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1. (WO2009155360) SYSTEMS AND METHODS FOR POSTERIOR DYNAMIC STABILIZATION
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CLAIMS

1. A spinal stabilization implant for attachment to a portion of a spine, the implant

comprising:

a first bridge element comprising a first bridge end having a first anchoring feature, a

second bridge end having a second anchoring feature, and a first bridge body extending

between the first and second bridge ends, the first bridge element sized and shaped for securing to a vertebra in a medial-lateral orientation;

a second bridge element comprising a third bridge end having an third anchoring

feature, a fourth bridge end having a fourth anchoring feature, and a second bridge body

extending between the third and fourth bridge ends, the second bridge element sized and shaped for securing to a vertebra in a medial-lateral orientation;

a plurality of anchoring members, wherein a first anchoring member interfaces with

the first anchoring feature for securing the first bridge end to a first vertebra, a second

anchoring member interfaces with the second anchoring feature for securing the second

bridge end to the first vertebra, a third anchoring member interfaces with the third anchoring feature for securing the third bridge end to a second vertebra, and a fourth anchoring member

interfaces with the fourth anchoring feature for securing the fourth bridge end to the second

vertebra; and

a first bias element that attaches to the first bridge element and the second bridge element to provide a stabilizing force between the bridge elements when the bridge elements

are properly secured to two respective vertebrae,

wherein the first bias element comprises a cephalad fixation portion removably

attachable to the first bridge element, a caudal fixation portion removably attachable to the second bridge element, and a bias body extending between the cephalad and caudal fixation

portions, wherein the cephalad and caudal fixation portions attach either to the corresponding

bridge element at any one of a plurality of discrete attachment locations or to the

corresponding bridge element at any one of a plurality of non-discrete attachment locations

2. The implant of claim 1 , further comprising:

a plurality of attachment mechanisms, wherein each attachment mechanism comprises a attachment portion for interfacing with a bias element to attach the bias element to one of

the bridge elements

3. The implant of claim 2, wherein the cephalad and caudal fixation portions each attach

at any one of the plurality of non-discrete attachment locations with one of the attachment mechanisms, wherein the attachment mechanism further comprises a clamp and a screw, the

attachment mechanism positionable such that the clamp at least partially surrounds one of the

bridge elements, wherein tightening the screw secures the first bias element to the attachment

mechanism and locks the position of the attachment mechanism relative to the bridge

element.

4. The implant of claim 3, wherein each bridge body comprises a circular cross-section

having a connection surface comprising a gripping feature, wherein the attachment

mechanism is positionable such that the clamp at least partially surrounds one of the bridge

bodies, wherein tightening the screw secures the first bias element to the attachment mechanism and locks the position of the attachment mechanism relative to the bridge body.

5. The implant of claim 2, further comprising:

a third bridge element, comprising a fifth bridge end having an fifth anchoring

feature, a sixth bridge end having a sixth anchoring feature, and a third bridge body extending

between the fifth and sixth bridge ends, the third bridge element sized and shaped for securing to a vertebra in a medial-lateral orientation, the third bridge element between the

first and second bridge elements, wherein the first bias element further comprises a middle portion between the

cephalad end and the caudal end. wherein the middle portion interfaces with one of the

attachment mechanisms to attach the middle portion to the third bridge element.

6. The implant of claim 2, wherein the cephalad and caudal fixation portions are

attachable at any one of the plurality of discrete attachment locations with one of the attachment mechanisms, wherein the attachment mechanism further comprises a screw,

wherein each bridge element comprises at least one hole extending through the bridge

element, the hole sized and shaped to receive the screw; and

wherein the attachment mechanism is positionable such that tightening the screw secures the bias element to the attachment mechanism and locks the position of the

attachment mechanism relative to the bridge element.

7 The implant of claim 1, wherein the first bias element comprises an elastically

deformable member formed from material chosen from the group consisting of elastomers,

silicones, urethanes, bio-absorbable materials, woven textile structures, knit textile structures, braided textile structures, molded thermoplastic polymers, ethylene-vinyl acetate, PEEK,

UHMWPE, nitinol, titanium and stainless steel, wherein the first bias element provides a

dynamic stabilizing force between the bridge elements.

8. The implant of claim 7, wherein the cephalad and caudal fixation portions are formed of a rigid material, and wherein the bias body consists of the elastically deformable material.

9. The implant of claim 1 wherein the first bias element is formed of a rigid material

selected from the group consisting of titanium, stainless steel, aluminum, cobalt chromium,

Nitinol, PEEK, and UHMWPE, wherein the first bias element provides a rigid stabilizing

force between the bridge elements.

10. The implant of claim 1, wherein each bridge body is positioned medial to its

respective bridge ends when the bridge ends are properly secured to a vertebra, wherein the cephalad and caudal fixation portions attach either to the corresponding bridge body at any

one of a plurality of discrete attachment locations or to the corresponding bridge body at any

one of a plurality of non-discrete attachment locations.

11. The implant of claim 1, wherein the first bias element removably attaches to the

bridge elements such that the first bias element extends substantially perpendicular to the bridge elements.

12. The implant of claim 11, wherein the cephalad fixation portion of the first bias

element attaches to the first bridge element and the caudal end of the first bias element

attaches to the second bridge element such that the first bias element is substantially parallel to the sagittal plane.

13. The implant of claim 1, further comprising:

a second bias element comprising a cephalad fixation portion, a caudal fixation

portion and a bias body extending between the cephalad and caudal fixation portions, wherein

the cephalad fixation portion attaches to the first bridge element at any of a plurality of attachment locations, and wherein the caudal fixation portion attaches to the second bridge

element at any of a plurality of attachment locations.

14. The implant of claim 13, wherein the cephalad fixation portion of the first bias

element attaches to the first bridge element at a first location and the caudal fixation portion of the first bias element attaches to the second bridge element at a second location medial- laterally offset from the first location;

wherein the cephalad fixation portion of the second bias element attaches to the first

bridge element at a third location and the caudal fixation portion of the second bias element attaches to the second bridge element at a fourth location medial-laterally offset from the

third location such that the second bias element crosses over or under the first bias element.

15. The implant of claim 1, further comprising:

a third bridge element comprising a fifth bridge end having an fifth anchoring feature,

a sixth bridge end having a sixth anchoring feature, and a third bridge body extending

between the fifth and sixth bridge ends, the third bridge element sized and shaped for

securing to a vertebra in a medial-lateral orientation; and a second bias element;

wherein the second bias element attaches to the second bridge element and to the third

bridge element to provide a stabilizing force between the second and third bridge elements

when the bridge elements are properly secured to three respective vertebrae.

16. The implant of claim 14, wherein the first bias element comprises an elastically

deformable material to provide an dynamic stabilizing force between the first and second

bridge elements, and wherein the second bias element is formed of a rigid material to provide

a rigid stabilizing force between the second and third bridge elements.

17. The implant of claim 1, wherein each anchoring feature comprises an aperture and each anchoring member comprises a screw sized and shaped to be received in the aperture,

wherein each screw is individually polyaxially positionable relative to the anchoring feature

when the screw is received in the aperture.

18. The implant of claim 1, wherein the first and second bridge elements each comprise an elastically deformable material, and wherein the first bias element is formed of a rigid

material.

19. A spinal stabilization implant for attachment to a portion of a spine, the implant

comprising: a first bridge element comprising a first bridge end having an first anchoring feature, a

second bridge end having a second anchoring feature, and a first bridge body extending between the first and second bridge ends, the first bridge element sized and shaped for

securing to a vertebra in a medial-lateral orientation;

a second bridge element comprising a third bridge end having an third anchoring

feature, a fourth bridge end having a fourth anchoring feature, and a second bridge body

extending between the third and fourth bridge ends, the second bridge element sized and shaped for securing to a vertebra in a medial-lateral orientation;

a plurality of anchoring members, wherein a first anchoring member interfaces with

the first anchoring feature for securing the first bridge end to a first vertebra, a second

anchoring member interfaces with the second anchoring feature for securing the second bridge end to the first vertebra, a third anchoring member interfaces with the third anchoring

feature for securing the third bridge end to a second vertebra, and a fourth anchoring member

interfaces with the fourth anchoring feature for securing the fourth bridge end to the second

vertebra; and

an elastically deformable first bias element that attaches to the first bridge element and the second bridge element to provide a dynamic stabilizing force between the bridge

elements when the bridge elements are properly secured to two respective vertebrae, the first

bias element comprising a first fixation portion, a second fixation portion and a bias body

extending between the first and second fixation portions; wherein the first fixation portion attaches to the first bridge element at a location

medially offset from the first and second anchor features, and wherein the second fixation

portion attaches to the second bridge element at a location medially offset from the third and

fourth anchor features.

20. The implant of claim 19, wherein the first and second fixation portions removably

attach to the corresponding bridge element at any one of a plurality of non-discrete attachment locations.

21. The implant of claim 19, wherein the first and second fixation portions removably

attach to the corresponding bridge element at any one of a plurality of discrete attachment

locations.

22. The implant of claim 19, further comprising: a plurality of attachment mechanisms, wherein each attachment mechanism comprises

a attachment portion for interfacing with a bias element to attach the bias element to one of

the bridge elements

23. The implant of claim 22, wherein each attachment mechanism further comprises a screw, the attachment mechanism positionable such that tightening the screw secures the bias

element to the attachment mechanism and locks the position of the attachment mechanism

relative to the bridge element

24. The implant of claim 22, further comprising:

a third bridge element, comprising a fifth bridge end having an fifth anchoring feature, a sixth bridge end having a sixth anchoring feature, and a third bridge body extending

between the fifth and sixth bridge ends, the third bridge element sized and shaped for

securing to a vertebra in a medial-lateral orientation, the third bridge element between the

first and second bridge elements, wherein the first bias element further comprises a middle portion between the first

fixation portion and the second fixation portion, wherein the middle portion interfaces with

an attachment mechanism to attach the middle portion to the third bridge element.

25. The implant of claim 19, wherein the first bias element comprises an elastically

deformable member formed from material chosen from the group consisting of elastomers, silicones, urethanes, bio-absorbable materials, woven textile structures, knit textile structures,

braided textile structures, molded thermoplastic polymers, ethylene-vinyl acetate, PEEK, UHMWPE, nitinol, titanium, and stainless steel, wherein the first bias element provides a

dynamic stabilizing force between the bridge elements.

26. The implant of claim 25, wherein the first and second fixation portions are formed of

a rigid material, wherein the bias body consists of the elastically deformable material.

27. The implant of claim 19, wherein the first bias element is removably attachable to the

bridge elements such that the first bias element extends substantially perpendicular to the

bridge elements.

28. The implant of claim 19, further comprising: a second bias element comprising a first fixation portion, a second fixation portion

end and a bias body extending between the first and second fixation portions, wherein the

first fixation portion is attaches to the first bridge element at any of a plurality of attachment

locations, and wherein the second fixation portion attaches to the second bridge element at

any of a plurality of attachment locations.

29. The implant of claim 19, further comprising:

a third bridge element comprising a fifth bridge end having an fifth anchoring feature,

a sixth bridge end having a sixth anchoring feature, and a third bridge body extending

between the fifth and sixth bridge ends, the third bridge element sized and shaped for securing to a vertebra in a medial-lateral orientation; and

a second bias element;

wherein the second bias element attaches to the second bridge element and to the third

bridge element to provide a stabilizing force between the second and third bridge elements

when the bridge elements are properly secured to three respective vertebrae.

30. The implant of claim 29, wherein the second bias element is formed either of an

elastically deformable material to provide a dynamic stabilizing force between the second and third bridge elements or of a rigid material to provide a rigid stabilizing force between the

second and third bridge elements.

31. The implant of claim 19, wherein each anchoring feature comprises an aperture and

each anchoring member comprises a screw sized and shaped to be received in the aperture,

wherein each screw is individually polyaxially positionable relative to the anchoring feature when the screw is received in the aperture.

32. A method of stabilizing a motion segment of a spine, the motion segment comprising

a first vertebra and a second vertebra, through the use of a system comprising a first bridge

element comprising a first bridge end having a first anchoring feature, a second bridge end having a second anchoring feature, and a first bridge body extending between the first and

second bridge ends, a second bridge element comprising a third bridge end having an third

anchoring feature, a fourth bridge end having a fourth anchoring feature, and a second bridge

body extending between the third and fourth bridge ends, a plurality of anchoring members, a

first bias element comprising a first fixation portion, a second fixation portion and a first bias body extending between the first and second fixation portions, and a second bias element

comprising a first fixation portion, a second fixation portion and a second bias body

extending between the first and second fixation portions; the method comprising:

resecting at least a portion of a lamina of the first vertebra; resecting at least a portion of a lamina of the second vertebra;

positioning the first bridge element adjacent to the resected portion of the first

vertebra in a medial-lateral orientation;

securing the first anchoring feature of the first bridge element to the first vertebra with

one of the anchoring members;

securing the second anchonng feature of the first bridge element to the first vertebra

with one of the anchoring members; positioning the second bridge element adjacent to the resected portion of the second

vertebra in a medial-lateral orientation;

securing the third anchoring feature of the second bridge element to the second

vertebra with one of the anchoring members;

securing the fourth anchoring feature of the second bridge element to the second vertebra with one of the anchoring members;

selecting an appropriate level of stabilization for the motion segment;

selecting the bias element of the first and second bias elements that most closely

matches the appropriate level of stabilization to provide a first selected bias element, wherein the bias body of the first bias element has an elasticity greater than an elasticity of the bias

body of the second bias element;

securing the first fixation portion of the first selected bias element to the first bridge

element; and

securing the second fixation portion of the first selected bias element to the second bridge element.

33. The method of claim 32, wherein securing the fixation portions of the first selected

bias element to the corresponding bridge elements further comprises:

coupling a first attachment mechanism to the first fixation portion of the first selected bias element and to the first bridge element;

actuating the first attachment mechanism to lockably secure the first fixation portion

of the first selected bias element to the first bridge element;

coupling a second attachment mechanism to the second fixation portion of the

selected bias element and to the second bridge element; and actuating the second attachment mechanism to lockably secure the second fixation

portion of the first selected bias element to the second bridge element.

34. The method of claim 32, the method further comprising:

selecting a first attachment location from a plurality of discrete attachment locations

on the first bridge element;

positioning the first fixation portion of the first selected bias element at the first

attachment location; securing the first fixation portion of the first selected bias element to the first bridge

element at the first attachment location;

selecting a second attachment location from a plurality of discrete attachment

locations on the second bridge element; positioning the second fixation portion of the first selected bias element at the second

attachment location; and

securing the second fixation portion of the first selected bias element to the second

bridge element at the second attachment location.

35. The method of claim 32, the method further comprising: selecting a first attachment location from a plurality of non-discrete attachment

locations on the first bridge element;

positioning the first fixation portion of the first selected bias element at the first

attachment location; securing the first fixation portion of the first selected bias element to the first bridge

element at the first attachment location;

selecting a second attachment location from a plurality of non-discrete attachment

locations on the second bridge element;

positioning the second fixation portion of the first selected bias element at the second

attachment location; and securing the second fixation portion of the first selected bias element to the second

bridge element at the second attachment location.

36. The method of claim 32, the method further comprising:

selecting a first attachment location on the first bridge body, wherein the first

attachment location is medially offset from the first and second anchoring features; positioning the first fixation portion of the first selected bias element at the first

attachment location;

securing the first fixation portion of the first selected bias element to the first bridge

element at the first attachment location; selecting a second attachment location on the second bridge body, wherein the second

attachment location is medially offset from the third and fourth anchoring features;

positioning the second fixation portion of the first selected bias element at the second

attachment location; and

securing the second fixation portion of the first selected bias element to the second bridge element at the second attachment location.

37. The method of claim 31, wherein the system further comprises a third bias element

comprising a first fixation portion, a second fixation portion and a bias body extending

between the first and second fixation portions, and a fourth bias element comprising a first fixation portion, a second fixation portion and a bias body extending between the first and

second fixation portions, the method further comprising:

selecting the bias element of the third and fourth bias elements that most closely

matches the appropriate level of stabilization to provide a second selected bias element, wherein the bias body of the third bias element has an elasticity greater than an elasticity of

the bias body of the fourth bias element; securing the first fixation portion of the second selected bias element to the first

bridge element; and

securing the second fixation portion of the second selected bias element to the second

bridge element.

38. The method of claim 32, wherein the system further a third bridge element comprising a fifth bridge end having a fifth anchoring feature, a sixth bridge end having a sixth anchoring

feature, and a third bridge body extending between the first and second bridge ends, a third

bias element comprising a first fixation portion, a second fixation portion and a bias body

extending between the first and second fixation portions, and a fourth bias element comprising a first fixation portion, a second fixation portion and a bias body extending

between the first and second fixation portions, the method further comprising:

selecting a second motion segment, the motion segment comprising the second

vertebra and a third vertebra adjacent the second vertebra;

resecting at least a portion of a lamina of the third vertebra; positioning the third bridge element adjacent to the resected portion of the third

vertebra in a medial-lateral orientation;

securing the fifth anchoring feature of the third bridge element to the third vertebra

with one of the anchoring members; securing the sixth anchoring feature of the third bridge element to the third vertebra

with one of the anchoring members;

selecting an appropriate level of stabilization for the second motion segment;

selecting the bias element of the third and fourth bias elements that most closely

matches the appropriate level of stabilization for the second motion segment, wherein the bias body of the third bias element has an elasticity greater than an elasticity of the bias body of

the fourth bias element; securing the first fixation portion of the selected bias element to the second bridge

element, and

securing the second fixation portion of the selected bias element to the third bridge

element

39. The method of claim 32, further comprising utilizing a tensioning tool to tension the selected bias element prior to securement of one of the first and second fixation portions.