Interspinous process implant having deployable wing and method of implantation

Abstract

Systems and method in accordance with an embodiment of the present invention can includes an implant comprising a first wing, a spacer extending from the first wing, and a distraction guide. The distraction guide is arranged in a first configuration to pierce and/or distract tissue associated with adjacent spinous processes extending from vertebrae of a targeted motion segment. The implant can be positioned between the adjacent spinous processes and once positioned, the implant can be arranged in a second configuration. When arranged in a second configuration, the distraction guide can act as a second wing. The first wing and the second wing can limit or block movement of the implant along a longitudinal axis of the implant.

1 .- 18 . (canceled) 
     
     
         19 . A distractor instrument, comprising:
 a first distractor member that engages at a distal end to a first skeletal segment;   a second distractor member that engages at a distal to a second skeletal segment; a distractor device mounted to proximal ends of the first and second distractor members;   a distraction actuator attached to the distractor device, wherein the distraction actuator is actuated to apply a distraction force to the first and second distractor members to distract the first and second skeletal segments relative to one another.   
     
     
         20 . An instrument as in  claim 19 , further comprising a force indicator attached to the distractor device wherein the force indicator provides measurement of the distraction force. 
     
     
         21 . An instrument as in  claim 19 , further comprising a localizing needle that attaches to the distractor device, wherein the localizing needle has a distal end that points to a target location for positioning an implant. 
     
     
         22 . An instrument as in  claim 19 , further comprising an insertion device pivotably attached to the distractor device, wherein the insertion device is pivotable to an orientation so as to deliver an object into a targeted space. 
     
     
         23 . An instrument as in  claim 22 , wherein the insertion device includes a connector portion and a curved portion, wherein the connector portion extends outwardly from the distractor device, and wherein the curved portion has a radius of curvature substantially equal to a distance defined by of the connector portion. 
     
     
         24 . An instrument as in  claim 23 , wherein the insertion device pivots about a pivot axis such that a distal end of the curved portion pivots toward the targeted space. 
     
     
         25 . An instrument as in  claim 22 , further comprising a trocar removably and slidably positioned inside the insertion device, the trocar having a sharpened tip. 
     
     
         26 . An instrument as in  claim 19  wherein the first and second distractor members each comprises an anchor that penetrates into the skeletal segment and an elongate sheath positioned over the anchor. 
     
     
         27 . An instrument as in  claim 22 , wherein the insertion device has a guide shaft, and wherein the insertion device is pivotable to an orientation such that the guide shaft provides a passageway for the delivery of an orthopedic device into the space between the pair of skeletal segments. 
     
     
         28 . An instrument as in  claim 22 , wherein the insertion device has a solid guide shaft and wherein the object is attached to a distal end of the guide shaft. 
     
     
         29 . An instrument as in  claim 19 , further comprising: a localizing needle that attaches to the distractor device, wherein the localizing needle has a distal end that points to a target location for positioning an implant; and an insertion device pivotably attached to the distractor device, wherein the insertion device has a delivery end that pivots to the target location for delivery an object to the target location. 
     
     
         30 . An instrument as in  claim 22 , further comprising a sizing device that couples to the insertion device, wherein the sizing device provides an indication as to the size the space between the skeletal segments, the sizing device including a tapered region that can be inserted into the space. 
     
     
         31 . An instrument as in  claim 30 , wherein the sizing instrument reduces a distractor load on the distractor device as the sizing instruments is inserted into the space wherein reducing a load of the distractor device serves as a confirmation that the sizing instrument is properly positioned to measure a size of an object to be inserted into the space. 
     
     
         32 . A distractor instrument, comprising: first and second distraction members that each engage a respective skeletal segment, wherein the distraction members can be distracted to cause distraction of the skeletal segments. 
     
     
         33 . An instrument as in  claim 32 , wherein at least one of the distractor members is an anchor that penetrates into a skeletal segment. 
     
     
         34 . An instrument as in  claim 32 , wherein at least one of the distractor members is an elongate member that abuts a skeletal segment but does not penetrate the skeletal segment. 
     
     
         35 . An instrument as in  claim 32 , wherein at least one of the distractor members clamps onto the skeletal segment. 
     
     
         36 . An instrument as in  claim 32 , further comprising a distraction device connected to the distractor members for applying a distraction force to the distractor members. 
     
     
         37 . An instrument as in  claim 36 , further comprising a measurement device for measuring the distractor force. 
     
     
         38 . A method of distracting a pair of spinous processes, comprising: using one or more distractor elements to engage the spinous processes to apply a distraction force to the spinous processes. 
     
     
         39 . A method as in  claim 38 , wherein at least one of the distractor elements penetrates a vertebral body. 
     
     
         40 . A method as in  claim 38 , wherein at least one of the distractor elements abuts a spinous process without penetrating the spinous process. 
     
     
         41 . A minimally-invasive surgical procedure, comprising: localizing a surgical point of interest using a localizing needle that points to the point of interest; and placing an implant at the point of interest using the localizing needle as a guide. 
     
     
         42 . A procedure as in  claim 41 , wherein the implant is placed using an inserter device that pivots about a central axis such that the inserter device travels along a curvilinear path that contains the localized point of interest. 
     
     
         43 . A minimally-invasive surgical procedure, comprising: localizing a surgical point of interest using an x-ray to identify the point of interest; relating the point of interest to a delivery apparatus; and delivering an implant to the point of interest using an inserter device that pivots about a central axis such that the inserter device travels along a curvilinear path that contains the localized point of interest. 
     
     
         44 . A skeletal implant holder, comprising: a hand-operated handle assembly; a holder assembly attached to the handle assembly, the holder assembly configured to be removably attached to an implant, wherein the handle assembly can be actuated to secure the implant to the holder assembly and to detach the implant from the holder assembly, and wherein the holder assembly is configured to apply a first force to the implant in a first direction and a second force to the implant in a second direction opposite the first direction when the handle assembly is actuated. 
     
     
         45 . A holder as in  claim 44 , wherein, upon actuation, a first portion of the implant remains stationary and at least a second portion of the implant move toward or away from the stationary portion. 
     
     
         46 . A holder as in  claim 44 , wherein the holder assembly is curvilinear. 
     
     
         47 . A holder assembly as in  claim 44 , wherein the holder assembly includes a lock ring that grabs an inside portion of the implant when the handle assembly is actuated to secure the implant to the holder assembly. 
     
     
         48 . A holder assembly as in  claim 44 , wherein a distal edge of the holder assembly is wedge-shaped for fitting the holder assembly between a pair of skeletal segments. 
     
     
         49 . An implant for implanting between a pair of skeletal segments, comprising: a first segment; at least one wing attached to the first segment, the wing movable between a collapsed configuration and an expanded configuration wherein the wing can engage a skeletal segment as an anchor when in the expanded configuration; and a second segment removably attached to the first segment, wherein the second segment can be detached from the first segment to disengage the wing from the skeletal segment. 
     
     
         50 . An implant as in  claim 49 , further comprising a ratchet mechanism that couples the first segment to the second segment, wherein the ratchet mechanism is configured to lock the wing in the expanded configuration