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Publication numberUS2677369 A
Publication typeGrant
Publication date4 May 1954
Filing date26 Mar 1952
Priority date26 Mar 1952
Publication numberUS 2677369 A, US 2677369A, US-A-2677369, US2677369 A, US2677369A
InventorsFred L Knowles
Original AssigneeFred L Knowles
Export CitationBiBTeX, EndNote, RefMan
External Links: USPTO, USPTO Assignment, Espacenet
Apparatus for treatment of the spinal column
US 2677369 A
Images(1)
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Description  (OCR text may contain errors)

y 4, 1954 F. Li KNOWLES 2,677,369

APPARATUS FOR TREATMENT OF THE SPINAL COLUMN Filed March 26, 1952 IN VEN TOR.

Fred L Know/es A TTOR NE Y Patented May 4, 1954 APPARATUS FOR TREATMENT OF THE SPINAL COLUMN Fred L. Knowles} Fort Dodge, Iowa Application March 26, 1952, Serial No. 278,596

The present invention relates to a method and an articl of manufacture for use in relieving an unstable low back.

An unstable low back in humans may be caused by one or more of a number of different factors.

In any event, it is a damage to the spine, generally the lower lumbar and sacral area, that portion immediately adjacent to the sacrum, and usually is accompanied by substantial pain.

Various practices for giving relief from this condition are used at present. All or part of the injured inter-vertebral disc may be removed. A laminectomy may be performed, or a spinal fusion may be used to give relief. None of these practices are simple and some require considerable skill. Where a spinal fusion is made it is not uncommon for the patient to be required to be inactive for a period of six months or more. The principal object of the present invention is to make possibl a simple method and apparatus for use in treating such a condition. It is simple not only in the sense that the surgery performed upon the patient is nominal and the patients recovery will be accomplished within a very brief period of time, but also the blocks which parent from the following description taken in conjunction with the drawings in which Fig. 1 is a side view of the lower portion of the spinal column;

Fig. 2 is a section taken at line 2-2 of Fig. 1;

Fig. 3 is a perspective view of a preferred embodiment of the block of this invention; and

Fig. 4 is an end view ofa block illustrating an alternative form of head therefor.

In some people the upper face 10 of the sacrum ll (Fig. 1) assumes a relatively vertical position with the result that the weight carried by the spine, generally I2, tends not to be securely supported on the sacrum I I. In many such cases the inter-vertebral facets l3 (Fig. 2) of the bones of the spine I2 may ride on each other excessively, causing pain to the individual.

In other instances there may be a traumatic degeneration of the spinal discs. This most often occurs to the disc l5 between the sacrum I! and the fifth lumbar vertebra [6. However, it may occur to other discs, such as disc ll between the fourth lumbar vertebra l8 and the fifth lumbar vertebra l6.

Continued degeneration of a disc may result in a bulging of the disc, such as is illustrated at I9 6 Claims. (01. 128-92) I in Fig. l, and a pressing against the spinal cord or cauda equina (Fig. 2). In extreme cases there may be a rupture of the inter-vertebral disc with a portion of the nucleus thereof being extruded into the canal occupied by the spinal cord or its lower prolongation, the cauda equina. Either is likely to produce a sensation of pain in the lower parts of the body because of the pressure on the nerves of the spinal cord.

An unstable low back may involve damage to the inter-vertebral facets [3 or to the intervertebral discs, such as [5 or H, or both. Other factors, such as nutritional disturbances, may be an element in producing the condition that is diagnosed as an unstable low back.

While the present practices for treating this condition will usually provide relief, those practices will often involve rather extensive operational procedures. In addition, th period of enforced inactivity maybe long. By employing the present invention all this is eliminated or greatly reduced.

I have discovered that by forwardly flexing the spine as far as possible, blocking apart the posterior processes situated above and below the point of injury, and returning the spine to the normal position the weight carried on the spine is leveled out at the inter-vertebral disc and facets at that point and transferred to the posterior processes. This relieves the pain and encourages the body to repair the injured members. To this end I have devised a block, generally 24, for insertion at the point of injury. Its use will be described on the basis of its insertion between the top 25 of the rear of the sacrum H and the posterior process 26 of the fifth lumbar vertebra l6, inasmuch as this is the most common point of trouble. It will be apparent that the block (and the method of its insertion at the fifth lumbar vertebrae) maybe usedbetw'een the posterior process 26 and the posterior process 21 of the fourth lumbar vertebra It, or elsewhere, depending upon the point of injury.

Block 24 should be formed of a material that will be tolerated by the human body. A stainless steel alloy of coba1t,.chromium, and molybdenum such as that sold under the name of Vitallium may be used. Other stainless steels such as the common 18% chromium and 8% nickel alloy may be acceptable. Certain plastics are also tolerated by the body and may be used.

The two ends 29 and 8B of block 24 are identical and each has recess means in the form of a groove 3! thereacross, with the two grooves being parallel to each other. The proportions of the grooves 3| are such as to cause the sides of the groove to fit snugly about the upper rear 25 of the sacrum II or posterior process 26 when the block is inserted therebetween with the grooves 3| parallel to the longitudinal axis of the posterior process. A groove three-sixteenths of an inch wide and one-eighth of an inch deep has been found to be suitable for most purposes.

Transverse to grooves 31 are a pair of shallow grooves 33 and 34 forming teeth 35, 36, and 31 across each of ends 29 and 30. The teeth are for engaging the processes or sacrum, as the case may be, to hold th block 24in place, particularly during the period while the ligament is building up about the block. The configuration and size of the transverse grooves and thus of the teeth is not particularly important. In the illustrated embodiment the transverse grooves 33 and 34 are about the same width as the grooves 3i and about one-fourth as deep.

7 Other types of grooves and teeth may be used, as for example those illustrated in Fig. 4. There a plurality of circular grooves 39 form teeth 40 in the end 29 of the block. In some instances it will be possible to completely dispense with the use of such teeth.

Preferably the blocks 24 are formed with concave sides 42 of generally circular configuration. This aids in grasping the blocks at the time of use. Also it reduces the sharp edges presented to the ligaments that grow around it.

It will be found to be desirable to have the blocks made up beforehand in an assortment of sizes. In most cases a set of blocks of sizes ranging from one-quarter of'an inch in length, as measured between the bottoms of grooves 3|, to one inch in length, in steps of one-sixteenth of an inch, will be adequate. The ends 29 of the blocks illustrated are one-half of an inch square.

Before one undertakes to-insert the blocks, it is desirable to X-ray the patient with the spine in forward flexure to make sure that the posterior process will open at the point where it is desired to insert the block. To insert the blocks the spine is placed in extreme forward fiexure and the skin separated at the point where the block is to go. The ligaments'between" the posterior process at that point are cut away and theavailable distance-between the adjacent portions of the posterior processes is determined.

A block is selected which will fit tightlybetween the processes. It is slid into place with the grooves 3! aligned'with the longitudinal axis of the processes. Preferably the blockshould be snug and if necessary it can be tapped intoplace.

Theincisionis closed and the spine returned to the normal position. The straightening of the spine causes theposterior processes to bear against the ends of the block with the result that the load carried by the spine is shifted from the facets and disc to the posterior processesv and block.

The foregoing description of a specific embodi-s. ment is for the purpose of complying with 35 U. S. C. 1 2 and should not be construed as im posing unnecessary limitations on the. appended claims.

I claim: I

1. A block for insertion between two adjacent posterior spinous processes, said block having recess means at opposite ends of the block adapted to form seats for the adjacent portions of said two processes, said block also having bone engaging means on said ends thereof.

2. A block for insertion between two adjacent posterior spinous processes, said block having recess means at opposite ends of the block adapted to form seats for the adjacent portions of said two processes, the distance between said seats being between about one-quarter of an inch and about one inch.

.3. A block for insertion between two adjacent posterior spinous processes, said bloc-k having recess means at opposite ends of the block adapted to form seats for the adjacent portions of said two processes, the distance between said seats being between about one-quarter of an inch and about one inch,;said block being formed of a rigid material tolerated by body tissues.

4. A block for insertion between two adjacent posterior spinous processes, said block having means to engage the processes including a groove on each end of the block, said-grooves being generally coplanar, said grooves forming seats for the adjacent portions of said two processes, the distance between said seats being between onequarter of an inch and one inch.

5. A block for insertion between two adjacent posterior spinous processes, said block having a groove on each end of the block, said grooves being generally coplanar, said grooves forming seats for the adjacent portions of said two processes, the distance between said seats being between one-quarter of an inch and one inch, said block being formed of a material tolerated by body tissue, said block having at least two grooves across the ends thereof transverse to said first mentioned grooves thereby forming teeth to engage the processes to prevent the block from slipping out of place.

6. A block for insertion between two adjacent posterior spinous processes, said block having recess means at opposite ends of the block adapted to form seats for the adjacent portions of said two processes, said block also having bone engaging means on said ends thereof, said block being formed of a rigid material tolerated by body tissues.

References Cited in the file of this patent UNITED STATES. PATENTS Number Name Date 1,401,056 Doyle Dec. 20, 1921 1,973,240 Werness et a1 Sept. 11, 1934 OTHER REFERENCES Catalog of Zirnmer Mfg. C0,, Warsaw, Ind, 1947, p. 40. (Copy in Div. 55'.)

Lumbar Disc Lesions, a book by J. R. Armstrong, published in London in 1952, pp. 188-191,. (Copy in Div. 55.)

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Classifications
U.S. Classification606/249, 623/10
International ClassificationA61B17/70, A61F2/44, A61F2/30, A61F2/00
Cooperative ClassificationA61F2002/30118, A61F2002/30879, A61F2002/30848, A61F2/4405, A61F2002/3082, A61F2310/00017, A61F2310/00029, A61B17/7062, A61F2230/0006, A61F2/442, A61F2002/30846
European ClassificationA61F2/44A, A61B17/70P