Apparatus for spinal fixation and methods of use

Abstract

In some embodiments, a method comprises forming a lumen in a first bone portion and forming a lumen in a second bone portion. The method further includes inserting a portion of a flexible fastening band through the lumen in the first bone portion and through the lumen in the second bone portion, and inserting the portion of the flexible fastening band into a fastener mechanism monolithically formed with the flexible fastening band. The method further includes advancing the portion of the flexible fastening band through the fastener mechanism until the first bone portion and the second bone portion are stabilized.

1 - 21 . (canceled) 
     
     
         22 . A method, comprising:
 disposing a flexible band into contact with a first bone portion and into contact with a second bone portion, wherein the flexible band comprises an aperture configured to receive a fastener, wherein the flexible band comprises an attachment connection, wherein the flexible band comprises an elongate body;   advancing a portion of the elongate body through the attachment connection of the flexible band to form a loop, wherein the flexible band comprises a ratchet configured to allow the portion to travel through the attachment connection in a first direction and substantially limit the movement of the portion in a second direction, opposite the first direction; and   advancing a portion of the fastener through the aperture and into the first bone portion.   
     
     
         23 . The method of  claim 22 , wherein the attachment connection is monolithically formed with the elongate body. 
     
     
         24 . The method of  claim 22 , wherein an anchor comprises the aperture, wherein the anchor is monolithically formed with the elongate body. 
     
     
         25 . The method of  claim 22 , wherein an anchor comprises the aperture, further comprising disposing the anchor about the elongate body. 
     
     
         26 . The method of  claim 22 , further comprising disposing an implant between the first bone portion and the second bone portion. 
     
     
         27 . The method of  claim 22 , further comprising advancing the portion of the elongate body through the attachment connection until the first bone portion and the second bone portion are stabilized. 
     
     
         28 . The method of  claim 22 , wherein the elongate body comprises a centerline between a proximal end of the elongate body and a distal end of the elongate body, wherein the aperture is substantially centered along the centerline. 
     
     
         29 . The method of  claim 22 , wherein the elongate body comprises a centerline between a proximal end of the elongate body and a distal end of the elongate body, wherein the aperture is laterally offset from the centerline. 
     
     
         30 . The method of  claim 22 , wherein the first bone portion is a spinous process of a first vertebra and the second bone portion is a spinous process of a second vertebra. 
     
     
         31 . The method of  claim 22 , wherein the first bone portion is a first transverse process of a first vertebra and the second bone portion is a second transverse process of a second vertebra. 
     
     
         32 . The method of  claim 22 , further comprising advancing the portion of the elongate body through the attachment connection of the flexible band such that the first bone portion is moved from a first orientation relative to the second bone portion to a second orientation relative to the second bone portion. 
     
     
         33 . A method, comprising:
 positioning a flexible band relative to a first bone portion and a second bone portion, wherein the flexible band comprises a distal end portion, a body portion located proximal to the distal end portion, an anchor portion comprising an aperture, and an attachment connection located proximal to the body portion;   advancing the distal end portion of the flexible band through the attachment connection of the flexible band, wherein the flexible band forms a loop, wherein the flexible band comprises a ratchet configured to allow the flexible band to travel through the attachment connection in a first direction and substantially limit the movement of the flexible band in a second direction, opposite the first direction; and   advancing a fastener through the aperture and into the first bone portion.   
     
     
         34 . The method of  claim 33 , wherein the flexible band comprises a longitudinal axis, wherein the aperture is located along the longitudinal axis. 
     
     
         35 . The method of  claim 33 , wherein the flexible band comprises a longitudinal axis, wherein the aperture is offset from the longitudinal axis. 
     
     
         36 . The method of  claim 33 , wherein the anchor portion is movable along the body portion. 
     
     
         37 . The method of  claim 33 , wherein the anchor portion is fixed relative to the body portion. 
     
     
         38 . A method, comprising:
 disposing a flexible band into contact with a first bone portion and into contact with a second bone portion, wherein the flexible band comprises an anchor portion, wherein the flexible band comprises an attachment connection;   advancing a portion of the flexible band through the attachment connection to form a loop, wherein the flexible band comprises a ratchet configured to allow the portion to travel through the attachment connection in a first direction and substantially limit the movement of the portion in a second direction, opposite the first direction; and   advancing a portion of a fastener through an aperture of the anchor portion and into the first bone portion.   
     
     
         39 . The method of  claim 38 , wherein the attachment connection is monolithically formed with the flexible band. 
     
     
         40 . The method of  claim 38 , wherein the anchor portion is monolithically formed with the flexible band. 
     
     
         41 . The method of  claim 38 , wherein the anchor portion is movable along the flexible band.