end of the rod is fitted to its outer end, the cap is then slid transverse to the pedicle screw axis and parallel to the rod, over the rod to capture it, and finally a cap screw threaded into the cap and tightened to press the rod down against the head of the pedicle screw and thereby fix the rod, cap, and screw together. Many other pedicle screw designs have been developed to simplify the insertion of the pedicle screw into the pedicle, and/or to reduce damage to the pedicle screw and/or the pedicle during surgery. Some of these pedicle screw designs are disclosed in U.S. Pat. Nos. 5,882,350; 5,989,254; 5,997,539; 6,004,322; 6,004,349; 6,017,344; 6,053,917; 6,056,753; 6,083,227; 6,113,601; 6,183,472; 6,224,596; 6,368,319; 6,375,657; and 6,402,752; and the patents cited and disclosed in such patents. All these designs of pedicle screws are incorporated herein by reference.
• After the pedicle screw is inserted in the pedicle, the bone around the pedicle screw must heal to properly secure the pedicle screw in the bone. Any infection that occurs around the pedicle screw can slow the healing process and/or damage the bone around the pedicle screw thereby weakening the connection between the bone and pedicle screw. Typically, a patient is given antibiotics for several days after the surgery to reduce the occurrence of infection about the pedicle screw. The patient may also receive electrical stimulation during surgery to promote the healing process of the bone about the pedicle screw. Both of these techniques have improved the post-operative success of the surgical procedure; however, improved success rates are still needed.
• Although the use of pedicle screws are successfully used in a variety of surgical techniques, there are instances wherein the use of the pedicle screw may unnecessarily damage the bone. For instance, a particular vertebrae may be too small, too fragile, partially damaged, etc. to accept a pedicle screw. As such, a particular spinal procedure cannot be performed by use of pedicle screws. Situations also arise in that the orientation of the pedicle screw in the vertebrae is awkward, thereby complicating a spinal procedure that involves the connection of one or more other components to the pedicle screw.
• In view of these situations, there is a need for a device that can be secured to one or more vertebrae which device does not need to damage or otherwise penetrate into a vertebra and which device can be used to connect to other components of a stabilizing system, to distraction rods, etc.
SUMMARY OF THE INVENTION
• The present invention is directed to a spinal implant, and particularly to a spinal implant used primarily in the posterior aspect of the spinal column for spinal reconstruction; revision surgery; deformity correction; and/or tumor surgery and/or trauma surgery of the cervical, thoracic and/or and lumbo-sacral spine surgery; however, it will be appreciated that the implant can be used in other regions of the spine and/or for use in other or additional applications.
• In one non-limiting aspect of the invention, the spinal implant is designed to secure to one or more spinal vertebrae without having to penetrate or substantially penetrate into the vertebrae. In one non-limiting embodiment of the invention, the spinal implant is configured to at least partially clamp to one or more portions of a vertebra. This clamping configuration enables the spinal implant to be connected to one or more vertebrae without having to penetrate into the one or more vertebrae. As such, the spinal implant does not require drilling of insertion holes into the vertebrae, which insertion holes can i) cause damage to the vertebrae (e.g., fracturing and/or splitting of the vertebrae, etc.), and ii) require healing of the vertebrae about the device that has been inserted into the hole in the vertebrae prior to securing a stabilizing system, to distraction rods, etc. to the inserted device, thereby increasing procedure times and/or inconvenience to the patient.
• In one non-limiting aspect of the present invention, the spinal implant is in the form of a “clamp” which is designed to be applied to the posterior elements of one or more spinal vertebrae. In one non-limiting embodiment of the invention, the spinal implant includes two or more legs or arms that are used to at least partially secure the spinal implant to one or more vertebra. One or more of the arms or legs can be adjustable; however, this is not required. One or more of the arms or legs can include a grasping portion or foot portion that is used to at least partially engage and secure at least a portion of the arm or leg to the one or more vertebra. In one non-limiting aspect of this embodiment, the spinal implant includes two arms or legs. In another and/or alternative non-limiting aspect of this embodiment, the grasping portion includes an angulated section at an end portion of one or more of the arms or legs. This angulated section deviates by at least about 20° from the planar, generally a planar or slightly curved profile of the arm or legs of the spinal implant. In one non-limiting design, the angulated section is designed to at least partially hook onto a portion of one or more vertebra. In still another and/or alternative non-limiting aspect of this embodiment, one or more of the arms or legs can include one or more engaging structures (e.g., teeth, ribs, non-smooth surfaces, etc.) that are used to facilitate in engaging a portion of the arms or legs to a portion of one or more vertebra.
• In another and/or alternative non-limiting aspect of the present invention, the spinal implant is designed to be at least partially clamped within the interval between the superior margin of the lamina of a vertebra and the lateral margin of the pars interarticularis portion of the vertebra. In one non-limiting embodiment of the invention, the spinal implant is designed to span at least a portion of the length of the pars interarticularis of the vertebra. In one non-limiting aspect of this embodiment, the spinal implant is designed to span a portion of the length of the pars interarticularis of the vertebra. In another non-limiting aspect of this embodiment, the spinal implant is designed to span the full length of the pars interarticularis of the vertebra. In still another non-limiting aspect of this embodiment, the spinal implant is designed to span more than one vertebra (e.g., two vertebra, three vertebra, etc.). In yet another non-limiting aspect of this embodiment, the spinal implant is designed to be formed into a pedicle “claw” to enable the spinal implant to be affixed to a vertebra if the lamina or pars has been removed. In this non-limiting design, the spinal implant can create a different configuration of the pedicle “clamp” with the clamping of the superior and inferior walls of the pedicle. In accordance with these non-limiting aspects of the invention, the spinal implant is designed to provide a strong and secure permanent or temporary fixation to the posterior elements of a vertebra or to multiple vertebrae. The spinal implant is also designed to allow for one or more attachments to be placed upon and/or connected to the spinal implant, thus functioning in part as a platform and/or docking station for one or more other components that are used to address one or more spinal issues and/or one or more issues located near the spine.
• In still another and/or alternative non-limiting aspect of the invention, the spinal implant is designed to simplify spinal procedures and/or facilitate the improvement of the patient's health in that the spinal implant can facilitate in partially replacing or eliminating the need for lamina and transverse process hooks, pedicle screws, sub-laminar wires, and/or spinous process buttons. The spinal implant is believed to be especially useful in medical procedures involving the young and aging spine alike since the spinal implant can improve and, in most cases, provide a strong, if not the strongest, fixation possible in comparison to other devices which can have a higher percentage of failure.
• In yet another and/or alternative non-limiting aspect of the invention, the spinal implant can be used in a variety of spinal procedures. A few non-limiting examples of the potential use and applications of the spinal implant include, but are not limited to, Scoliosis surgery (e.g., Pediatric, Adult, Geriatric (i.e., “Aged”), Degenerative, Post Surgery, etc.); Degenerative Spine Conditions; Spine Fractures; Tumors; Small Pedicles that cannot be or are difficult to be accessed by a pedicle screw; Repair of Spondylolysis (Pars Defects); and/or Bone Anchor for an “artificial facet” type implant. As can be appreciated, other or additional applications of the spinal implant can be appreciated.
• In yet another and/or alternative non-limiting aspect of the invention, the spinal implant can include one or more of the following components: 1) a fixed or adjustable medial lamina clamp and/or foot (e.g., first clamp arm, etc.); 2) an adjustable hinged (or otherwise articulated) pars clamp and/or foot which (e.g., a lateral pars clamp and/or foot, etc.) (e.g., second clamp arm, etc.); 3) a set-screw and/or locking nut or other device or mechanical means for adjustments and/or tightening one or more components of the spinal implant; 4) an integral base (e.g., arm hub, etc.) which can include one or more docking stations—which may be threaded and/or constructed with another coupling device or mechanism; 5) one or more fixed and/or variable motion attachments that are at least partially designed to connected to one or more other components of a stabilizing system and/or other type of treatment system (e.g., modular heads; one or more attachment sites for rods, plates, and/or medication delivery devices, etc.); 6) one or more smooth surfaces, 7) one or more surfaces that are coated with one or more materials (e.g., medicines and/or drugs, adhesives, proteins, cells, antibodies, etc.); 8) one or more porous regions to allow for bone ingrowth into the clamp to facilitate in providing a permanent bond between the implant the spinal lamina and/or to allow for fluid flow (e.g., body fluids, medicine, drugs, cells, etc.) into and/or out of the spinal implant; and/or 9) one or more cross links connect to at least one side of a vertebra to another vertebra (e.g., force coupling) by use of one or more fixed or flexible couplers (i.e., cross links could connect single or multiple levels of vertebral bodies, etc.).
• In still yet another and/or alternative non-limiting aspect of the invention, the spinal implant can be manufactured in variable sizes to better meet the needs of the particular patient's anatomy.
• In a further and/or alternative non-limiting aspect of the present invention, the spinal implant can be constructed of a single material or from a combination of materials. Non-limiting materials that can be used to fully or partially form the spinal implant include, but are not limited to, metals, alloys, ceramics, polymers, plastics, memory metals, HA, fiber reenforced materials, mammalian bone, cartilage and/or other appropriate materials. The material used to form one or more portions of the spinal implant can be porous or non-porous, coated and/or non-coated. The material can include a bioactive and/or bioinert material. The material can be bioabsorbable or non-bioabsorbable. The material can include one more medicines or drugs. The spinal implant can also or alternatively include one or more drugs, medicine and/or other osteobiologics (e.g., BMPs, bone marrow concentrate, fillers, medicine, one or more biological agents, substitutes, etc.). The one or more drugs, medicine and/or other osteobiologics can thus form at least a portion of the spinal implant, be imbedded in at least a portion of the spinal implant and/or be coated on at least a portion of the spinal implant. As can be appreciated, different concentrations and/or different types of one or more drugs, medicine and/or other osteobiologics can be located on different portions of the spinal implant.
• In yet a further and/or alternative non-limiting aspect of the present invention, the spinal implant can be designed to permanently or detachably connect to a “Lamina Plate.” A Laminal Plate can be attached so as to replace or reconstruct the lamina or posterior wall of the spinal column. Such a Lamina Plate can include one or more smooth and/or porous regions, and can, among other goals, connect the spinal implant (e.g., right side, left side, etc.).
• In still yet another and/or alternative non-limiting aspect of the present invention, the spinal implant can be constructed with low profile features so as to inhibit or prevent possible injury and/or damage to neurological elements adjacent or near the spinal implant.
• In a further and/or alternative non-limiting aspect of the present invention, the spinal implant can be used in conjunction with innovative instrumentation to facilitate the preparation of the surgical site, the insertion of the spinal implant, the revisitation to the surgical site, and/or the attachment/disconnection of one or more components to the spinal implant device. Non-limiting examples of such innovate instruments include, but are not limited to, 1) An Inserter-Manipulator-Tightener which can be a single instrument or a set of instrument, 2) Exposure instrument(s), 3) Site prep instrument(s), 4) Inserter/remover instrument(s), and/or 5) Trial or sizing device(s). As can be appreciated, other or additional instruments can be used in conjunction with the spinal implant.
• In still a further and/or alternative non-limiting aspect of the present invention, the spinal implant can include a “Third Foot” attachment for 3-point fixation to one or more vertebra. Such a “Third Foot” arrangement can also be referred to as “The Long Arm” attachment of the spinal implant. In one non-limiting embodiment of the invention, the third arm is designed to be adjustably positionable. In this particular aspect of the invention, the third arm is able to be moveably positioned to a desired location to facilitate in securing the spinal implant to one or more vertebra. The length of the third can be selected so that the third is securable to the same vertebra as the first and second arm, or the third arm can have a length to secure to a vertebra other than the vertebra that the first and second arm are secured to. In another and/or alternative embodiment, third arm can be designed to be secured or locked in positioned once the third arm is properly oriented. The locking or securing arrangement can be accomplished by a variety of means such as, but not limited to, bolts, locking teeth, clamp, ribs, slots, screws, pins, etc.
• In yet a further and/or alternative non-limiting aspect of the present invention, the spinal implant can be configured so as to address the various needs of different portions of the mammalian spine, including but not limited to, cervical, thoracic, and lumbar-sacral” versions.
• In still yet a further and/or alternative non-limiting aspect of the present invention, the spinal implant can be designed to span more than one segment if one or more pars has been removed.
• In another and/or alternative non-limiting aspect of the present invention, the spinal implant can include a cap and/or other device to cover one or more openings in the spinal implant to 1) facilitate the revisitation to the spinal implant, 2) for the purpose of changing the one or more attachments and/or attachment methodology on the spinal implant, and/or 3) inserting and/or removing one or more drugs, medication, etc. in one or more cavities in the spinal implant. The cap, when used, can be made of one or more materials including, but not limited to, plastic, metal, etc. The cap can be biodegradable or non-biodegradable. The cap can include a threaded and/or other connection arrangement to permanently or removably secure the cap to the spinal implant.
• In still another and/or alternative non-limiting aspect of the present invention, the spinal implant can be designed so that a surgical site, the vertebra and/or the spinal implant can be re-visited from time to time as necessary. This capability can be instrumental in the future success of motion preservation implants (such as the concept of an artificial facet which would be designed and manufactured to be attached to a vertebra).
• In yet another and/or alternative non-limiting aspect of the present invention, the spinal implant can be designed to attach to the laminar portion of a vertebra for purposes of surgical treatment of a spinal condition.
• In still yet another and/or alternative non-limiting aspect of the present invention, the spinal implant can be designed to attach to two adjacent vertebrae for purposes of surgical treatment of a spinal condition.
• In a further and/or alternative non-limiting aspect of the present invention, the spinal implant can be designed to attach to two vertebrae' laminae.
• In still a further and/or alternative non-limiting aspect of the present invention, the spinal implant can be designed to clamp onto at least a portion of the vertebral body by gripping onto the natural faces of the vertebra.
• In still yet a further and/or alternative non-limiting aspect of the present invention, the spinal implant can be designed to utilize a locking nut and/or other type of mechanism to affix, position and/or disconnect the spinal implant to the one or more vertebra.
• In another and/or alternative non-limiting aspect of the present invention, the spinal implant can be designed to utilize a hinged and/or articulated device to attach to one or more vertebral bodies, or a portion thereof.
• In still another and/or alternative non-limiting aspect of the present invention, the spinal implant can be designed to utilize a capping or covering device to cover one or more access ports of the surgical implant to keep the access port clear and/or avoid tissue ingrowth. The capping or covering device can be removable or non-removable. The capping or covering device can be biodegradable or non-biodegradable.
• In yet another and/or alternative non-limiting aspect of the present invention, the spinal implant can be designed to form an artificial facet onto a vertebral body to facilitate in improving a patient's spinal function.
• In still yet another and/or alternative non-limiting aspect of the present invention, the spinal implant can be used in a variety of methodologies. One non-limiting methodology that can include the use of the spinal implant includes 1) Performing at least one exposure procedure to access/prepare at least a portion of a surgical site (e.g., Surgical exposure via open or minimally-invasive surgery (“MIS”) approach, Preparing surface for bio-ingrowth; Small laminotmy, if necessary, in superior lamina, small laminotmy, if necessary, in lateral pars; etc.), 2) Determining the proper size of the spinal implant, 3) Positioning/securing the spinal implant to one or more vertebra, and 4) Connecting one or more components (e.g., third arm of the spinal implant, universal connector, modular connection head, connection extension, cross-link, rod, plate, motion preservation device, medicine/drug delivery device, electro-simulation device, etc.) to the spinal implant. As can be appreciated, many modifications of this methodology can be used in conjunction with the spinal implant. One non-limiting specific methodology that can include the use of the spinal implant, such non-limiting methodology includes 1) Performing at least one an exposure procedure to access/prepare at least a portion of the spine, 2) Determining the proper size of the spinal implant, 3) Securing the spinal implant to one or more vertebra, 4) Positioning/securing one or more components of the spinal implant for optimum fixation and position on one or more vertebra, 5) Reviewing position of the spinal implant (e.g., MIS review, radiological review, visual review, etc.), and 6) Connecting one or more components to the spinal implant. In another and/or alternative non-limiting specific methodology that can include the use of the spinal implant, such non-limiting methodology includes 1) Performing at least one an exposure procedure to access/prepare at least a portion of the spine, 2) Determining the proper size of the spinal implant, 3) Positioning/securing the spinal implant to one or more vertebra (e.g., engaging the medial lamina foot of spinal implant on a vertebra, next engaging the lateral pars foot of the spinal implant on the same or different vertebra, secure/tighten the feet of the spinal implant to the one or more vertebra (e.g., close or tighten clamp or other type of tightening mechanism across pars, etc.), etc.), 4) Manipulating/adjusting the position of the spinal implant on the vertebra and/or one or more components of the spinal implant to obtain the desired fixation and/or position of the spinal implant on the one or more vertebra, 5) Reviewing position of the spinal implant on the one or more vertebra, 6) Performing final tightening/positioning of the spinal implant on the one or more vertebra, 7) Repeating the above steps for the connection of one or more other spinal implants on the same or different vertebra, and 8) Connecting one or more components to the spinal implant. As can be appreciated, other or additional methodologies can be used with the spinal implant of the present invention.
• In still yet another and/or alternative non-limiting aspect of the present invention, the spinal implant can provide one or more of the following benefits: 1) Eliminates the need for a hospital or other medical facility to carry a large inventory of lamina hooks, wires, screws, buttons, etc.; 2) Enhances fixation to a vertebral body or multiple vertebral bodies (e.g., clamp design, cortical bone, etc.); 3) Allows for force coupling of the construct, if desired, for enhanced purchase and better control for manipulating the vertebra body and motion segment (deformity surgery); 4) Allows for bio-ingrowth capability for permanent fixation to lamina biologically; 5) Allows for the attachment of growth rods for pediatric scoliosis; 6) Provides a method of addressing the disease of
• Osteoporosis; 7) Facilitates in Motion Preservation in the spine, as compared to alternative surgical methodologies; 8) Allows Revision Surgery to be undertaken with greater ease than current devices; 9) Provides “lamina prosthesis” for repair or reconstruction surgery; 10) Creates or permits the formation of a permanent “docking” site that can be revisited by the surgeon or a subsequent surgeon; 11) Permits the ability to control vertebral motion or manipulation such as, but not limited to e-Rotation, 3-D contouring, etc.; 12) Provides similar advantages to standard pedicle screw fixation; 13) Allows for Uni or bilateral control or fixation; 14) Allows for Single or Multi-level construct using “links”; 15) Provides a substitute for pedicle screws (thus target surgeons that might be “squeamish” on using pedicle screws); 16) Provides a substitute for pedicle screws when pedicle screw usage is impractical (e.g., small, osteoporotic, missing pedicle, etc.); 17) Provides a replacement for pedicle screw prosthesis or, in the alternative, can be used to complement the pedicle screw prosthesis implant system; 18) Can be attached to or be used with pedicle screw instrumentation; 19) Can be attached to or be used with artificial vertebral body implant (e.g., 360°) reconstruction; 20) Can be created and/or be modified utilizing injection molding technology for customization; and/or 21) Can be staged using MIS approach for bio-ingrowth application, such as surgically inserting a sleeve into the site and, later, inserting this device into the fixed sleeve site. As can be appreciated, the spinal implant can have other or additional benefits.
• In a further and/or alternative non-limiting aspect of the present invention, the spinal implant can be used in a variety of treatments. Some of the diseases the spinal implant can be used to help in the treatment of include, but are not limited to: 1) Tumors, 2) Infections, 3) Revision surgery, and/or 4) Trauma.
• In still a further and/or alternative non-limiting aspect of the present invention, the spinal implant can be designed for bio-ingrowth. A Bio-ingrowth version of the spinal implant can be used with motion preservation devices by providing a solid fixation point to the bone—minimizes loosening, and/or stress shielding and maximizes load sharing.
• In summary, the spinal implant is a new and innovative spine implant that can be used be used primarily in the posterior aspect of the spinal column for spinal reconstruction, revision surgery, deformity correction, tumor, and trauma surgery of the cervical, thoracic, and lumbo-sacral spine. The spinal implant can be designed to removably or irremovably “clamp” or secure onto the posterior elements of one or more spinal vertebrae. In one non-limiting embodiment, the spinal implant can be clamped within the interval between the superior margin of the lamina of a vertebra and the lateral margin of the pars interarticularis portion of the vertebra. The spinal implant can be designed to span the length of the pars interarticularis, or, secondarily, a portion thereof or, in the alternative, more than one vertebra's surface. The spinal implant, when secured to one or more vertebra, can provide strong permanent or temporary fixation to the posterior elements of a vertebra or multiple vertebrae and allow for a variety of attachments to be placed upon and/or connected to the spinal implant, thus functioning a platform and/or docking station for one or more other components. The spinal implant is envisioned to simplify spinal procedures and/or facilitate the improvement of the patient's health in that it can replace the need for lamina and transverse process hooks, pedicle screws, sub-laminar wires, and/or spinous process buttons. The primary market for the spinal implant is believed to be for the young and aging spine alike since the spinal implant is believed to provide improved and, in most cases, the strongest fixation possible in comparison to other devices which can have a high percent of failure. The spinal implant is believed to be usable to assist in Scoliosis surgery (e.g., Pediatric, Adult, Geriatric), Degenerative Post Surgery, Degenerative Spine Conditions, Spine Fractures, Tumors, Small Pedicles that cannot be accessed by a pedicle screw, Repair of Spondylolysis (Pars Defects), and/or a Bone Anchor for an “artificial facet” type implant. The spinal implant may have other uses. The spinal implant can be formed into a clamp-type device. When the spinal implant is a clamp-type device, the spinal implant can include one or more of the following components: 1) A fixed medial lamina clamp and/or foot; 2) An adjustable hinged (or otherwise articulated) pars clamp and/or foot which, in its primary embodiment, will be a lateral pars clamp and/or foot; 3) A set-screw or locking nut or other device or mechanical means for adjustments and/or tightening; 4) An integral base which might include docking station—which may be threaded or constructed with another coupling device or mechanism; 5) A variety of fixed and/or variable motion attachments to the docking station which might consist of, for example, Modular heads (see pedicle prosthesis system), Attachment sites for rods, plates, medication delivery devices, etc.; 6) Smooth or porous surfaces, coated which may be coated with an appropriate substance or not—If constructed with a porous surface, this would allow bone in-growth into the clamp providing a permanent bond between the implant the spinal lamina. The intent is that the surgical site, the vertebra and/or the clamp can be re-visited from time to time as necessary. This capability can be critical to the future success of motion preservation implants (such as the concept of an artificial facet which would be designed and manufactured to be attached to a vertebra); and/or 7) Cross Links to connect right to left side of one vertebra to another (force coupling) by means of fixed or flexible couplers. In this regard, it is contemplated that cross links could connect single or multiple levels of vertebral bodies. The spinal implant could also be designed as a pedicle “claw” to enable the device to be affixed to a vertebra if the lamina or pars has been removed). This design could create a different configuration of the pedicle “clamp” with the clamping of the superior and inferior walls of the pedicle. The spinal implant could be manufactured in variable sizes to better meet the needs of the particular patient's anatomy. The spinal implant can be constructed of a single material or of a combination of materials. Such materials could include metals, alloys, ceramics, plastics, memory metals, mammalian bone, cartilage and/or other appropriate materials. One or more spinal implants can be used in conjunctions with a “Lamina Plate.” The “Lamina Plate” can be attached to one or more vertebra so as to replace or reconstruct the lamina or posterior wall of the spinal column. Such a “Lamina Plate” could be smooth or porous. The“Lamina Plate” could be designed to connect to a one spinal implant or to a plurality of spinal implants. The spinal implant can be constructed with a low profile foot to minimize possible injury to the neurological elements adjacent or near the spinal implant. Innovative instrumentation can be used with the spinal implant to facilitate in the preparation of the surgical site, the insertion of the spinal implant, the revisitation to the surgical site, and/or the attachment of one or more components to the spinal implant. Some of these innovative instruments can include 1) An “Inserter-Manipulator-Tightener” which is envisioned as an All-in-one concept or, if appropriate, in multiple components, 2) Exposure instrument(s), 3) Site prep instrument(s), 4) Inserter/remover instrument(s), and/or 5) Trial or sizing device(s). The spinal implant can include a “Third Foot” attachment for enhanced 3-point fixation (e.g., “A Long Arm” attachment). As can be appreciated, the spinal implant could include four or more feet. The spinal implant can be configured in one or more designs so as to address the various needs of different portions of the mammalian spine, including but not limited to cervical, thoracic, and lumbar-sacral” versions. The spinal implant can be design to span more than one segment if pars has been removed. The spinal implant can include one or more caps or other devices to at least partially cover one or more openings in the spinal implant. These one or more openings can be used to facilitate in the revisitation to the spinal implant, facilitate in changing the attachment arrangement and/or methodology of the spinal implant, facilitate in connecting one or more components to the spinal implant, and/or receive one or more medicine or drugs. The cap can be made of one or more materials including plastic, metal, etc. The cap can be threaded or connected to the spinal implant by one or more mechanical methodologies. The spinal implant can be designed to attach to the laminar portion of a vertebra for purposes of surgical treatment of a spinal condition. The spinal implant can be designed to onto two adjacent vertebrae for purposes of surgical treatment of a spinal condition. The spinal implant can be designed to attach to two vertebrae' laminae. The spinal implant can be designed to clamp onto the vertebral body by gripping onto the natural faces of the vertebra. The spinal implant can be designed to include a locking nut or device to affix the spinal implant onto the vertebra. The spinal implant can be designed to include a hinged or articulated structure for use in attaching the spinal implant to a vertebral body, or a portion thereof. The spinal implant can be designed to include a capping device to cover one or more access ports of the spinal implant to keep the access port clear and/or avoid tissue ingrowth. The spinal implant can be designed to form one or more artificial facets on a vertebral body which can be used to improve a patient's spinal function. Many methodologies can be used with the spinal implant, depending in part on the configuration of the spinal implant. When the spinal implant is a clamped-shaped device that includes at least two arms or legs, the following non-limiting methodology can be used: 1) Exposure of a surgical site (e.g., Surgical exposure via Open or minimally-invasive surgery (“MIS”) approach, Preparation of one or more surfaces of the vertebra for bio-ingrowth, Small laminotmy in superior lamina, Small laminotmy in lateral pars, etc.); 2) Determine proper size of spinal implant; 3) Engage medial lamina foot on first leg of spinal implant; 4) Engage lateral pars foot on second leg of spinal implant; 5) Close or tighten clamp on spinal implant that is positioned across pars; 6) Manipulate position of spinal implant for optimum fixation and position; 7) Review position of spinal implant by MIS, radiological review, etc.; 8) Final tightening of spinal implant with set-screw or lock nut or other methodology; 9) Insert second spinal implant, if necessary; and 10) Attach one or more components to spinal implant (e.g., modular head, third or fourth “long arm”, “lamina plate”, cross-link, longitudinal member (e.g., rod, plate, motion preservation device, etc.), etc.). The spinal implant can have a variety of benefits such as, but not limited to, 1) Eliminate the need for a hospital to carry a large inventory of lamina hooks, wires, screws, buttons, etc.; 2) Provide enhanced fixation to a vertebral body or multiple vertebral bodies—clamp design, cortical bone, etc.; 3) Allow for forced coupling of the construct, if desired, for enhanced purchase and better control for manipulating the vertebra body and motion segment (deformity surgery); 4) Allow for bio-ingrowth capability for permanent fixation to lamina biologically; 5) Allow for the attachment of growth rods for pediatric scoliosis; 6) Provides a method of addressing the disease of Osteoporosis; 7) Facilitate in motion preservation in the spine, as compared to alternative surgical methodologies; 8) Allows for revision surgery to be undertaken with greater ease than current devices; 9) Enables “lamina prosthesis” for repair or reconstruction surgery; 10) Allows for the treatment of Tumors, Infections, Revision surgery, Trauma, etc.; 11) Permits the creation of a permanent “docking” site that can be revisited by the surgeon or a subsequent surgeon, if necessary; 12) Per with the ability to control vertebral motion or manipulation (e.g., De-Rotation, 3-D contouring, etc.); 13) Provide similar advantages to standard pedicle screw fixation; 14) Allow for Uni or bilateral control or fixation; 15) Allow for Single or Multi-level construct using “links”; 16) Provide a substitute for pedicle screws when pedicle screws usage is impractical (small, osteoporotic, or missing pedicle); 17) Replace the pedicle screw prosthesis implant; 18) Provide a complement to the pedicle screw prosthesis implant system; 19) Can be attached to or be used with pedicel screw instrumentation; and/or 20) Can be attached to or be used with artificial vertebral body implant (360) reconstruction. The spinal implant can be at least partially formed of a material that has been created or modified utilizing injection molding technology so as to customize the spinal implant. The spinal implant can be staged using a MIS approach for bio-ingrowth application, such as surgically inserting a sleeve into the site and, later, inserting this device into the fixed sleeve site. The spinal implant can be designed so that at least a portion of the spinal implant promotes and/or allows bio-ingrowth to at least provide a solid fixation point to the bone, thereby minimizing loosening, and/or stress shielding and maximizes load sharing. The spinal implant can be formed of a variety of materials (e.g., solid metal, polymer, ceramic, memory metal, HA, etc.). The spinal implant can be at least partially coated with osteobiologics (BMPs, bone marrow concentrate, fillers, and substitutes.
• One non-limiting object of the present invention is the provision of a spinal implant that can be used be in the posterior aspect of the spinal column for spinal reconstruction, revision surgery, deformity correction, tumor, and trauma surgery of the cervical, thoracic, and/or lumbo-sacral spine.
• Another and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can removably or irremovably secure onto the posterior elements of one or more spinal vertebrae.
• Still another and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can be secured within the interval between the superior margin of the lamina of a vertebra and the lateral margin of the pars interarticularis portion of the vertebra.
• Yet another and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can span at least a portion of the length of the pars interarticularis, or span more than one vertebra's surface.
• Still yet another and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can provide strong permanent or temporary fixation to the posterior elements of a vertebra or multiple vertebrae.
• A further and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can allow for a variety of attachments to be placed upon and/or connected to the spinal implant.
• Still a further and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can simplify spinal procedures and/or facilitate the improvement of the patient's health.
• Yet a further and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can replace the need for lamina and transverse process hooks, pedicle screws, sub-laminar wires, and/or spinous process buttons.
• Still yet a further and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can eliminate the need for a hospital or other medical facility to carry a large inventory of lamina hooks, wires, screws, buttons, etc.
• Another and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can provide enhanced fixation to a vertebral body or multiple vertebral bodies.
• Still another and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can allow for bio-ingrowth capability for permanent fixation to lamina biologically.
• Yet another and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can allow for the attachment of growth rods for pediatric scoliosis.
• Still yet another and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can be used to treat the disease of Osteoporosis.
• A further and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can facilitate in motion preservation in the spine.
• Still a further and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can allow for revision surgery to be undertaken with greater ease.
• Yet a further and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can enable “lamina prosthesis” for repair or reconstruction surgery.
• Still yet a further and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can allow for the treatment of tumors, infections, revision surgery, and/or trauma to the spin or regions about the spine.
• Another and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can permit the creation of a permanent “docking” site for one or more components.
• Still another and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can permit the ability to control vertebral motion or manipulation.
• Yet another and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can provide similar advantages to standard pedicle screw fixation.
• Still Yet another and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can allow for unilateral or bilateral control or fixation.
• A further and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can allow for single or multi-level construct using “links”.
• Still a further and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can provide a substitute for pedicle screws.
• Yet a further and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can provide a complement to the pedicle screw prosthesis implant system.
• Still yet a further and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can be attached to or be used with pedicel screw instrumentation.
• Another and/or alternative non-limiting object of the present invention is the provision of a spinal implant that can be attached to or be used with artificial vertebral body implant reconstruction.
• These and other advantages will become apparent to those skilled in the art upon the reading and following of this description taken together with the accompanying drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
• Reference may now be made to the drawing, which illustrates an embodiment that the invention may take in physical form wherein:
• FIG. 1 is an elevation view of one non-limiting embodiment the spinal implant in accordance with the present invention connected to a vertebra;
• FIG. 2 is a cross-sectional view along line2-2 ofFIG. 1;
• FIG. 3 is an exploded view of the spinal implant ofFIG. 1;
• FIG. 4 is an enlarged sectional view of the arm adjustment mechanism for two arms of the spinal implant ofFIG. 1;
• FIG. 5 is an enlarged sectional view of a non-limiting alternative arm adjustment mechanism for two arms of the spinal implant;
• FIG. 6 is an exploded view of the spinal implant that includes the arm adjustment mechanism ofFIG. 5;
• FIG. 7 is an enlarged sectional view of a non-limiting alternative arm adjustment mechanism for two arms of the spinal implant;
• FIG. 8 is an exploded view of the spinal implant that includes the arm adjustment mechanism ofFIG. 7;
• FIGS. 9A-9D, and10-13 illustrate non-limiting alternative configurations of the arm adjustment mechanism ofFIG. 1;
• FIG. 14 is an elevation view of another non-limiting embodiment the spinal implant in accordance with the present invention; and,
• FIG. 15 is a cross-sectional view along line15-15 ofFIG. 14.
DETAILED DESCRIPTION OF THE INVENTION
• Referring now to the preferred embodiment of the drawings, wherein the showings are for the purpose of illustrating a preferred embodiment of the invention only and not for the purpose of limiting the invention,FIGS. 1-15 illustrate aspinal implant100 in accordance with the present invention. As best illustrated inFIG. 1, the spinal implant is designed to be at least partially secured to the posterior elements of a spinal vertebra V. In particular, the spinal implant, as shown inFIG. 1, is secured to the vertebra V within the interval between the superior margin of the lamina of the vertebra and the lateral margin of the pars interarticularis portion of the vertebra. As can be appreciated, the spinal implant can be designed to span the full length of the pars interarticularis, a portion of the pars interarticularis, or connect to more than one vertebra. As best illustrated inFIG. 1, one or morespinal implants100 can be secured to a vertebra.
• As illustrated inFIGS. 3-8, the spinal implant includes at least twoarms110,120. At least one arm is designed to be adjustably connected to anarm hub130. Eacharm110,120 includes abody portion112,122 and anend foot114,124. The body portion of both anus is illustrated are being generally planar or flat; however, it can be appreciated that the body portion can be slightly curved and/or include other configurations. The end foot on the end of each arm is designed to secure the end portion of the arms to a portion of a vertebra. Each foot is angularly oriented with respect to the body portion of the arms; however, this is not required. Each foot is illustrated as having a maximum angular orientation of over 90° relative to the longitudinal axis of the body portion. Typically, the maximum angular orientation is about 90-160°, and more typically about 90-130°; however, other angles can be used. As can be appreciated, the maximum angular orientation can be less than 90°. The angular orientation of the feet can be the same or different. The inner surface of each foot has a generally planar or slightly curved profile; however, it can be appreciated that one or more of the feet can include other configurations.
• Although not shown, the inner surface of one or more feet can include one or more structures and/or materials to facilitate in the gripping of the one or more feet of the arms to a portion of the vertebra; however, this is not required. For instance, one or more feet can include one or more gripping arrangements such as, but not limited to, one or more teeth, one or more ribs, one or more rough regions, etc.; however, this is not required. In addition or alternatively, an adhesive (e.g., bone cement, bio-grout, polymer adhesive, etc.) can be used to facilitate in the gripping of the one or more feet of the arms to a portion of the vertebra; however, this is not required. Furthermore, one or more portions of one or more feet can alternatively or additionally be porous and/or include one or more openings or cavities so as to promote bone ingrowth, and thereby facilitate in the gripping of the one or more feet of the arms to a portion of the vertebra; however, this is not required. The one or more porous regions can include one or more materials (e.g., bone, etc.), medication, drugs, etc. to promote and/or inhibit bone growth on one or more regions of the feet; however, this is not required. As can be appreciated, other or additional arrangements can be used to facilitate in the gripping and/or proper operation of the one or more feet of the arms on a portion of the vertebra.
• As illustrated inFIGS. 3-8, the body section and foot of each arm is formed of a single piece of material. Typically, the material is a metal material; however, other or additional materials can be used. As can be appreciated, the body portion and the foot of one or more arms can be formed of different materials. The body portion and foot of each arm is also illustrated as being about the same shape and size. As can be appreciated, the body portion and/or foot of each arm can be the same or different from another arm. For instance, the length, profile, thickness and/or cross-sectional shape of the body portion of each arm can be the same or different of the body portion of one or more other anus. Furthermore, the length, profile, thickness and/or cross-sectional shape of the foot of each arm can be the same or different from the foot of one or more other arms. Although not shown, the foot on one or more arms can be designed so as to be connected to the body portion by use of an adhesive, solder, weld, etc.; however, this is not required. As can further be appreciated, the foot can be designed so as to be adjustably oriented relative to the body portion by use of a hinge mechanism, a ratchet mechanism, ball/socket mechanism, etc.; however, this is not required. A set screw and/or other locking arrangement can be used to adjust and/or secure the adjustable foot in place; however, this is not required.
• The orientation of the two arms relative to one another can be accomplished in a variety of ways. As can be appreciated, the spinal implant can include more than two arms; however, this is not required. The arrangement used to orient the arms can be designed to orient the arms about one or more axes of the spinal implant. A first non-limiting arrangement is illustrated inFIGS. 3 and 4, a second non-limiting arrangement is illustrated inFIGS. 5 and 6, and a third non-limiting arrangement is illustrated inFIGS. 7 and 8. In all the examples illustrated inFIGS. 3-8, the spinal implant includes two arms that are adjustable along the longitudinal length of the spinal implant. As can be appreciated, these three arrangements merely illustrate a few of the possible arrangements that can be used to orient and set in position the arms relative to one another. As can be appreciated, the spinal implant can be designed such that one or more of the arms are not adjustable along the longitudinal axis of the spinal implant; however, this is not required. As can also be appreciated, one or more arms can be adjustably oriented in one or more less axes that one or more other arms; however, this is not required. For instance, one or more arms could be adjustably oriented in one or more axes of the spinal implant, and one or more arms could be adjustably oriented in no axis of the spinal implant. In another instance, one or more arms could be adjustably oriented in two or more axes of the spinal implant, and one or more arms could be adjustably oriented in only one axis of the spinal implant. In still another instance, one or more arms could be adjustably oriented in three axes of the spinal implant, and one or more arms could be adjustably oriented in two or one axes of the spinal implant.
• Referring again toFIGS. 3 and 4,arm hub130 includes anarm opening132 that enablesfront portions116,126 ofarms110,120 to be at least partially telescopically received in the opening. Each of the front portions of the arms include two legs117,118,127,128 that are separated by a slot119,129. The configuration of the front portions of the two arms is such that when both front portions of the arms are partially inserted intoopening132, leg118 ofarm110 partially enters slot129 ofarm120 and leg127 ofarm120 partially enters slot119 ofarm110. This engagement of the front portion of the arms in the arm hub is partially illustrated inFIG. 4. As illustrated by the arrows inFIG. 4, the two arms of the spinal implant are both adjustable along the longitudinal and latitudinal (i.e., 90° to a longitudinal axis) axes of the spinal implant. Once the arms are positioned on a portion of one or more vertebra, the arms can be set relative to one another by use of aset screw140. Setscrew140 is a threaded screw that is designed to be inserted into set opening134 ofarm hub130. The set opening is positioned on one side of the arm hub; however, it can be appreciated that the set opening can be position in other locations on the arm hub (e.g., bottom side, top side, front end, back end, etc.). It can also be appreciated that more than one set opening can be used to set the arms in position in the arm hub. The set opening includes a thread to receive the thread onset screw140. The head of the set screw includes a configuration that enables a tool to engage the top of the set screw so as to insert/remove the set screw from the set opening. When the set screw is inserted into the set opening, the front end of the set screw engages a side portion ofleg116 and causes thearm110 to move intoarm120, which in turn causes leg128 to engage an inner side surface ofopening132. The pressure exerted onarm110 by the set screw causes the two arms to be set in position inarm hub130. Removal of the set screw from the set opening can enable the arms to be adjusted in the arm opening. As can be appreciated, arrangements other than the set screw can be used to set the arms relative to one another (e.g., set pin, adhesive, adhesive, clamp arrangement, etc.).
• Arm hub130 also includes one ormore connection arrangements136. As illustrated inFIGS. 3 and 4, theconnection arrangement136 is positioned on the top surface of the arm hub. As can be appreciated, theconnection arrangement136 can be located on other regions of the arm hub. As also can be appreciated, the arm hub can include more than one connection arrangement. The one or more connection arrangements on the hub are designed to connection to a stabilizing system and/or other type of treatment system (e.g., modular heads; one or more attachment sites for rods, plates, and/or medication delivery devices, etc.), and/or connect another arm to the spinal implant.Connection arrangement136, as illustrated inFIGS. 3 and 4, includes a threadedcavity138 designed to receive a threaded end of a stabilizing system and/or other type of treatment system such as, but not limited to, a threaded end of a rod R. As can be appreciated, theconnection arrangement136 can have many other and/or additional configurations (e.g., slot configuration, ball configuration, polyaxial head, etc.) so as to connect a variety of stabilizing systems and/or other type of treatment system to the spinal implant. Although not shown, theconnection arrangement136 can be designed to be removable so that other types of connection arrangements can be connected to the arm hub to enable other types of stabilizing systems and/or other type of treatment system to be connected to the spinal implant; however, this is not required. Theconnection arrangement136 is illustrated as extending outwardly from a surface of the arm hub; however, this is not required. As can be appreciated, the connection arrangement can be formed at least partially internally in the arm hub such that little, if any, portion of the connection arrangement extends outwardly from the surface of the arm hub.
• Referring now toFIGS. 5 and 6, a different configuration ofarms110 and120 is shown. The front portion of each of the arms includes a plurality ofteeth200,210. The teeth are designed to engage one other when a portion of each arm is positioned in thearm opening132 ofarm hub130 and theset screw140 is inserted into set opening134 as illustrated inFIG. 5. The teeth configuration of the arms can be designed to create a ratcheting configuration for the arms when positioning the arms relative to one another; however, this is not required. As theset screw140 is inserted into set opening134 as illustrated by the arrow inFIG. 5, the front end of the screw engages the side ofarm110 and moves the arm into engagement witharm120, which in turn causesarm120 to engage an inner wall ofopening132. The pressure exerted by the set screw causes the two arms to be set in opening132 ofarm hub130. The removal of the set screw enablesarms110,120 to be adjustable positioned inarm hub130. As can be appreciated, the location of opening132 can be in other locations as described above with regard toFIGS. 3 and 4. As can be appreciated, other or additional mechanisms can be used to adjust/set one or more of the arms inarm hub130 as described above with regard toFIGS. 3 and 4. The design ofarms110,120 inFIGS. 5 and 6 enables the arms to be adjusted along the longitudinal axis of the spinal implant as illustrated by the arrows inFIG. 5. Due to the configuration of the teeth on the arms, the arms are primarily adjustable on the longitudinal axis of the spinal implant; however, the teeth could be designed to enable one or both arms to be adjustable in an axis other than the longitudinal axis. Aconnection arrangement136 having a threadedcavity138 is positioned on the top surface of the arm hub. The connection arrangement is designed to connection to a stabilizing system and/or other type of treatment system, and/or connect another arm to the spinal implant. A variety of designs, orientations and number of connection arrangement can be used as described above with regard toFIGS. 3 and 4.
• Referring now toFIGS. 7 and 8, a different configuration of the arms and arm hub is illustrated.Arm110 includes afront portion116 that includes an adjustment landing300.Arm120 includes afront portion126 that includes a stop landing310. As illustrated inFIG. 7, a portion of the front portions of both arms are designed to be insertable inarm opening132 ofarm hub130. Stop landing310 limits the movement ofarm120 in one direction along the longitudinal axis of the spinal implant as shown inFIG. 7. Adjustment landing300 onarm110 is used to adjust the longitudinal position ofarm110. Anadjustment screw140 is designed to be threaded into set opening134 ofarm hub130. As shown inFIG. 7, as the adjustment screw is threaded into set opening134, the front end of the set screw engages adjustment landing300, thereby pushing the front portion ofarm110 into the front portion ofarm120 to cause both arms to be set inarm hub130. As shown inFIG. 7, the arms are adjustable along the longitudinal axis of the spinal implant as illustrated by the arrows. This particular arm configuration can allow the one or both arms to be adjustable in an axis other than the longitudinal axis. As can be appreciated, the location of opening132 can be in other locations onarm hub130 as described above with regard toFIGS. 3 and 4. As also can be appreciated, other or additional mechanisms can be used to adjust/set one or more of the arms inarm hub130 as described above with regard toFIGS. 3 and 4. Aconnection arrangement136 having a threadedcavity138 is positioned on the top surface of the arm hub. The connection arrangement is designed to connection to a stabilizing system and/or other type of treatment system, and/or connect another arm to the spinal implant. A variety of designs, orientations and number of connection arrangement can be used as described above with regard toFIGS. 3 and 4.
• The three non-limiting configurations of the spinal implant illustrated inFIGS. 3-8, merely set forth three of a number of arrangements that can be used to adjustably position the one or more arms of the spinal implant relative to one another. Other non-limiting arrangements can include, but are not limited to, 1) one or more arms connected to the arm hub by a hinge, 2) one or more arms connected to the arm hub by a ball and socket arrangement, 3) one or more arms connected to the arm hub by a slot arrangement, 3) one or more arms secured to the arm hub by a threaded connection, etc. As illustrated inFIGS. 3-8, both arms of the spinal implant are adjustable in at least one axis of the spinal implant; however, it can be appreciated that one or more of the arms of the spinal implant are in a fixed positioned relative to the arm hub; however, this is not required.
• Referring now toFIGS. 9A-D and10-13, there are illustrated a variety of arm hub configurations that could be used to connect to a variety of components of a stabilizing system and/or other type of treatment system. As can be appreciated, the various configurations of the arm hubs shown inFIGS. 9A-D and10-13 are non-limiting examples of just a few of the many arm hub configurations that can be used in conjunctions with the spinal implant of the present invention.
• Referring now toFIG. 9A, there is illustrated anarm hub130 having a similar configuration as the arm hub ofFIGS. 3 and 4 except that theconnection arrangement400 is in the shape of a polyaxial head. As can be appreciated, the polyaxial head can be used on other arm hubs such as, but not limited to, the arm hubs illustrated inFIGS. 5-8.
• Referring now toFIG. 9B, there is illustrated anarm hub130 having a similar configuration as the arm hub ofFIGS. 3 and 4 except that theconnection arrangement500 is in the shape of a ball. As can be appreciated, the ball-shaped connection arrangement can be used on other arm hubs such as, but not limited to, the arm hubs illustrated inFIGS. 5-8.
• Referring now toFIGS. 9C and 9D, there is illustrated a modified version of the arm hub shown inFIGS. 3 and 4. The arm hub is absent aconnection arrangement136 on the top surface of the arm hub; however, it can be appreciated that a connection arrangement similar toconnection arrangements136,400,500 as discussed above could also be included on the anti hub. The connection arrangement on the side ofarm hub130 shown inFIGS. 9C and 9D is in the form of a partiallyspherical cavity600. Thecavity600 is accessed from the side of the arm hub by atapered opening610. As can be appreciated,cavity600 can be located in other or additional regions of the arm hub.Cavity600 is designed to receive auniversal connector device700 that includes a two generally spherical shaped ends710,720 which are connected by a rod-shapedmember730. As can be appreciated, end720 have a variety of other shapes to enableend720 to connect with and/or interact with a variety of stabilizing systems and/or other type of treatment systems.End710 is designed to be at least partially positioned incavity600. The shape ofcavity600 and end710 enablesconnector device700 to be moved in a variety of positioned as indicated by the arrows inFIGS. 9C and 9D. The ability to move theconnector device700 in a variety of positions enhances the versatility of the spinal implant so that the spinal implant can be used with a variety of stabilizing systems and/or other type of treatment systems. The arm hub also includes a set opening800 that is designed to receive aset screw900. As shown inFIG. 9D, as the set screw is threaded into set opening800, the front end of the set screw enterscavity600 and engages end710 ofconnection device700, thereby pushing the end into the side ofcavity600 to causeend710 to be substantially immovably positioned incavity600. The head of the set screw is typically designed to allow an instrument to insert/remove the set screw in/from opening800; however, this is not required. The loosening of theset screw900 enablesconnector device700 to again be adjusted, if so desired. As can be appreciated, the location of opening800 can be in other locations onarm hub130. As also can be appreciated, other or additional mechanisms can be used to adjust/setend710 incavity600.
• Referring now toFIG. 10, there is illustrated another modified version of the arm hub shown inFIGS. 3 and 4. The arm hub is absent aconnection arrangement136 on the top surface of the arm hub; however, it can be appreciated that a connection arrangement similar toconnection arrangements136,400,500 as discussed above could also be included on the arm hub. The connection arrangement on the side of arm hub that is shown inFIG. 10 is in the form oftubular slot1000. The tubular slot is illustrated as being positioned fully through the side of the arm hub; however, this is not required. As can be appreciated, the tubular slot can have other or additional cross-sectional shapes along the length of the slot (e.g., oval, polygonal, etc.). As can be appreciated,slot1000 can be located in other or additional regions of the arm hub.Slot1000 is designed to receive one or more components R of a stabilizing system and/or other type of treatment system (e.g., rod, etc.). As illustrated by the arrows, component R can be adjusted along the length of the slot. The tubular shape ofslot1000 in conjunction with the tubular shape of the end of component R enables component R to be rotated in the slot as indicated by the arrows; however, this is not required. The ability to move component R in a variety of positions enhances the versatility of the spinal implant so that the spinal implant can be used with a variety of stabilizing systems and/or other type of treatment systems. The arm hub also includes a set opening1100 that is designed to receive aset screw1200. As the set screw is threaded into set opening1100, the front end of the set screw entersslot1000 and engages a portion of component R that is positioned inslot1000, thereby pushing a portion of component R into the side ofslot1000 and causing component R to be substantially immovably positioned inslot1000. The head of the set screw is typically designed to allow an instrument to insert/remove the set screw in/from opening1100; however, this is not required. The loosening of theset screw1200 enables component R to again be adjusted, if so desired. As can be appreciated, the location of opening1100 can be in other locations onarm hub130. As also can be appreciated, other or additional mechanisms can be used to adjust/set component R inslot1000.
• Referring now toFIGS. 11-13, there is illustrated another modified version of the arm hub shown inFIGS. 3 and 4. The arm hub is absent aconnection arrangement136 on the top surface of the arm hub; however, it can be appreciated that a connection arrangement similar toconnection arrangements136,400,500 as discussed above could also be included on the arm hub. The connection arrangement on the side of arm hub that is shown inFIGS. 11 and 13 is in the form of an angulatedextension member1300 that includes a connection arrangement on a side of the extension member that is in the form of a partiallyspherical cavity1400. Thecavity1400 is accessed from the side of the extension member by atapered opening1410. As can be appreciated,cavity1400 can be located in other or additional regions of the extension member.Cavity1400 is designed to receive designed to receive one or more components R of a stabilizing system and/or other type of treatment system (e.g., rod, etc.). As best shown inFIG. 13, component R includes a generally spherical shaped end S. End S is designed to be at least partially positioned incavity1400. The shape ofcavity1400 and end S enables component R to be moved in a variety of positions as indicated by the arrows inFIGS. 11-13. The ability to move component R in a variety of positions enhances the versatility of the spinal implant so that the spinal implant can be used with a variety of stabilizing systems and/or other type of treatment systems. As illustrated inFIG. 13, the extension member includes twosection1310,1320.Section1310 is secured to the main body ofarm hub130.Section1310 is typically formed as a single piece with the main body of the arm hub and/or with the same material as the main body ofarm hub130 as shown inFIG. 13; however, this is not required. The angular orientation ofsection1310 is typically about 5-90°; however, other angles can be used. As shown inFIG. 13, the top surfaces ofsection1310 and the main body ofarm hub130 lie generally in the same plane; however, this is not required. The front end ofsection1310 forms about 50% ofcavity1400; however, it can be appreciated that the front end ofsection1310 can be formed so as to accept more or less or no portion ofcavity1400. A front side end portion ofsection1310 forms about 50% of taperedopening1410; however, it can be appreciated that the front side end ofsection1310 can be formed so as to accept more or less or no portion of taperedopening1410.Section1320 is illustrated as being separate and detachable fromsection1310; however, this is not required. One side ofsection1320 forms about 50% ofcavity1400; however, it can be appreciated that the side ofsection1320 can be formed so as to accept more or less or no portion ofcavity1400. A back side end portion ofsection1320 forms about 50% of taperedopening1410; however, it can be appreciated that the back side end ofsection1320 can be formed so as to accept more or less or no portion of taperedopening1410. As can also be appreciated, the tapered opening can be formed in other or additional regions of theextension member1300.Section1320 includes aconnection passageway1322 that is designed to receive a portion of aset screw1500. Thebody1502 of the set screw is sized and shaped to pass into and through at least a portion ofconnection passageway1322. Thehead1504 of the set screw has a size and/or shape that prevents the head from fully passing throughconnection passageway1322. As can be appreciated, a portion ofconnection passageway1322 can include a recess, not shown that is designed to receive a portion ofhead1504; however, this is not required. The front end face ofsection1310 also includes aconnection passageway1312 that is designed to receive a portion ofbody1502 ofset screw1500.Connection passageway1312 can include a thread that is designed to receive a thread on the body ofset screw1500; however, it can be appreciated that many connection arrangements can be used to securesections1310 and1320 together byset screw1500 and/or by one or more other or additional connection arrangements (e.g., adhesive, pin, latch, etc.). In the arrangement shown inFIGS. 11-13, the spherical end S of component R is inserted intocavity1400 by loosening setscrew1500 so as to enablesection1310 and1320 to be at least partially separated from one another. Once end S is positioned in cavity1440, component R is secured in positioned by tightening theset screw1500, The tightening of the set screw drawssections1310 and1320 together. The head of the set screw is typically designed to allow an instrument to insert/remove the set screw; however, this is not required. The loosening of theset screw1500 enables component R to be again adjusted, if so desired. As can be appreciated, the location ofpassageways1312,1322 can be in other locations. As also can be appreciated, other or additional mechanisms can be used to adjust/set component R incavity1400.
• One non-limiting methodology for insertingspinal implant100 on vertebra V as illustrated inFIGS. 1 and 2 is set forth; however, it will be appreciated that the spinal implant can be inserted on vertebra V in a different manner. Prior to inserting the spinal implant on a vertebra, an exposure procedure is performed to provide access to one or more vertebra, During this exposure procedure, one or more vertebra and/or a region about one or more vertebra may be prepared, treated, etc. prior to the insertion of the spinal implant. Prior to being the insertion process of the spinal implant, the proper size of the spinal implant is assessed. This assessment can take place prior to, during and/or after the exposure procedure. Once the proper spinal implant has been selected, onefoot114,124 is inserted onto a portion of the vertebra. Typically, the first foot is positioned to engage the medial lamina of the vertebra. The foot can be adhesively secured to the vertebra, if desired. After the first foot is positioned on the vertebra, the second foot is then positioned on the vertebra such as, but not limited to, the lateral pars of the vertebra. This other foot can also or alternatively be adhesively secured to the vertebra, if desired. If the spinal implant includes more than two arm and feet, these additional feet can be positioned on the vertebra or a different vertebra. Once two or more feet of the spinal implant are positioned on Vertebra V, setscrew140 is tightened in opening134 to securearms110,120 in position relative to one another and relative toarm hub130. The position of the spinal implant on the vertebra can be reviewed to determine if the spinal implant is properly positioned on the vertebra. If the spinal implant needs to be adjusted on the vertebra, the set screw can be loosened and retightened until the spinal implant is properly positioned on the vertebra. Once the spinal implant is properly positioned on the vertebra a component R such as, but not limited to, a rod that fully forms or forms a portion of a stabilizing system and/or other type of treatment system is positioned in opening138 ofconnection arrangement136. As set forth above, the spinal implant of the present invention can be used to secure one or more components of a stabilizing system and/or other type of treatment system to one or more vertebra with having to penetrate or substantially penetrate into the vertebra. As is appreciated, the spinal implant has many other or additional features and advantages as previously discussed above.
• Referring now toFIGS. 14 and 15, there is illustrated a modifiedspinal implant100 that includes three arms. The structure of the spinal implant is similar to the structure of the spinal implant described inFIGS. 1-13. The spinal implant illustrated inFIG. 14 includes twoarms110,120 and athird arm150. At least one arm is designed to be adjustably connected to anarm hub130. Eacharm110,120,150 includes abody portion112,122,152 and anend foot114,124,154. The body portion of the arms is illustrated are being generally planar or flat; however, it can be appreciated that the body portion can be slightly curved and/or include other configurations. The end foot on the end of each arm is designed to secure the end portion of the arms to a portion of a vertebra. Each foot is angularly oriented with respect to the body portion of the arms; however, this is not required. Each foot is illustrated as having a maximum angular orientation of over 90° relative to the longitudinal axis of the body portion. Typically, the maximum angular orientation is about 90-160°, and more typically about 90-130°; however, other angles can be used. As can be appreciated, the maximum angular orientation can be less than 90°. The angular orientation of the feet can be the same or different. The inner surface of each foot has a generally planar or slightly curved profile; however, it can be appreciated that one or more of the feet can include other configurations.
• Although not shown, the inner surface of one or more feet can include one or more structures and/or materials to facilitate in the gripping of the one or more feet of the arms to a portion of the vertebra; however, this is not required. For instance, one or more feet can include one or more gripping arrangements such as, but not limited to, one or more teeth, one or more ribs, one or more rough regions, etc.; however, this is not required. In addition or alternatively, an adhesive (e.g., bone cement, bio-grout, polymer adhesive, etc.) can be used to facilitate in the gripping of the one or more feet of the arms to a portion of the vertebra; however, this is not required. Furthermore, one or more portions of one or more feet can alternatively or additionally be porous and/or include one or more openings or cavities so as to promote bone ingrowth, and thereby facilitate in the gripping of the one or more feet of the arms to a portion of the vertebra; however, this is not required. The one or more porous regions can include one or more materials (e.g., bone, etc.), medication, drugs, etc. to promote and/or inhibit bone growth on one or more regions of the feet; however, this is not required. As can be appreciated, other or additional arrangements can be used to facilitate in the gripping and/or proper operation of the one or more feet of the arms on a portion of the vertebra.
• As illustrated inFIGS. 14 and 15, the body section and foot of each arm is formed of a single piece of material. Typically, the material is a metal material; however, other or additional materials can be used. As can be appreciated, the body portion and the foot of one or more arms can be formed of different materials. The body portion and foot ofarms110 and120 are illustrated as being about the same shape and size. As can be appreciated, the body portion and/or foot ofarms110 and120 can be the same or different from another arm. Thebody portion152 ofarm150 is illustrated as being longer than the body portion ofarms110 and120; however, this is not required. Thefoot154 ofarm150 is illustrated as being about the same size offoot124 ofarm120; however, this is not required. As such, the body portion and/or foot of the arms can be the same or different from another arm. For instance, the length, profile, thickness and/or cross-sectional shape of the body portion of each arm can be the same or different of the body portion of one or more other arms. Furthermore, the length, profile, thickness and/or cross-sectional shape of the foot of each arm can be the same or different from the foot of one or more other arms. Although not shown, the foot on one or more arms can be designed so as to be connected to the body portion by use of an adhesive, solder, weld, etc.; however, this is not required. As can further be appreciated, the foot can be designed so as to be adjustably oriented relative to the body portion by use of a hinge mechanism, a ratchet mechanism, ball/socket mechanism, etc.; however, this is not required. A set screw and/or other locking arrangement can be used to adjust and/or secure the adjustable foot in place; however, this is not required.
• The orientation ofarms110 and120 relative to one another can be accomplished in a variety of ways. Non-limiting examples of a few ways the two arms can be oriented with respect to each other described and illustrated above with respect toFIGS. 3-8. As can be appreciated, these three arrangements merely illustrate a few of the possible arrangements that can be used to orient and set in position the arms relative to one another. As can be appreciated, the spinal implant can be designed such that one or more of the arms are not adjustable along the longitudinal axis of the spinal implant; however, this is not required. As can also be appreciated, one or more arms can be adjustably oriented in one or more less axes that one or more other arms; however, this is not required. For instance, one or more arms could be adjustably oriented in one or more axes of the spinal implant, and one or more arms could be adjustably oriented in no axis of the spinal implant. In another instance, one or more arms could be adjustably oriented in two or more axes of the spinal implant, and one or more arms could be adjustably oriented in only one axis of the spinal implant. In still another instance, one or more arms could be adjustably oriented in three axes of the spinal implant, and one or more arms could be adjustably oriented in two or one axes of the spinal implant.
• Referring again toFIGS. 14 and 15,arm hub130 includes an arm opening that enables front portions ofarms110,120 to be at least partially telescopically received in the arm opening. Oncearms110,120 are positioned on a portion of one or more vertebra, the arms can be set relative to one another. As can be appreciated, many arrangements can be used to setarms110 and120 relative to one another (e.g., set screw, set pin, adhesive, adhesive, clamp arrangement, etc.).
• Arm hub130 also includes one ormore connection arrangements136. As illustrated inFIGS. 14 and 15, theconnection arrangement136 is positioned on the top surface of the arm hub. As can be appreciated, theconnection arrangement136 can be located on other regions of the arm hub.Connection arrangement136 is illustrated as securing thefront end156 toarm hub130. Thefront end156 includes anopening158 that allow a base portion ofconnection arrangement136 to pass through the opening and secure toarm hub130. The base portion ofconnection arrangement136 can be threaded so that the head of theconnection arrangement136 can be tightened ontofront end156 to secure the third arm is position. As can be appreciated, many other or additional arrangements can be used to secure the third arm in position relative to the arm hub. In operation, the third arm can be positioned on the vertebra V prior to, during or afterarm110 and/orarm120 is secured to the vertebra.
• Arm hub130 can include more than one connection arrangement. The one or more connection arrangements on the arm hub can be designed to connection to a stabilizing system and/or other type of treatment system (e.g., modular heads; one or more attachment sites for rods, plates, and/or medication delivery devices, etc.), and/or connect another arm to the spinal implant. several non-limiting configurations of the one or more configurations of the arm hub and/or the one or more configurations of the connection arrangements on the arm hub are described and illustrated inFIGS. 3-13.
• It will thus be seen that the objects set forth above, among those made apparent from the preceding description, are efficiently attained, and since certain changes may be made in the constructions set forth without departing from the spirit and scope of the invention, it is intended that all matter contained in the above description and shown in the accompanying drawings shall be interpreted as illustrative and not in a limiting sense. The invention has been described with reference to a preferred embodiment. Modifications and alterations will become apparent to those skilled in the art upon reading and understanding the detailed discussion of the invention provided herein. This invention is intended to include all such modifications and alterations insofar as they come within the scope of the present invention. It is also to be understood that the following claims are intended to cover all of the generic and specific features of the invention herein described and all statements of the scope of the invention, which, as a matter of language, might be said to fall therebetween.

Claims (22)

1-17. (canceled)

18. A spinal implant for connecting to at least a portion of a vertebra comprising an arm hub and first and second arms, each of said first and second arms having first and second ends, said first end of said first and second arms are both securable to said arm hub, said second end of said first arm connected to a foot adapted to engage a portion of vertebra, said second end of said second arm connected to a foot adapted to engage a portion of vertebra, said arm hub including an adjustment arrangement and a set mechanism, said adjustment arrangement enabling said first arm to be adjustably positioned relative to said second arm, said adjustment arrangement including an opening designed to at least partially telescopically receive said first and second arms, said set mechanism designed to secure said first arm in position relative to said second arm, said set mechanism including an arrangement to at least partially engage at least one of said arms positioned in said adjustment arrangement, said adjustment arrangement designed to enable multi-axis movement and positioning of at least one of said first and second arms in said arm hub such that at least one of said first and second arms can be positioned to lie in a parallel plane or to lie in a non-parallel plane with respect to one another when secured to said arm hub.

19. The spinal implant as defined inclaim 18, wherein said foot of at least one of said first and second arms is designed to substantially not penetrate into the vertebra when connected to the vertebra.

20. The spinal implant as defined inclaim 18, including a third arm, one end of said third arm connected to a foot adapted to engage a portion of vertebra.

21. The spinal implant as defined inclaim 20, wherein said third arm is securable to said arm hub.

22. The spinal implant as defined inclaim 20, wherein said foot of said third arm is designed to substantially not penetrate into the vertebra when connected to the vertebra.

23. The spinal implant as defined inclaim 18, wherein said arm hub includes a stabilizing system connection arrangement designed to secure to a component of a stabilizing system or other type of treatment system.

24. The spinal implant as defined inclaim 18, wherein said set mechanism includes a contact arrangement to at least partially engage at least one of said first arm and said second arm in said adjustment arrangement so as to at least partially secure at least one of said first arm and said second arm in said arm hub by one or more forces selected from the group consisting of a frictional force and a clamping force.

25. The spinal implant as defined inclaim 24, wherein said contact arrangement of said set mechanism includes an adjustable contact piece designed to contact at least one of said side walls of said first arm or said second arm or a structure on at least one of said side walls of said first arm or said second arm when at least one of said first arm and said second arm are at least partially positioned and secured in said arm hub.

26. The spinal implant as defined inclaim 25, wherein said adjustable contact piece is designed to only contact one of said side walls of said first arm or said second min or a structure on said side wall of said first arm or said second arm and to apply said one or more forces to said side wall of said first arm thereby causing said first arm and said second arm to be secured in said arm hub when said first arm and said second arm are at least partially positioned in said arm hub.

27. The spinal implant as defined inclaim 18, wherein said first arm including a) a first slot in a first end of said first arm that is designed to receive at least a portion of a first end of said second arm, b) a plurality of teeth on a first end of said first arm that is designed to engage at least a portion of a first end of said second arm, or c) an adjustment landing on a first end of said first arm designed to engage said set mechanism when said set mechanism secures said first and second arms in said arm hub.

28. The spinal implant as defined inclaim 27, wherein said set mechanism includes a contact arrangement to at least partially engage at least one of said first arm and said second arm in said adjustment arrangement so as to at least partially secure at least one of said first arm and said second arm in said arm hub by one or more forces selected from the group consisting of a frictional force and a clamping force, said contact arrangement including a contact piece designed to contact a side wall of said first arm or said an adjustment landing on said first arm when said first min is at least partially positioned and secured in said arm hub and to apply said one or more forces to said side wall of said first arm or said adjustment landing on said first arm thereby causing said first arm and said second arm to be secured in said arm hub when said first arm and said second arm are at least partially positioned in said arm hub.

29. A spinal implant for connecting to at least a portion of a vertebra comprising an arm hub and first and second arms, each of said first and second arms having first and second ends, said first end of said first and second arms are both securable to said arm hub, said second end of said first arm connected to a first foot designed to at least partially encircle a pars portion of a vertebra, said second end of said second arm connected to a second foot designed to at least partially encircle a pars portion of the same vertebra as said first foot, said first arm including a) a first slot in a first end of said first arm that is designed to receive at least a portion of a first end of said second arm, b) a plurality of teeth on a first end of said first arm that is designed to engage at least a portion of a first end of said second arm, or c) an adjustment landing on a first end of said first arm designed to engage said set mechanism when said set mechanism secures said first and second arms in said arm hub, said arm hub including an adjustment arrangement and a set mechanism, said adjustment arrangement enabling said first arm to be adjustably positioned relative to said second arm, said set mechanism designed to secure said first arm in position relative to said second arm, said first and second arms both securable to said arm hub and adjustably positionable in said arm hub, said adjustment arrangement including a first opening designed to at least partially telescopically receive said first arm and a second opening designed to at least partially telescopically receive said second arm, said set mechanism including a contact arrangement to at least partially engage one or both of said first arm and said second arm in said adjustment arrangement so as to at least partially secure one or both of said first arm and said second arm in said arm hub by one or more forces selected from the group consisting of a frictional force and a clamping force, said contact arrangement of said set mechanism including a contact piece designed to contact a side wall of said first arm or said adjustment landing on said first arm when said first arm is at least partially positioned and secured in said arm hub and to apply said one or more forces to said side wall of said first arm or said an adjustment landing on said first arm thereby causing said first arm and said second arm to be secured in said arm hub when said first arm and said second arm are at least partially positioned in said arm hub.

30. The spinal implant as defined inclaim 29, wherein said adjustment arrangement is designed to enable multi-axis positioning of one or both of said first arm and said second arm in said arm hub prior to said set mechanism securing one or both of said first arm and said second arm in said arm hub such that said first and second arms can lie in a parallel plane or in a non-parallel plane with respect to one another when secured to said arm hub.

31. The spinal implant as defined inclaim 29, wherein said arm hub includes a stabilizing system connection arrangement designed to secure to a component of a stabilizing system or other type of treatment system.

32. The spinal implant as defined inclaim 29, wherein said first arm includes i) a plurality of teeth on a first end of said first arm that is designed to engage at least a portion of a first end of said second arm, or ii) an adjustment landing on a first end of said first arm designed to engage said set mechanism when said set mechanism secures said first and second arms in said arm hub.

33. The spinal implant as defined inclaim 32, wherein said first arm includes an adjustment landing on a first end of said first arm designed to engage said set mechanism when said set mechanism secures said first and second arms in said arm hub.

34. A spinal implant for connecting to at least a portion of a vertebra comprising an arm hub and first and second arms, each of said first and second arms having first and second ends, said first end of said first and second arms are both securable to said arm hub, said second end of said first arm connected to a foot adapted to engage a portion of vertebra, said second end of said second arm connected to a foot adapted to engage a portion of vertebra, said arm hub including an adjustment arrangement and a set mechanism, said adjustment arrangement enabling said first arm to be adjustably positioned relative to said second arm, said adjustment arrangement includes an opening adapted to at least partially telescopically receive said first and second arms, said set mechanism substantially securing said first arm in position relative to said second arm, said set mechanism including an arrangement to at least partially engage at least one of said arms positioned in said adjustment arrangement to cause at least one of said first and second arms to be secured in said arm hub, said set mechanism is designed to cause said first and second arms to frictionally engage one another in said adjustment arrangement, said first arm includes an adjustment landing on a first end of said first arm designed to engage said set mechanism when said set mechanism secures said first and second arms in said arm hub.

36. The spinal implant as defined in claim35, wherein said set mechanism is designed to create a force that is not normal to the longitudinal axis of said first or second arms.

37. The spinal implant as defined in claim35, including a third arm, one end of said third arm connected to a foot adapted to engage a portion of vertebra.

38. The spinal implant as defined inclaim 37, wherein said third arm is securable to said arm hub.

39. The spinal implant as defined in claim35, including a connection arrangement adapted to secure to a component of a stabilizing system or other type of treatment system, said connection arrangement positioned on said arm hub.

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